Shehada Bondad

BSN4

1. The principle of Totality – The whole is greater than its parts

- A simple expression of the principle of totality means, "the parts of the
physical entity, as parts, are ordained to the good of the physical
whole." From the medical perspective, the principle of totality would
mean that "all the parts of the human body, as parts, are meant to exist
and function for the good of the whole body, and are thus naturally
subordinated to the good of the whole body."5 The term "totality"
points to the duty to preserve intact the physical component of that
integrated whole.6 In the following sections we will discuss the
philosophical and theological foundations, different views, and the
scope of the principle of totality.
- Suppose a man’s foot is gangrenous, should he consent to an
amputation? Since the amputation will save the patient’s life and he can
still walk through the aid of crutches or artificial limbs, he can consent
to an operation.

2. Epikia – There is always an exemption to the rule

- As a "principle of equity", the virtue of epikeia allows doctors medical,
ethical and individual decisions with respect to the personality and dignity of
patients especially in those cases, which have ben proved to be impersonal
due to the extremes of medical over- and underdoing so far.
- exception to the general rule”  It is a reasonable presumption that the
authority making the law will not wish to bind a person in some particular
case, even though the case is covered by the letter of the law.  if a mental
patient went berserk and the doctor could not be contacted, the patient may
be restrained by the virtue of epikia. Another example is allowing a relative to
see a seriously ill patient who expresses the desire to see the former although
it is not yet visiting hours.

3. One who acts through as agent is herself responsible – (instrument to

the crime)
- For example, a patient wants to have an abortion and asks a nurse if she can
do it. The nurse refuses, but then recommends a doctor who is capable of
performing an abortion. The nurse becomes liable to such crime, since he/she
is an accomplice of the said doctor.

4.. No one is obliged to betray herself – You cannot betray yourself

- In testifying before a court, no one can force any person to answer a question
if such will incriminate him/her.

5. The end does not justify the means

- Giving a sleeping tablet to a chronically ill person so he/she can die in peace
is morally wrong. A physician in the US assisted a woman, diagnosed as having
Alzheimer’s disease, in committing suicide. This is both legally and morally
wrong.
6. Defects of nature maybe corrected .
- Patients with a cleft palate may have their defects corrected by plastic
surgery. What shall be the role of the nurse in a case in which parents of a
severely deformed newborn child (Down’s Syndrome with intestinal atresia)
refuse to feed and allow their child to starve to death?  Withholding nutrition
can constitute nursing neglect and expose the nurse to criminal charges of
negligence or conspiracy to commit suicide.

7. If one is willing to cooperate in the act, no justice is done to him

- Suppose a patient subjects himself/herself willingly to an experimental drug
and he/she has been told of the possible effects of the same, is of right age, and
is sane, there is no violation of human rights.

8. A little more or a little less does not change the substance of an act.
- If a nurse gets a medicine from a hospital stock without permission or
without prescription, he/she will be guilty of theft even if he/she got only one
tablet of the same.

9. No one is held to impossible

-To promise that a patient with heart transplant will live may be an
impossibility. Yet, such procedures are done in the hope of saving or
prolonging a patient’s life. The doctor or the nurse cannot be held to the
impossible if they have done their best to take care of the patient and the
latter dies.