Nursing Ethles for Seasons Pray 48 “= ‘context of an act, which has an essential purpose the conception of children» (Thompson, 2003). i | purpose of the i this specific and particular natural a ae that avert wilfully frustrates the maha ouien (of the . act should at least be bbe viewed as ethically wrong. Every sexual Satie possibilty of conceiving a child. Anything outside of itis always morally unjustified” (Thompson 2003). any other form of sexual intercourse that does not lead, are eerie ip the possibility of conception like anal and oral intercourse, masturbation, homosexuality and the like ate considered to be morally wrong. All these acts are simply against nature. They are known as sexual perversions. Some Other Principles Developed from Natural Law Ethics Relevant to the Medical Setting A. The Principle of Double Effect Moral thinkers following the doctrine of natural law are aware that there are certain complex situations wherein the morality of an act cannot be categorized into a definite and simple labeling of good and bad. There are situations in life wherein good and bad effects or consequences of an act are both present and unavoidable. In a problematic and com plicated situation such as the one mentioned, which we can consider as a moral dilemma, natural law theorists were able to Effect is a moral principle that “provides a neat algorithm for solving all moral disputes [and problems] in which am act wil hhave two effects, one good and the other bad” (Pojman 2002:45). This Principle applies to a situation in which a good effect and an evil effect will rel from an net with a-goodior noble cause cr istention imatine In principle, an act that has good and bad eff iodicg Inj cts. justifiec permissible as long ascertain conditions are met ene 1. Theaction intended, in and of itself rm st morally indifferent or neutral. pages ovo or ales 2. The evil effect must not be directly intended but morally allowed only as a regrettable side issue (side effectNatural Law and the Morality of Health & Nursing Care 49 3. The evil effect must not be the means by which the good effect is achieved, 4. The good effect must outweigh the evil effect or at least proportional. The first con: ion simply reaffirms the fundamental moral principle that one may never do evil in order to achieve the good. Just because the act may also have some good consequences does not thereby make it justified. Thus, first and foremost, the act intended must be in itself good or at least ethically neutral, otherwise it is wrong at the very outset. This first condition clearly rules out any consideration of actions that are bad in themselves or inherently wrong and immoral. This goes to show that the primary moral consideration here is the nature of the act rather than its motive and consequence, The second condition concems the motive or intention of the moral agent. What this means is that our primary intention in doing the act is to achieve the good effect. The negative effect, though foreseen at the outset, should not be the primary reason for acting. One is only permitted to have the evil effect as an indirect consequence of the act, something that is a “necessary evil.” Here, the motive or intention takes a central role in assessing the morality of the act. A good act that is done out of a bad motive will automatically invalidate whatever moral worth the good act may have. ‘The third condition is a restatement of the traditional moral principle that says: “The end does not justify the means.” One is not morally justified to do something evil even with a good intention in mind, even if the reason or Purpose of acting is good but the means of obtaining it is wrong, itis wrong. ‘The fourth and the last condition points to the presence of a sufficient reason for allowing the evil effect to happen while doing the act. When Placed in the balance, the good effect should be of more weight than the evil effect or at least proportional. The act is never justified if the evil effect is heavier than the good effect. Common sense tells us that it is foolish to do something if more harm than good will come out of the act that we intend to do. {tis important o take note thatall the above conditions have to be fulfilled inorder for an act to be morally justified and permissible. Ifit happens that one of the conditions is not met, the entire act is deemed morally objectionable ‘and thus, should not be performed.. Nursing EAMES 0° Ssutoe FP, The principle of double effec finds concrete relevance in troubles, cases that are commonplace in the medical context. This is particular invoked in situations where the action of the medical practitioner involve saving and losing lives such as in the case of a woman whose life and that of the baby are equally both at risk due to a delicate pregnancy ot problems or complications in delivery. B. The Principle of Totality A traditional element in biomedical discussions, the principle of totality refers to the view that a part (of the human body, that is) exists for the good 6f the whole. This particular bicethical principle is often invoked when particular part or organ of the human body has to be cut off, mutilated, or removed. However, a person is morally permitted to do this “only insofar as the general well-being of the whole body requires it” (Timbreza, 1993:). Hence, it is only when an infectious organ is putting the entire body at risk, that it may be removed. Here, the preservation of the whole is more important than the conservation of the part. Under the ethical principle of natural law, each person has a natural right to live and to continue in existence. Anything that will obstruct or put in jeopardy that natural basic drive and tendency goes against what is considered ‘good. Itis therefore morally justified for anyone to do whatever is necessary to protect that right, provided no unjust harm is done to others. Accordingly, a defective organ “may be amputated or excised for the good of the whole body organism” (Timbreza, 1993). Thus, a woman who is suffering from breast cancer may have this part of her body removed to stop the disease from invading the entire body and thas putting her life at grave risk, However, healthy organs may not be subjected to any form of mutilation and/or amputation, as this would pose a mortal danger to the person's health and well-being, Though the principle of totality primarily applies to amputations ané the removal of infected and diseased organs, it also involves the ethical religious principle that says that persons are not the owners of their bodies but only given the task of administration. Thus, the principle of totality © a way of affirming that we may legitimately sacrifice a part of our body if this * necessary to preserve and maintain the health of the entire body.Natural Law and the Morality of Health & Nursing Care 24 On this regard, therefore, we can say that the principle of totality considers as immoral the mutilation or removal of healthy organs for commercial purposes. C. The Principle of Stewardship ‘The principle of stewardship has its basis on the religious belief that all life comes from God, the supreme creator and maker of all. This would imply that no individual person could claim that he or she is the owner of anything in the world and that of his or her own body. We humans are only given the power to take good care of creation and do not have sole authority to do whatever we want. It is therefore morally wrong to commit actions such as suicide and euthanasia since stewardship entails proper protection and responsible care of what the Almighty has given. It goes without saying therefore that itis only God who has dominion over life and of our bodies. Our duty is to take care of them until God takes them back from us in His own good time (Timbreza, 1993). From the foregoing contentions, it follows that ‘one has [the moral] obligation to seek medical aid when something goes wrong with one’s) body. [This would also mean]...that each [person] has a responsibility not to behave in a way which will damage the body, and take appropriate action to prevent ill health” (EPH, 2003). In the words of the Reverend Kail H. Peschke (1987): Bodily life isa gift of God entrusted to man notin ownership—the Lord and owner of our life is God who created itbut in stewardship... Therefore man is not allowed to use and to damage this life and the integrity of his body arbitrarily. On the other hand he is obliged to restore injured health in a responsible way. The principle of stewardship also finds concrete and practical application 6n issues concerning the natural environment (the domain of environmental ethics, which is fast becoming as one of the more pressing issues in bioethical discussions among philosophers in contemporary times). The earth and everything in nature as a gift from God, has to be taken cared of and should ot be abused in any way. In this light, we human beings do not own it but rather, we are just caretakers whose responsibility is to protect it from harm. This is not just an individual obligation but also a collective one, This involves the whole