BASIC ETHICAL PRINCIPLES

1. Stewardship
>>> This principle is grounded in the presupposition that God has absolute Dominion over creation,
and that, insofar as human beings are made in Gods image and likeness (Imago Dei), we have been
given a limited dominion over creation and are responsible for its care. The principle requires that the
gifts of human life and its natural environment be used with profound respect for their intrinsic ends.
Accordingly, simply because something can be done does not necessarily mean that it should be
done (the fallacy of the technological imperative). As applied to Catholic-sponsored health care, the
principle of stewardship includes but is not reducible to concern for scarce resources; rather, it also
implies a responsibility to see that the mission of Catholic health care is carried out as a ministry with
its particular commitment to human dignity and the common good.
Example: Helping a sick guy recover from illness.
2. Totality
>>>These principles dictate that the well-being of the whole person must be taken into account in
deciding about any therapeutic intervention or use of technology. In this context, "integrity" refers to
each individuals duty to "preserve a view of the whole human person in which the values of the
intellect, will, conscience, and fraternity are pre-eminent. Totality" refers to the duty to preserve
intact the physical component of the integrated bodily and spiritual nature of human life, whereby
every part of the human body "exists for the sake of the whole as the imperfect for the sake of the
perfect".
Example: Being contented with my own self and not changing or removing anything like noselift,
breast enlargement, etc.
3. Double Effect
>>> An action that is good in itself that has two effects--an intended and otherwise not reasonably
attainable good effect, and an unintended yet foreseen evil effect--is licit, provided there is a due
proportion between the intended good and the permitted evil.
When there is a clash between the two universal norms of "do good" and "avoid evil," the question
arises as to whether the obligation to avoid evil requires one to abstain from a good action in order to
prevent a foreseen but merely permitted concomitant evil effect. The answer is that one need not
always abstain from a good action that has foreseen bad effects, depending on certain moral criteria
identified in the principle of double effect.
Example: Amputating a gangrenous foot. The gangrenous foot will harm the rest of the limb so it is
better to amputate it as early as possible.
4. Cooperation
>>> Along with the principles of double effect and toleration, the principles of cooperation were
developed in the Catholic moral tradition as a way of helping individuals discern how to properly
avoid, limit, or distance themselves from evil (especially intrinsic evil) in order to avoid a worse evil or
to achieve an important good. In more recent years, the principles of cooperation have been applied
to organizations or "corporate persons" (the implication being that organizations, like individual
persons, are moral agents).
Example: Participating in activities within the group.
5. Solidarity
>>> The principle of solidarity invites us to consider how we relate to each other in community. It
assumes that we recognize that we are a part of at least one family - our biological family, our local
community, or our national community - but then challenges us to consider the full range of
relationships with others. In a globalizing economy, we participate in a vast, international economic
community, one in which goods and services are provided for us by those on the other side of the
world. Solidarity requires us to consider this kind of extended community, and to act in such a way
that reflects concern for the well-being of others.
Example: Participating in community projects.

MAJOR BIOETHICAL PRINCIPLES

The commonly accepted principles of health care ethics include:
1. Principle of respect for autonomy and justice
2. Principle of nonmaleficence
3. Principle of beneficence
1. Respect for Autonomy and Justice
Any notion of moral decision making assumes that rational agents are involved in making informed
and voluntary decisions. In health care decisions, our respect for the autonomy of the patient would,
in common parlance, mean that the patient has the capacity to act intentionally, with understanding,
and without controlling influences that would mitigate against a free and voluntary act. This principle
is the basis for the practice of "informed consent" in the physician/patient transaction regarding health
care.
Justice in health care is usually defined as a form of fairness, or as Aristotle once said, "Giving to
each that which is his due." This implies the fair distribution of goods in society and requires that we
look at the role of entitlement. The question of distributive justice also seems to hinge on the fact that
some goods and services are in short supply, there is not enough to go around, thus some fair means
of allocating scarce resources must be determined.
2. The Principle of Nonmaleficence
The principle of nonmaleficence requires of us that we not intentionally create a needless harm or
injury to the patient, either through acts of commission or omission. In common language, we
consider it negligence if one imposes a careless or unreasonable risk of harm upon another.
Providing a proper standard of care that avoids or minimizes the risk of harm is supported not only by
our commonly held moral convictions, but by the laws of society as well. In a professional model of
care one may be morally and legally blameworthy if one fails to meet the standards of due care. The
legal criteria for determining negligence are as follows:
1.
2.
3.
4.

the professional must have a duty to the affected party

the professional must breach that duty
the affected party must experience a harm
the harm must be caused by the breach of duty

This principle affirms the need for medical competence. It is clear that medical mistakes occur;
however, this principle articulates a fundamental commitment on the part of health care professionals
to protect their patients from harm.
Do no harm. Includes:
* Deliberate harm - - always impermissible
* Risk of harm - - what degree of risk is permissible?
* Harm that occurs during performance of beneficial acts.
3. The Principle of Beneficence
The ordinary meaning of this principle is the duty of health care providers to be of a benefit to the
patient, as well as to take positive steps to prevent and to remove harm from the patient. These
duties are viewed as self-evident and are widely accepted as the proper goals of medicine. These
goals are applied both to individual patients, and to the good of society as a whole. For example, the
good health of a particular patient is an appropriate goal of medicine, and the prevention of disease
through research and the employment of vaccines is the same goal expanded to the population at
large.