BASIC ETHICAL PRINCIPLES

BASIC ETHICAL PRINCIPLES1. 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 PRINCIPLESThe commonly accepted principles of health care ethics include:

1. Principle of respect for autonomy and justice2. Principle of nonmaleficence

3. Principle of beneficence

1. Respect for Autonomy and JusticeAny 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. the professional must have a duty to the affected party

2. the professional must breach that duty

3. the affected party must experience a harm

4. 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.