COURSECODE: NCM-6308/NCM-5308 BIOETHICS/PRE-FINALS

BASIC ETHICAL PRINCIPLE

The expression "basic ethical principles" refers to those general
judgments that serve as a justification for particular ethical
prescriptions and evaluations of human actions.

PRINCIPLE OF STEWARDSHIP
Stewardship is a way of life, a way that begins with
acknowledging God as the creator and giver of all and responding
with generosity and the responsible management of our resources.
As disciples of Jesus Christ, we choose to be caretakers of all God
has given to us. Gratitude for these gifts and blessings is expressed
in prayer, worship, offering and sharing our gifts out of love for God
and one another.
Stewardship is a path to holiness. It makes us more like Christ
who came not to be served, but to serve. It is the humble awareness
that all we have and all we are has been given to us freely from God.
When we offer our lives back to God in love, He blesses that
generosity a hundredfold.
Stewardship is principally understood in relation to ecological
themes in Catholic social teaching. In this context, human beings are
understood to have limited dominion over the rest of God's creation.
Yet many health ministries have incorporated the principle into their
statements of mission, vision, or values. This inclusion reflects
Catholic health ministries' recognition that, possessing only limited
dominion over their resources, they have a responsibility to allocate
these limited resources in the communities they serve in a manner
consistent with their commitment to human dignity and the common
good.
 COURSECODE: NCM-6308/NCM-5308 BIOETHICS/PRE-FINALS

Catholic social teaching views health as integrally related to

human dignity and human flourishing. Access to health care is
therefore considered a basic human good to which there is a basic
human right, insofar as health care can improve one's ability to
flourish on a personal and social level. For this reason, the principle
of stewardship as applied to Catholic health care should not be
limited simply to how we allocate resources and manage the "bottom
line." It should also concern the way we do both of these things while,
at the same time, promoting equity, fairness, basic human rights,
and the common good. In this conception of stewardship, an inherent
tension exists between our limited resources and the social and
individual goods we promote. For example, Catholic health ministries
have a responsibility, on one hand, to increase access to health care
and, on the other, to reimburse the physicians they employ in a fair,
just, and competitive manner.

THE INVIOLABILITY OF HUMAN LIFE

The value of human life should have even greater significance
for those who have professed faith in Jesus Christ. Human life is
sacred because ultimately it belongs to God. Human beings were
created to reflect His glory. It is His by right of creation and, for those
who have professed faith in Christ’s sacrificial death and
Resurrection, by virtue of redemption. No greater value than this can
be assigned to human existence.
Human life has a "unique" status in that God impresses onto
man His image and resemblance and therefore makes the human
being above all the other beings which are His creatures but not really
a mirror of the Creator. Man is part of the creation but he is also
distinguished from the rest of creation as he is to rule creation. Man's
dominion is not a license to exploit creation but rather a charge to
rule as God would rule. All life, since it comes from God, has a
sacredness about it and demands respect for it belongs to another. It
belongs to God. The special dignity and sanctity of human life comes
from bearing the image of God and the responsibility to rule like God.
 COURSECODE: NCM-6308/NCM-5308 BIOETHICS/PRE-FINALS

Human life at any stage of development, from the moment of

conception until its natural decline, must be respected and protected.
Inviolability means that no life can be directly killed.

THE PRINCIPLE OF TOTALITY

The principle of totality states that all decisions in medical
ethics must prioritize the good of the entire person, including
physical, psychological and spiritual factors. This principle derives
from the works of the medieval philosopher St. Thomas Aquinas, who
synthesized the philosophy of Aristotle with the theology of the
Catholic Church. The principle of totality is used as an ethical
guideline by Catholic healthcare institutions.
According to the philosopher Thomas Aquinas, all of the organs
and other parts of the body exist for the sake of the whole person.
Because the purpose of the part is to serve the whole, any action that
damages a part of the body or prevents it from fulfilling its purpose
violates the natural order and is morally wrong. This is called the
“principle of totality.” However, a single part may be sacrificed if the
loss is necessary for the good of the whole person. For example, the
principle of totality would justify the amputation of a gangrenous
limb, because the person could die if the gangrene spread.
The principle of totality states that all decisions in medical
ethics must prioritize the good of the entire person, including
physical, psychological and spiritual factors. This principle derives
from the works of the medieval philosopher St. Thomas Aquinas, who
synthesized the philosophy of Aristotle with the theology of the
Catholic Church. The principle of totality is used as an ethical
guideline by Catholic healthcare institutions.
According to the philosopher Thomas Aquinas, all of the organs
and other parts of the body exist for the sake of the whole person.
Because the purpose of the part is to serve the whole, any action that
damages a part of the body or prevents it from fulfilling its purpose
violates the natural order and is morally wrong. This is called the
 COURSECODE: NCM-6308/NCM-5308 BIOETHICS/PRE-FINALS

“principle of totality.” However, a single part may be sacrificed if the

loss is necessary for the good of the whole person. For example, the
principle of totality would justify the amputation of a gangrenous
limb, because the person could die if the gangrene spread.
Aristotle explains it in the following manner: 1) A part denotes
any portion of a quantum into which it can "be divided, for that which
is taken from a quantum qua quantum" remains always a part of it.
For example, two can be named "in a sense a part of three." There are
two types of meaning for it. In the first place, part means "only those
which measure the whole," which includes only two. In another sense
a part cannot be considered as a "part of three." 2) Part can be
understood as the constituent element of a dividable kind "apart from
the quantity." For instance, "species are part of the genus." 3) Whole,
which includes a part, can be divided. Here Aristotle uses the term
'whole' in the sense of "form or that which has form." He gives the
example of the bronze sphere or bronze cube which is from bronze or
it can denote a portion of material body which gives form to that. 4)
Finally, the constituent "elements in the definition which explain a
thing are also parts of the whole."
Concerning the whole, in a general understanding it is very
difficult to define. However, in everyday life we see whole things,
either they are natural composites (plants, animals, human persons)
or they are things made by a human person for his/her own use
(machines, houses, ships). Here, the totality is seen as a harmonious
development of a human person's powers in the psychological or
ethical sense. So the notion is analogous in a restricted sense, and it
is transcendental. In a limited sense "a whole is properly conceived
in relation to its parts, and God has no parts. But even this limited
transcendentality which it enjoys makes it impossible to be defined
in the strict sense of the word, viz., through genus and difference, for
it transcends them all. In general, a whole is in reference to parts and
a part is in reference to a whole.
 COURSECODE: NCM-6308/NCM-5308 BIOETHICS/PRE-FINALS

Aristotle explains the 'whole' in the following way. The whole is

(1) "that from which is absent none of the parts of which it is said to
be naturally a whole, and (2) that which so contains the things it
contains that they form a unity; and this in two senses - either as
being each severally one single thing, or as making up the unity
between them. Aristotle's concept of a whole includes two things: 1)
"the perfection of the whole be integrated from the parts of which it
is constituted;" 2) "that these parts form a unity." Without its parts,
there is no ground for the whole. Hence, the concepts of part and
whole are correlative.
The idea of totality is closely related to the concept of unity.
Unity does not include division, whereas there is a different intensity
in the totality of a unity. Thomas makes a difference between unity
as a 'simply so unity' (simpliciter unum) and as a 'unity in some
respect' (secundum quid unum). A simple unity receives its species
from some one element, it is the form or the composition or the order
whereas a unity under one respect or other obtains its species from
the multitude of its parts. For Thomas, the "substantial unity and
totality comes first in order." It is also known as the natural unity.
Thomas presents three types of ends or final causes for the
parts in a whole. The first is the particular activity to which the
individual part is oriented; for example, the eye is for seeing. The
second considers the function as in an operation, a minor (less
important) part gives service to a more important part. For instance,
the veins serve the heart in the cardio-vascular system. Third, "the
final cause of all the parts is the perfection of the whole that they
comprise." This includes a person's overall well-being.
Concerning the philosophical foundation for the principle of
totality in Thomas' thinking, it presents that metaphysically the
principle of totality is mainly concerned with the ordination of the
parts to the overall perfection of the whole. This means, parts are
integrated in the whole, which is a "perfect being." At the same time
parts receive their own perfection as parts in the whole. Thus, parts
are destined for the good of the whole. There is a mutual interrelation
of parts and whole "being directed toward the perfection of totality."
 COURSECODE: NCM-6308/NCM-5308 BIOETHICS/PRE-FINALS

PRINCIPLE OF DOUBLE EFFECT

The doctrine (or principle) of double effect is often invoked to
explain the permissibility of an action that causes a serious harm,
such as the death of a human being, as a side effect of promoting
some good end. According to the principle of double effect, sometimes
it is permissible to cause a harm as a side effect (or “double effect”)
of bringing about a good result even though it would not be
permissible to cause such a harm as a means to bringing about the
same good end. This principle aims to provide specific guidelines for
determining when it is morally permissible to perform an action in
pursuit of a good end in full knowledge that the action will also bring
about bad results.
The principle of double effect has played a significant role in the
discussion of many difficult normative questions. Its most prominent
applications are in medical ethics, where it figures prominently in
attempts to distinguish among permissible and impermissible
procedures in a range of obstetrical cases. The Catholic magisterium
has argued that the principle allows one to distinguish morally
among cases where a pregnancy may need to be ended in order to
preserve the life of the mother. The principle is alleged to allow the
removal of a life-threatening cancerous uterus, even though this
procedure will bring the death of a fetus, on the grounds that in this
case the death of the fetus is not "directly" intended. The principle
disallows cases, however, in which a craniotomy (the crushing of the
fetus's skull) is required to preserve a pregnant woman's life, on the
grounds that here a genuine evil, the death of the fetus, is "directly"
intended. There is significant disagreement, even among those
philosophers who accept the principle, about the cogency of this
application. Some philosophers and theologians, by emphasizing the
fourth, "proportionality," condition, argue that the greater value
attaching to the pregnant woman's life makes even craniotomy
morally acceptable. Others fail to see a morally significant difference
between the merely "foreseen" death of the fetus in the cancerous
uterus case and the "directly" intended death in the craniotomy case.
 COURSECODE: NCM-6308/NCM-5308 BIOETHICS/PRE-FINALS

PRINCIPLE OF SEXUALITY
Based upon a comparison of the sexuality of humans and the
sexuality of lower animals (mammals, in particular), Aquinas
concludes that what is natural in human sexuality is the impulse to
engage in heterosexual coitus. Heterosexual coitus is the mechanism
designed by the Christian God to insure the preservation of animal
species, including humans, and hence engaging in this activity is the
primary natural expression of human sexual nature. Further, this
God designed each of the parts of the human body to carry out
specific functions, and on Aquinas’s view God designed the male
penis to implant sperm into the female’s vagina for the purpose of
effecting procreation. It follows, for Aquinas, that depositing the
sperm elsewhere than inside a human female’s vagina is unnatural:
it is a violation of God’s design, contrary to the nature of things as
established by God. For this reason alone, on Aquinas’s view, such
activities are immoral, a grave offense to the sagacious plan of the
Almighty.
Sexual intercourse with lower animals (bestiality), sexual
activity with members of one’s own sex (homosexuality), and
masturbation, for Aquinas, are unnatural sexual acts and are
immoral exactly for that reason. If they are committed intentionally,
according to one’s will, they deliberately disrupt the natural order of
the world as created by God and which God commanded to be
respected. In none of these activities is there any possibility of
procreation, and the sexual and other organs are used, or misused,
for purposes other than that for which they were designed. Although
Aquinas does not say so explicitly, but only hints in this direction, it
follows from his philosophy of sexuality that fellatio, even when
engaged in by heterosexuals, is also perverted and morally wrong. At
least in those cases in which orgasm occurs by means of this act, the
sperm is not being placed where it should be placed and procreation
is therefore not possible. If the penis entering the vagina is the
paradigmatic natural act, then any other combination of anatomical
connections will be unnatural and hence immoral; for example, the
penis, mouth, or fingers entering the anus. Note that Aquinas’s
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criterion of the natural, that the sexual act must be procreative in

form, and hence must involve a penis inserted into a vagina, makes
no mention of human psychology. Aquinas’s line of thought yields an
anatomical criterion of natural and perverted sex that refers only to
bodily organs and what they might accomplish physiologically and to
where they are, or are not, put in relation to each other.

SELF ASSESSMENT TASK:

1. Among the Principles Discussed in this Module, choose 1

principle that you have take interest in and explain it based
on your understanding. Relate this to real situation/s that you
usually encounter every day.

REFERENCES:
1. https://www.cmalliance.org/about/beliefs/perspectives/sanctity
-of-life
2. Dignity, Solidarity, and the Sanctity of Human Life Birth,
Suffering, and Death, Antonio Autiero, 1992, Volume 41 ISBN :
978-0-7923-2545-1
3. http://jomaximianolife.blogspot.com/2010/07/inviolability-of-
human-life.html
4. https://work.chron.com/ethical-principles-totality-
4478.html#:~:text=The%20principle%20of%20totality%20states,p
hysical%2C%20psychological%20and%20spiritual%20factors.&te
xt=The%20principle%20of%20totality%20is,guideline%20by%20
Catholic%20healthcare%20institutions.
5. http://www.bbc.co.uk/ethics/euthanasia/overview/doubleeffect.
shtml#:~:text=Print%20this%20page-
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,The%20doctrine%20of%20double%20effect,bad%20effect%20wo
uld%20probably%20happen.
6. https://plato.stanford.edu/entries/double-effect/
7. http://sites.saintmarys.edu/~incandel/doubleeffect.html