Totality &

its integrity

Presented by Celestine Jane Babon

BSN 3B
 Introduction
The principle of totality states that all decisions in medical ethics must
prioritize the good of the entire person, including physical and
psychological and spiritual factors.

derived from the works of the medieval philosopher St. Thomas

Aquinas; synthesized the philosophy of Aristotle with the
theology of the Catholic Church.
used as an ethical guideline by Catholichealthcare institutions.
 Background
Integrity
refers to each individual’s duty
to “preserve a view of the
whole human person in which
the values and intellect, will,
consience and fraternity are
pre-eminent.”
Totality
all of the organs and other
parts of the body exist for
the sake of the whole
person. - Thomas Aquinas
any action that damages a
part of the body, violates
the natural order and is
morally wrong
 CoNDITIONS
The action must be
The bad results cannot be
morally good or neutral
the means for acheiving
in itself
the good results.

The motivation for The good result must be

carrying out the action at least as significant as
must be solely to achieve the harm from the side-
the good results effects.
Ethico-moral Responsibility
of nurses in surgery

nurses are obligated to morally respect the dignity

and worth of individual patients wherein nursing
care must be provided in a manner that preserves
and protects patient autonomy and human rights.

Nurses must be able to interact with a variety of

other professionals and ancillary providers in the
perioperative environment.
 Ethico-moral Responsibility
of nurses in surgery

Nurses have the responsibility to recognize and

identify ethical issues that affect staff and patients
and make the best possible decision

when providing patient care, nurses must take into

consideration of patients values, religious beliefs,
and lifestyle choices;
Age specific care
Changing face of culture
Ethico-moral Responsibility
of nurses in surgery

Nurse have the responsibility to recognize and

identify ethical issues that affect staff and patients
snd make the best possible decisions
 sterilization vs
mutilation
removal of procreative member
or element of the human in
order to prevent procreation
an act of physical injury that degrades
the appearance or function of the
body,usually without causing death

Direct
Direct Indirect
Indirect
Types: Totum quam parte, prius
Eugenic esse necess est.
Hedonistic Aristotle on the Part/s
Demographic Aristotle on the Whole
Aquinas’ simplification
 Sterilization
Indirect vs. Direct Sterilizations
Indirect (Therapeutic)
required for survival and health of a person,
sexual organs, integrating parts which must
yield to the good of the whole.
Direct
immediate effect is to render procreation
impossible.
Eugenic - to avoid transmission of
hereditary defects
Hedonistic - to evade the complications
and responsibilities of procreation
without giving up sexual pleasure
Demographic-done to control birth rate
Procedures
Vasectomy - cutting and closing of the vasa deferentia.
Perevnting sperm to enter the ejaculated semen.
Tubal Ligation - procedure that involves severing and tying
the fallopian tube.
Tubal Ligation - procedure that involves severing and tying
the fallopian tube.
Hysterectomy - surgical removal of the uterus,
permanently preventing pregnancy.
Castration - is any action by which an individual loses use of
gonads. (Gonadectomy - males ; Oophorectomy - females)
 Ethical issues Surrounding Sterilization

The catholic Church In relation to totality

“all parts of the human body,
Strongly all artificial my friends
as parts, are meant to exist and
are contraception
Disapproves direct sterilization function for the good of the
because it separates unnaturally whole body, and are, thus
the dual purpose of the marital naturally subordinated to the
act. good of the whole body”
BC pills or condoms are not
allowed sterilization without a
Indirect sterilization, resulting medical purpose is a
from the cure of some violation of the principle.
pathological condition is allowed.
 Mutilation
Direct Mutilation - intended and cause intrinsically wrong.
- offends human dignity and the individual does not have the
right to mutilate himself, much less society.

Indirect Mutilation - is done necessary to save a patient’s life or to

free them from proportions, sufferings or infirmary.
 preservation of bodily
functional integrity
- Bodily
integrity
pertains to the respect for certain
wholeness. It is the envoy debility of
the physical body and emphasizes the
importance of personal autonomy,
self ownership, and self determination
of human beings over their own
bodies.
-issue of bodily
integrity
practices that violate a persons, bodily
integrity can range from piercing a
baby girls, ears being exposed to toxic
chemicals without one’s knowledge,
rape and medical treatment
administered against a patient wishes.
solution of
bodily integrity
The decision about one’s body should rest only
with the person in question and be taken by
them to give their free prior and informed
consent, or to refuse it. The only exception is
when an intention an intervention is medically
necessary to save the person from serious, urgent
and irreparable harm.
 organ donation
It is a process of surgically, removing an organ or tissue from one person(the donor) and
placing it to another person (the recipient). a person I will dispose of his body and a dessert
at the end that are useful, morally irreproachable, and even noble among them, the desire
to add the sick and suffering

Criteria Ethical Issues

recipient needs it and cannot be fulfilled Beliefs
in any other way Death and the dead donor rule
funtional integrity of the donor and Informed Consent
recipient will not be impaired. Voluntary Consent
risk taken by the donor is proportionate to
the goodof the recipient. Donation, not sales
consent from donor is free and informed.
the recipient must be selected justly.
Nurse’s role
primary caregivers for patients approaching the final stage of life.
anchored on counseling and facilitating the process for organ or
tissue donation by educating and guiding to the donor families.
stays with the family and helps them understand the donation
process, which includes keeping the donor’s body functioning
until organ is collected
must have deep knowledge regarding the whole organ donation
procedure; before, during and after
abides by the ethics of organ donation
Thank
You