CHAPTER FOUR BIOETHICAL ISSUES AND MORALITY Before delving into the moral issues falling under the province of BIOETHICS, let us first of all know its meaning. Bioethics refers to the systematic study of human con- duct in the areas of the life sciences and health care.' This human conduct, however, must be duly examined from the viewpoint of moral values and principles. From its very definition, it is evident that bioethics ex- clusively belongs to medical ethics. Yet, what is obvious in the definition of bioethics poses a sounding ambiguity on the part of the moralists themselves. The arrows they shoot from their own quarters go to different directions. Let us consider the views of some noted experts in the field of bioethics, namely: 1. A.C. Varga. This moralist argues that bioethics inquires into the morality of human conduct in the area of life sciences and beyond, inasmuch as it also endeavors to examine manifold ethical prob- lems of the life sciences which are not primarily medical.” Daniel Callahan. This moralist contends that the scope of bioethics extends outside the scope of medical ethics. Further, Callahan notes that until now, bioethics is still developing as it continuously seeks a firm foundation and clear recognition as applied ethics.? 215! ‘ 3. Erich Fromm. This noted thinker claims that there is no such thing as medical ethics. To support this claim, he argues further that there is only one universal human ethics applied to specific human situations.* . Based on the foregoing arguments, it is clear that bioethics is loosely anchored in the life sciences. This leads us to position ourselves for some moral investigations rela- tive to the followin, drug addiction, ig issues, namely: surrogate motherhood, suicide, murder, self-defense, euthanasia, punishment, abortion, and mutilation. A Surrogate Motherhood Is a woman's labor a commodity? Is the labor of a Surrogate mother a labor of love or a labor for money? Is surrogate motherhood a gesture of exploitation or gesture of empowerment? Is surrogate motherhood moral or immoral? Obviously, the issue of surrogate motherhood has not as yet attracted the interest of the Filipinos. Never have we heard of any official report citing a Filipina sur- Togate mother in the Philippines. This is to plausibly in other countries there might have been women who became Surrogate mothers, It appears that to Some, surrogate motherhood is a very lucrative business. In fact, we can Project two competing advertisements, one which says: ROOMS FOR RENT, and the other which says: WOMBS FOR RENT! some Filipina The following gate motherhood: 1, are the essential features® in surro- Awoman is insemina ted with the sperm of a man to whom she is not married. 2162. When the baby is born, the surrogate mother relinquishes her claim to the child in favor of another, usually the man from whom the sperm was obtained. 3. The woman (would-be surrogate mother) pro- vides the egg, so, her biological input is at least equal to that of the man. To pay a closer look at surrogate motherhoéd, we can raise the following issues: 1. Is not the surrogate mother selling the serv- ices she gives when she takes the risk and burden of pregnancy for another? 2. Does not surrogate motherhood separate sex and reproduction? 3. Does not surrogate mothgrhood separate re- production and marriage? The foregoing three (3) specific problems evidently open the room for a moral treatment of surrogate moth- erhood. It must be underscored that surrogate mother- hood is one of the progressive ways of alleviating infer- tility. It, therefore, offers immeasurable happiness to childless couples who dream of having a child of their own. Also, one must be keen in observing that preg- nancy may be a serious risk, if not a burden, for one woman, yet, it may be much less for another. In fact, there are women who consider pregnancy as barbaric, while others love to be pregnant. Finally, it must be noted that pregnancy could also pose higher levels of risk to health, or even life, to some women. Considering the benefits of surrogate motherhood, contemporary moralists claim that there is nothing wrong when the surrogate mother is remunerated for the services she gives to another person or a childless couple. However, these moralists see some shades of exploitation relative to these services. It is exploitation that makes surrogate motherhood wrong. This exploi- tation may take the form of the exploitation of the poor or of women by men. 217| | nag \ Does not surrogate motherhood separate sex from reproduction? As has been cited earlier, artificial in- semination is a condition sine qua non in surrogate motherhood. Banking on the rigid traditional Catholic Christian morality, reproduction outside sex is immoral, especially if it is done outside the context of marriage. Does not surrogate motherhood separate. repro- duction and marriage? Most of the beneficiaries of sur- rogate motherhood are childless couples who cannot have children of their own because of infertility either of the husband or of the wife. With the advent of surro- gate motherhood, childless couples can forego adop- tion as a means through which they can acquire a child and take the alternative of really having a child of their own. However, this advantage offered in surrogate moth- erhood runs counter to the dogma of the Catholic faith concerning reproduction. The Catholic Church is em- phatic in saying that reproduction is reproduction only in the context of marriage. Thus, reproduction outside marriage is illicit, if not a proof of promiscuity, and, therefore, immoral.” Drug Addiction® What are drugs? Generally, drugs are defined as chemicals that when taken will influence the mind and change the behavior, mood, and mental functioning of the person. In this way, we speak of psychotropic drugs.? Drugs are classified into two, namely: (1) therapeutic; and (2) nontherapeutic. 1. Therapeutic Drugs Therapeutic drugs are classified into three, namely: antipsychotic, antidepressant, and anti- anxiety. Generally, therapeutic drugs are meant to cure illness. a. Antipsychotic drugs are those that provide the following effects: mood-elevating, hyp- notic, and sedative or sleep inducing. Accord- ingly, these drugs are used to treat major 218occur when they are used to alleviate minor anxieties. Drug abuse means the use of any chemical ina way that is not sanctioned medi- cally, socially, or culturally. The drug abuser takes drugs without medical guidance.!° b. Antidepressant drugs or stimulants are those . that stimulate the central nervous system; depressed patients are required to take them. Awidely known antidepressant drug is called amphetamine. On the other hand, hyperac- tive patients are given drugs that are called psychomotor stimulants. Examples of these are: Cylert, Dexedrine, Ritalin. c. Anti-anxiety drugs are those which are used to treat epilepsy, tension, anxiety, and depres- sion. Epileptic patients are given barbiturates which are considered dangerous drugs since total withdrawal from them means death for their users. Patients who suffer from tension, , and depression are advised to take ae Sea andicty drugs like Valium (di- azepam), Librum (chlorodiazepoxide), and Serax. However, when these drugs are abused, it could mean addiction for their us- ers. Nontherapeutic Drugs at en are meant for personal. enjoy- ean recreation, and etl ses. The effect of these drugs are: ela- eg a ss, and joy. Examples of these drugs ae ah tobacco, coffee, tea, heroine, cocaine, are: mare “nd LSD (Lysergic Acid Diethylamide) marijuana, 219Nee er therapeutic drugs and amphetamine. All these non‘ are nonsedatives, meaning they are nonsleep- inducing drugs. ‘or the purpose of classification, opium, mor- erie and heroine are called opiates since they produce sleep in their users. LSD and marijuana or tetrahydrocannabinol (THC) are called halluci- Nogens or psychedelics since they create distor- tions of the mind like hallucinations, etc." The next question that we are going to un- derscore is: Does a person who use drugs become immoral? Our answer is, it depends. Accordingly, drugs are judged according to their effects. In this light, a drug user cannot be judged as if the drug intake is meant for curing an illness. Nobody is a total non-drug user, anyway. However, the immo- rality of drugs would surface if they are used out- side their purpose. Excessive and untimely use of drugs could ruin the human person. This is why the law prohibits the intake of destructive drugs. Perhaps, we should pause for a while and ponder on why people take drugs. There are mani- fold reasons why people take drugs. The imma- ture take destructive drugs out of curiosity; the mature ones take drugs out of a serious purpose, like a security guard taking stimulants to keep himself awake. The real drug addicts take drugs because of despair and frustration in life. Of course, there are many other reasons. However, we claim that most of drug users and abusers are people who encounter meaninglessness in life. They are the lost souls who have discovered the vacuum in human existence. To fill this vacuum, they resort to drugs. If this existential vacuum is not properly understood, or at least considered, the problem of drug addiction will never be solved. Who is to blame for drug addiction? The an- swer is multifarious. They can be the parents, so- ciety, government, school administrators, media, 220and the user. in, depression, anxiety, frustra- the like are Part of existence as of thi Drugs are not the ultimate fillers iS vacuum. The best thing to do is to accept this vacuum and consider it as part of our human existence, . human beings, Suicide Suicide connotes. to It is defined as “the direct killing of oneself on one’s own authority,”!2 Therefore, murder, homicide, infanti- cide, genocide, and Parricide are not suicides. To com- mit suicide is to kill oneself; the agent of death is the person himself. Thus, Starving oneself to death is sui- cide; throwing oneself down from atop a building is suicide. In other words, all acts that cause death is suicide if the person's own death is volitionally self- caused. : tal resignation from mankind. Is suicide immoral? Yes, suicide is cowardice; it is an immoral total cessation of a God-given life. Suicide is a negation to accept life courageously. If life is God- given, then it is God alone who has the absolute right for the total cessation of human life. Therefore, suicide is immoral. Murder Once I read in a novel the contention that goes: “Murder is the art of killing. Genuises murder, dunces just kill.” What a statement! Murder is defined asa direct killing of an innocent person. A direct killing is a direct voluntary act. An innocent person means one who has not forfeited his primordial right, i.e. right to life. Murder is an unjust killing since it is done without legitimate authority. Hence, the State does not commit murder when it punishes a criminal by capital punish- 221ment; a soldier does not commit murder if he Sanaa enemy in a just war; a person who kills fa eaee aggressor in self-defense does not commit mi 7 Murder is immoral since it violates the right of God over human life and the right of the State to pres justice and public safety. Self-defense Self-defense is not a duty but a right. It is not our duty to kill an aggressor; but we have the right to de- fend ourselves from any unjust and illegal attack of an aggressor. Killing an aggressor in self-defense is justifi- ' able since killing here is not murder. There are five conditions to consider in a blame- less self-defense (meaning a due exercise of a right of self-defense). They are as follows: 1. « The sole motive in self-defense should not be hatred or revenge. If the act is masked ‘by hatred or revenge, the act is evil and morally wrong. 2. Physical force should be employed only at the time of the attack. This means that the at- tack is actual not just an intimidation or threat. Peaceful negotiatio; ficers should be d No more injury should be inflicted than what a necessary to avert actual danger. Death of e ay ‘geressor should not b the defence ff ot be the direct goal of Possible, the aggessor should ee Physically incapacitated or knocked ious: ee us; there is no Need to kill the ag- the ate a unjust. This means that the ir pias € victim is an innocent per- 222 Be.‘ Euthanasia (Painless Death) Euthanasia o tentional killing " Mercy killing is defined as the in- because of the follo wing reasons": 1. Euthanasia is a violation of the natural incli- ' nation to Preserve life and, therefore, it goes against nature. Every human being, main- tains Williams, has a natural inclination to Preserve life or continue living and a normal Person is always afraid of death. Everyone of us has the instrict to protect ourselves. Eve- tyone has that natural goal of survival. Eu- thanasia violates this goal. 2. Euthanasia may work against our own inter- est if we practice it or allow it to be practiced on us. Williams assesses that the practice of euthanasia would endanger life preservation since it might make medical practitioners less efficient and inept. He says that a doctor's diagnosis and prognosis can be’ mistaken. “Consequently, we may believe that we are dying of a disease when, as a matter of fact, we may not be. We may think that we have no hope of recovery when, as a matter of fact, our chances are quite good. In such circum- stances, if euthanasia were permitted, we should die needlessly.” 3. Accepting euthanasia as a practice may re- sult in certain undesirable long-term conse- quences. Williams claims that to save lives is ‘ the total commitment of doctors and nurses, Thus, losing the life of a patient must be for them a personal failure which is an insult to their skills and knowledge. Nevertheless, if euthanasia would be practiced, this situation will change. “Doctors and nurses might not try hard enough to save the patient. They might decide that the patient would simply 223be better off dead and take steps necessary to make that come about.”'* In conclusion, Williams says: Euthanasia is inherently wrong because it violates the nature and dignity of human beings. But even those who are not convinced by it must be persuaded that the potential, personal, and social dangers inherent in eu- thanasia are sufficient to forbid our approv- ing it either as a personal practice or as a public policy.'® Another view gathered from the research of E. J. Hayes, P. J. Hayes, and D. E. Kelly says that euthana- sia should not be legalized since it is impractical and immoral. These researchers give six reasons:!” 1, Légalized euthanasia would lessen the incen- tive for medical research; 2. It would become possible to arrange for the death of an enemy or a wealthy relative; 3. Voluntary euthanasia is but a step removed from compulsory euthanasia; 4. The purpose of the medical profession is to preserve life, not to destroy it; 5. Many patients today surprise the doctor by recovering. If euthanasia is legalized, they would be killed; and 6. The practice of euthanasia would make the doctor a man from whom we would wish to flee in terror when we are seriously ill. What does the World Medical Association say about euthanasia? This association condemns euthanasia since eae is contrary to the public interest and 0 medical ethical principles as well vights.!8 p! as to natural In sum, we say euthanasi: not to be practiced since it is mental right of man, i.e., the condemn it because it is an ou! a is immoral and ought a violation of a funda- right of life. Besides, we ‘trageous infringement of 224 ' ' 4the exclusive right of q nates from God, therefar human life. Since life origi- right over life, + He alone has a sovereign Capital Punishment Our Philippine laws have just rec abrogation of capital eee co EeE — sill remains a polemic in the reimposition of capital pun- ishment. Definitely, in the Philippine setting, there ex- ist varied opinions; others are in favor of the reimposi- tion of capital punishment while others are not. Capital punishment is a global phenomenon. There exists a global debate between the proponents of capi- tal punishment and the proponents of the imposition of life imprisonment, instead. In America, a noted psy- chiatrist by the name of Karl Menninger says: Capital punishment is, in my opinion, morally wrong. It has a bad effect on everyone, espe- cially those involved in it. It gives a false sense of security to the public. It is vastly expensive. Worst of all, it beclouds the entire issue of moti- vation in crime, which is so importantly relevant to the question of what to do for and with the criminal, that will be most constructive to the society as a whole. Punishing, and even killing, criminals may yield a kind of grim gratification; let us all admit that there are times when we are so shocked at the depredations of the of- fender that we persuade ourselves that this man the Creator didn’t intend to create, and that we had better help correct the mistake’®.... i imisti f Menninger that It is the optimistic conviction of criminality cannot be solved by capital punishment. He believes that a hardened criminal can still be trans- fe d into an active contributor for the growth of so- sety. Th r claim that therapy is the i es Menningé! ‘ aa ee solve the criminal offenses, not capital punishment. 225os Cc x mu! capital punishment a i aa isp) nment Oe e ul herents of ca more interested ould prope ba sc in cul {hors ider other au the Menninger. We will consid® ‘van den Haag: who are a jook, and ™ pital pun- cia ° fends his view in freer 7 Se sguinst J, Barzun dele} main argu ishment by first citing four é the death penalty. The: - 1. Punishment for a crim , rooted in revenge; 7 Capital punishment does not dete: isan Judicial error being possible, taking life appealing risk; and . its name, must 4. A civilized State, to deserve u uphold, not violate, the sanctity of human life. uments are: is a primitive idea rime; Despite these arguments, Barzum is still for the imposition of capital punishment. Says Barzun: I replace the term capital punishment with “ju- dicial homicide.” The uncontrollable brute whom I want to put out of the way is not to be pun- ished for his misdeeds, nor used as an exam- ple, or a warning; he is to be killed for the pro- tection of others.... No anger, vindictiveness, or moral conceit need Preside over the removal of such dangers. But a man’s inability to control his violent impulses or to ims Sequences of his acts s] , Teason for his climination fom eeeecumptive In Barzun’, . ishment is done Bea in clear ae Sool ee venge but in order top nce or anger or re- and ven killed by criminal, ers from being harmed mans 0B kd for the wee STZOM says that a € Protection of others, detere; 226Similar to Barzun's two reasons for lows: lL = Position, S. Hook maintains ital puntshment.” They are as fol- ‘ Care iminal defendants, when sentenced F iprisonment, may in fact prefer death. ‘or Hook, a defendant who is convicted of murder and sentenced to lifé imprisonment should be permitted to choose the death pen- alty instead. pe Some convicted murderers, having served one prison sentence, murder again, When such twice-guilty murderers are found to be sane, and when there is reasonable probability that they will murder again, the death penalty should be imposed. For Hook, people who are against capital punish- ment are those who are indifferent to the lives of hu- man beings doomed to be victims of criminals. Hook writes: ° .. there is a reasonable probability that such murderers will murder again or attempt to mur- der again, a probability which usually grows with the number of repeated murders and still insist they would never approve of capital punishment. I would conclude that they are indifferent to the lives of the human beings doomed, on their po- sition, to be victims.”° E. Van den Haag’s argument jibes with the argu- ments both of Barzun and Hook. However, this psy- choanalyst and professor of social philosophy at New York University fashions his arguments in capital pun- . terms of gain and loss. For him, if we im- ose the death penalty, and achieve no deterrent effect thereb’ the life of a convicted murderer has been ex- ea ‘in vain. There is a net loss. If we impose the aie d thereby deter some future mur- ce an death ie spared the lives of some future victims. ‘ eee prospective murderers gain too since they they are deterred. are spared from punishment in case they 227Analyzing this, death penalty manifests a net gain, unless the life of a convicted murderer is valued more highly than that of the unknown victim. Haag concludes: “To be sure, we must risk some- thing certain — the death... of the convicted man, for Something uncertain — the death... of victims of mur- derers which may be deterred.”*® Thus, Haag is telling us that if we are for capital punishment, then we are Protecting the lives of the would-be victims of murder- ers. On the contrary, if we are against capital punish- ment, then, we are protecting the lives of the murder- ers, Now, what is our stand? Definitely, we must be for capital punishment. However, we advocate massive Values Education for our people, especially the youth. We have to accept that no man is born a criminal or a murderer. It is hard to believe that Mussolini, Hitler, and Mao were already murderers when they were still infants; it is hard to imagine that these people were already monsters in their cradles. Sometimes, senti- mentalism can make a villain or a culprit instead of a hero or a saint. Thus, education should be emphasized. Every young Filipino should be Properly molded or Abortion Abortion is one Of the + e ” We have gathered at least three St issues in Morality. : + defing : tions of 5 228 abortion:1 t nes expulsion of an embryo or an inviable face rom the body ofa Pregnant woman with 7 resulting death of the embryo or the fe- It refers to the unsought and spontaneous untimely ending of pregnancy;2” and It refers to an intentional interference with a developing life.28 It is well-settled that human life begins at fertili- zation or conception. In this light, it is necessary that one must be able to know what terms like zygote, em- bryo, fetus, and viability of a fetus mean. Zygote refers to the developing human being from the time of conception until the 14th day of gestation. Embryo refers to the developing human being from the time of conception until the 8th week of gestation. Fetus refers to the developing human being from the 8th week of gestation until delivery. Viability of a fetus refers to the capacity of the fe- tus to survive outside the maternal womb. Medical ex- perts claim that normally a fetus attains viability at 23 to 24 or 24 to 28 weeks gestation age. Abortion is classified into three, namely: sponta- neous, indirect, and induced. 1. Spontaneous Abortion Spontaneous abortion is commonly called “miscarriage” if it occurs earlier than the child is expected to be born. In medical terms, “miscar- riage” means spontaneous delivery between twelve to fourteen weeks or twenty-four weeks of preg- nancy. In layman's term, “miscarriage” refers to invqluntary expulsion of a nonviable fetus and therefore not abortion. In legal parlance, however, miscarriage means abortion at any state or preg- nancy. Most often, spontaneous abortion is caused by vitamin deficiency or disease such as syphilis, pneumonia, and influenza. 229Under spontaneous abortion, we can talk of three other kinds of abortion, namely: threatened abortion, inevitable abortion, and incomplete abor- tion. a. Threatened abortion occurs when there is bleeding resulting in a doubtful judgment o! whether the fetus is expelled or not. b. Inevitable abortion, just like threatened abor- tion, occurs when there is bleeding. However, the bleeding is certainly caused by the ex- pulsion of the fetus. c. Incomplete abortion is a kind of abortion in which parts of the products of conception are retained in the uterus. Indirect Abortion Indirect abortion means the foreseen but unintended loss of the fetus following a medical - procedure necessary to preserve the life or health of the mother.” In this kind of abortion, the loss of the fatal life is not directly intended. Thus, indi- rect abortion falls under indirect voluntary acts. This is kind of abortion which is justifiable, par- ticularly in the case of a mother who takes medi- cines to recover from severe cough without know- ing that her fetus will be affected. Induced Abortion Induced abortion is also called direct abor- tion. It is defined as any procedure by which the normal course of the development of the child be- fore birth is intentionally interfered with. In this case, induced abortion is a deliberate cessation of pregnancy in order to destroy the life of the fetus. There are two kinds of abortion under induced abortion. They are: criminal abortion and thera- peutic abortion. Criminal abortion is also called illegal abortion. It means an abortion performed to kill the unwanted child. The reason why crimi- 230nal abortion is also called its performance is cont criminal law. Criminal law since it is murder, illegal abortion is that trary to the provisions of abortion is punishable by It is, therefore, immoral. On the other hand, therapeutic abortion means an abortion which is directly and deliber- ately performed to save the life of the mother. This may happen when there is ectopic pregnancy. In this case, therapeutic abortion is called legal abor- tion since it is legally allowed and therefore not punishable by law. However, despite the abortion being therapeutic still; it is an induced abortion and is therefore a direct attack on the life of the fetus. Just like criminal abortion, therapeutic abor- tion is immoral. Now, what does the church and other con- cerned sectors in society say about abortion? a. The Code of Canon Law of the Catholic Church states the following: Persons who procuré abortion, the mother not excepted, automatically in- cur excommunication reserved to the Ordinary (Bishop in the Diocese) at the moment the crime takes effect.°° Excommunication here is applied to both criminal and the therapeutic abortions. Those that. cooperate, aside from the mother, are subject to this penalty. They are the interns, doctors, nurses, hospital authorities, or others who are involved in the procedure. b. The Catholic Bishops in America have this to say: ‘We restate with strong conviction and growing concern our opposition to abor- tion.... Fully aware of problem situations that may exist at times, such as illegiti- macy, great emotional stress, possible disadvantage for the child after the birth, 231we find no evidence that easy abortion laws will solve these problems. In fact, the termination of life in these particu- lar situations violates our whole legal heritage, one that has always protected the right to life.... We strongly urge a re- newed positive attitude towards life and anew commitment to its protection and support.?! c. Let us inquire from the Catholic Chris- tian Thinkers: (1) Tertullian Tertullian was a lawyer who was converted to Christianity at the end of the second century. Later, however, he became a heretic. At any rate, this is what Tertullian says about abortion: For us, since homicide is forbidden, it is not even permitted while the blood is be- ing formed into a man to dissolve the con- ceptus in the uterus. For to prevent its . being born is an acceleration of homicide and there is no difference whether one shuffles off a life already born or disturbs one that is in the process of being born. For he is also a man who is about to be one, just as every fruit already exists in the seed.%? Clearly, Tertullian is saying that abortion is homicide. Further, he remarks: ... the fetus in the uterus is a man. For the law of Moses also judged abortion to war- rant life to life since already it is a case involving a man, since already it is consid- ered alive or dead, since already it has in- scribed a destiny, even though it still lives in the mother..,.33 (2) For this celebrated Eastern Christian priest, abortion means murder, Thus, people who engage in it are murderers, says Basil the Great: 232we Dena utPosely destroys a fetus incurs eine Ta for murder. We do not ask pre- For iE ether it is formed or not formed. “ ere not that which would have been orn is vindicated, but also the woman herself who prepared her own destruction, since oftentimes, women die in such at- tempts. But to this, the fetus destroyed adds another killing, at least if the judg- ment of those who dare such things is cor- rect.4 (3) St. Jerome Jerome rejects abortion. For him, abortion is a grave sin; it is parricide of the inborn. Says Jerome: . Indeed, ‘others drink sterility beforehand and so perform homicide on what is not yet even a man. Some, when they notice that they have illicitly conceived, take poi- sons of abortion. Frequently, they even kill themselves and then they are led to hell for the guilt of three crimes: for killing themselves, for infidelity to Christ, and for parricide of their child unborn....° d. Protestants’ View Most, if not all, of the leading protestant theologians like Karl Barth, Dietrich Bonhoeffer, and Helmut Thielicke are con- vinced that abortion is immoral. Generally, the Protestants believe that the inborn child is already a human being. They are convinced” that as a God-given responsibility parenthood starts with conception. Thus, their.condem nation of abortion.%° Mutilation : der in modern science, particularly in the field ie edicine, makes this mutilation issue more in- serutable than ever. Today, wonderful inventions and 233Wonderful theories in Telation to heali Sively coming to the fore. before in Telation to healt Possible today. Before, Ith are Progres- Much of the impossibllities th and bodily care are made It was impossible to change one's Pregnant, to have an offspring outside coitus with a marital partner, to have a child outside the mother’s uterus, and so on and so forth. Today, one can change one's facial image through Plastic Surgery by having a “face lift," a “nose lift,” ete. One can have a heart or lung replaced through organ transplants. Today, although it is not yet applied to human beings, one can duplicate himself through clon- ing. Today, it is Possible for men to get pregnant. To- day, through artificial insemination, a couple can have a child outside sexual intercourse. Today, a couple can have a child who is not being developed in the wife through surrogate motherhood. Today, a woman de- virginized through sexual intercourse or through child delivery can restore virginity through surgical virginity or vaginal repair. Today, the sex of the fetus can al- ready be determined through proper dieting of the mother or through ultrasound. Today, sexual hormones (androgen and estrogen) can be imparted to their un- natural holders. This is done by some celebrities like Michael Jackson, Prince, etc. These noted figures are believed to have estrogen introduced into their bodies. True, not all in these wonderful inventions bring good to mankind, because some bring harm and dis- tortion to human bodies. This is where morality lies in mutilation. But, just a point of clarification, not all of the foregoing are included in mutilation. So, what is mutilation? By mutilation is meant any action performed to injure or destroy some part or function of the body. This means that mutilation ts intended to lessen the integrity of the human body. If this is the meaning of mutilation, the question to be posited here is: Is muti- lation morally allowable? The answer is yes. It is mor- 234 Anoerrteseset ransenxT wot eto a nmally allowable in the conte ext principle of totality, Accordin, sti is for the sake of the whole, than the part and the part is just a parcel of the whole. However, the intention behind the performance of mu- tilation greatly affects the morality of mutilation. Obvi- ously, it is this sphere where the morality in mutilation can be discerned. Principle called the g to this principle, the part since the whole is greater For further clarification, we will distinguish two kinds of mutilation based on the context of the func- tional integrity of the human body. Mutilation can be a minor or a major one. Minor mutilation means any act performed to lessen the sum total of the body which does not include the destruction of the functional in- tegrity of a human body. Under minor mutilation, we can cite tooth extraction, circumcision, and tonsillec- tomy performed to destroy the functional integrity of the human body. Surgery and sterilization are exam- ples of this. Under mutilation in general, we will discuss the following topics: surgery, organ or tissue transplant, sterilization, and plastic surgery. 1. Surgery God's approval can be postulated in a muti- lation which is indispensable for the preservation of life or for the preservation of the health of one’s body. Fhe preservation of life and health is some- times impossible without an operation. In this vein, surgery is in correlation with the Natural law. Therefore, a removal of a diseased organ or part of the body is moral and valid as in the case of am- putation of a gangrenous leg. 2. Organ Transplantation Organ transplantation is the transfer of any organized living matter. This is a broad term inas- much as this includes blood transfusions, bone graft, skin graft, etc. For purposes of specification, let us consider the three kinds. of tissue trans- plants, namely: homograft, heterograft, and autograft. 235a. Homograft refers to the transplantation of tis- sue from a living or a dead human body. The latter incurs no moral problem if the body is really dead. The former, however, refers to the transfer of tissue from a living body to an- . other. This is why homograft from the living is called “tissue donation.” This involves mu- tilation. The mutilation here is morally allow; able only if its donor's functional integrity is not destroyed. Examples of this are kidney transplant and bloodletting. b. Heterograft refers to the transplantation of tissue from an animal to a human being. Is this moral? So far, this is permissible as long as the transplantation does not alter the emo- tional and psychological spheres of its recipi- ent. c. Autograft refers to transplantation of one’s own tissue. An example of this is skin graft. This warrants no moral repercussion. A contemporary issue in organ transplant should be cited here. This concerns heart and brain transplant. The former requires a clarification of death while the latter remains in hot waters since it was conceived. Concerning heart transplant, the moral diffi- culty can only surface when the donor is not yet dead. What aggravates the issue is that even to- day medical practitioners and moralists are still in polemics as to when a person is to be consid- ered dead. At any rate, what is morally and medi- cally held is that death means “death” of the brain (brain death) and not the cessation of the heart- beat. By brain death is meant deterioration of the brain whereby no restoration ol possible.%” f consciousness is Thus, a heart transplant can only be consid- ered moral if its donor ts already eal Modern medicine considers heart transplant to be moral 236since thro its son alive tieoangeavancements it can keep a per- an artificial heart, possible for al heart, or making it person, a heart to be kept alive outside the alists show ning brain transplantation, the mor- ward its pots strong reaction of repugnance to- imm ization. For them, brain transplant is oral since it would mean altering the attitude, behavior, emotion, p , Mem person. emory, and personality of the Sterilization Sterilization is not synonymous with frigidity or impotency since it means causing inability to reproduce or procreate. There are two kinds of sterilization, viz.: direct and indirect. Direct steri- lization means the production of sterility itself ei- ther as an end or as a means. When direct sterili- zation is done, the immediate purpose is the im- possibility of reproduction. Direct sterilization is mutilation. Hence, it is only morally allowable if it is required for the sake of life or the health of the whole body. Aside from this, direct sterilization is immoral since it becomes contraceptive steriliza- tion. This is why ligation (of the vas deferens or of the fallopian tube), vasectomy, and orchidectomy are immoral if they are intended to avoid concep- tion or procreation and not for the sake of life pres- ervation or the health of the body. Thus, for direct sterilization to be moral, it should be done only in the context of therapeutic sterilization (or sterili- zation for purposes of cure). On the other hand, indirect sterilization is one anondeliberate consequence ofa. yecurs aS woe diseased organ or tissue or part of a Hare es words, indirect sterilization falls aa ane voluntary act. In this case, since it i not directly intended, it is moral. Aside from direct and indirect sterilization, there exists also punitive sterilization and eugenic 237sterilization. Punitive sterilization is one done to a criminal as a form of punishment for a sex crime. Punitive sterilization is immoral, because it is in- effective; it neither saves the health nor the life of the sex offender although it spares sexual dam- age to his would-be victims. Eugenic sterilization however, is done to those who are expected to have less gifted or defective offspring. This kind of steri- lization is immoral since it is a violation of the . Natural law. Plastic Surgery Plastic surgery is one which is intended to restore or repair parts of the body that have been injured, deformed, or lost. Plastic surgery, no doubt, is a form of mutilation. For it to be moral, the following circumstances must be considered: a) physical looks; and b) to conquer inferiority com- plex. Outside these considerations, plastic surgery is immoral. 238