SN 5 Bauzon, Franchesca D.
HETHICS Notes
4G – Pharmacy
1ST Shifting Notes
Introduction
Is Ethics an indispensable knowledge?
Is the study of Ethics important?
Basically,
 To know what is right & wrong.
 To understand why it’s right/moral
(wrong/immoral)
 To be corrected, clarified
 To be affirmed & to deepen one’s
knowledge & moral conviction
 To be formed by moral principles & have
moral integrity
 To exercise my freedom correctly
 To be able to choose the good
Ethics serves as the foundation of every human
society.
 “Without civic morality, communities
perish…”
- B. Russell
 “When the moral foundations of a nation
are threatened the society itself is
threatened.”
- L. Shahani
 “At the bottom of our economic problems,
& political instability is the weakness and
corruption of the moral foundations of our
society. We do need an economic recovery
program. We also urgently need a
moral…recovery program.”
- N. Joaquin
We need:
 Correct ethical principles
 Correct state laws
AND of course:
 Good moral conduct – by applying the laws
& will truly become a:
 VIRTUE
April 25, 2019
Characteristically, as a rational being (with intellect
& will) we are able to: (as RATIONAL Beings we are
therefore MORAL because)
1. We can distinguish good from bad/evil.
2. We feel within our self an obligation to do
good and avoid evil.
3. We feel that we are accountable for our
actions, expecting “reward” or punishment
for them.
DIFFERENT APPROACHES TO ETHICS/MORALITY:
I. Foundation (Two Ethical Systems)
a. Theistic
b. Atheistic
II. Framework/Approach
a. Utilitarian
b. Rights
c. Fairness/Justice
d. Common Good
e. Duty
f. Virtue
CLARIFICATION OF TERMS
ETHICS & MORALITY/MORALS DIFFERENCE:
Etymologically they are the same.
ETHICS
 from the Gk. word ethikos, which means
character, & ethos, which means custom.
 “Custom” means a more or less permanent
moral behavior in accordance with the
precepts of natural moral law which is
universally known and common to all men.
MORALS
 from the Latin mos, mores, meaning
tradition or custom (hence, etymologically,
the Latin equivalent of the Greek ethos).
A Nuance:
 MORALS are intrapersonal in nature. One is
acting with moral virtue, or character, when
he or she strives to “do the right thing.”
 Morality/Morals deeper because it is about
the whole person, his very character.
  One may be ethical but is he/she moral? Ethics
 Difference:  a practical science.
 We talk of “morals” when a person  also known as moral philosophy.
has already interiorized the ethical  a philosophical science dealing with the
principles, making it one’s personal rightness or wrongness of human acts.
beliefs, principles, &values. Therefore, a practical science.
 He is therefore not only applying  the (practical) science of human acts with
ethics but acting according to reference to right & wrong.
values.
MATERIAL OBJECT OF ETHICS:
Ethics & Moral Theology Human Acts (Constituents):
Difference between Ethics (as a branch of 1. Knowledge
Philosophy) and Moral Theology 2. Freedom
Difference ETHICS MORAL THEOLOGY 3. Voluntariness
FORMAL OBJECT OF ETHICS:
1. Human Reason
1. Human It is the study of the rectitude of human conduct.
2. Human Experience
Reason
Sources 3. Divine Revelation
2. Human HUMAN ACTS:
(Sacred Scripture,
Experience
Sacred Tradition)  Doing an act with knowledge makes it
Material deliberate.
Human Acts Human Acts  Human acts are free acts that may or may
Object
The rightness not be done by the agent. He can choose
The rightness and between doing & not doing the act. His
and wrongness
Formal wrongness of human choice is based on freedom.
of human acts
Object acts in view of its
in view of its  No person may claim that his act is
supernatural end.
natural end. voluntarily done unless he has knowledge
of his act & he has freedom in doing the act.
Logic  ACTS WHICH LACK THESE ELEMENTS ARE
 guides man’s intellect in the acquisition of NOT CLASSIFIED AS HUMAN ACTS; RATHER
truth. THEY ARE CALLED ACTS OF MAN.
Ethics
 guides the intellect in the acquisition & ACTS OF MAN: (involuntary actions)
application of the moral principles.  Actions which merely happen in the body or
 a natural science. through the body without the awareness of
 employs the power of human reason the mind or the control of the will.
 the study of the moral behavior or conduct  Nutritive processes of the body, circulation,
of man as viewed from ultimate principles respiration, growth, chemical reaction.
in so far as these principles are known by  They comprise all spontaneous, biological,
human reason. & sensual processes without the use of
reason.
Ethics as a branch of philosophy, investigate Human Act Acts of Man
truths by means of:
Deliberate Indeliberate
1. Human reason
Free Not free
2. Human Experiences
Voluntary Involuntary
 Personal experience, and the
experience of others (contemporary &
TWO KINDS OF ELICITED HUMAN ACTS:
historical).
A. Elicited Acts (a simple WILL-ACT)
Kinds of Elicited Human Acts:
 1. Wish
 the first tendency of the will
towards a thing, whether this
thing be realizable or not. It is
the simple love of a thing.
(Desire)
2. Intention
 the purposive tendency of the
will towards a thing regarded as
realizable, whether the thing is
actually done or not. (Active
Desire; will to obtain it).
3. Consent
 the acceptance by the will of the
means necessary to carry out the
intention. (A definite decision).
4. Selection → ELECTION →CHOICE
 the selection by the will of the
precise means to be employed in
carrying out the intention.
5. Use
 the employment by the will of
powers to carry out its intention
by the means elected.
6. Satisfaction/Fruition
 the enjoyment of the thing
willed & done; the will’s act of
satisfaction in intention fulfilled.
(The actual attainment &
enjoyment of the desired good).
B. Commanded (under orders from the will)
Kinds of Commanded Human Acts:
1. Internal
 acts done by internal mental powers
under command of the will.
 Ex. effort to remember, conscious
reasoning, effort to control anger,
and deliberate use of the
imagination in visualizing a scene
2. External
 acts effected by bodily powers
under the command of the will.
 Ex. deliberate walking, and chores
3. Mixed
 acts that involve the employment of
bodily & mental powers.
 Ex. study which involves the use of
intellect, and the use of eyes in
reading
Question: Knowing that our human acts are not
always elicited, what then is the importance of
knowing about commanded human acts?
MORAL THEOLOGY
 Christian Ethics
 when ethics is treated from the
point of view of Christian faith.
 Moral Theology
 the term used in Catholic thought as
a study of morality.
 Sources:
1. Divine Revelation in the Catholic
Tradition
2. Human reason
3. Experience
Moral Theology
 a systematic attempt to understand Divine
Revelation in reference to the Christian
person’s loving response in faith to God’s
salvific invitation.
 the material object of moral theology is
Human Acts.
 the formal object of moral theology is the
morality of human acts in relation to our
Supernatural End (GOD).
Specific Goals of Moral Theology:
1. To understand, appreciate, & accept the
moral norms and principles given to us by
the Church.
2. To assimilate in our life these moral norms.
3. To follow Christ.
General Goals of Catechesis:
 ORTHODOXY
 correct understanding of the Faith.
 ORTHOPRAXIS
 integration of Doctrine, Morals, and
Worship
 the correct application of the Faith
in moral living and in worshipping.
  Living the challenges & demands of faith
with the support of prayer & sacraments.
Moral Theology:
 Proximate Goa
 to say no to sin and yes to love
 to say no to sin and yes to God NOW
 it is continuing conversion, integral
liberation, to be holy
 NOW, the present moment
 Immediate Goal
 to develop moral adulthood
 Christian maturity
 Ultimate Goal
 union with God in heaven in the
company of all the saints
Characteristics of Moral Theology:
1. A dynamic morality
 Church teachings are not static,
addresses the situations of the time
while remaining faithful to God’s
Law.
2. A personalist morality
 helps us to be accountable and
responsible for our choices, and to
understand and integrate or
interiorize the Church’s teachings.
3. A positive morality
 focuses on genuine happiness and
freedom, values and virtues not
merely “dos and don’ts.”
4. A God and Christ-centered morality
 to follow Christ.
5. A Biblical & Sacramental morality
 Biblical: teachings rooted in the
Word of God.
 Sacramental: moral life needs to be
sustained by prayer and sacramental
life.
6. A Communitarian morality
 concerned about the whole
humanity’s welfare not just
members of the Catholic Church.
 moral discernment is made not just
by one person but the community
(Pope, college of Bishops,
consultation with other experts).;
7. A Dialogical & Ecumenical morality
 dialogues with: experts, other
cultures and religion.
8. A morality of praxis
 to follow Christ, his attitudes and
dispositions. Thus Christian morality
is not mere head knowledge but
applying the teachings of Christ,
genuinely following Jesus.
Divisions of Ethics & Moral Theology:
I. Fundamental of General Ethics
 present truths about human acts,
and from these truths deduces the
general principles of morality.
 treats basic components of the
moral action.
II. Special or Applied Ethics
 a.k.a. applied moral theology/ethics.
 applies principles of general ethics in
different areas of human activity
(individual and social).
 studies moral behavior in a specific
life.
 special moral issues, cases,
problems.
Human Acts can be:
 Ethical
 right, correct, acceptable
 Unethical
  not right, incorrect, unacceptable
standard of behavior.
 Good, Moral
 specific sense
 Good Moral: one who correctly
judges between right & wrong, and
consequently act on what is
virtuous. general sense: deals with
the question of good or bad.
 Bad, Immoral, Evil
 not only wrong or bad, but also evil
& sinful.
 when one does not only act in
conformity with the principles of
right and wrong but also chooses to
do what is evil and sinful.
 Indifferent, Amoral
 lacking moral sensibility; one who is
not concerned with any moral
standards at all.
 not caring about right and wrong.
 having no moral standards,
restraints or principles.
 with callous conscience.
 when a person is blind to some
moral
 values.
 unaware of what is right or wrong.
 not “neutral” or “indifferent”
 neither good nor bad
 term used in the Principle of Double
Effect
 do not possess ethical notions at all
as a result of:
 unusual upbringing,
 culture
 mentally handicapped
 still an infant/child.
 Clarification:
 Should we use “amoral”
synonymously or
interchangeably with morally
neutral or indifferent acts?
 Neutral
 The act must be good never bad or
at least “neutral” or “indifferent.”
 e.g. Cutting the fallopian
tube
 (from the Principle of Double
Effect)
 Nonmoral
 a nonmoral act/neutral or
indifferent:
 ex. wearing a pink baseball
cap
OTHER TERMS:
 Imputable
 to impute
 to implicate, charge or accuse a
person with fault, an offense or a
crime
 Culpable
 (Latin) “mea culpa” – my fault
 guilty or blameworthy
 Accountable
 answerable or responsible
 Liable
 legally responsible
Popular Notions of Morality
A. DEONTOLOGICAL ETHICS or ETHICS OF DUTY
- the theory of duty or moral obligation
- “What one is compelled to do by reason of
duty”
The most famous deontological theory was advanced by the
German philosopher Immanuel Kant.
Immanuel Kant's theory of ethics is considered deontological
for several different reasons.
First, Kant argues that to act in the morally right way, people
must act according to duty (deon).
Second, Kant argued that it was not the consequences of
actions that make them right or wrong but the motives of the
person who carries out the action.
Kant's argument that to act in the morally right way, one
must act from duty, (begins with an argument that the
highest good must be both good in itself, and good without
qualification.
Something is 'good in itself' when it is “intrinsically good” and
“good without qualification” when the addition of that thing
never makes a situation ethically worse.
CHARACTERISTICS
1. UNIVERSAL
- What is right or wrong for one person is the same
- For any other person anytime, anywhere
2. RATIONAL
- the test for the rightness of an action is reason
3. CATEGORICAL
- absolute
- unqualified
- without condition
4. CATEGORICAL IMPERATIVE
- denotes an absolute, unconditional requirement
that exerts its authority in all circumstances.
- “it is wrong to commit murder”
- hence the principle, act only according to that
maxim by which you can also will that it would
become a universal law
5. ALTRUISM
- is a code of ethics which holds the welfare of others
as the standard of "good" and self-sacrifice as the
only moral action.
- the unstated premise of the doctrine of altruism is
that all relationships among men involve sacrifice
- this leaves one with the choice:
- maliciously exploiting the other person or being
"moral" and offering oneself up as the sacrificial
victim
6. INTRINSICISM
- the belief that value is a non-relational characteristic
of an object
- this means that an object can be valuable or not,
good or bad, without reference to who it is good or
bad for, and without reference to the reason it is
good or bad
7. SUBJECTIVISM
- the belief that values are subjective.
- this means that values are whatever we choose to
pursue and whatever we desire
- it means there is no such thing as good or evil,
except what you think is good or evil
- if you believe something is evil, that's just your own
personal preference. it is not, and cannot be, a
statement about reality
8. COLLECTIVISM
- the concept of value requires a purpose and a
beneficiary
- it requires answers to the questions "value to
whom?" and "value for what?"
- collectivism says value to the collective, whether
that is society, tribe, family, nation, race, sex, or any
other group or category one "belongs" to
- the standard of good is that which benefits the
group
9. PACIFISM
- the moral principle which advocates that the use of
force is wrong for any reason
- this applies to both the initiation of force, as well as
defensive or retaliatory force
- if your life is being threatened, pacifism holds that
you should not defend yourself
- if someone has stolen from you, pacifism holds that
you should not retrieve your property
- if someone has murdered other people, pacifism
holds that nothing should be done about it
10. HUMANISM
- expresses renewed confidence in the power of man
to respond positively to his own problems and so
discover new things for himself
- humanism entails a commitment to the search for
truth and morality through human means in support
of human interests
- in focusing on the capacity for self-determination,
humanism rejects dependence on faith, the
supernatural or divinely revealed texts
11. ANARCHISM
- expresses man’s freedom to express himself without
repression of any kind
- freedom is the highest attainment of a humanity
- anarchism is centered on rejection of any form of
compulsory government and supporting its
elimination
- the term "anarchism" is derived from the geek word
αναρχια "without archons" or "without rulers“
12. EXISTENTIALISM
- a philosophical movement which posits that
individuals create the meaning and essence of their
lives
- existentialism generally postulates the absence of a
transcendent force
- this means that the individual is entirely free, and,
therefore, ultimately responsible
- it is up to humans to create an ethos of personal
responsibility for themselves, outside of any branded
belief system
- “the highest attainment of man is to find his own
unique vocation”-soren kierkegaard
13. EUDAIMONISM
- comes from the greek word eudaimonia which
means happiness
- refers to any conception of ethics that puts human
happiness and the complete life of the individual at
the center of ethical concern
14. UTILITARIANISM
- the ethical doctrine which believes that the moral
worth of an action is solely determined by its
contribution to overall utility
- utility, the good to be maximized, whatever brings
the greatest happiness to the greatest number of
people has been defined by various thinkers as
happiness or pleasure versus suffering or pain
15. PRAGMATISM
- the meaning of concepts is to be sought in their
practical bearings
- the function of thought is to guide action
- truth is preeminently to be tested by the practical
consequences of belief
CONCLUDING NOTES
- the people today have a strong sense of freedom
veritatis splendor (31)
- according to dignitatis humanae.
- one of the positive achievements of the modern
culture is the heightened sense of dignity of the
human person
- however, some trends diverge from the truth about
man as a creature and image of god
- some trends absolutize freedom to the point of
atheism making the individual conscience the
supreme moral judge
THE CRISIS OF TRUTH
- the loss of the idea of universal truth about good
knowable by human reason.
- changes the notion of conscience:
o an act of the person’s intelligence which seeks to
apply universal knowledge of good in a specific
situation…
o this tendency leads to individualist ethic
o where every individual is faced with his own
version of truth different from the truth of
others.
o this new found freedom would lay claim to
moral autonomy or absolute sovereignty where
individuals or social groups have right to
determine what is good or evil
o when people lay claim to absolute sovereignty,
people “create” values disregarding the
dependence of human reason on divine wisdom
Healthcare Ethics
I. INTRODUCTION
Ethics is concerned with moral principles, values and
standards of conduct. The field of health and health
care raises numerous ethical concerns, related to,
for example, health care delivery, professional
integrity, data handling, use of human subjects in
research, and the application of new techniques,
such as gene manipulation.
II. HISTORY
Prior to 1906, when the Pure Food and Drug Act was
passed, there were no regulations regarding the
ethical use of human subjects in research. There
were no consumer regulations, no Food and Drug
Administration (FDA), no Common Rule, and no
Institutional Review Board (IRB). What follows is a
brief discussion of why federal rules and regulations
were established and why the IRB became a
necessity.
A. Nuremberg Trials
 A well-known chapter in the history of
research with human subjects opened
on December 9, 1946, when an
American military tribunal opened
criminal proceedings against 23 leading
German physicians and administrators
for their willing participation in war
crimes and crimes against humanity.
Among the charges were that German
physicians conducted medical
experiments on thousands of
concentration camp prisoners without
their consent. Most of the subjects of
these experiments died or were
permanently crippled as a result.
 As a direct result of the trial, the
Nuremberg Code was established in
1948, stating that "The voluntary
consent of the human subject is
absolutely essential," making it clear
that subjects should give consent and
that the benefits of research must
outweigh the risks.
B. Declaration of Helsinki
 In 1964, the World Medical Association
established recommendations guiding
medical doctors in biomedical research
involving human subjects. The
Declaration of Helsinki (DoH) is a set of
ethical principles regarding human
experimentation developed for the
medical community by the World
Medical Association (WMA). It is widely
regarded as the cornerstone document
on human research ethics. The
Declaration of Helsinki was revised in
1975, 1983, 1989 and 1996 and is the
basis for Good Clinical Practices used
today.
C. Issues addressed in the Declaration of Helsinki
include:
 Research with humans should be based
on the results from laboratory and
animal experimentation
 Research protocols should be reviewed
by an independent committee prior to
initiation
 Informed consent from research
participants is necessary
  Research should be conducted by
medically/scientifically qualified
individuals
 Risks should not exceed benefits
D. The Belmont Report
 A report created by the National
Commission for the Protection of
Human Subjects of Biomedical and
Behavioral Research. Its full title I the
Belmont Report: Ethical Principles and
Guidelines for the Protection of Human
Subjects of Research, Report of the
National Commission for the Protection
of Human Subjects of Biomedical and
Behavioral Research.
 The Belmont Report was first written by
the National Commission for the
Protection of Human Services of
Biomedical and Behavioral Research.
Prompted in part by problems arising
from the Tuskegee Syphilis Study
(1932–1972) and based on the National
Commission for the Protection of
Human Subjects of Biomedical and
Behavioral Research (1974–1978). The
Belmont Report is one of the leading
works concerning ethics and health
care research. It allows for the
protection of participants in clinical
trials and research studies.
E. Indian Council of Medical Research Guidelines
on Code of Conduct for Research Scientists
engaged in field of Life Sciences
 Guidance on transfer of human
biological material for
research/commercial purposes
 'ICMR-DBT' Guidelines for evaluation of
probiotics in food
 Knowledge Management policy for
Health - Service, Education and
Research (Draft)
 Ethical Guidelines for Biomedical
Research on Human Participants
 Intellectual Property Rights Policy
III. PRINCIPLES
The four principles of health care ethics
developed by Tom Beauchamp and James
Childress in the 1985 Principles of Biomedical
Ethics provide medical practitioners with
guidelines to make decisions when they
inevitably face complicated situations
involving patients.
1. Autonomy
In medicine, autonomy refers to the
right of the patient to retain control
over his or her body. A health care
professional can suggest or advise,
but any actions that attempt to
persuade or coerce the patient into
making a choice are violations of this
principle. In the end, the patient
must be allowed to make his or her
own decisions – whether or not the
medical provider believes these
choices are in that patient’s best
interests – independently and
according to his or her personal
values and beliefs.
2. Beneficence
This principle states that health care
providers must do all they can to
benefit the patient in each situation.
All procedures and treatments
recommended must be with the
intention to do the most good for
the patient. To ensure beneficence,
medical practitioners must develop
and maintain a high level of skill and
knowledge, make sure that they are
trained in the most current and best
medical practices, and must take
their patients’ individual
circumstances into account: what is
good for one patient will not
necessary benefit another.
3. Non-Maleficence
Non-maleficence is probably the
best known of the four principles. In
short, it means, “to do no harm.”
This principle is intended to be the
end goal for all of a practitioner’s
decisions, and means that medical
providers must consider whether
other people or society could be
harmed by a decision made, even if
it is made for the benefit of an
individual patient.
4. Justice
The principle of justice states that
there should be an element of
fairness in all medical decisions:
fairness in decisions that burden and
benefit, as well as equal distribution
of scarce resources and new
treatments, and for medical
practitioners to uphold applicable
laws and legislation when making
choices.
IV. CASE STUDY
A Closer Look: Case Study
One hypothetical case study involves a patient
who has an ovarian cyst that, left untreated,
will result in kidney failure. An operation to
remove the cyst is the best treatment, but the
patient is frightened of needles and is against
the surgery which would require a needle to
give her anesthesia. The doctor must work
with the patient to respect the fact that she
dislikes needles and doesn’t want the
operation (her autonomy), and needs to find
a solution that would prevent her from going
into kidney failure, which is in her best
interest (beneficence). Although the surgery is
the best choice, forcing the patient to accept
the needle would be harmful to her (non-
maleficence). Finally, the doctor needs to
consider the impact that the patient’s choices
might have on others if she starts to go into
preventable kidney failure, she’ll need
dialysis, which affects other people who need
the same treatment (justice). So before
making the final decision the doctor must
consider all four principles of health care
ethics which will help the physician make the
choice that will have the best possible
benefits for both the patient and society.
2nd Shifting Notes
V. SUMMARY
 Nazi atrocities in World War II drew
attention to the lack of international
standards on research with human
subjects and led to the formulation of
the Nuremberg Code, the first
international document which
advocated voluntary participation
and informed consent.
 The Declaration of Helsinki is the
basis for Good Clinical Practices used
today.
 The National Research Act codified
the requirement that human subjects
in research must be protected and
set the stage for the issuance of the
Belmont Report.
Research ethics govern the standards of conduct for
scientific researchers. It is important to adhere to ethical
principles in order to protect the dignity, rights and
welfare of research participants. As such, all research
involving human beings should be reviewed by an ethics
committee to ensure that the appropriate ethical
standards are being upheld. Discussion of the ethical
principles of beneficence, justice and autonomy are
central to ethical review.
Principles subordinated to the good of the whole
body.”
─ that from which something proceeds  The term "totality" points to the duty to
─ principium (origin, cause) preserve intact the physical component of
─ principia (foundation) that integrated whole.
─ priceps (first, chief)  The well-being of the whole person must be
taken into account in deciding therapeutic
Natural moral law (do good, avoid evil) > procedures.
fundamental moral principle > chief principle  Parts exists for the good of the whole
(morality)  Removal of an organ is morally permitted:
o When the preservation of the organ
may cause grave injury
DISCIPLINE OF CASUISTRY o When the removal means avoiding
─ Casuistry is from the Latin word casus, more serious complications.
meaning “case” or “occurrence” o When the removal will diminish the
─ helps determine which principle applies risk of death.
or has precedence in particular cases  The whole is the sum total of its parts
─ each situation calls for a specific  Each part is essential:
principle that would fit it o Bodily Integrity
─ completeness of body parts
1. Double Effect o Functional Integrity
─ complete operation of body
 The principle that says it is morally
functions, systems and
allowable to perform an act that has at processes
least two effects, one good and one  Applications:
bad. o Body Mutilation
2. Toleration ─ to save the rest
 A moral attitude of being detached ─ to enhance/ beautify (grave
from a wrong doing while permitting it reason, psychologically
 Conditions: insecure, will not harm)
─ not if functioning right
o there is a wrongdoer present
o Functional Mutilation
before a tolerant person ─ between two systems,
o the tolerant person prioritize one with higher
o the scandal/wrong act function
 When to tolerate an act: ─ allowed and encouraged to
o to prevent greater harm sacrifice any lower function to
o to maintain the common good save a life
of the community/ majority o Organ Donation
─ informed consent (procedures,
consequences, effects, possible
3. Totality risk/dangers)
 "The parts of the physical entity, as ─ do not sell (except when
parts, are ordained to the good of the person is dead for science)
physical whole." ─ do not donate if it endangers
 Medical perspective the donor (unless consented)
"All the parts of the human body, as parts, are  Cannot be applied to society because it will
meant to exist and function for the good of the remove the dysfunctional members
whole body and are thus naturally
4. Cooperation In Evil
 The principle of cooperation with evil
concerns a class of acts in which one
person is considering committing an act
that is related to the sinful act of
another person.
 Degrees of cooperation that measure
of liability and culpability:
Formal Cooperation
o cooperator intends the evil
Explicit
o cooperator directly approves of
(intends and concurs with) the
principal agent’s immoral act
Implicit
o cooperator intends the evil of the
principal agent, not for its own
sake but as a means to some other
end that, might be morally good.
Material Cooperation
o cooperator does not intend the
evil
o Immediate Material Cooperation
• cooperator does not share
the intentions of the
principal agent
o Mediate Material Cooperation
• cooperator participates in
circumstances that are not
essential
• Proximate Mediate
Material Cooperation
 has direct causal
influence
• Remote Mediate Material
Cooperation
 has indirect causal
influence
o Cooperator
• The one who assists the evil
doer in some way.
o Formal
• Intends the immoral act to
occur (Equally guilty of the
immoral o act)
o Material
• Does not intend the
immoral act to occur. (May
be guilty in the immoral act)
o Immediate
• Providing the material that
is necessary for the immoral
act to occur. (Guilty of the
immoral act)
o Mediate
• Providing material not
necessary for the immoral
act to occur (May be guilty
of the immoral act)
o Proximate
• Makes a contribution to the
act that leads to the
commission of the act.
(Guilty of the immoral act)
o Remote
• Makes a contribution to the
act that does not lead to the
commission of the act. (Not
guilty when there is a
proportionately reason to
do so)
 The morality of helping/ cooperating in
a wrongdoing
 Conditions:
o two agents: principal agent/
mastermind and cooperator
o principal agent’s act is morally wrong
o the act of cooperator helps the
principal agent (cooperator is liable)
o cooperator’s aim is as little as possible
cooperation
5. Compromise
 “letting go and letting in”
 “Meeting halfway”
 “Win-win situation”
 Finding middle ground
 When one actively participates in
actions that have a clear morally evil
component
 One’s action in a step towards
achieving an ideal
 Maximizing the possible good in a
concrete situation
6. Lesser Evil
 Permitted only when it is the only
way to prevent a greater evil
  But it is not justified when it means
harming a third party whom the
wrong doer had not intended to
wrong
 Revolves around the idea of
choosing between two options that
have clear evil implications
 Pre-condition:
o exhausted all possible solutions
(else moral blunders)
o implications are known (but it is
not justified when it means
harming a third party whom the
wrongdoer had not intended to
wrong)
 Conditions:
o permitted only when it is the
9. Subsidiarity
only way to prevent a greater
evil
7. Epikeia
 A liberal interpretation of law in instances
not provided by letter of the law.
 Etym. Greek epiikiea — reasonable
 Applications of Epikeia
o Correct an impossible law
o Correct an inhuman law
o Correct a law which did not foresee
this particular set of circumstances
 Virtue of epikeia is built on the principles of
human rights and dignity of man
 proof of moral strength and conscience of
doctors.
 Between letters of the law and spirit of the
law (only for life and death situations)
 In every rule, there is an exception (rule
cannot be applied)/ exemption (rule can be
applied but is suspended): take exception as
the rule not an exception
8. Stewardship
 theological belief that humans are
responsible for the world, and should take
care of it.
 demands a way of life that encourages
virtue and bears the fruit of solidarity
among peoples.
 God is creator or author
 Man is co-creator or co-author or
caretaker
 Man’s responsibility:
o manage, utilize, and direct all
resources for the glory of God and
the betterment of His creation
 Everything we own is on loan from
God
 Solidarity means, one with others
 Limit of private property is sharing
 an organizing, principle that matters
ought to be handled by the smallest,
lowest or least centralized competent
authority
 based on the autonomy and dignity
of the human individual
 should be in the service of the human
person.
 assumes that human beings are by
their nature social beings
 emphasizes the importance of small
and intermediate-sized communities or
institutions as mediating structures
 ways:
o technological transfer
o expertise transfer
o financial aid
 when to practice:
o politics (local, national
government)
o economics (big communities
help small communities help
themselves)
10. Just Remuneration
 Payment or compensation received
for services or employment. This
includes the base salary and any
bonuses or other economic benefits
 that an employee or executive  Intrinsic goods
receives during employment. o objects, actions, or qualities
 There should be fair and full that is valuable in themselves
rewarding of a well-directed effort,  Non-intrinsic goods
but the rewarding should not o good only for developing or
produce overpayment beyond serving an intrinsic good
reason.  Sommum bonum
 Just means to give his due o principle of the highest good
that cannot be subordinated to
 Remuneration means payment
another
received due to services rendered
 commensurate = equitability
13. Legitimate Defense
 family wage
 “The act of self-defense can have a
 measured by:
double effect: the preservation of one's
o professional qualification
life and the killing of the aggressor...
o attitude
o experience The one is intended, the other is not”
o performance (bonus) (St. Thomas Aquinas)
o price (of goods), inflation: external  There are three situations where the
factors use of force may be justified:
 rights of workers: o Self-defense
o economic (salary, wage, bonus)  this is a common-law
o political (form unions) defense
 'private defence'
o social (maternity/ paternity leave,
 includes defense of another
sick leave)
person and defense of
o religious
property
o Defense of property
11. Solidarity  this area is regulated
 valuing our fellow human beings partially by common law
and respecting who they are as and partially by statute
individuals o Prevention of crime
 This is a public or statutory
defence
12. Hierarchy of Values
 Legitimate Defense
 deciding whether the value being o Legitimate defense of innocent
pursued is greater or at least equal persons is not an exception to
to the value sacrificed, one must be murder...
guided by the hierarchy of rights  Murder is intentional killing.
and values its moral object is to take
 universal moral order, manifesting innocent human life
 Self-defense — (or of 3rd
a hierarchy of values based on the
person)
degree of perfection naturally  Moral object is different
existing in things- beginning in God from murder
 natural law, the expression of this  i.e. protecting
moral order and demands that this innocent life!
natural order of things be  Love toward oneself
preserved and forbids it be remains a fundamental
principle of morality.
disturbed.
  Therefore, it is legitimate to
insist on respect for one's
own right to life.
 Someone who defends his
life is not guilty of murder
even if he is forced to deal
his aggressor a lethal blow
 Principle of "double effect"
14. Autonomy
 From Greek words autos ‘self’
+ nomos ‘law’
 (in medicine) The right of the
patient to retain control over his or
her body
 A health care professional can
suggest or advise, but any actions
that attempt to persuade or coerce
the patient into making a choice are
violations of this principle.
 In the end, the patient must be
allowed to make his or her own
decisions—whether or not the
medical provider believes these
choices are in that patient’s best
interests—independently and
according to his or her personal
values and beliefs.
15. Beneficence
 From Latin words bene (“good”) + -
ficens, combining form
from faciens, present participle
of facere (“to make or do”).
 Health care providers must do all
they can to benefit the patient in
each situation.
 All procedures and treatments
recommended must be with the
intention to do the most good for
the patient.
 To ensure beneficence, medical
practitioners must:
o develop and maintain a high level of
skill and knowledge
o make sure that they are trained in
the most current and best medical
practices; and
o must take their patients’ individual
circumstances into account
 What is good for one patient will
not necessary benefit another.
16. Non-Maleficence
 probably the best known of the
four principles (Autonomy,
Beneficence, Non-Maleficence, and
Justice).
 It means, “to do no harm.”
 Intends to be the end goal for all of
a practitioner’s decisions, and
means that medical providers must
consider whether other people or
society could be harmed by a
decision made, even if it is made for
the benefit of an individual patient.
17. Justice
 From Latin word
iūstitia (“righteousness, equity”),
iūstus (“just”), iūs (“right”)
 States that there should be an
element of fairness in all medical
decisions:
o in decisions that burden and benefit
o in distribution of scarce resources
and new treatments; and
o for medical practitioners to uphold
applicable laws and legislation when
making choices
Just War Theory
 Jus ad bellum (Latin for "right to war")
 under self-defense
 To know when you are going to defend
yourself and to what extent should you
use force or engage in war
 You cannot use non-conventional
weapons to defend yourself
 Remember that you may win the signs of aggression would mean
battle/war, but you may not celebrate a crime against humanity. There
would be no justification that
the victory.
would serve as a valid ground.
o Because your enemies/opponents
o Retaliatory defense is not used
that are lands people are totally
to destroy civilians or people,
destroyed or wiped out but to destroy military satellites
o To win in a war is not a gain that are used to launch war.
o To gain is not the essence of war  According to the
o The true essence of war is to let International
your enemies understand the humanitarian law (IHL),
truths about the value of: “You are not allowed to
 Human life kill civilians, you may be
 Human dignity allowed to kill
 Private properties combatants/soldiers.”
 Preservation of sovereignty  When you see a civilian
 Preservation of peritoneal that needs help, you are
integrity bound by the IHL to help
 Nation; and the civilian (regardless
whether that civilian is
 People
your enemy or your
 Act: friend).
o Object  Even those who are
o Defense captured during wartime,
 Intrusion/invasion/aggressio they are supposed to be
n treated with dignity.
 Motive: They cannot be tortured
o Defend to preserve life unjustly.
o Defend to protect life  During wartime you are
not allowed to use
 Circumstances: chemical/biochemical
o Threat to national community weapons
o Should not amount to the
extraction itself
o Means must warrant to the loss of
destruction
1. Lives:
 Must have
commensurate/proportionate
reason
o The end should not justify the
means
o Have to consider the manner of
self-defense
 Preventive and retaliatory
o Two ways to defend yourself
o Preventive defense, follows the
principle “the best defense is
offense” meaning the best way
to defend yourself is to attack
first
o In morality, if you attack first
without the enemy showing