The Consistent Ethic of Life
The consistent ethic of life II
A Principled Approach to Beatitude in Bioethical Applications at the End of Life
Other special questions on Birth Control
"Indirect contraception" • applies principle of double effect Use of condoms to prevent HIV/AIDS • Compare Martin Rhonheimer to Nicanor Austriaco • Risk mitigation v. risk compensation Contraceptive use during/after sexual assault andrape protocols • Consensual sexual intercourse not the same moral act assexual assault/rape • Prior to conception, which introduces another person with moralstanding, morally licit to contracept using non abortifacientmethods Pair and share re: clarity and coherence of text's presentation (Austriaco 2011, 89-97).
A place for catholic bioethics in pluralistic society ?
- The Catholic tradition upholds the right to freedom of conscience and the grounds forthat right and the right to life in the dignity of the human person (see Vatican IIdeclaration Dignitatis Humanae) - Be active in tradition-constituted inquiry (i.e. Alasdair MacIntyre) 1. Place interlocutor's argument in best possible light, assume best intentions, and assumetheir standards for rational justification 2. Examine whether arguments: A. Lead to necessary inconsistency and self-contradiction B. Are affirmed by the claims of other worldview - Is an exercise in prudence: Honor memory, be docile, and use quick wit (solertia) - More importantly, is an exercise in charity: love your neighbor, & there by love God
What "consistency" implies
"The issue of consistency is tested in a different way when we examine the relationship between the "right to life" and" quality of life" issues. I must confess that I think the relationship of these categories is inadequately understood in the Catholic community itself. My point is that the Catholic position on abortion demands of us and of society that we seek to influence an heroic social ethic. (Bernardin, 1983, emphasis added) If one contends, as we do, that the right of every fetus to beborn should be protected by civil law and supported by civilconsensus, then our moral, political and economicresponsibilities do not stop at the moment of birth. Those whodefend the right to life of the weakest among us mustbeequally visible in support of the quality of life of the powerlessamong us: the old and the young, the hungry and thehomeless, the undocumented immigrant and the unemployedworker. Such a quality of life posture translates into specificpolitical and economic positions on tax policy, employmentgeneration, welfare policy, nutrition and feeding programs,and health care. Consistency means we cannot have it bothways. We cannot urge a compassionate society andvigorous public policy to protect the rights of the unbornand then argue that compassion and significant publicprograms on behalf of the needy undermine the moralfiber of the society or are beyond the proper scope ofgovernmental responsibility."(Bernardin, 1983, emphasis added) - need to get somewhere where we can come up with ways to solve the problems rather than
Social Bioethics: Looking at Global and Long-Run Concerns
- Determination of particular action decisions on the wider attitudes and policiesthat affect families, local communities, states, and global ecology - Often encountered in issues of resource allocation and the balance betweenbeneficence and autonomy - Three common methods for ethical reasoning employed: - Utilitarianism: maximization of net benefits - Libertarianism: respect for autonomous individual choice (a philosopher says that if you put work into something like a physical object then it becomes yours) - Egalitarianism: producing equal benefits for all when possible - 1) inequalities should benefit the least well off; 2) equal opportunity for all to gain fromadvantages of treating people unequally (i.e. John Rawls's Theory of Justice)
Evangelium Vitae: Good news for life and living
- Encyclical letter of Pope John Paul II in 1995 responding to the rise of what he sees as a "culture of death" in the late 20th century - Challenges the ethical relativism of postmodern, secular, and liberal ideologies .... Appeals to the rationality of natural law to ground claims to universal ethics that are intelligible to all and consistent despite pluralism and diversity .... Call to moral heroism grounded in charity and justice understood as mercy - Invites personal reflection and engaged action with regard to the mystery of suffering and death .... Encourages conscientious action or objection in the face of unjust laws that further marginalize the most vulnerable in society, e.g. unborn, disabled, aged
Theological Bioethics: Cura Personalis (care for the whole person)
- Historically, all accounts of all ethics until the Enlightenment period were grounded in metaphysics and metanarratives that invited faith sources as evidentiary warrants for deliberation along with rational, empirical, and sentimental sources. ...... Rise of relativism that challenges ability to have any meaningful discourse on right and wrong - Theological bioethics affirms the integral nature of human persons as matter and spirit, rational and emotional, individual and social ...... Catholic bioethics committed to vision of God of Life that wills the whole good of each andevery person => beatitude = happiness in both temporal & eternal context
4 common objections to Catholic Church on NFP
1. "The only differ- ence between the permitted method and other forbidden methods, such as condoms, would have to be found in the act itself. Surely the couple's intention is the same in both procedures: to have sex and avoid having children. Thus, both procedures would seem equally to `separate the uni- tive and the procreative aspects of married sexuality,' 2. Wiping out all acts of NFP if they did it for years by doing one think like getting surgery... NFP is a daily practice, if they don't want anymore kids bc they don't want to use NFP anymore since it did not work and the church views it as a sin from this one act 3. Opposition to contraception is outdated and emphazies the physical aspects of sex rather than the actual people 4. Many catholics disagree with the teachings and that they are not from the Holy Spirit... many catholics reject the view on contraception.. just because everyone is doing something doesn't mean you should so this is not a good objection
Discussion
1. Given the principle of autonomy in law and medical ethics, why is there so much controversy about PAS/MAiD? Discuss the scope and limits ofthe role of medical professionals. 2. What are the social consequences of legalized PAS/MAiD?3. How do the four principles of CST apply to this issue? E.g. Is PAS/MAiDfor the common good? Does it express subsidiarity?4. How is PAS/MAiD different than active euthanasia, i.e. where a physician or other agent actively administers lethal dosing? 5. Thought-experiment: Your best friend comes to you with news that she has a terminal illness and does not want to burden family and friends. She asks for your advice on options. What do you say?
Law: Order for the Common Good
= "an ordinance of reason for the common good made by one who has care of the community, and promulgated. " Rules of law help define clearly for all the real mean that issought by justice in objectifiable way Types of law - Eternal Law: God's will for order in creation - Divine Law: God's will for order revealed directly to us - Natural Law: God's will for order understood by reason - Law of Nations (ius gentium): a nearly universal human law that arises across cultures to deal rationally with common concerns for social order (e.g. slavery, property law, rights of passage, etc.) - Positive/Human Law: Common will for social order made by sovereign civil authorities Civil and customary instantiations based on how created
Natural Family Planning (NFP)
A natural method of spacing the birth of children in a marriage, practiced by recognizing the wife's fertile period and engaging in chaste abstinence from sexual relations during that time.
"Go and do likewise" Luke 10:37 Sharing the Gospel of Life!!!!!! Fill out this slide!!!!!!! know the theological anthropology 4 things, know virtues, principle of double effect, pastoral circle (connect it to an issue) !!!!!!!!
Approach health carethrough an ethic of virtueand care Moral virtues and theological virtues •Moral virtues not only acquired byregular, intentional practice, butalso infused by grace Seek the common good with apreferential option for the poor andvulnerable •No one left behind or discarded;ethic of accompaniment •Vocation to moral heroism in theface of inevitable moral distress Rely on the four principles ofCatholic social teaching Dignity of the Human Person Solidarity Subsidiarity Common Good Remember the three platitudes of ethical reasoning "Is" does not imply "ought. "What is legal is not always moral and what is moral is not always legal. Just because one can does not meanone should .Keep instruments of "ethical tool belt" in good condition and order Principle of Double Effect Discernment of Cooperationwith/Appropriation of Evil
Joseph Cardinal Bernardin (1928-1996)
Archbishop of Chicago who initiated public discourse on "consistent ethic of life" • Gannon lecture at Fordham and Wade Lecture at St. Louis U Makes "Pro-Life" position more than opposition to abortion • Commitment to defense of life "from womb to tomb" • Nuclear arms reduction in late Cold War • Abolition of capital punishment • Immigration reform and asylum for refugees • Access to social welfare and labor justice
Vocation of the parent: The Example of Regulating Birth
At least five criteria: 1. Good of the marriage, incl. health of husband and wife 2. Good of the children, those born and perhaps to come 3. Financial welfare of the family 4. Spiritual development of all involved 5. Good of the Church and society-at-large (Austriaco 2011, p. 79) • Discerned by parents with prayer and prudence - Applies the principle of subsidiarity to appreciate the dignity of parents as agents with responsibility in wider circles of communities of concern - Focus on not only verbalized communication, but coherence of signs and body language to intention
"Theology of the body": An approach to the "language" of love and sexuality
Based in the phenomenological approach to Personalism in speeches andwritings of John Paul II (Karol Wojtyla) - Where we get an appreciation of examining moral action from "theperspective of the acting person" - Focus on consciousness of mediated intentionality of signs, symbols, and language in the world ....... Not only humans but all things can reveal nature through themeans by which we understand communication • Enters into Catholic moral theology through sexuality but has broad application and insight into other ways we relate and communicate with world - Has limitations in failure to account for being-itself and failures of communication/miscommunication ex. smiling, glad your here or if you don't know what else to do its just good to smile and dignified in some places.. pushing, get away from me... kissing, we are close and I love you
The patient as Acting Person
Consonant with principle of autonomy, patient is ultimately responsible fordecisions taken with regard to health and well-being • Freedom Responsible; freedom and knowledge necessary forfull moral act • In Christian and virtue traditions, these decisions are invitations to excellence • Four moral challenges for patient 1. Maintaining good relationships and participating in community 2. Maintaining self-respect 3. Being realistic 4. Being courageous How do each of these challenges reflect the call to subsidiarity and solidarity?
Scriptural roots
Decalogue and Torah Consistent argument in Old Testament for choices that promote life and justice (Dt 30) Jesus own example of promoting life Miracles of healing, forgiveness & resurrection "Seamless Garment" Metaphor taken from Passion in Gospel of John;Cf. (Jn 19) Cannot rip, divide, separate issues of life and death; all interweave into one attitude toward life or death ... this is thought because usually when you execute someone the executioner gets to keep the garments of the people so they would divide them up but Jesus garments were not able to be divided up, representing we can't only apply his teaching or beliefs to one concept or another only when we want to, it comes as a package basically ex. can't say no to abortion but then increase war
Complementary contexts for ethical reflection on health care
Ethics are often divided into three arenas of action: - personal - professional - social Ethics can also be divided by context of sources and tradition: - secular ethics - religious ethics Each context can and should integrate the insights from different frameworks for moral reasoning including: 1) consequentialism (e.g. act-utilitarianism, rule-utilitarianism); 2) non-consequentialism (e.g. deontology/formalism); 3) virtue theory
Some key definitions
Euthanasia = an action or omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated • Active when by action of agent, either oneself or other, e.g. nurse, and passive when by omission of agent Physician-assisted suicide (PAS) or Medical Aid in Dying (MAiD) =form of voluntary euthanasia when a physician intentionally seeks to help a person, usually a patient suffering from terminal or chronically debilitating disease to take his/her own life, usually by providing lethal dose of drug... sub category
What is just.. well it depends
Justice (iustitia): "the firm, constant will to render to eachhis/her ius" (Ulpian, famous Roman jurist) Ius = the object of justice (circular!) Different understandings: A. welfare; B. right; C. desert Seeks the REAL mean rather than the RATIONAL mean John Rawls: A Theory of Justice Public consensus for equality based on the judgment frombehind the "veil of ignorance" and difference principle Amartya Sen: The Idea of Justice Focus on realization rather than ideal; comparative Relative merits/demerits of utilitarian, egalitarian, andlibertarian frameworks; turn to capabilities/freedoms
Division of Justice
Legal/General Justice: "What I owe to society." - Equivalent to moral virtue Commutative/Rectificatory Justice: "What I owe to you is what you owe to me." - E.g. contracts, market prices, legal tort Distributive Justice: "What society owes to me." - Canons (measures) include: equality, needs, efforts/sacrifices, productivity, scarcity, human welfare Social Justice: "What I and intermediate divisions of society owe to you and other intermediate groups." - What do wealthy nations owe to poorer? Whites to non-whites? Men to women? (and the converse of all these!) - Addresses longitudinal/generational justice as well
Recap: Considering the InstrumentalEnds of Catholic Social Teaching
Solidarity "My personal good is intimately and inextricably tied to the good of each and every other person." • "Solidarity highlights in a particular way the intrinsic social nature of the human person, the equality of all indignity and rights and the common path of individuals and peoples towards an ever more committed unity." • "Not a 'feeling of vague compassion or shallow distress at the misfortunes of so many people, both near and far. On the contrary, it is a firm and persevering determination to commit oneself to the common good.That is to say to the good of all and of each individual, because we are all really responsible for all.'"(Compendium of the Social Doctrine of the Church, nn. 192,196) Subsidiarity "Agency should be realized at the most local level with help and support drawn from other persons and social groups/institutions as needed to realize responsible action." • "The principle of subsidiarity protects people from abuses by higher-level social authority and calls on these same authorities to help individuals and intermediate groups to fulfil their duties. This principle isimperative because every person, family andintermediate group has something original to offer to thecommunity." • "subsidium" (Latin, "auxiliary support, aid, help") • Personal agency, initiative, freedom and responsibility may not be supplanted. (Compendium of the SocialDoctrine of the Church, nn. 186f.)
Considering the Instrumental Ends of Catholic Social Teaching
Solidarity - "Solidarity highlights in a particular way the intrinsic social nature of the human person, theequality of all in dignity and rights and the common path of individuals and peoples towards anever more committed unity.." • Is a fundamental social virtue ordered to common good - "Not a 'feeling of vague compassion or shallow distress at the misfortunes of so many people,both near and far. On the contrary, it is a firm and persevering determination to commit oneselfto the common good. That is to say to the good of all and of each individual, because weare all really responsible for all.'" (Compendium of the Social Doctrine of the Church, nn. 192, 196)... helps us to be motivated when others can't do so.. in willed action for the sake of other persons... helps people become agents and participate responsibly for the sake of the common good!!!!!!.. ana code of autonomy, inviting people to participate in activities they find valuable and participate for the common good Subsidiarity - "The principle of subsidiarity protects people from abuses by higher-level social authority and calls on these same authorities to help individuals and intermediate groups to fulfil their duties.This principle is imperative because every person, family and intermediate group has something original to offer to the community." • On the basis of this principle, all societies of a superior order must adopt attitudes of help("subsidium") — therefore of support, promotion, development — with respect to lower-ordersocieties. - Personal agency, initiative, freedom and responsibility may not be supplanted.(Compendium of the Social Doctrine of the Church, nn. 186f.) 2 of the 4 aspects of catholic social teaching: solidarity and subsidiarity
Solidarity
Support or sympathy; unity
Tradition of church on consistent ethic
TRADITION OF CHURCH ONCONSISTENT ETHIC • Primative Church teaching The Didache (c. 120 C.E.) teaches Christian nonviolence, care and compassion for the sick and dying, and impermissibility of abortion and infanticide - "You will not murder offspring by means of abortion, [and] you will not kill one having been born." • First Council of Mainz (847 C.E.) - penitential rites for "women who procure the elimination of the fruit conceived in their womb" - Practice for healing and reintegration/reconciliation with God, community, and oneself after sin and trauma • Thomas Aquinas argues procured abortion as violation of natural law - Against precept to procreate and educate progeny
Overview
The "consistent ethic of life" is a systematic vision of the Catholic Church that informs approaches to specific ethical issues - Comprehensive method to apply moral reasoning to related, though distinct issues In addition to beginning and end of life issues, the Church's consistent ethic of life includes the entire scope of all human life - Engages peace, poverty, social justice, etc.
Common objections
The appeal to autonomy and self-determination •Mistakes autonomy and freedom to choose as absolute goods rather than means to greater value of beatitude •Performatively inconsistent: Cannot be ultimate value if morally acceptable to destroy it. The appeal to compassion •Rather than focusing on accompaniment, sets conditions and seeks end of relationship •Makes dignity extrinsic, given by others rather than inherent •Contra Dr. Quill, dignity does not reside in bladder and rectum The difference between killing and letting die •Withdrawing ordinary means of preserving life is equivalent to killing by act of omission •"passive euthanasia" •Moral difference between allowing someone to die by withholding morally obligatory means v. withholding morally optional means
Review
The "consistent ethic of life" is a systematic vision of the Catholic Church that informs approaches to specific ethical issues - Comprehensive method to apply moral reasoning to related, though distinct issues Initiated by Joseph Cardinal Bernardin, Archbishop of Chicago in the 1980s, to challenge partisan public discourse - Rooted in Old and New Testament scriptural tradition and Natural Law In addition to beginning and end of life issues, the Church's consistent ethic of life includes the entire scope of all human life - Engages peace, poverty, social justice, etc. "The issue of consistency is tested in a different way when we examine the relationship between the "right to life" and "quality of life" issues. I must confess that I think the relationship of these categories is inadequately understood in the Catholic community itself. My point is that the Catholic position on abortion demands of us and of society that we seek to influence an heroic social ethic. (Bernardin, 1983, emphasis added)
Common objections to catholic position on abortion
The Post-Conception Beginning of Life Argument - Unique, individual teleology from conception The Non-Personhood Argument - Confuses being with function; suffers from substance dualism The Bodily Rights Argument - Moral obligation is not voluntary; right to preserve life prior to right to free use of body The Delayed Hominization Argument - Arbitrary criteria and nomenclature for "human" based on rationality... talks about soul which is an ethics component not medical Special Cases: Rape and Incest - Like bodily rights argument, the question of justice is focus - two wrongs don't make a right - a women who was raped should be able to have an abortion is the main objection and austriaco says 2 wrongs do not make a right so the women could have even more trauma by terminating the pregnancy - there was a poll where 75% of women chose not to have one believing their child may have intrinsic value 1. Explain the main criticism of those who object to the Catholic doctrine on abortion with reference tokey terms and people who advance the argument. 2. Explain the response made by Catholic theologians to the objections. 3. Discuss whether the objection or the criticism is more compelling. Why? What is the framework formoral reasoning (e.g. utilitarian, deontological, cirtue, rights) that you employ?
Subsidiarity
The principle of Catholic social teaching that holds that a higher unit of society should not do what a lower unit can do as well (or better).
Application: who gets the covid-19 vaccine first
Think about possible frameworks of justice andwhat is sought in each: Utilitarian => welfare maximization How do we do most good while avoiding inflicting least suffering? Egalitarianism => equal rights Who has priority if a conflict of rights is identified? Libertarianism => desert and freedom Who deserves to get the vaccine first? ... utilitarian says healthcare workers so they can keep taking care of others/ egotarian says poor or immunocompromised so they can become on a more equal level to everyone else/ libertarian says people who pay for it so they can make the most money out of it Why? What principles of Catholic social teaching orvirtues help one make assessment for justoutcomes for all? Ex. worksheet egalitarian = china, communist utilitarian = africa, Northern Europe
Equality vs Equity
Virtue concerning the application of law that determines judges according to spirit of the law rather than letter - When application of law will do injury to a party and frustrate the equality (real mean) of justice - Arises because law cannot account for every particular circumstance - equality does not fulfill justice in this example, equity (justice) does not necessarily mean equality
Justice... the real mean, others, and equity
You and two classmates were responsible for a grouppresentation in class. You and "Partner A" met three times to work on the projectoutside of class. Partner B was "unavailable." All three ofyou met only once to work together. You prepared an exceptional PowerPoint presentation andscript using your partners' research. Partner A wrote 5 poorly researched pages of the 8 pagereport. "Partner B" wrote 3 excellent pages of your report. Your professor gives you a cumulative total of 240 pointsto divide among yourselves that each person receive agrade out of 100 points. How do you divide the points?Why?An illustrative scenario.
Assisted Reproductive Technology
a general term for the techniques designed to help infertile couples conceive and then sustain a pregnancy Gattaca film • Hormonal treatments - With Clomid and Pergonal, cannot "reduce" pregnancy • Surgical interventions • Gamete intrafallopian tube transfer (GIFT) • Artificial insemination by husband (AID) • In vitro fertilization (IVF) • Intracytoplasmic sperm injection (ICSI) • Zygote intrafallopian tube transfer (ZIFT) • Catholic condemnation of pre-implantation genetic diagnosis • Cloning prohibited; distortion of nature and social relationships • What are prospective social justice issues associated with ART?
Special theological concerns
• Application of principle of double-effect in case of ectopic pregnancy - Illustrates variable theological consensus on therapies • Question of Ensoulment - Reminds us of present divine activity in creation even today • Role of the Virtue of Fortitude - Courage enabled by love to achieve the difficult good even in crisis or victimhood
Special theological concerns
• Application of principle of double-effect in case of palliative care pain medication administration - Hastening of death in administration of analgelsics • Question of Clinical Death - Traditional cessation of cardiopulmonary activity or newer "brain death" definitions and their challenges to define incapacity to integrate bodily functions • Prudential discernment of whether means of preserving life are ordinary or extraordinary - What is "futile care" and effect on "moral distress" for community of care? • Role of the Virtue of Hope - Begets moral courage; can remind patient 1) of God's providence, 2) the reality of eternal life and 3) the accompaniment of Church in prayer and sacrament
Highlighting the role of virtue
• As always, charity, or the agape/self-sacrificing love of others for the sake of divine is perfective of our action • Justice and its annexed moral virtues here aremost relevant to analysis in organdonation/transplantation - "the constant and firm will to render to the otherher ius (due right, desert, share) - Justice accounts for: • 1-1 relationships = commutative • Social responsibility for individuals = distributive - Liberality helps one use one's possessions well - Magnificence helps one to use wealth/possessions to make something great for others/public good • Gratitude should be inculcated both in recipient,donor, and community of concern for gifts received,incl. one's native health and life
Confidentiality
• Born out of respect for dignity of the person and trust in care community - Both natural and professional secrets to guard .... Part of professional codes of ethics (e.g. ANA,AMA) and Hippocratic Oath • Two categories when unilateral disclosure may be licit - To protect society as a whole - To protect an individual whose life may be at risk • Act of solidarity in every case, aiming at the common good
Catholic Doctrine
• Christian theology of death rejects that it is the annihilation of personhood, but does recognize the tragedy of natural death in context of faith and hope in God • What is death? • How does thinking about death affect life choices? Medical choices? • Does the medical definition of have an effect on philosophical definition? Five (5) moral arguments against euthanasia and PAS 1. Intrinsic inviolability of innocent human life 2. Integrity of the medical profession 3. Society's commitment to support palliative medicine 4. Protection of the sick and aged 5. Could lead to acceptance of euthanizing incompetent persons, e.g.comatose, mentally disabled or those with mental illness The important thing about being a person is that we are interdependent with each other because when you say you are made in the image and likeness of god It means you are in community with one another
Organ procurement and transplantation in Catholic doctrine
• Early concerns for principle of totality rendered surgical organ transplantation illicit due to mutilation of healthy individual regardless of intention - Object of the act was perceived as intrinsically evil - Later interpretation distinguishing anatomical v.functional integrity under virtue of charity makes procedures licit under certain conditions • Must not place donor at disproportionate risk forharm in procedure • Must have explicit informed, not presumed,consent • Prohibits use of organs and tissues from: - Commodity exchange/paid transactions - Fetal tissue (appropriation of evil, twin sister of doing the evil) - Anencephalic or PVS patient donors
Exceptions to informed consent
• Exceptions to informed consent 1. Legal or mandatory directives, often for public health crises (e.g.immunizations) 2. During medical emergencies, in ER or accident scenes presumed consent 3. When patients waive their right to informed consent, leaving choice towilling proxy or physician to make decisions in best interest Are there any other feasible reasons or situations wheninformed consent may not be morally required? Why?
Challenges to Regulating Birth
• Natural Family Planning (NFP) - Only Church-approved method of birth regulation - 1) Billings Ovulation Method and/or 2) sympto-thermal method .... Not "rhythm method" • Contraception - Three basic kinds: 1) chemical, 2) barrier ex. condom, and 3)surgical • Questions of effectiveness - Personal effect? - Spousal effect? - Social effect? • Common Objections to Catholic Church- In small groups, name and evaluate the four (Austriaco 2011, 84-89).
After Dobbs vs Jackson
• On 24 June 2022, the U.S. Supreme Court overruled both Roe v. Wade (1973) and Planned Parenthood v. Casey (1992), giving individual states the full power to regulate any aspect of abortion not preempted by federal law • Diverse responses by many groups and individuals including Catholic Church bishops, theologians, and lay people • What do you think is the prudential way forward regarding medical practice and care for vulnerable populations? • How has your opinion or approach to discourse on abortion changed since June 2022? Is it consonant with a "consistent ethics of life"? Why?
Virtue in the clinical encounter
• The moral virtue of truth is annexed/part of justice, virtue regulating our relationships as "constant, enduring will to give others their due right" - Ask the question: What does the patient deserve that is consonant with his/her dignity? • The act of truth-telling is governed by prudence, setting the proper means to the end of happiness and flourishing for each and every person in context - Often more important is how one tells the truth = pastoral/ministerial approach - More than good "bedside manner," it is sincere interest and care in solidarity
Informed consent
• Three basic moral [and legal] requirements • All relevant information must be provided to the patient - Standard of a) reasonable physician or b) reasonable patient or c) subjectivestandard• The patient must comprehend the information and confirm understanding. • Surrogate, proxy, or durable power of attorney (DPOA) can stand in to fulfilladvanced directive • 1) oral directive, 2) written directive: living will or medical care directive, 3)proxy directive - The patient must exhibit freedom in electing opinion and freedom to seek secondopinion • Act of subsidiarity as patient's agency is respected but supported by community of care
Health Care Professional as Acting Person
• Vocation (Latin, vocare "to call") = God-given mission/calling in life whose fulfillment gives God glory and the one called happiness - Model of Jesus to holistic care of body, mind and spirit in communal context - Guardians and servants of [human] life • Have fiduciary (Latin, fiducia "confidence") relationship of trust withpatient • E. Pellegrino (1997) on realities of clinical encounter in healing 1. The fact of the illness: "I, the patient, need help and healing."2. The act of profession: "How may I, the health professional, help you?" 3. The act of healing: "We, the patient and professional, will work together on this."
