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CHAPTER I: INTRO to BIOETHICS Hence our treatment of bioethics proper will

Bioethics is the systematic study of human be preceded by some considerations regarding
conduct in relation to human life, especially in the moral dimension of the human person.
the areas of the life sciences and of health
care, insofar as that conduct is examined from Our consideration of all aspects of the human
the viewpoint of moral values and principles. being leads us to propose, as the guiding vision
●​ Bioethics is one of the main areas of of our personal ethics, the construction of an
“personal ethics” or “the ethics of the authentically humanizing ethics.
person,” which in turn forms part of
concrete ethics (also called “special The authentically humanizing ethics that we
morals”). seek to realize is not an abstract ideal, but
●​ St. Thomas Aquinas (Summa theologiae) rather one that effectively helps concrete
one finds the division of moral theology human beings achieve the full development and
into “general” and “special.” expression of their humanity in each historical
o​ “General” moral theology, situation in which they find themselves.
recently renamed “fundamental,” Our authentically humanizing ethics is
studies the foundations of therefore a “humanism of responsibility,”
Christian ethics and the general o​ we affirm and accept that all human
categories for correctly beings, to the extent that they are
understanding morals, while persons, have the moral responsibility
o​ “special” moral theology deals to promote and defend the dignity of
with concrete problems of the other human beings.
various sectors of ethical RESPECT FOR THE DIGNITY OF THE
commitment and endeavor (for HUMAN PERSON: STRUCTURAL NUCLEUS
which reason it is also called OF ETHICS
“concrete” or “sectorial”
Christian ethics or moral Respect for the personal character of human
theology). life is the structural nucleus of moral life in
FOUR NUCLIE: contents of personal ethics in the sense that the moral life is basically the
turn can be organized around four nuclei, actualization of what it means to be a person
namely: in relation to other persons and sentient
a.​ the moral dimension of the human beings.
person;
b.​ bioethics or the ethics of human -The person is the primary subject and object
life; of moral life.
c.​ the ethics of love and sexuality; BASIC CHARACTERISTICS OF RESPECT
d.​ and the ethics of consciousness, FOR THE DIGNITY OF THE HUMAN
manipulation and interpersonal PERSON
encounter. A.​ CONCRETE: A concrete human Being
NOTE WELL: The first of these nuclei—that B.​ UNIVERSAL: applicable to all man
of the moral dimension of the human C.​ EGALITARIAN: equality to all w/o
person—is fundamental to the other three. discrimination
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D.​ UNCONDITIONAL: value of they are the best of human

personhood (value in itself). beings);
E.​ PARTISAN: preferential option o​ nor is it massification (the
(liberation for the oppressed). leveling down of human persons to
Personhood a BIOLOGICAL FRAME: the mediocre standards of the
Corporeality- “corpus” means “body” multitude).
o​ Social nature – social animal o​ The human ideal, rather, is the
o​ Freedom – (liberty) person who is able to relate
o​ Rationality respectfully with all human
Human NEEDS: aside from the BASIC NEEDS beings, while at the same time
(Food, Water, Shelter, Clothing, Education), continually striving for excellence
security, health care, respect for life and in all fields of human valuing,
Physical Integrity. especially the ethical.
PERSON IS SOCIAL: 2.​ POSITIVE: to aim a goal of
o​ Interacts with other person in the humanization & possible of human being.
society. o​ The positive aspect of human
o​ Active participation in social & cultural dignity as a normative ideal
life integration. refers to the fact that the
o​ Value of PERSON as “PERSON’S ethical category of human dignity
VALUE” (right to liberty is not orients our practice towards the
absolute). goal of humanization, that is, the
HUMAN DIGNITY INTEGRATES: fullest possible self-realization
o​ Natural necessity and human liberty of human beings.
(to be subject to necessity but free CHRISTIAN PERSPECTIVES FOR THE
from to make his own history) MORAL DIMENSION OF THE HUMAN
o​ Sacral & profane (sacral: made in the PERSON
image and likeness of God; profane: as 2 LEVELS:
“humans”) 1.​ ontic level of the human person
o​ NO DICHOTOMY because Human o​ At the ontic or premoral level,
Person is a primary Value. Christian faith, to begin with,
HUMAN DIGNITY AS NORMATIVE IDEA contains a concrete historical
1.​ NEGATIVE: correcting possibilities of contribution to the promotion of
w/c human being may be subjected human dignity.
reductionism. Its negative aspect 2.​ ethical level of the human person
includes the fact that affirming human o​ At the ethical level the Christian
dignity entails correcting all possible viewpoint also exercises its
reductionisms to which the human being influence upon the concept of the
may be subjected. human person, and this also not
o​ The human ideal is not elitism (a primarily in terms of content but
system in which decisions and rather of worldview. This
benefits and monopolized by a worldview deepens the dignity of
few persons who believe that the human being.
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NORMATIVE ELEMENT IN THE PAULINE

ANTHROPOLOGY
o​ Human beings reflect the creator
o​ With the person of Christ
o​ New human beings
o​ Human being who “discerns”
o​ The “Free” Human Beings
NORMATIVE ELEMENT IN THE
JOHANNINE ANTHROPOLOGY
o​ Human being as receiving the light
o​ Human person- an essential “in
communion”
o​ Human person – essential in faith and
Love
BIOETHICS AS PHILOSOPHICAL OF
THELOGOGICAL?
o​ to take into account the problems
raised & the solutions proposed by
philosophical bioethics.
o​ Also, maintains Christian revelation as
its orienting worldview
NATURAL LAW: “HOLISTIC VIEWPOINT
[Respect to Life and the Dignity of Life)\
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Chapter II THE BIBLE AND THE VALUE in war, nor to suicide, nor to the death
OF HUMAN LIFE penalty. What was really prohibited in
Christian ethical reflection has always based the Decalogue, in relation to killing,
itself on a fundamental point of was illegal homicide, that is to say,
reference—[the biblical message—]However, taking justice into one’s own hands,
it has also been always being affirmed that and this prohibition was meant to
Christian ethical demands have validity not safeguard the lives of the innocent.
only for Christian believers, but rather LAW OF TALION [Retaliation]
represent values that all human beings, o​ Psalm 58;7-11
whether Christian or of some other beliefs, o​ Psalm 109:8-19
find inscribed in their conscience. VIOLENCE IS FREQUENTLY ASSOCIATED
o​ The revealed message of the Bible is WITH THE O.T. IMAGE OF GOD.
not primarily moral; it is situated at Yahweh is frequently aroused to anger, and in
the level of faith experience and of the Old Testament the word “anger” is applied
the relation of human beings with God to God five times more frequently than to
who has moved to initiate an human beings (Genesis 32:23 ff; Exodus 4:24;
encounter with them in history. 19:9-25; 32:10; 33:20; Numbers 14:11 ff;
AS CHRSTIANS, the question of those first 17:11; Judges 13:22; 17:11; Isaiah 5:5;
believers to the apostles who bore witness to 30:27-33; Jeremiah 21:5; Ezekiel 20:30; 1
the Risen Christ Samuel 6:19; 2 Samuel 6:7).
o​ “What should we do?” is an excellent o​God is described as using and ordering
formulation of the relation between vengeance (Genesis 12:20; 20:18;
faith and action, between Christian Exodus 4:23; 11:4-6; 14:23-28; Numbers
religious experience and ethical 31:2-17; 33:51-55; Judges 18).
response. o​It is also Yahweh himself who orders
THE OLD TESTAMENT
Israel to carry out the practice of
The principal Old Testament texts [ EX.
herem or war of extermination:
2:17 & DEAUT. 5:6-21) 10
Exodus 17:14-16; Deuteronomy 7:1-2;
COMMANDMENTS
12:29; 19:1; 20:16-18; Joshua 6:17-21;
o​ The fifth commandment of the
7:1; 8:20-23; 10; 11; Judges 8:13-17;
Decalogue, “You shall not kill,” is the
11:29-33; 1 Samuel 15:1-9; 27:8-12;
best known summary of the attitude of
30:16-17.
the Bible with regard to human life.
o​Yahweh even appears to be using
o​ HEBREW “RASAH”- means do not
deception and treason: Genesis
commit homicide. “Do not kill a human
12:11-19; 20:2-22; 26:7-10; 27:30; 34;
being,” and includes in its prohibition
Exodus 3:21; 11:2-3; Judges 4:17; 9:23;
the involuntary killing of a human being,
18; 2 Kings 10:18-25.
within an ethical mentality that it not
o​Finally God sometimes punishes in a
yet sensitive to the willful or voluntary
fierce manner: Genesis 38:24; Exodus
in the evaluation of behavior from an
21:12; 22:17-19; Leviticus 17:13-14;
ethical point of view. The verb used
18:29; Numbers 14:36-37.
does not refer to killing a human being
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ENTIRE OT- has an attitude in defense of •​Life is a gift; it possesses the great
the weak, the abandoned the exploited & the value that God has conferred on it.
oppressed. •​God confers great value on life because
THE NEW TESTAMENT-Strong aspirations God is its author and its goal.
and movements towards liberation. •​Human beings are pilgrims on earth, in
The ,essence, Zaducees, Zealots, the Hasidim which they do not have their permanent
or the “pious one” home.
•​God has related with human kind in many
JESUS AS A POLITICAL REVOLUTIONARY ways, but God’s supreme and definitive
o​ as a liberator of the Israelites to the manifestation or epiphany is God’s son
Roman Oppression(taxes Jesus Christ.
o​ BY NAMING HIS DISCIPLES •​Human beings have been transformed
a.​ As ZEALOTS (of the member of into new creatures, in a new community of
revolutionary party) persons transformed by the life, death,
b.​ BY ISCARIOTS (dagger-wielding) and resurrection of Jesus; sin and death
o​ SAYING OF JESUS have been vanquished.
a.​ To bring peace (Lk 12:51) •​The ultimate meaning of life consists in
b.​ Denunciation of the Riches (Lk developing and nurturing the “new life”
6:20-23) [in Christ].
c.​ Socio-ethical struggle (Mk. 2:14) •​The Spirit has been given to Christians
d.​ Invitation to rebellion (Lk 22:36) to inspire them and guide them in this
o​ SOME ACTIONS OF JESUS way [of life].
a.​ Entrance into JERUSALEM •​The final destiny of humankind is the
b.​ Expulsion of the merchants in the coming of the Kingdom, the return of the
Temple glorified Christ in order to definitively
c.​ Enter the City redeem the world.
JESUS” TEAHING: NON VIOLENCE in the •​Christ has conquered sin and death, and
Gospels God is the foundation and guarantee Christians ought to place their hope in
of “Human Autonomy” him and take him as their law and model.
THUS, these fundamental ethical experiences •​The New Testament (New Covenant) has
and insights do not provide a ready menu or been entrusted to the people of God,
checklist of prescriptions or responses, but guided by their pastors.
they do provide a channel or way of valid moral •​The new People ought to make their
approach, whether for dilemmas that were Lord continually present in his [salvific]
already addressed by the Bible itself, or for death and resurrection, through the
the whole vast field of new problems that the celebration of the Eucharist.
progress of the biomedical sciences is •​The concrete manifestation of this new
continually giving rise to. life in Christ is love for one another,
•​ God is the author and preserver of life; which is shown in concrete acts of
human beings are created in the image and justice, of gratitude, and of love.
likeness of God.
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Other elements of biblical origin also influence

the ethical reflection of Christians, in general
and in the specific field of Bioethics. These
include the following:
•​ Human beings have been created in the
image of God, from whom they received their
life as a gift, and they have no right to
question the value of the lives of the weak.
•​ Jesus Christ, who did not strike back at
those who wounded him, is a model and
example for Christians

Elements of the concept of the human being

that flow more directly from Christian faith
include the following:
1.​ the affirmation that the unborn child is
an object of God’s providence; that
there are no human beings without
rights, and on the contrary, slaves and
our enemies are human beings, and
possess the dignity of God’s sons and
daughters.
2.​ Finally, one ought to mention the
eschatological hope of a life after
death, which leads to a
relativization—sometimes
exaggerated—of the goods of this
passing world.

What it means to be human?

o​ Promoting to live a life to the full so we
can aim to create: “a humanizing ethic &
defend the dignity of the other human
beings.
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CHAPTER IV: VIRTUE ENTAILS NATURAL LAW: it an important element of

PRINCIPLES; COMBINATIONS OF Church Teaching; innate law, it flows in “human
DEONTOLOGICAL AND TELEOLOGICAL nature”​
APPROACH IN NORMATIVE ETHICS
THE SOURCES OF MORALITY OF HUMAN
ENLIGHTENMENT AND NEW ETHICAL ACTS
SYSTEM: o​ The ultimate purpose of human
●​ Questioned the ethical & moral norms life is HAPPINESS
●​ Enlightenment worldview: has taken o​ To have friendship with GOD &
control the society and even debank neighbor.
ethical &moral principle for basis of ETHICAL DIMENSIONS
human progress. 1.​ ACT: action should be aimed towards
●​ Ethical Principles the ULTIMATE GOOD.
1.​ David Hume 2.​ CHOOSE the effective means to
2.​ Emotism achieve the GOAL.
3.​ Formalism 3.​ IF the ACT chosen is an appropriate
4.​ Utilitarianism means to the ULTIMATE END.
OTHER ETHICAL SYSTEMS IN THE a.​ Intention
UNITED STATES b.​ Circumstances
●​ LEGALISM AND POSITIVISM c.​ Actions
Human laws are not ultimate criteria for These three contribute to the
human morality because: moral object.
o​ Legal morality is always broad and CONTENT OF CATHOLIC CHRISTIAN
unrefined HEALTH CARE ETHICS
o​ Human laws often become unjust CATHOLIC ETHICS-uses the word
due to change of circumstances “PRINCIPLE” in a sense that is much different
o​ Some laws are promulgated by sense.
those wield political power. CATHOLIC CHRISTIAN ETHICS
●​ RELIGIOUS LEGALISM - have an ethical priorities as the
o​ Moral principles when concrete theological virtues: FAITH; HOPE; LOVE
moral norms are directly desired CHRISTIAN TRADITION
form religious text. Catholic ​ Has recognized the pursuits the goal
moral theology seeks to that fulfills the individual human person.
understand God’s wise purpose to CHRISTIAN FAITH
enlighten by Grace in our own ​ Moves people from an emotional to an
daily lives. rational level of ethical understanding because
●​ THE MORAL SYSTEM OF THE rathier than a blind trust, faith is a genuine
CATHILOC CHRISTIAN CHURCH understanding of God.
o​ Combination of truths accepted FAITH: is a free assent to the whole truth
on Divine Faith as revealed by that God has revealed (CCC 1997).
God and natural law reasoning
(Mt. 22:24). 5​ PRINCIPLES OF HEALTH CARE
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1.​ PRINCIPLE OF WELL INFORMED o​ Principle of inner freedom

CONSCIENCE (Judge as authentic o​ Principle of personalized
dignity of person) sexuality
2.​ PRINCIPLE OF FREE AND o​ Principle of growth through
INFORMED CONSENT (Required to suffering
incompetent, another person, proxy or o​ Persons seeking Health
surrogate) BIOETHICS is concerned with fulfilling the
3.​ PRINCIPLE OF DOUBLE EFFECT need of human person in an integrated manner.
a.​ an element of Catholic Theology Ethics concerns the need & values of human
4.​ PRINCIPLE OF COOPERATION persons
a.​ to cooperate to others in a moral ​ -a common concern we call health
duty o​ Human needs, rights, duties,
5.​ PRINCIPLE OF PROFESSIONAL laws ARE NECESSARY FOR
COMMUNICATION (build HUMANIZATION.
interpersonal relations between the Human person is a being with a radical
“staff & Doctors”) capacity for embodied intelligent freedom,
LOVE AS RELATED TO HEALTH CARE (to whether that capacity is still undeveloped of
attend to the person’s true need) has been frustrated by accident, disease, or
o​ Principle of human dignity neglect and thus has inalienable rights that
(no discrimination; must should be ethically respected including those
treat every person equally) rights that are related to health.
o​ Principle of common good & DEVELOPING COMMON VALUES
subsidiarity (it is the Catholic Christians also should realize that
participation of the they have something in common with secular
community) humanist.
o​ Principle of totality and PRIORITIES IN NEEDS & VALUES
integrity (to care for all o​ Biological needs
like body & psychic o​ Physiological needs
function; basic capacities o​ Social needs
that define personhood.) o​ Spiritual needs
HOPE AS RELATED TO HEALTH CARE o​ Spiritual needs
o​ : the desire to attain the kingdom SAINT THOMAS AQUINAS gave somewhat
of God & eternal life; by pacing a different and simplier classification of basic
the trust in the promise of Christ needs
& the grace of the holy spirit. o​ The need to preserve health and
(CCC 1997) life
o​ Assisted by temperance & o​ The need to procreate the future
fortitude generations
ETHICAL NORMS REALTED TO CHRISTIAN o​ The need to live in a society
HOPE o​ The need to know the truth
o​ Principle of stewardship and SUMMARY POINTS
Creativity o​ Heath care must SERVE persons
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o​ A truly human community must

base primarily on the sharing of
human values.
o​ All ethical decisions (Concerning
Health Care) should satisfy both
the innate &cultural needs of
every person in each of the
world’s practical communities.
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CHAPTER III: THE TRADITION OF THE of self-defense, arguing that

CHRUCH IN RELAITON TO HUMAN LIFE hands that have received the
PRE-CONSTANTINIAN TRADITION Eucharist ought not to be stained
CONSTANTINE EMPIRE ​ with blood
o​ condemnation of Murder (the o​ Lactantius also wrote in the same
penalties also imposed by the vein, saying that Christians could
church on murder) not defend themselves against
o​ CAPITAL PUSHISMENT (Death attacks as the animals do,
is condemned) because to do so would be canino
o​ TERTULIAN considered it modo vivere—“to live like dogs.”
unpardonable, together with two o​ As Schöpf affirms, in all the
other capital sins: idolatry or epoch studied here, there cannot
apostasy, and adultery be found in any Christian writer
As Evangelium vitae affirmed, the Church's even an insinuation that homicide
Tradition has always consistently taught the is permitted in case of legitimate
absolute and unchanging value of the defense.
commandment “You shall not kill,” and in the o​ Those who wrote about this
first centuries, murder was put among theme perceive a sin in bloody
-IDOLATRY, APOSTACY, ADULTERY legitimate defense.
(consistent value of the commandment) the o​ According to the same author,
three most serious sins, along with apostasy there were three reasons for
and adultery, and required a particularly heavy this: the literal interpretation of
and lengthy public penance before the the Sermon on the Mount and of
repentant murderer could be granted the text of Matthew 26:52 about
forgiveness and readmission to the ecclesial the last judgment; an insufficient
community distinction between vengeance
and self-defense; and probably
PUNISHMENT: though not explicitated, fear at
Legitimate defense all bloodshed, the horror
o​ legitimate defense, in which two sanguinis mentioned earlier.
situations have to be distinguished: Death Penalty
when the menace is directed against o​ the early Christians the death
one’s own life, or when the menace is penalty had been converted into a
directed against one’s property suspicious institution because it
o​ Thus Tertullian affirmed that had been applied frequently
Christians could not defend their against the Christians
own property with the use of themselves.
arms, and neither could they do o​ Athenagoras recognized the
so when their own lives are possibility that the death
threatened. penalty could be just, but he
o​ Cyprian demanded from held that Christians could not
Christians the same renunciation
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attend an execution, a position o​ Seneca said, “If life pleases you,

common to all the Apologists. stay; if it displeases you, you may
o​ Tertullian prohibited Christian leave. Those who put an end to
officials of the state from their lives are heroes.”
pronouncing death sentences and Christianity, which was close to
affirmed that persons who had Stoicism in its sexual ethics,
power of life or death should be distanced itself from the Stoic in
turned away at the front relation to the topic of suicide.
entrance of the Church. Probably o​ Nevertheless, in relation to their
he did not reject all penalties, own lives, the earliest Christian
including that of death, but he writers seem to have admitted
affirmed that Christians could certain nuances. A burning issue
not participate in such public for them was that of flight in
acts. case of persecution. Tertullian’s
o​ Lactantius considered the death passionate character led him to
penalty to be a measure affirm the illicitness of what he
necessary for the protection of considers as tantamount to
society, but at the same time he desertion, and to praise those
says that by virtue of the fifth who spontaneously presented
commandment, “it is not licit to themselves before the judges.
put anyone in danger of death o​ Contrary to this, the majority of
through one’s personal these earliest Christian writers,
testimony.” while rejecting apostasy, allowed
o​ Origen speaks in various passages flight and sometimes even urge it.
of his works on the death penalty Justin considered a provoked
as something given, but shares martyrdom as a kind of suicide,
with Tertullian the opinion that it and Clement of Alexandria shared
is not licit for Christians to this opinion when referring to
pronounce or to execute the those who voluntarily presented
death penalty. themselves to the judges. At the
SUICIDE same time, the attitude of some
o​ Suicide was condemned by Justin: martyrs who actually hastened
“God put human beings in the the moment of their death met
world and they could not abandon with praise:
it simply by their own decision”. o​ Ignatius of Antioch wrote that
o​ Clement of Alexandria also he would provoke the wild beasts
condemned suicide as a grave sin, in order to consummate his
o​ Stoicism itself admitted the martyrdom, and similar instances
value of suicide in the face of of witnessing are cited with
adverse circumstances in life; praise in the case of Germanicus,
Cicero, Marcus Aurelius, and Saint Apollonia—who threw
Seneca held such a position.
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herself into the flames—and that was already being hinted at

Saint Eulalia of Merida. in preceding years by the growing
o​ The same weight was given to spread of Christianity throughout
the behavior of various Christian the Roman Empire. This new
women martyrs who acted to style was manifested by the use
hasten their own death in order of force. Thus the Council of
to defend their Arles (314) threatened
purity—Sophronia, Pelagia. All excommunication against soldiers
these cases received approval who deserted the army, now that
from Eusebius , Ambrose , and the State was no longer a
Jerome. persecutor.
Tyrannicide TRADITIONAL CATHOLIC CHRISTIAN
o​ was a topic that Christian DOCTRINE
tradition considered later. Catholic Christian moral theology has strongly
Nonetheless, as Schöpf writes, defended the value of human life and has
the Christians of the early always condemned murder and suicide, on the
centuries affirmed the State and basis of three classic reasons:
its authority as realities desired ​ 1) Life is a personal good; therefore, to
and disposed by God. In general, take one’s own life or the life of other human
the Christian faithful kept beings goes against the love owed to others
themselves distant from the and to oneself. Saint Thomas Aquinas and
political doings of their time, Francisco de Vitoria condemned murder and
since many of them were poor suicide because they attack the natural
persons who did not feel called to inclination and the love that we owe to
fulfill a role in politics, and ourselves and to others.
moreover their religious ​ 2) Life is a good of the community;
convictions kept them apart from therefore, to try to take the life of other
worldly matters. human beings or one’s own life violates justice.
o​ Irenaeus is the first to hint at Saint Thomas Aquinas and Vitoria argued that
the possibility of active each human person is oriented to society as a
resistance against usurpers. He part to the whole, and those who deprive
holds that the authority of the others or themselves of life are inflicting
State comes from God, and then harm on the community.
adds that only against usurpers ​ 3) Life is a gift from God, to whom it
does the obligation to obedience properly belongs. Therefore, to try to take
come to an end. the life of others or one’s own life is to usurp
POST CONSTANTIAN (EDICT OF MILAN) a right that belongs to God alone. The
o​ With the Edict of Milan commandment “You shall not kill” expresses
promulgated by Constantine and the right of God over human life, and is
his co-emperor Licinius there rendered concretely in the following classic
came about a notable change in formulation: “God is the only lord of human
the mentality of the Church, one life, and human beings are only its stewards.”
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This being the case, it is nevertheless also

true that the classic moral tradition of the
Church enumerated various exceptions to the
general principle of the inviolability of human
life. The three classic exceptions are:
legitimate defense; the death penalty; and the
just war. Still some other reasons have to be
added, as permitted by casuist morals :

•​ Indirect abortion, as a consequence of

applying the principle of double effect
•​ “Indirect suicide,” and later on,
“indirect euthanasia,” also by virtue of the
principle of double effect
•​ Legitimate defense, by which the killing
of the aggressor came to be an exception
admitted by Catholic Christian moral theology
•​ The death penalty or capital
punishment, generally admitted by Catholic
Christian morals
•​ The killing of an enemy in a just war
•​ The killing of a tyrant, but with qualms
and scruples, shown by the withholding of
moral permission for the killing if the tyrant
was installed by legal means or has attained
legality—the tyrannus regiminis—and the
granting of moral permission if the tyrant is
still aspiring to seize control of government or
to consolidate his rule—tyrannus usurpationis.
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PRICIPLE OF OF BENEFICENCE & NON approach we will take, which considers all
MALEFICENCE relevant factors and looks to the
Principle of Beneficence consequences of acts, may be expressed in
●​ “DO GOOD” or “confer benefit” to what is called the principle of
others. proportionality. This provides that:
Principle of nonmaleficence
●​ “avoid evil” or “refrain from inflicting ​ Provided the action does not go directly
harm” against the dignity of the individual person
●​ Do no harm (the intrinsic good), a proportionate good
Principle of Beneficence jus mtifies permitting or risking an evil
consequence.
●​ is a valid “Prima facie” and can be
overridden for proportionate reason.
​ The proportionality contained in this
(based by accepted correct)
principle is to be judged by considering the
The impossibility of doing all good following four factors:
1. whether there are alternative ways of
●​ Time restrain, space, limited talents
attaining the intended good with no evil or
●​ Principle of nonmaleficence limits the
less evil consequences
principle of bebeficence.
2. the level of good intended and the level
Principle of Beneficence (moral obligation to of the evil risked or permitted
act for the benefit of others) 3. the certitude or probability of the good
or evil intended, permitted, or risked
1.​ Protect & defend the right of others.
4. the causal influence of the agent
2.​ Prevent harm form occurring to
ALTERNATIVES
others.
3.​ Remove conditions that will cause ●​ the good is to be done with the
harm to others. smallest amount of evil possible.
4.​ Help persons with disabilities. The patient has the obligation to consider
5.​ Rescue patients if in danger. these, weighing proportionality.
Principle of Non Maleficence (PRIMUM NON A.​ The level of good and evil - The loss of
NOCERE) “above all DO no HARM” life, or of the freedom of choice, or
●​ Principle of Proportionality helps in even of movement is considered a great
“deciding what evil can be tolerated] , evil; the loss of a favorite sweater or a
to risk for evil consequences. small sum of money at cards is not.
FACTORS FOR CONSIDERATIONS In short, what threatens basic human
Framework of reasons for such rights and dignity or what threatens
specifications: life or physical integrity in a major
​ ​ the principle of proportionality way is considered serious. In
​ Because most people realize that it is practice, the hope of a serious good
impossible to avoid all evil, ethicists have is needed to justify even risking such
devised various general rules to help in evils.
deciding what evils can be tolerated. The
 Outline BIOETHICS | 15

B.​ Certitude or probability of the good ●​ This reformulation of the principle of

or evil – nonmaleficence calls for a more precise
C.​ Two forms of the wedge principle working of the principle of beneficence:
a.​ The first or logical form is “Do good” or “Confer benefit.” The
concerned with logical reformulation of the principle of
consistency and not necessarily beneficence now reads: “Do good unless
with the actual effects. the consequences of doing good
b.​ The empirical form of the produce a disproportionate evil,
wedge principle does not worry provided that the good is accepted as
only or so much about logical such by the person receiving it.”
consistency, but about the actual Alternatively it could read: “Confer
consequences of the act or the benefit unless the consequences of
exception to the rule. conferring benefit produce a
BENEFIT for a “greater good” (causal disproportionate harm, provided that
influence of the agent) the benefit is accepted as such by
Preliminary Summary and Further Precisions the person receiving it.”
​ (1)​ Reformulations of the principles Comparison and contrast between Non
of nonmaleficence and of beneficence maleficence and Beneficence
​ The detailed consideration of the Non maleficence - Obligation; universally
principle of proportionality brings us to a prohibited by doing no harm”
reformulation of the principle: “Avoid evil” or and Beneficence - favoring person,
“Avoid inflicting harm.” The principle of prevailing the choices of person to have Good
nonmaleficence now reads: Health.
●​ “Avoid evil and evil consequences PATIENT’S Obligation – Must make health
unless you have a proportionate care decisions in an context that includes
reason for risking or permitting obligations, family, society & the value of
them.” things other than health
●​ Alternatively the principle of Health Care Provider’s Obligations
nonmaleficence now reads: “Avoid ​ ​ – medical indications principle
inflicting harm and harmful (for the physicians)
consequences unless you have a -​ Nursing indications
proportionate reason for risking or principle (for the Nurses)
permitting them.” -​ Individuals are obliged to
●​ An alternative formulation would be “Do use ordinary and not the
not inflict intentional and unjustified means of preserving
harm and harmful consequences to the health. (see the scenarios
psyche or the body of a person,” with in the materials
the absence or presence of justification particularly on abuses)
being discerned by the use of -​ Must seek the good of the
proportionate reason. patient & not the good of
the parties
 Outline BIOETHICS | 16

-​ Loyalty is to the Patient

(Quality of Life is greater
that medical decisions)
-​ To the moral
responsibilities of the
patient continue the
intention of the patient.
-​ Best interest principle –
Best interest of the person
-​ Rational choice Principle –
what the patient choice if
competent (judgment
involves the value and
meaning of life itself.)
PROBLEM OF MEDICAL INDICATIONS
PRINCIPLE
-the health care professional doesn’t have the
right to make quality life decisions because it
is beyond their competence. But still,
Doctors/Physicians (are the best source of
advice about health care services).

Note: To reject a patient requires two points

for considerations: against their promise to
serve society and the sick)
RIGHT OF HEALTH CARE PROFESSIONAL
to refuse because of DANGER to
themselves.
NOTE: it is impossible to do all the good
(confer all benefits) or to avoid evil
(inflicting any harm)
●​ a patient should be turned away except
for relevant reasons.
 Outline BIOETHICS | 17

Chapter V RECENT REFLECTIONS ON THE ​ Human life is the link between moral
VALUE OF HUMAN LIFE AND THE integrity and necessity.
DEVELOPMENT OF HUMAN PERSONHOOD HUMAN LIFE; PRESERVATION OR
​ Human life and personhood are basic PROMOTION OF HUMAN LIFE
categories in Christian bioethics. In a sense, The demand to ‘humanize’ life to the maximum
Christian bioethics essentially consists in the is the core of ethics of “human life”
defense and promotion of human life in its MORAL INTEGRITY [PRESERVE OR CUT
fullness, and human life in its fullness is OFF?] for humanization?
personal life.
B.) ETHICAL VALUE OF HUMAN LIFE -
(A)​ The Value of Human Life: Recent The demand to ‘humanize’ life to the maximum
Reflections is the core of ethics of “human life”
​ One way by which Christian moral UPDATE NORMATIVE UNDERSTANDING
OF ETHICAL VALUE
reasoning regarding the value of human
​ Positive rather than negative (concern
life can attain an adequate level of
for promotion of life; than limits of
coherence is by its paying attention to
human life)
at least four aspects of the theme:
​ Existential rather than Formalistic
first, the distinction and interrelation
(consequences rather than the manner
between the ontic and ethical aspects
of the effect: indirect/direct)
of human life; second, the explication
​ Tending to absoluteness but realistic
of the ethical aspect of human life;
conflict of values (inviolability of human
third, the normative understanding of
life).
the principle; and fourth, the
CHRISTIAN WORLVIEW
contribution of the Christian worldview
Christian views human life is a “fundamental
​ HUMAN LIFE is the fundamental
value” but only a subordinate to MORAL
Vehicle of ethical value.
INTEGRITY means friendship with God.
​ ONTIC LEVEL (Human Life is often
​ Christians are quite willing to sacrifice
involved in a conflict with other
present mortal life for the sake of
intrinsic “human value”
moral integrity that means the fullness
​ HUMAN Life is considered ethical value
of life for others. (suffering as a
when it is an object of voluntary
redemptive value)
effoert og a human being toward
​ Integrity that means fullness of life for
fulfillment.
others
HUMAN LIFE IS NOT AN ABSOLUTE
​ Suffering unites us in Christ Paschal
VALUE
Mystery;
​ Human integrity is the absolute ethical
​ Is an ultimate service of life; (life being
value and human life may have to be
lived to the full- CHRISTIAN
given up.
HUMANIZATION).
​ Human life is the precondition o for
DEVELOPMENT OF THE PERSHONHOOD
attainment or pursuit of other values.
​ It should not be approached form
​ Human life is the precondition for moral
spiritualist and dualist
agency.
 Outline BIOETHICS | 18

​ To integrate the findings of the various

fields of human learning.
​ NEEDS Sciences & Philosophical
Reflections)
HUMAN LIFE (FERTILIZATION)
From the moment of conception
46 chromosomes; (zygote as human reality)
Genetic code: (Unique and irrepeatable human
being)
​ BIOLOGICALLY, an embryo is NOT
part of a mother, but rather an
increasingly distinct biological reality.
 Outline BIOETHICS | 19

Principle of Justice understood in 3.​ OPTIMIZING THE PATIENT’S CHANCE

FOR A HAPPY LIFE- to give patient a
primarily as Equitable humanizing dignity of living alleviate
Distribution suffering & preserving the dignity of the
human person.
Principle of Justice; equitable distribution; can be
4.​ PROVIDING BENEFITS TO HEALTH CARE
considered an aspect of Justice
PROVIDER- aiming to benefit the patient
●​ Firm will to give due respect to the dignity,
but in the process, limits the limits of
legitimate interest, or value of each creature
health care can also cause harm but must
or community of creatures.
be subdue for humanization.
ASPECT OF JUSTICE
HUMANE HEALTH CARE
1.​ DISTRIBUTIVE JUSTICE-demands that
Society will be working toward a distribution of
those in authority within the community
basic health care that is adequate for the
must distribute aids, burdens and honors in
restoration and preservation of heath as society
proportion to needs, capabilities and merits
defines it.
of community life.
2.​ CONTRIBUTIVE JUSTICE- obliged to
Principle of Justice understood as primarily as
comply with the demands of common good.
equitable Distribution
3.​ SOCIAL JUSTICE-demands the equitable
NEEDS – it is a deficit or a lack of something
distribution of wealth and opportunity
considered requisite
among social groups.
-​ Many needs, if unsatisfied
These four principles were first proposed as a
will lead to the destruction of
system in the late 1970s by two North
the human person.
Americans—the philosopher Tom L. Beauchamp and
DISTRIBUTIVE JUSTICE: CONTRIBUTION
the theologian James F. Childress—and this
●​ Practical Wisdom and Just
system has come to be known as principlism
Distribution (Justice as distribution
is accomplished through the
JOHN RAWLS (Theory of Justice)
application of wisdom and to meet
●​ All social primary goods –liberty and
the demands of human dignity.)
opportunity, income and wealth and of
BASIC NOTIONS (micro allocations, macro
self-respect are to be distributed equally
allocations & rationing)
unless unequal distribution of any of all
●​ Micro allocations- distribution of
these value is to the advantage of the
health care on a day to day basis by
favored.
individuals, as well as, as institutions.
DISEASE- any deficit in the physical form or
(nursing homes or Hospitals)
psychological functions of the individual in terms
●​ Macro allocations- the way the
of what society wants or expects form that
society & its chief instrument, the
individual or expects for himself/herself.
government, distribution of health
care to the members of society;
GOALS OF HEALTH CARE
primarily through policies &
1.​ PROLOGATION OF LIFE- to avoid or
programs.
postpone death; intention of health care is
●​ Rationing- distributing limited
to aid and preserve human life.
resources by any allocation
2.​ ALLEVIATION OF SUFFERING- it
mechanism & marketing
believed that to live life free from
Danger of social power
reasonable possible suffering. (pain killers).
 Outline BIOETHICS | 20

a.​ Diminish the dignity of individual labeling

the person “diseased”
b.​ Diminish those people who can’t pay and
powerless patient.
Note: All allocations is under institutional
allocations ; means there are set of rules
proposes by either lottery or by first come
first serve rule.

HEALTH MAINTENANCE
ORGANIZATION(HMO’s)
●​ Manage care and the common good
●​ Proposes the solution to the problem of
scarce resources;
●​ Relying to the physicians discretion of
distribution of ration(health care)
(prioritizes the needs)
●​ A just society seeks to protect the
dignity of its members & satisfy their
basic needs.
THEREFORE, NO easy way to answer the question
what is the mminimum given in society & how it is
to be attained. As we have suggested, human
dignity is maintained only by consistent attempts
to the conscious aware of its demands.
 Outline BIOETHICS | 21

PRINCIPLE OF TRUTHFULNESS AND no explicit purchase information. The

CONFIDENTIALITY “Patient has a right” to the information
●​ RELATED TO THE PRINCIPLE OF when he needs it to make important
AUTONOMY nonmedical decision or to “avoid great
●​ PRINCIPLE OF TRTUTHFULNESS harm.”
Sum up 2 commands: 1. Do not lie. 2. You ●​ The personal affairs may involve no
must communicate with those who have more than a goodbye but call also for a
the right to the truth. reconciliation, estranged
---You must tell everyone everything family/enemies/member.
you know on everything they want to ●​ Even if one tries to deny the patients
know. strict right to know that he/she is
st
1 Command: dying. The denial of treatment, if
●​ Leaves free not to communicate, to dignity of a person is mocked, it can be
remain “silent or to evade to tell terminated if he needs more that
falsehood (not same as lies). (medical treatment) [Spiritual Care/
nd
2 Command: Reconciliation).
●​ To tell the truth to those “who have
the right to know” the truth. A placebo (Latin for “I will please”) has
Lying- a Falsehood in those circumstances
been traditionally defined as “a
which the other has a reasonable expectation
of the truth.
preparation devoid of pharmacological
effect given for psychological effect,
3 FACTORS AFFECTING THE or as a control in evaluating a
IDENTIFICATION OF LYING medicinal believed to have
1.​ The place of communication. (certain pharmacological effect.” In short, it is
privacy)
something that chemically should not
2.​ The roles of communicators. (Connected
to the obligation of confidentiality.)
have an effect.
3.​ The nature of truth involved.
It is not always a lie to conceal the truth. Pharmacological VS Psychological
●​ means to harm, and granting the effect (Psychological factors such as
“proportionality is present” (something the confidence of a patient in a
virtuous)
physician are still important
TRUTHFULNESS OF INFORMATION
1.​ unless the informant tells/ until she/he
placebo-like factor in helping people.
tells the whole story. ●​ Placebo Effect (Ethical
2.​ Respect the patient’s rights to privacy. Explanation)
3.​ Loyalty of the physicians to the 1.​ Even drug with pharmacological
patients (unless it can “harm others”) effect/enhance effect if
THE RIGHT TO THE TRUTH
patient’s believe on it.
●​ The patient has a right to information
even though there is no consent involved
 Outline BIOETHICS | 22

2.​ Increase productivity and IMPORTANCE OF PROFESSIONAL SECRET

cooperation (Harthowne in HEALTH CARE: contemplating the
consequences should patients have faith in the
effect)
confidentiality if their dealing with the health
3.​ Placebos have been shown to
care system.
have effect on the immune
system & even to produce Exceptions to Confidentiality
addiction. 1.​ RELATION TO PUBLIC WELFARE
But; placebo use involves deliberate 2.​ COMMUNICABLE DISEASE
3.​ CHILD ABUSE/ PHYSICAL OR
deception;
MENTAL/ PHYSCHOLOGICAL ABUSE
●​ It is against/ permitted by the Principle
PHYSICIAN-PATIENT REALTIOSHIP
of Truthfulness (Prima Facie of
(Physician renders treatment to an employee)
Trustworthiness).
●​ Physician must provide &comply
●​ It prohibits deception.
requirement of laws if _______.
●​ In the event of employee’s incapacity,
ETHICAL CONDITIONS USE IN PLACEBO
the family’s consent is necessary.
EFFECT
EXEPTIONS:
1.​ The illness to be treated whould be
●​ In terms of communicable disease
known as one that has high response
●​ Involvement to crime
rates.
●​ If it arouses confusion to family.
2.​ The alternative placebo is either
●​ MEDIA Publicity & Confidentiality (if
continued illness or use drug with
the Public has rhe
known.
●​ Hospital records, research &
3.​ The patient wishes to be treated
confidentiality
and cured.
●​ Confidentiality & Third Party Payers
4.​ The patient insisted on prescription.
●​ Confidentiality and Public Welfare
Justifiable. Because
(AIDs Patient be quarantined)
●​ Placebo is known to be an effective
THEREFORE, Society must need to be left to
agent and harmless or is less harmful;
individual judgment because the roles of
the alternative course of treatment.
health care can providers are determined by
PROMISED SECRET​ the knowledge we
society & clients as well as the members of
promise to conceal. (natural secret/ can be
the profession.
revoked if the reason of revealing is
necessary)
Society needs to speak through specific
PROFESSIONAL SECRET -​ knowledge in
legislation which will spell out the expectation
which if revealed, will harm not only the
so that both health care providers & patients
professional’s client, but will do serious harm
will know where they stand in the relationship.
to the professional & the society which
demands on that profession for important
services. Professional secrecy is the most
obligatory of all secrets, since the
violation of confidentiality damages not
 Outline BIOETHICS | 23

only the patient but also the sacredness

of promises and the welfare of society
and the profession. Professional
secrets can be shared in legitimate
medical consultations and revealed for
proportionate reasons or when there
are proper statutory or court-imposed
exceptions. There is also an exception
to confidentiality in special
relationships, which are not true health
care provider-patient relationships.