The part exists for the whole. Sometimes medical procedures may be enacted which in themselves may be painful in order to save the person. Ex. amputating a limb.
Absolute means at all costs regardless of the benefit. If there is no benefit from extraordinary means than it should not be employed. The Christian understanding of death makes us realize that death is a new beginning and not an end.
If in a society faults and failings were publicly acclaimed it thwarts the public life, causes for the disintegration of society and breads mistrust. Natural Secret – accidently discovered in the course of medical investigation. Professional Secret – receives in the course of treatment. Only to be used for health related issues. Parents – obvious in the case of younger children, not clear in the case of older children. In some cases of health and overall safety, confidentiality may have to be broken.
Example of reporting a gunshot wound. American Medical Association supports this posture. HIV secrecy is a state by state case. Some states require reporting, some do not.
Giving an sedative to someone suffering from extreme pain despite the consequence of unintended death which is likely to occur. The bad effect is tolerated.
Operating on an infected fallopian tube may result in the destruction of an embryo. That is not the desired effect, neither is it the means to obtain the good effect. (the prevention of the infection) Removal of a healthy uterus from a mother suffering from a serious heart condition. Permissible.
The principle of subsidiarity requires that higher authorities permit the smaller communities of which they are composed to secure their own good with minimal interference, unless and until the smaller community fails in its aims. Pg 31 CHCE Local community – zoning ordinances, playground, National Government – space agency, Defense
Building a train to develop better transportation. Sacrifice your house. Family vacation – sacrifice your particular goods for the good of the family.
Two principles of actions: Never act on a doubtful conscience – resolve the doubt. You have a moral obligation to resolve the doubt. Always obey a certain conscience. Not to do so is evil, or sin.
A person has a duty to inform their conscience about right and wrong. The degree of information makes the conscience more certain. End of life issues for example.
Catholic health care ethics select moral principles
Ch 3 Selected Moral Principles
A. Totality and Integrity “All persons served by Catholic health care have the right and duty to protect and preserve their bodily and functional integrity. The functional integrity of the person may be sacrificed to maintain the health or life of the person when no other morally permissible means is available.” Ethical and Religious Directives for Catholic Health Care Services.
The principle of totality is based on the natural law which says that life is to be preserved and maintained. Although this does not mean using life-prolonging procedures that are insufficiently beneficial.
Surgery for the good of the human body is directly opposed to mutilation which is a destruction of the body. The principle of totality aims to preserve life in its totality, in its whole and sometimes that may mean sacrificing a part of the body.
More concretely – examples may be amputations, cancerous tissue removal, organ removal. Pg 14. On the removal of Healthy organs1) when the preservation of the organ may cause grave injury. 2)when the removal means avoiding more serious complications 3) when the removal will diminish the risk of death.
This principle however may not be applied to the generative organs (sterilization) when the health of the individual is not at stake. Here the end of preserving life is not present. Organ transplants are permissible as long as the life of the donor is not placed at risk.
B. Ordinary and Extraordinary Means. These two terms refer to the means to preserve life. Ordinary means are obligatory. Extraordinary are optional and many not be chosen. The extraordinary may be chosen with the hope of healing a person or they may produce no benefit.
The principle to preserve life is not absolute. Patients have the right to all information concerning their status, this is not a doctors decision. Read aloud directives 55, 56 and 57 pg 17 Analysis of Benefits and Burdens can be complicated.
Videos on the Issues Fr. Koterski - Speach on End of Life Issues EWTN Roundtable on Last Issues What is PVS? NCBC Why is Catholic Health Care Unique?
C. Confidentiality Confidentiality – the root word is a latin word confidere – to trust. To show confidence is to show trust with one another. Confidence – is not only having trust for one another but showing respect for one another. Authority – given the position of authority of a doctor care should be taken for a persons reputations and condition.
Esteem for patience – speak well and not in a depreciative manner. Slander x Protect reputation Upon receiving confidence, do not have the right to divulge for whimsical matters. “Those who might be privy to certain confidences do not have the right to disclose them to others without the approval of the person whom the knowledge is about” pg 20
Maintaining confidentiality for the Common good. Three types of secrets Natural Secret Professional Secret Parent – Children Secrets
Professional Secrecy and the Common Good. If the observance of the professional secrecy would be more harmful than helpful for the common good, then the obligation of secrecy ceases and is replaced by the obligation to reveal the secret. Pg 22
D. Principle of Double Effect A good effect that is intended but along with the good effect there is a concomitant evil effect that is not intended. “the principle of double effect governs situation in which one action is followed by two effects, one good (and intended), the other evil (foreseen but not intended).”
Four Conditions for DE 1) the action in itself is a good act considered in its object. 2) the good effect is intended not the bad effect. 3) the good effect is not produced by the bad effect. 4) there is a proportionately grave reason for performing the bad act. Pg 24
Action Good in itself. The object itself has to be good, if it is not than the action cannot be taken, no matter the good intent or good effects. Some acts are always objectively wrong.
Intention of the act is for the morally good act. The intention for the good effect and the bad effects are merely tolerated and not wanted. Although the intention is not enough for a good act, the object in itself must be good.
No Evil Means to a Good End The bad effect once again is not intended but merely tolerated. In these cases all other remedies must be attempted first, this is a last resort type of intervention. We cannot do evil in order to procure goodness.
Proportionate Reason – due proportion between the good and bad effects. Usually the overall health and life of a person is a proportionate reason to a loss of bodily function. Video - Principle of Double Effect
F. Common Good “The common good is a good that is shared or participated in by many persons” pg 31CHCE Requires an organization – Politics, Authority Different from an an individual good Principle of Subsidiarity
Principle of Common good requires sacrifices from Individuals.
G. Conscience Definition: Conscience is a persons reason making a judgment of right or wrong according to a set of moral principles that a person holds with conviction.
Types of Conscience Certain conscience – judges without doubt or fear that the opposite is true. Doubtful conscience – is a conscience that either makes no judgment or judges with fear that the opposite is true. Erroneous conscience – is one that judges good as evil or evil as good. Correct conscience – judges good as good, evil as evil.
Read Directive 28 and 32 from the book CHCE and comment. Conscience is inviolable, yet not infallible The subjective guide to morality hearing the objective voice speaking to it from within, yet not confused with the self. Pg 32
Videos on Conscience Catholic Conscience Video Comments Fr. Barron Catholic Conscience Cardinal Newman on Following Conscience