Medical Ethics I: the Beginning of Life Moral decision making related to medical research and practice

Important Principles 1. Life is a gift of inestimable value All uses of technology must respect human life All uses of technology must respect human life 2. Science and technology are valuable resources Can have positive effects on life Can have positive effects on life Must be used to support human dignity and life Must be used to support human dignity and life

3. Humans are a unity of body and spirit We are more than the sum total of our parts We are more than the sum total of our parts 4. What is technically possible is not for that very reason morally admissible Not every potential medical “breakthrough” necessarily serves humanity Not every potential medical “breakthrough” necessarily serves humanity Advances must be measured in terms of respect for life Advances must be measured in terms of respect for life

Terms DNA: DNA: The intricate interlocking chain of genetic material that makes up all living cells The intricate interlocking chain of genetic material that makes up all living cells Artificial insemination: Artificial insemination: Mechanically introducing a sperm to a uterus to facilitate fertilization Mechanically introducing a sperm to a uterus to facilitate fertilization Embryo: Embryo: A fertilized egg possessing a unique genetic makeup A fertilized egg possessing a unique genetic makeup In Vitro: In Vitro: Literally, “in a glass” Literally, “in a glass” An embryo that is placed in a woman’s uterus An embryo that is placed in a woman’s uterus

In Vitro Fertilization and Marriage Catholic view of marriage: Catholic view of marriage: Unitive (love, connection) and procreative (creating life) Unitive (love, connection) and procreative (creating life) Problems with IVF: Problems with IVF: Separates the unitive and procreative characteristics of marriage; Separates the unitive and procreative characteristics of marriage; Destruction of unused embryos - e nding of human life Destruction of unused embryos - e nding of human life Children understood as being gifts from God. Children understood as being gifts from God.

Genetic Engineering Changing inherited characteristics by changing the makeup of a plant, animal, or person – limiting to and prefering specific desirable physical or psychological traits. Changing inherited characteristics by changing the makeup of a plant, animal, or person – limiting to and prefering specific desirable physical or psychological traits. Eugenics – (from Greek – “well born” – a program that tries to steer human reproduction in a specific direction. Restricting immigration from places other than Europe ( ) – in fear of contaminating the American gene pool. Climax – Holocaust. Eugenics – (from Greek – “well born” – a program that tries to steer human reproduction in a specific direction. Restricting immigration from places other than Europe ( ) – in fear of contaminating the American gene pool. Climax – Holocaust.

Cloning Cloning - creating a plant, animal, or person asexually. They is genetically identical with a donor plant, animal, or person. There are two major types of cloning – reproductive and therapeutic:

Reproductive/ therapeutic cloning Reproductive – 1) Genetic material transferred from a donor adult cell to an egg whose nucleus has been removed; 2) The reconstructed egg which contains the DNA must be treated with chemicals in order to stimulate cell division; 3) Then it is transferred to the uterus of a female host where it develops until birth (Dolly). Therapeutic - is the production of a human embryo for the use in stem cell research.

Abortion Abortion: Abortion: The spontaneous or induced expulsion of a fetus from the womb. The spontaneous or induced expulsion of a fetus from the womb. Dealing with those that are caused / not miscarriages Dealing with those that are caused / not miscarriages Roe vs. Wade (1973) Roe vs. Wade (1973) Supreme Court allows women to choose whether or not to have an abortion Supreme Court allows women to choose whether or not to have an abortion Rights of woman over rights of unborn child Rights of woman over rights of unborn child

Church Teaching Human life must be respected and protected absolutely from conception. Human life must be respected and protected absolutely from conception. Key points: Key points: A new and distinct human life begins at the moment of conception A new and distinct human life begins at the moment of conception Respect for life at all times in all situations Respect for life at all times in all situations Even in cases of rape or presumed disorders Even in cases of rape or presumed disorders The right to life outweighs any others “rights” The right to life outweighs any others “rights”

Abortion Arguments Pro-life Human beings are required to respect their bodies Human beings are required to respect their bodies Life begins at the moment of conception Life begins at the moment of conception All life is sacred All life is sacred Unborn have a right to be born Unborn have a right to be born It is wrong to kill an innocent human being and wrong to legalize an action that is immoral It is wrong to kill an innocent human being and wrong to legalize an action that is immoral Pro-choice Human beings are free to do whatever they think is right It is unclear when life actually begins Quality of life is more important than life A woman has a right to determine what happens to her body It is wrong to put one’s moral position into law

Culture of Death The basis of human life is not the sacredness of life and human dignity, but is the ability to get what we want The basis of human life is not the sacredness of life and human dignity, but is the ability to get what we want People have the right to more than they need, even as poverty causes death for others People have the right to more than they need, even as poverty causes death for others

Culture of Death (2) People who cause a burden to others as less worthy of life People who cause a burden to others as less worthy of life The quality of a life as the only measure of whether it is worth living The quality of a life as the only measure of whether it is worth living Euthanasia  the intentional killing of someone whose life is deemed no longer worth living Euthanasia  the intentional killing of someone whose life is deemed no longer worth living

Culture of Life We are images of God; more than our physical bodies We are images of God; more than our physical bodies Being fully alive means reflecting God by loving God and one another Being fully alive means reflecting God by loving God and one another Calls people to share what they have with others Calls people to share what they have with others

Culture of Life (2) Views all people as gifts of God, even those who require extra care Views all people as gifts of God, even those who require extra care Sees life as worth living even if it involves suffering Sees life as worth living even if it involves suffering Respects and fosters the dignity of each person as being created imago dei. Respects and fosters the dignity of each person as being created imago dei.

Medical Ethics II: Moral Issues Near the End of Life

Pain and Suffering One of the great, enduring questions: Why do we feel pain and suffer? Important question. One of the great, enduring questions: Why do we feel pain and suffer? Important question. Reality: no one is free from either: is widespread and common Reality: no one is free from either: is widespread and common

Jesus and Suffering 3 belief statements 3 belief statements Suffering does not separate us from God. God cares about our suffering. Suffering does not separate us from God. God cares about our suffering. God does not let us face our suffering alone. God is always with us, lightening our burdens and giving us sufficient strength. God does not let us face our suffering alone. God is always with us, lightening our burdens and giving us sufficient strength. Suffering IS NOT THE END. It need not destroy us or defeat the possibility of eternal happiness in God’s kingdom. Suffering IS NOT THE END. It need not destroy us or defeat the possibility of eternal happiness in God’s kingdom.

Euthanasia Deliberately taking steps to bring about a person’s death for the purpose of eliminating suffering Deliberately taking steps to bring about a person’s death for the purpose of eliminating suffering

U.S. Bishops’ Statement on Euthanasia (1980): In modern society, in which even the fundamental values of human life are often called into question, cultural change exercises an influence upon the way of looking at suffering and death; moreover, medicine has increased its capacity to cure and to prolong life in particular circumstances, which sometime give rise to moral problems.

U.S. Bishops’ Statement on Euthanasia (1980): Thus people living in this situation experience no little anxiety about the meaning of advanced old age and death. They also begin to wonder whether they have the right to obtain for themselves or their fellowmen an "easy death," which would shorten suffering and which seems to them more in harmony with human dignity.

Euthanasia (cont) Two types: Two types: Direct (Active) / Indirect (Passive) Direct (Active) / Indirect (Passive) Direct Euthanasia: Direct Euthanasia: Involves taking deliberate steps to end the life of a suffering and incurably ill person Involves taking deliberate steps to end the life of a suffering and incurably ill person

Indirect Euthanasia: Indirect Euthanasia: Deliberately not taking steps to prevent a sick person’s death, precisely with the desire and intention that this “withholding” will lead to or cause death Deliberately not taking steps to prevent a sick person’s death, precisely with the desire and intention that this “withholding” will lead to or cause death All forms of Euthanasia are immoral: All forms of Euthanasia are immoral: Violate Human Dignity and the value of life Violate Human Dignity and the value of life

Physician-Assisted Suicide Physician-Assisted Suicide: Physician-Assisted Suicide: Closely related to Euthanasia Closely related to Euthanasia A person who is incurably ill killing him/herself with the help of a physician A person who is incurably ill killing him/herself with the help of a physician

Seemingly positive motivation: Seemingly positive motivation: Reducing suffering (patient’s and family’s) by ending life Reducing suffering (patient’s and family’s) by ending life Immoral action: Immoral action: Violates human dignity Violates human dignity John Paul II “false mercy” John Paul II “false mercy” Loss of hope Loss of hope

Allowing Death to Occur Involves withholding or withdrawing useless or disproportionately burdensome treatment, thus allowing to die from the fatal disease or condition Involves withholding or withdrawing useless or disproportionately burdensome treatment, thus allowing to die from the fatal disease or condition Key difference from Euthanasia: Key difference from Euthanasia: The intention of the action must be considered – it is not that one wills death to occur, but that one accepts the fact that death can’t be prevented The intention of the action must be considered – it is not that one wills death to occur, but that one accepts the fact that death can’t be prevented

Right to Die: Principles 1. Death is imminent; 2. Illness is irreversible; 3. All ordinary means are exhausted; 4. The person is at peace with God; 5. Excessive burden on the family.

Ordinary means of life support: Ordinary means of life support: Medical procedures that offer sufficient or reasonable benefits without excessive or undue burdens to the patient or family (food, drink, medication, medical procedures); Medical procedures that offer sufficient or reasonable benefits without excessive or undue burdens to the patient or family (food, drink, medication, medical procedures); Extraordinary means of life support: Extraordinary means of life support: Medical procedures that offer little hope of benefits or which cause undue or excessive burdens to the patient or family Medical procedures that offer little hope of benefits or which cause undue or excessive burdens to the patient or family

Living Will A legal document in which people make known their wishes about what medical or health care treatment that would or would not want if they became seriously ill. A legal document in which people make known their wishes about what medical or health care treatment that would or would not want if they became seriously ill. Usually expresses a person’s wish not to receive extraordinary means of life support Usually expresses a person’s wish not to receive extraordinary means of life support Potential problem  not all situations addressed and no one named to make decisions Potential problem  not all situations addressed and no one named to make decisions

Care for the Dying How do we, as Christians, care for the terminally ill, especially those with intense suffering? How do we, as Christians, care for the terminally ill, especially those with intense suffering? Respect for human dignity: Respect for human dignity: Must always reassure the individual of their holiness as a child of God Must always reassure the individual of their holiness as a child of God

Practically face end of life issues: Practically face end of life issues: Living Will: Living Will: A declaration that a competent adult makes identifying the medical care desired if s/he becomes incapacitated A declaration that a competent adult makes identifying the medical care desired if s/he becomes incapacitated Durable Power of Attorney (Designated Decision Maker): Durable Power of Attorney (Designated Decision Maker): Someone appointed to make medical decisions for a person who is incapacitated Someone appointed to make medical decisions for a person who is incapacitated

Hospice Hospice: Hospice: An intense, multi-faceted, spiritually based approach to assisting people through the dying process An intense, multi-faceted, spiritually based approach to assisting people through the dying process Does not try to either hasten or postpone death Does not try to either hasten or postpone death Attempts to help the patient live last days/weeks as comfortably and fully as possible Attempts to help the patient live last days/weeks as comfortably and fully as possible