Health Care Ethics

Terms and Concepts

Chapter 1: Bioethics in a Multicultural Age
1.1 The Emergence of Secular Bioethics
Why did secular medical schools recently begin to offer medical ethics courses?
scientific outlook[leads] many to think that if something is technically
possible it is therefore morally admissible

1.2 The Foundations of Ethics of Health Care
- Hippocratic Oath:
o Hippocrates was an ancient Greek physician
o Oath: new physicians swear by the old healing gods that they will practive
medicine honestly and hold professional and ethical standards.

- Deontological versus Teleological
o Deontological (duty ethics/voluntarism): judges the morality of an action
based on the action's adherence to a rule or rules (ex: Torah)
What if the legislature is not morally trustworthy?
o Teleological (ends-means ethics): judges the morality of a decision in
terms of the relation of an action taken as a means to happiness.

- Jesus as Model
o Torah/Mosaic Law
Evaluates behavior ethically based on whether or not it agrees with
laws God presented to Moses
o Canon Law
body of laws and regulations made by Church leaderships made for
a Christian church and its members
o Natural Law
a system of law that is determined by nature, and so is universal
accessible to human reason
- Luther and Calvin
o faith alone St. Paul justification
o Manuals for Confessors
Published by Catholic theologians as a response to accusations of
moral laxism
Included questions about the ethics of health care
o St Thomas Aquinas
Used ethical writings of Aristotle to provide a strict ends-means
system of ethics
Probabiliorism: follow the most probably interpretation because
the purpose of law is to guide what will best allow us to reach our
goal.
o Francesco Suarez, SJ
Voluntarist
Supporters split between his and Aquinass interpretation of the
manual
Probabilism: doubtful law does not apply because it is the
obligation of the lawmaker to make it clear; thus, one can choose
an easier interpretation if its truth is probable.
o St Alphonsus Liguori, C.Ss.R.
Resolved the matter between Suarez and Aquinas.
Compromise: accept probabilism but insist that the more lenient
interpretation of the law could be followed only if it has solid
(credible) probability


1.3 Current Methodologies in Bioethics
- Rene Descartes
o Father of modern philosophy
- Immanuel Kant
o Formalism; Proposed duty ethics independent of revealed religion
o Insisted on altruistic behavior
o Eudemonism: ethics of happiness
o Emotivism: values on the basis of essentially subjective and emotional
preferences
- John Rawls
o Adopted two fundamental principles of justice:
1. Right of each person must match others
2. Social and economic positions are to everyones advantage and
open to all
- Jean-Jacques Rousseau
o Argued that most people were naturally and instinctually good but this
could be distorted by bad education
- David Hume
o Supported emotivism because it is the naturalist fallacy
the claim that what is natural is inherently good or right, and that
what is unnatural is inherently bad or wrong.
- Tom L Beauchamp and James F Childress
o Wrote Principles of Biomedical Ethics
o Principalism: follow the course of action which you want everyone else to
follow
o 4 middle principles:
1. Autonomy, right of self-care
2. Nonmalfeasance
3. Beneficence (seeking patients benefit)
4. Justice to all concerned
- Casuistry
o A kind of duty ethics in contrast to the other forms of rule duty ethics
because it did not propose any general norms
- Incommensurable Goods
o Proposed by Germain Grisez
o Propose absolute ends, so anyone who acts contrary to them is evil
- Ends-Means Ethics
o Joseph Fletcher: do what is most loving in the circumstance

- Proportionalism
o Joseph Fuchs, Peter Knauer, Bruno Schuller, Richard McCormick,
Bernard Haring
Developed proportionalism
o Pope John Paul II
Rejected proportionalism
Some actions are intrinsically evil regardless of the circumstances

- The Need for Virtue
o Virtue: to make good decisions consistently ( good morals)

1.4 Faith and Reason in Health Care Ethics
- Ethics in a Pluralistic Society
o
- Is there a Christian Ethic?
- How the Church Solves Moral Controversies
- Why Four Levels of Teaching?
- Is there a Right to Dissent?
- Teaching of Vatican II
- Sensus Fidei
- Human Rights Sensitivity

1.5 Conclusion
Secular humanism in bioethics dominates modern culture. Still, the church believes that
both faith and reason influence one another and such an influence leads to a deeper
understand of both parts.