Bioethics. question Are there absolute truths? Truths that cannot change? Did the martyrs believe in...
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Random Fundamental Principles Bioethics
Bioethics. question Are there absolute truths? Truths that cannot change? Did the martyrs believe in absolute principles or truths? Explain Review: What
question Are there absolute truths? Truths that cannot change?
Did the martyrs believe in absolute principles or truths? Explain
Review: What is Moral Relativism?
Slide 3
Principle of non-contradiction Something can not be and not be
at the same time. Relativism says truth depends on your
perspective. MORAL RELATIVISM: morality depends on your opinion How
does this apply to bioethics?
Slide 4
Faith and Reason JCCHS motto: Where faith and reason flourish
Scientific learning can never contradict the faith. Fides et Ratio:
Church document showing how Faith and Reason work together.
Slide 5
But, what about feelings? feelings are morally neutral; - may
be clouded by psychological needs, cultural bias, focus on personal
advantage (burning for witchcraft, racism). - help us empathize or
stay zealous for a right cause
Slide 6
Morality Morality deals with choices. Judgments are about
actions and NOT the person. What actions are intrinsically evil?
CCC 1756 It is therefore an error to judge the morality of human
acts by considering only the intention that inspires them or the
circumstances (environment, social pressure, duress or emergency,
etc.) which supply their context. There are acts which, in and of
themselves, independently of circumstances and intentions, are
always gravely illicit by reason of their object; such as blasphemy
and perjury, murder and adultery. One may not do evil so that good
may result from it.
Principle of autonomy Persons should be able to exercise their
capacity for self-determination: A person should be well informed A
person must give consent to procedure Prima Facie (not absolute)
because autonomy may be curtailed - When undermined by nature or
nurture (mental instability, drug addictions, age) - when a danger
to self or others
Slide 9
Principle of paternalism Overriding a persons actions or
decisions for his own good There are many issues when this
principle is applied and it is controversial Eg. A doctor withholds
truth from terminally ill patient to spare feelings; experimenting
with life-saving treatment without consent; families claiming
mental incapacity
Slide 10
Principle of beneficence Principle of nonmaleficence We should
do good to others and avoid doing them harm No question doctors
should show due care There are debates over to whom this applies
are we all our brothers keepers? What is our obligation to
strangers, the poorWhat is the governments obligation, etc
Slide 11
Principle of beneficence Principle of nonmaleficence Negligence
The legal criteria for determining negligence are as follows: the
professional must have a duty to the affected party the
professional must breach that duty the affected party must
experience a harm; and the harm must be caused by the breach of
duty. This principle affirms the need for medical competence.
Slide 12
Principle of Utility We should produce the most favorable
balance of good over bad (i.e. weighing risks) Eg: should a doctor
perform risky surgery or try medicine and diet, etc should
immunization against deadly communicable disease be required if
there is a probability some may have a fatal allergic reaction? A
company has resources to develop medicine for either a fatal heart
disease or a fatal skin cancer if used for both, neither will
succeed, so which do they choose?
Slide 13
Principle of justice Justice in health care is usually defined
as a form of fairness, or as Aristotle once said, "giving to each
that which is his due." This implies the fair distribution of goods
in society and requires that we look at the role of entitlement.
The question of distributive justice also seems to hinge on the
fact that some goods and services are in short supply, there is not
enough to go around, thus some fair means of allocating scarce
resources must be determined. Can you articulate the current
concerns about the health care debate?
Slide 14
Variations on distributive justice Libertarian theories:
emphasize personal freedoms and rights in a free market against
government assistance and universal healthcare people have dignity
and entitled to only what they require through own work Egalitarian
theories maintain that a just distribution is equal distribution
Can you articulate the difference between Capitalism and Socialism?
What do you think? What does the Church say?
Slide 15
Physical and Moral evil Physical evil may be tolerated Moral
evil should be avoided at all cost
Slide 16
There is a natural law What principles have been held by most
generations and cultures? 1.Do good avoid evil 2.Self-preservation
How is this related to bioethics? (see video on natural law)
Slide 17
Do good. Avoid evil. Natural Law! Review: Can behaviors be
good, evil or neutral? Explain. What is moral relativism? How are
these distinctions important to bioethics?
Slide 18
Each person has dignity How can people be treated as objects?
How do people potentially place a value judgment on the quality of
ones life? Is there ever a person who is not made in the image and
likeness of God? If not, what ramifications does that have? How is
this related to bioethics?
Slide 19
God loves each person We dont determine a persons value How is
belief in this important in bioethics?
Slide 20
Principle of Solidarity Am I my brothers keeper? YES!!!
Solidarity: "mutual responsibility," a coinage of the "Encyclopdie"
(1765), from solidaire "interdependent, complete, entire," from
solide (see solid).
Slide 21
Principles of integrity and totality The well being of the
whole person must be taken into account in deciding therapeutic
procedures. St. Thomas: a member of the human body is to be
disposed of according as it may profit the whole if a member is
healthy and continuing in its natural state, it cannot be cut off
to the detriment of the whole (good to cut into someone to heal but
not to mutilate)
Slide 22
Integrity cont. Tests, treatments and surgeries include a risk
which must be considered Vasectomies and tubal ligations violate
the dignity of the human person Anytime we treat a person simply as
a physical body without regard to his spiritual soul, we violate
his integrity.
Slide 23
The end does NOT justify the means i.e. One may never do evil
that good may come from it {Machiavelli said the end does justify
means} Give examples how this principle applies to bioethics. Apply
both to a same situation.
Slide 24
Slide 25
Principle of Double Effect An action that is good in itself
that has two effects--an intended and otherwise not reasonably
attainable good effect, and an unintended yet foreseen evil
effect--is licit, provided there is a due proportion between the
intended good and the permitted evil. When there is a clash between
the two universal norms of "do good" and "avoid evil," the question
arises as to whether the obligation to avoid evil requires one to
abstain from a good action in order to prevent a foreseen but
merely permitted concomitant evil effect. The answer is that one
need not always abstain from a good action that has foreseen bad
effects, depending on certain moral criteria identified in the
principle of double effect. Though five are listed here, some
authors emphasize only four basic moral criteria (the fifth listed
here further specifies the third criterion): (see next slide)
Slide 26
Principle of Double Effect (remember the trolly scenarios)
Women with Uterine Cancer Deliberate administration of pain-killer
9even if it weakens immune system) Homicidal self-defense
Slide 27
Double Effect: The nature-of-the-act condition. The action must
be either morally good or indifferent. The means-end condition. The
bad effect must not be the means by which one achieves the good
effect. The right-intention condition. The intention must be the
achieving of only the good effect, with the bad effect being only
an unintended side effect. The proportionality condition. The good
effect must be at least equivalent in importance to the bad effect.
The second of these four conditions is an application of the more
general principle that good ends do not justify evil means (cf.
Romans 3:8).Romans 3:8
Slide 28
Direct and Indirect Abortion What is the difference between
consequence that is willed and a consequence that is tolerated? How
is this related to bioethics? Direct Abortion is ALWAYS wrong An
indirect abortion may be tolerated
Slide 29
Principle of Subsidiarity Holds that a larger body and greater
body should not exercise functions which can be carried out
efficiently by one smaller or lesser Give an example involving
authority structures at school? Give an example using govt.
structures What does the Catholic Church advise re: political
structures? (violation of this pinc is the risk of socialism too
much govt. control) How is this related to bioethics?
Slide 30
Suffering is a powerful prayer How do we know this? Dantes
levels of Purgatory
Slide 31
What is the definition of love? to will the good of the other
Considering that union with God in Heaven is a greater good than
life, how does this apply to bioethics? Should one do evil out of
love? The Law of Love All is governed by charity
Slide 32
Principles of Cooperation Formal and material cooperation Can
you guess what they mean? HHS Mandate Sweat Shops Planned
Parenthood sponsors Vaccines with aborted fetuses (pepsi
products)
Slide 33
Principle of Cooperation Formal Cooperation. Formal cooperation
occurs when a person or organization freely participates in the
action(s) of a principal agent, or shares in the agents intention,
either for its own sake or as a means to some other goal. Implicit
formal cooperation occurs when, even though the cooperator denies
intending the object of the principal agent, the cooperating person
or organization participates in the action directly and in such a
way that the it could not be done without this participation.
Formal cooperation in intrinsically evil actions, either explicitly
or implicitly, is morally illicit
(http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=82:principles-of-formal-
and-material-cooperation&Itemid=171)
Slide 34
Immediate Material Cooperation. Immediate material cooperation
occurs when the cooperator participates in circumstances that are
essential to the commission of an act, such that the act could not
occur without this participation. Immediate material cooperation in
intrinsically evil actions is morally illicit. There has been in
the tradition a debate about the permissibility of immediate
cooperation in immoral acts under "duress." When individuals are
forced under duress (e.g., at gunpoint) to cooperate in the
intrinsically evil action of another, they act with diminished
freedom. Following Church teaching, the matter of their action
remains objectively evil, but they do not intend this object with
true freedom. In such cases, the matter remains objectively evil as
such, but the subjective culpability of the cooperator is
diminished. Very recently, the Vatican has rejected the arguments
of those who would apply this concept of duress to Catholic
organizations as a way to justify their immediate material
involvement in certain objectionable actions.
(http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=82:principles-of-formal-and-material-cooperation&Itemid=171)
Slide 35
Mediate Material Cooperation. Mediate material cooperation
occurs when the cooperator participates in circumstances that are
not essential to the commission of an action, such that the action
could occur even without this cooperation. Mediate material
cooperation in an immoral act might be justifiable under three
basic conditions: If there is a proportionately serious reason for
the cooperation (i.e., for the sake of protecting an important good
or for avoiding a worse harm); the graver the evil the more serious
a reason required for the cooperation; The importance of the reason
for cooperation must be proportionate to the causal proximity of
the cooperators action to the action of the principal agent (the
distinction between proximate and remote); The danger of scandal
(i.e., leading others into doing evil, leading others into error,
or spreading confusion) must be avoided.scandal
Slide 36
The devil is real When Peter tried to dissuade Jesus from
suffering and dying, Jesus replied Get behind me Satan We pray
Deliver us from evil Keeping Screwtape Letters in mind, how might
the devil be involved in bioethics?
Slide 37
Declaration of Independence We hold these truths to be self
evident (objective truth) That all men are created equal That they
are endowed by their creator with certain inalienable rights That
among these are life liberty and the pursuit of happiness
Slide 38
Purpose of sex Unitive and procreative (babies and bonding) All
problems are from denying one or both What are practices that deny
one or the other?
Slide 39
Principle of Proportionate and Disproportionate Means (Ordinary
vs extraordinary) As conceived in the Catholic moral tradition, the
principle holds that one is obligated to preserve his or her own
life by making use of ordinary means, but is under no obligation to
use extraordinary means
Slide 40
Legally ok does not mean morally ok Dred Scott decision 1853
slaves are property with no rights, like chattel Roe v Wade
1973
Slide 41
CCC on ordinary vs. extraordinary 2278 Discontinuing medical
procedures that are burdensome, dangerous, extraordinary, or
disproportionate to the expected outcome can be legitimate; it is
the refusal of over-zealous treatment. Here one does not will to
cause death; ones inability to impede it is merely accepted. The
decisions should be made by the patient if he is competent and able
or, if not, by those legally entitled to act for the patient, whose
reasonable will and legitimate interests must always be respected.
(1007)1007 2279 Even if death is thought imminent, the ordinary
care owed to a sick person cannot be legitimately interrupted. The
use of painkillers to alleviate the sufferings of the dying, even
at the risk of shortening their days, can be morally in conformity
with human dignity if death is not willed as either an end or a
means, but only foreseen and tolerated as inevitable. Palliative
care is a special form of disinterested charity. As such it should
be encouraged.
Slide 42
Ethical and Religious Directives 56. A person has a moral
obligation to use ordinary or proportionate means of preserving his
or her life. Proportionate means are those that in the judgment of
the patient offer a reasonable hope of benefit and do not entail an
excessive burden or impose excessive expense on the family or the
community.39 57. A person may forgo extraordinary or
disproportionate means of preserving life. Disproportionate means
are those that in the patients judgment do not offer a reasonable
hope of benefit or entail an excessive burden, or impose excessive
expense on the family or the community. 58. In principle, there is
an obligation to provide patients with food and water, including
medically assisted nutrition and hydration for those who cannot
take food orally. This obligation extends to patients in chronic
and presumably irreversible conditions (e.g., the persistent
vegetative state) who can reasonably be expected to live
indefinitely if given such care.40 Medically assisted nutrition and
hydration become morally optional when they cannot reasonably be
expected to prolong life or when they would be excessively
burdensome for the patient or [would] cause significant physical
discomfort, for example resulting from complications in the use of
the means employed.41 For instance, as a patient draws close to
inevitable death from an underlying progressive and fatal
condition, certain measures to provide nutrition and hydration may
become excessively burdensome and therefore not obligatory in light
of their very limited ability to prolong life or provide
comfort