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BIOETHICS

 ETHICAL SHOOLS OF THOUGHT

 Bioethics is an applied ethical study dealing with moral problems that demand deliberate decisions. Moral
judgments or decisions made are justified according to moral rules, which in turn are grounded in ethical
principles and ultimately in ethical theories.
 That there is a need to study ethical schools of thought becomes readily evident.
 Example:
 A Doctor does not want to perform an abortion on a patient, upholding that it is morally wrong to kill unborn
human beings. This doctor may justify the said moral precept against killing innocent human beings by referring
to the principle of the sanctity of human life; finally, the particular moral decision, the precept, and the principle
may be grounded in an ethical theory which contends that aborting a fetus is against the natural moral law.
 Ethicians classify theories as teleological or consequential and deontological.
 Theological ethics (Greek teleos, “end” or “purpose”), so called because it stresses the end result, goal or
consequence of an act as the determining factor of rightness and wrongness, is also called Consequential ethics.
 Deontological ethics (Greek deon, deontos, discourse on duty or obligation) stresses duty as norm of moral
actions, hence it is also known as Duty ethics.
 Bioethicians have introduced the classification of ethics into rule and act, resulting from the influence of
utilitarianism.
 Rule ethics appeals to a set of criteria, norms, or rules to settle what is the right and just and ethical decision to
make.
 The famous Ten Commandments of Judaeo – Christian religion exemplifies rule ethics.
 Act ethics determines rightness and wrongness by weighing the consequences of the act itself.
 An example of act ethics is utilitarianism together with a new approach.

 ETHICAL SHOOLS OF THOUGHT

 Ethical Relativism
 Every culture has its own norm of moral actions. Some societies consider as right several kinds of actions that
other societies consider to be wrong.
 Example:
 In the case of the arctic Eskimo, the practice of abandoning old folks in the snow and allowing them to die in the
starvation and exposure is morally legitimate.
 In some cultures, a man has an obligation to marry his brother’s widow. This was the practice not only among
the early Israelites but among the Muslims as well.
 In some African cultures, to kill twins at birth is considered morally just and right. Likewise, to offer virgins in the
worship of volcanoes is morally acceptable.
 Among Eskimos, lending or allowing one’s wife to sleep with one’s special guest overnight is an expression of
hospitality.

 In olog or trial marriage among some Igorots and live – in practices among Americans, which are done in order
to test marital compatibility.

 Criticism & Objections

 Ethical relativism contradicts common beliefs and ordinary experiences in several ways.
 For instance, the brutal assassination of the late Senator Ninoy Aquino was heinous crime, we feel that the
cruelty or wickedness of the act is not dependent upon our culture alone but is universally acknowledged to be
so.
 The view that Hitler was wicked in killing six million Jews.

BIOETHICS – ETHICAL SCHOOLS OF THOUGHT | CPPA Ibisate, RN

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In Medical Context

 Patients who are adherents of the religious sect Jehova’s Witnesses have notoriously refused blood transfusions
because their religious convictions do not permit them to have them.
 When one refuses life – saving medical treatment, the propriety of one’s decision is not in question, but rather
whether a physician’s act in violation of that decision is morally proper and legitimate.
 The patient’s refusal is tantamount to consenting to death, or is a form of passive euthanasia. Should the doctor,
in such instances, simply allow the patient to die? Is the saving of human life, under these circumstances,
morally wrong?

 SITUATION ETHICS
 Is advocated by Joseph Fletcher, an American Protestant medical doctor and the author of Situation Ethics: The
New Morality.
 He mentions three (3) approaches to morality: legalism, antinomianism, and situationism.
 Legalistic approach describes certain general moral prescriptions, laws, norms by which to judge, determine,
and settle the rightness and wrongness of human judgments or decisions. Also known as normative for obvious
reason.
 Fletchner considers legalism as too restrictive and circumscribed, and hence, inadequate for and insensitive to
the complexity of over varying situations in which one finds oneself.
 The antinomian approach , frees the Christian from the obligations of the moral law in which case there are no
absolute precepts or moral principles by which to be guided in making decisions.
 To Fletchner, antinomianism is too liberal and unconventional, which may lead to anarchy and chaos.
 The situationism approach
 It is the preferred approach of Fletchner to the problem of morality.
 This ethical theory states that the moral norm depends upon a given situation, but whatever this situation may
be, one must always act in the name of Christian love.
 A situation in this context refers to a human condition or any state of moral affairs and issues that demands a
moral judgment or action.
 To abort or not to abort a fetus conceived by accident rather than by design exemplifies a given situation.
 To inject a lethal drug into a terminally ill patient at his own request in order to relieve him completely from
terrible pain and suffering in another.
 One must decide on any of these situations in the name of Christian love.
 What is Christian love? Fletcher sites three (3) types of love namely: eros, philia, and agape.
 Erotic love means sexual love which normally relates a man to a woman, but it may also exist between a tomboy
and another woman, or between a gay and another male. Primarily, however it refers to heterosexual
relationships.

 Filial love refers to the affection that binds a parent to his/her child, a brother to his sister, a brother to his
brother or a sister to a sister. Both eros and philia are ambivalent.

 Agapeic love which refers to one’s care and concern and kindness towards others.

 Christian love, in Fletchner’s view, best exemplifies agape. Love of and for one’s neighbor (in its biblical sense)
just as Christ is a love in which one cares for well – being of another, regardless of his station in life.

 It is characterized by charity, respect, and responsibility towards the other. This is the kind of love by which an
individual should act, should settle what is right or wrong, just and unjust in any complicated situation, according
to Fletchner.

 Why not eros and philia? These two are biased and partial; they have preferences and inclinations. They are
usually motivated by selfish interests and ulterior motives.

 Example, one may perform and extend medical attention to another person with thee end in view for some
sexual favor that one may derive from the other. A surgeon may decide on slowly and painlessly ending the life
of his/ her own grandmother, under the pretext of mercy killing, while in fact the surgeon is simply in a hurry to
get his/ her inheritance from her.

BIOETHICS – ETHICAL SCHOOLS OF THOUGHT | CPPA Ibisate, RN

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The following six propositions are the fundamentals of Christian conscience:

 Proposition I: The nature of love

 Only one thing is intrinsically good, namely love: nothing else

 Love alone is good per se, the only thing that is by its very own nature.
 Thus one who acts and decides and judges the agapeic love can never be wrong. Love is never selfish or self-
conceited, neither biased nor unfair. It is always geared towards the good of the others, because it cares,
respects, and protects the dignity of the other.
 Example: A doctor, who helps a rape or incest victim to abort the fetus conceived a s result of sexual assault
would be acting out of concern and kindness towards the pregnant woman.

 Proposition II: Reduces all the values of love

 The ultimate norm of Christian decisions is love: nothing else
 Christians, in order to deserve their calling, should based their moral judgment on agapeic love. All codes, laws
and rules and principles can be reduced to the love alone.
 This ultimate norm (i.e. agape) is “no respecter of persons”, seeking the good of the other radically and non-
preferentially.
 Christian love goes beyond racism and religionism.
 A Christian loves another not because he or she is a fellow Christian, but because he or she is a human being
with the same dignity as his.
 Example: A physician who extends medical assistance to an injured NPA rebel acts out of Christian love, which
knows no barriers save for apathy, reluctance and indecision to serve the good of the other.

 Proposition III: Equates love and justice

 Love and justice are the same, for justice is love disturbed.
 Love and justice goes together; they are compatible bedmates so to speak.
 To love means to be just to the other we love.
 If one say he/she loves someone, but at the same time treats the latter unfairly, one is not being faithful or
honest with onself.one does not really love the other in that situation; one loves oneself.
 To be just and responsible means that we are ready to face and accept the consequences of our act of love.
 Example: One may not say one truly loves another individual if one abandons and deserts the individual once one
hears “a newborn baby cry”. In such a situation, one does not truly care but is instead being irresponsible.

 Proposition IV: Frees love from Sentimentality

 Love wills the neighbor’s good whether we like him or not.

 We may like a person because of the good qualities the person possesses; or dislike that person because of his /
her bad traits.
 Hence, an individual may be either likable or unlikable, depending upon the good qualities we expect that
person to have.
 One’s likability or dislikability is therefore due to good or bad characteristics. Nevertheless, within the context of
agapeic love, we may still love an individual, even if we do not like that person’s bad manners.
 Christian love is literally benevelonce: it is a matter of loving the unlovable, the unlikable, the uncongenial, the
unresponsive.
 Agapeic love is a matter of attitude- perhaps human attitude, not one feeling, so that we can still love the people
we hate.
 Example: This must have been what Jesus meant by” Love your enemies…” (Matt. 5:44). Thus, a doctor’s most
hated neighbor, literally speaking, also deserves medical assistance even as he/she lapses into unconsciousness
after berating the former.

 Proposition V: The relation between means and ends

 Only the ends justifies the means

BIOETHICS – ETHICAL SCHOOLS OF THOUGHT | CPPA Ibisate, RN

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 Christian ethics teaches that “the end justify the means”. No matter how good or beneficial the end may be, one
may not employ evil means to attain it.
 A right thinking individual, for instance, may not seduce, abduct, and rape a woman with the end in view of
marrying her.
 The end (i.e. Marriage) is good, but the means (i.e. seduction and rape) by which is achieved is evil.
 Fletchner on the contrary, claims that an evil means does not nullify a good end; it all depends upon the
situation, i.e. “the relative weight of the ends and the means and motives and consequences all taken together,
as weighed by the agapeic love.
 Circumstances do alter cases. An act which is right in some circumstances may be wrong in others – that is, we
may do what would be evil in some situations, if in this one, agape gains the balance.
 Example: Stealing a neighbor’s licensed revolver to keep him from shooting somebody fuming in anger against
him would be morally legitimate act under the circumstances.

 Proposition VI: Validates every judgment within its own context

 Decisions ought to be made situationally, not prescriptively

 There is no system of prefabricated morality. A “prefab” code of ethics offers a ready-made moral norm, a ready
– made answers to moral problems.
 Situation ethics, on the other hand puts a premium on freedom and responsibility, since the modern individual
lives in a technological culture that becomes increasingly complicated and wide – scoped, thereby making
ethical issues and decisions grow complex.
 Moral decisions are relative to the situation. Agapeic love plots the course of action according to the
circumstances, and the obligation to make and stand by our decisions must be carried out.
 Example: (Medical Context)
 Situational ethics combines love and justice in treating ill patients.
 Healthcare professionals and personnel should not only be fair to patients; they should also show loving care and
concern for them.
 Medical assistance is not motivated by kinship, favoritism, friendship, utang na loob, pakikisama, comradeshi[ or
camaraderie.
 A Patient who seeks medical treatment should be extended help irrespective of creed, race, color, or ideology.
Even an enemy of the state, injured in a bloody clash with government troops, deserves medical aid. Medical
attention should be given above and beyond monetary gains.
 Money in short, should not dictate medical procedures and exigencies. People who need immediate medical
service should be given their due within the context of justice and love. Walang palakasan.

BIOETHICS – ETHICAL SCHOOLS OF THOUGHT | CPPA Ibisate, RN