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CONTENT OF CATHOLIC HEALTH

ETHICS
Is there a Catholic Ethics?
• Certain moral values contained in the
Bible or the teaching of the Catholic
Church are found also in other
Philosophies of life.
• Natural law values and principles may be
utilized to some extent by any method of
ethical theory.
• But when people agree on a set of values, they differ
on which values are more important. Thus there is
always a hierarchy of values.
• Christians summarize their priorities as the
theological virtues : faith, hope and charity.
• These virtues primarily concerned with
pursuing an intimate friendship with God and
neighbor; and secondarily, pursuing other
goals that fulfill their individual human
person.
• The Christian tradition also recognized the
need for other four principal virtues :
Prudence, Justice, Fortitude and temperance
which are called moral virtues , which support
the practice of theological virtues.
• For Christians, the practice of the theological virtues
are not mere sentiments or feelings but based on the
deep faith in the Incarnate Word of God, who is Jesus
Christ, who tells us who God is and what our
relations with Him and what our relations with our
neighbors must be.
• For ST. Paul, the primary virtues of faith, hope
and charity derive from the conviction that a
fully human life can be achieved only through
a personal union with God by incorporation
into the risen Christ.
First conclusion:
• The gifts of faith, hope and charity work
towards the satisfaction of our deeper needs.
• “ so faith, hope and love remain but the
greatest of the these is love” ( 1Cor. 13:13)

• Hence, they can serve well to classify a SET OF


ethical principles that are explicitly and
exclusively Christian and that can be applied
to ethical issues in health care.
What is an Ethical Principle?
• An Ethical principle is a general norm or
statement that helps us reach any conclusion,
including practical conclusions in ethical
reasoning, from the well known and less well
known conclusions.
• The use of the principles is to understand what it
means to be human.

• Our model is Jesus Christ. He express his moral


teachings in principles and norms, which we find
throughout the gospel.
Second conclusion:
• The principles we present are derived from human
experience, enlightened by the teaching and example
of Jesus.
Cluster of the principles of Catholic health care
ethics around the theological virtues
I. Principles of Christian Faith
Faith – is the a free assent to the whole
truth that God has revealed ( CCC,150)
- It gives us definite goals to be pursued:
Love God and love of neighbor
- These goals are pursued by practical acts
of the intellect and will, inspired by the
grace of God.
- We have certain practical goals to strive for
and norms that guide our pursuit.
- The practical aspect of divine faith is
• Christian prudence ( often called “ wisdom” in
the Bible) is faith in its practical aspect as it
enables us to open the guidance of Christ’s
spirit as we pursue the purpose of life.

• Prudence is synonymous with caution in the


contemporary world, in the sense used to
denote a virtue that implies the correct
selection of the means to a goal.
Principles of health care ethics in perfecting
the choice of a means to an end

1.Principle of a well-formed conscience


2.Principle of free and informed consent
3.Principle of double effect
4.Principle of cooperation
5.Principle of Communication
1. Principle of a Well-Formed
Conscience
• To make a prudential decision, a person must
make four determinations
a. the person must proceed on the basis of a
fundamental commitment to God and the
authentic dignity of the human persons,
including themselves
- In every person’s life there is a commitment to
some goals that has priority and that has
influences the choice of the subordinate goals.
• B. Among possible actions that might seem able to
achieve a proximate goal, the person must exclude
all that is contradictory to loving God and neighbor
as oneself- that is, all actions that are intrinsically
evil.
• C. The person must analyze the moral object
of the action ( essential or primary intention,
or finis operis), his, her circumstantial
motives( secondary intentions, finis operantis)
and other circumstances of the action to
assure that the action is in accord with
striving for friendship with God, the person’s
own integrsl well-bneing and the well-being of
others.
• D. The person must act in accord with his well-
formed conscience.
-PRUDENCE IS SOMETIMES DESCRIBED AS A
PROCESS BY WHICH WE SEE, JUDGE AND ACT.
( too often people are influenced by the
attitudes of others, thus the virtue of fortitude is
necessary to activate the decisions of prudence.)
2. The Principle of Informed
Consent
• It would be unethical to ask others to
cooperate if they were not informed of
relevant information required for an ethical
decisions.

• If the person from whom consent is required


then another person, a proxy, must offer the
necessary consent.
* Mere consent – consent is really out of
ignorance.
* Informed consent – individual is informed of the
purpose of the study, the procedures to be employed,
the risks and benefits of the procedures, and the
medical / psychological services available if any injury
occurs during experiment.
* The individual is encouraged to ask questions
and to have other people present to make
decisions. If the subject is a child, both the
child and the parent/guardian are fully
informed in a language they can understand.
* The subject and the guardian (if appropriate)
then sign a consent form indicating their
understanding of the experiment and their
willingness to take part.
* Presumed Consent – for a competent person,
consent must be clear and explicit. It cannot be
presumed. For an incompetent person, in emergency
situations and consent for therapeutic interventions,
the attending physician is presumed to be working
for the best interest of the patient. (Beneficence)
• SUBSTITUTE DECISION-MAKER
* In non-emergency situations, when a person is
incompetent to make decision (too immature or too
sick), the decision is made by a substitute decision-
maker (as in proxy consent). The substitute
(guardian, family member, designated surrogate)
decides primarily according to what the patient
would have chosen, secondarily according to the
patient’s best interest.
• Educated Consent
* The individual is given all of the information stated
in the informed consent definition. In addition, there
is a real attempt to educate the individual regarding
the physiological, psychological, physical or
biomedical underpinnings of the study and the risks
and benefits without disclosing so much of the study
that it biases the subject. The individual is then asked
to make a decision from this educated base.
3. Principle of Double Effect
• “ Nothing hinders one act from having two
effects, only one of which is intended, while
the other is beside the intention. ( St. Thomas)
Four conditions for invoking this principle:
1, the directly intended object ( finis operis) of
the act must not beto intrinsically contradict
one’s own fundamental commitment to God anf
neighbor and oneself . ( it must be an act judge
to be good by reason of its moral object)
2. The intentions of the agent ( bothe primary
and circumstantial) must be to achieve the good
effect and avoid the harmful effect in so far as
possible, i.e, the evil effect is only indirectly
intended.
3. The foreseen beneficial effects must not be
achieved by means of the evil effect.
4. The benefits of the action must be equalor
greater than the forseen harmful effects.
• Principle of Double Effect: Requisites
A – act must be good in itself.
G – good effect must precede the evil
effect, or they must occur
simultaneously.
E – evil effect must not be intended in
itself, or there must be an honest
intention for doing the act.
P - proportionate reason for doing the
act.
4. Principle of Cooperation
Sometimes people cooperate with persons
doing evil by approving, what the person does,
or by willfully and knowingly partaking in evil
action.

Formal Cooperation – to participate freely in an


evil act.
Material Cooperation - When duress is present
- Immediate Material Cooperation -
cooperating with what is essential in the
performance of the evil act.
- Mediate Material Cooperation – if one
cooperates in an accidental or nonessential
manner in the evil action
( Ethical and Religious Directives for Catholic
Health Care Services, 2001)
5. Principle of Professional
Communication
• Truth cannot be arrived at simply by an individual
effort.
• The whole network in health care facility
depends upon good communication, which is
impossible without :
1. trust
2. contact among people who have information
3.clear articulation and expression of information
4. continues feedback to correct failures in
communication
• The work of communications depends upon a good
emotional relations among the communicators
because emotional conflict is a powerful barrier to
exchange information. The principle of professional
communication can be formulated as:
1. To strive and establish and preserve trust at both the
emotional and rational levels
2. To share information one possess that I is legitimately
needed by others to develop an informed consent
3. To refrain fro lying or giving misleading information
4. To keep secret information that is not legitimately
needed by others but that if revealed might harm
either the patient or others or destroy trust
PRINCIPLE OF CONFIDENTIALITY
- In close connection with the principle of
professional communication is the principle of
confidentiality.
- This means that patient/s have the right to know
the truth about their health because they have the
responsibility for their health.
- They also have the right to privacy about those
aspects of life that do not directly affect others.
- Human community is based on free communication,
which is impossible if confidence cannot be shared.
Hence, health care professionals have a serious
obligation to maintain such confidence that protect
the patient’s right to confidentiality.
PRINCIPLE OF AUTONOMY
- This essentially refers to the personal
choice/determination of the health care users with
regard to management or treatment of their illness /
disability.
- An essential component of autonomy is knowledge.
Failure to obtain informed consent from patients or
their guardians (when patients are incapable to
choose) is to undermine the patient’s autonomy.