CHRISTIAN PRINCIPLES OF ETHICAL ACTION

Source: Ashley, Benedict M., OP and Kevin D. O’Rourke, OP. Ethics of Health Care. St. Louis,
MO: The Catholic Health Association of the United States, 1986. [85-101]

How do Christians reach decisions concerning specific issues? They apply Christian
principles to particular cases. By a principle we do not mean a priori rules that are deduced from
more abstract value statements, which in turn have been deduced from broad, metaphysical
axioms. Nor do we mean mere postulates or assumptions accepted for the sake of consistency in
behavior. Rather, we mean practical generalizations derived from human experience of our basic
human needs and confirmed by the Gospel.

Principles of Christian Faith

Christian faith, which enables us to understand not only our natural needs, but, more
important, our deeper needs awakened by God’s grace, is a kind of knowing, a light that guides
our way in life. Hence the principles of faith instruct us how to form a prudent conscience,
because forming a prudent conscience is fundamentally a process of knowing and strengthening
and deepening of human insight and reason. Christians are aware that in forming their
conscience they depend on the Holy Spirit to overcome the prejudice and blindness of sin (Rom.
1:18-20) With this assistance and the light of faith, we are guided in making prudent decisions by
six principles.

1. Principle of a Well-Formed Conscience

To attain the true goals of human life by responsible actions, in every free decision
involving an ethical question, people are morally obliged to do the following:
a. Inform themselves as fully as practically as possible about the facts and the ethical
norms.
b. Form a morally certain judgment of conscience on the basis of this information.
c. Act according to this well-formed conscience.
d. Accept responsibility for their actions.

2. Principle of Free and Informed Consent

To protect the basic need of every human person for health care and the person’s primary
responsibility for his or her own health, no physical or psychological therapy may be
administered without the free and informed consent of the patient, or, if the patient is
incompetent, of the person’s legitimate guardian acting for the patient’s benefit and, as far as
possible, in accordance with the patient’s known and reasonable wishes.

3. Principle of Moral Discernment

 To make a conscientious ethical decision, one must do the following:
a. Proceed on the basis of a fundamental commitment to God and the authentic
dignity of human persons, including oneself.
b. Among possible actions that might seem to be means of fulfilling that
commitment, exclude any which are in fact intrinsically contradictory to that commitment.
c. Also consider how one’s own motive and other circumstances may contribute
to or nullify the effectiveness of the other possible actions as means to fulfill one’s fundamental
commitment.
d. Among the possible means not excluded or nullified, select one most likely to
fulfill that commitment, and act upon it.

4. Principle of Double-Effect
To form a good conscience when act is foreseen to have both ethically beneficial and
physically harmful effects, the following conditions should be met:
a. The directly intended object of the act must not be intrinsically contradictory to one’s
fundamental commitment to God and neighbor (including oneself).
b. The intention of the agent must be to achieve the beneficial effects and as far as
possible to avoid the harmful effects (that is, must only indirectly intend the harm).
c. The foreseen beneficial effects must be equal to or greater than the foreseen harmful
effects (proportionality).
d. The beneficial effects must follow from the action at least as immediately as do the
harmful effects.

5. Principle of Legitimate Cooperation

To achieve a well-formed conscience, one should always judge it unethical to cooperate
formally with an immoral act (that is, directly to intend the evil act itself), but one may
sometimes judge it to be an ethical duty to cooperate materially with an immoral act (that is, only
indirectly intend its harmful consequences) when only in this way can a greater harm be
prevented, provided (a) that the cooperation is not immediate and (b) that the degree of
cooperation and the danger of scandal are taken into account.

6. Principle of Professional Communications

To fulfill their obligation to serve patients, health care professionals have the
responsibility to do the following:
a. To strive to establish and preserve trust at both the emotional and rational levels.
b. To share such information as they possess which is legitimately needed by others in
order to have an informed conscience.
c. To refrain from lying or giving misinformation.
d. To keep secret information which is not legitimately need by others and that if revealed
might harm the patient or other or destroy trust.

Principles of Christian Love

 We have just considered the norms that guide our thinking as we strive to make
intelligent realistic moral decisions. These norms are rooted in one of our basic human needs, the
need for truth. Another basic human need is the need for society. Our fundamental motivation is
the drive to self-fulfillment, but human self-fulfillment is possible only through relationship with
other beings, and above all with the three divine persons, Father, Son, and Holy Spirit. The
ethical norms that govern these relationships can rightly be called norms of love. Love is not
only a kind of feeling, but also the practical will that leads one person to be concerned about
another and that person’s true needs. Furthermore, love motivates people to help others fulfill
these needs by sharing with another the values they themselves enjoy. In any Christian ethics the
fundamental truth is that there is a Triune God and that “God is love” (Jn. 4:8).

7. Principle of Human Dignity

All ethical decisions (including those involved in health care) must aim at human dignity,
that is, the maximum, integrated satisfaction of the innate and cultural needs of every human
person, including his or her biological, psychological, social, and spiritual needs as a member of
the world community and national communities.

8. Principle of the Common Good, Subsidiarity, and Functionalism

Human communities exist only to promote and share the common good among all their
members “from each according to ability, to each according to need” in such a way that:
a. Decisions making rests vertically first with the person, then with the lower social levels
and horizontally with the functional social units.
b. The higher social units intervene only to supply the lower units what they cannot
achieve by themselves while at the same time working to make it easier in the future for lower
units and individuals to satisfy these needs by their own efforts.

9. Principle of the Totality of the Human Person

To promote human dignity in community, every person must develop, use, care for, and
preserve all of his or her natural physical and psychic functions in such a way that:
a. Lower functions are never sacrificed except for the better functioning of the whole
person, and even then, with an effort to compensate for this sacrifice.
b. The basic capacities that define human personhood are never sacrificed unless this is
necessary to preserve life.

Principle of Christian Hope

 After discussing the norms of faith and love, let us now consider what theologians call
the eschatological aspect of ethics (looking to the final coming of Jesus Christ in the fully
realized kingdom of God). The person and the community are not structures of static relations
but are dynamic- loving, growing, developing, and evolving. This is why we have opted for a
teleological, goal-directed, means-ends ethics. Furthermore, human goals are not always clearly
envisioned in advance. The kingdom of God, on which Jesus centered his preaching, is a goal so
mysterious that he could express it only in terms of parables.
Recently, Christian theologians have developed theologies of hope and theologies of
liberation to bring out the many ways in which the Gospel is not merely a declaration that heaven
is better than earth, but a call to transform the earth as we journey heavenward. In this way they
are finding areas of agreement with humanism and Marxism which teach that to be human is to
work for the future. In health care this sense of hope is the source of healing. So that to be health
care professional is constantly to affirm the possibility of turning suffering into a victory over
disease and death.

10. Principle of Growth Through Suffering

As bodily pleasure should be sought only as the fruit of the satisfaction of some basic
need of the total human person, so suffering and even bodily death when endured with courage
can and should be used to promote personal growth in both private and communal living.

11. Principle of Personalized Sexuality

The gift of sexuality must be used in keeping with its intrinsic, indivisible, specifically
human teleology. It must be a loving, bodily, pleasurable expression of the complementary,
permanent self-giving of a man and a woman to each other which is open to fruition in the
perpetuation and expansion of this personal communion through the family they responsibly
beget and educate.

12. Principle of Stewardship and Creativity

The gifts of multidimensional human nature and its natural environment should be used
with profound respect for their intrinsic teleology, and especially the gift of human creativity
should be used to cultivate nature and environment with a care set by the limits of actual
knowledge and the risk of destroying these gifts.