Loyola School of Theology

Theo 262
Bioethics
1st Semester SY 2015-2016

Chapter I
Introduction to Bioethics

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 Sequence of Topics
(A) The Place of Bioethics within
Concrete Christian Ethics
(B) The Moral Dimension of the Human
Person: General Considerations
(C) Christian Perspectives for the Moral
Dimension of the Human Person

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(D) Conclusion: The Ethical Value of the
Human Person—Conjoint Affirmation
of Civil Ethics and of Christian Ethics
(E) The Present Situation of Bioethics
(F) Various Approaches to Constructing
Bioethics

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(A) The Place of Bioethics
within Concrete Christian Ethics

Bioethics
• the systematic study of human conduct in
relation to human life,
• especially in the areas of the life sciences
and of health care
• insofar as that conduct is examined from
the viewpoint of moral values and
principles.

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 Bioethics
is one of the main areas of “personal ethics” or
“the ethics of the person,”
which is turn forms part of concrete ethics (also
called “special morals”)

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 Already in the works of St. Thomas Aquinas
(Summa theologiae) one finds the division of
moral theology into “general” and “special.”

“General” moral theology, recently renamed

“fundamental,” studies the foundations of
Christian ethics and the general categories for
correctly understanding morals.

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“Special” moral theology deals with concrete
problems of the various sectors of ethical
commitment and endeavor (for which
reason it is also called “concrete” or
“sectorial” Christian ethics or moral
theology).

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 The matter of concrete Christian ethics is
organized into two parts or two big groups of
problems.

The first group is integrated around the

“person.”

The second group is integrated around

“society.”

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From this arise two main tracts:
Christian personal ethics or the Christian ethics
of the person
Christian social ethics.

One should not understand the Christian

ethics of the person as if it were a purely
individual ethics in contrast to another ethics
which would be a social one.

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 All moral problems have both personal and
social aspects. Thus it is incorrect to understand
the division of concrete Christian ethics into
“personal” and “social” in a rigid and
dichotomizing manner.

This division is made ultimately for practical

reasons of ease of presentation, the latter being
afforded by the systematic organization of moral
problems around two ethically significant
realities--the person and society.
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 “Personal ethics” is the systematic
treatment of various ethical problems
related to the person, but the correct
understanding and solution of these
problems necessarily has a social
dimension.

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The contents of personal ethics in turn can be
organized around four nuclei

 the moral dimension of the human person

 bioethics or the ethics of human life
 the ethics of love and sexuality
 the ethics of consciousness, manipulation and
interpersonal encounter.

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 The first of these nuclei—that of the
moral dimension of the human person—is
fundamental to the other three.

Hence our treatment of bioethics

proper will be preceded by some
considerations regarding the moral
dimension of the human person.
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 (B) The Moral Dimension of the Human
Person: General Considerations

Sequence of topics
- Initial remarks
- (1) Respect for the dignity of the human
person: structural nucleus of ethics
- (2) Basic characteristics of respect for the
dignity of the human person
- (3) Relation of human dignity to the concrete
dimensions of the human person

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Sequence of topics (continued)
- (4) Relationship of human dignity with the
individual, interpersonal, and societal
aspects of human existence
- (5) Human dignity integrates natural necessity
and human liberty
- (6) Human dignity integrates the “sacral” and the
“profane” aspects of the human person
- (7) Human dignity as a normative ideal

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Objective: arriving at a criticorationally
acceptable understanding of the moral
dimension of the human person

Guiding vision of personal ethics: “authentically

humanizing ethics”
- in harmony with anthropological turn of much
of contemporary theology
- corrective to truncated or distorted
theological or philosophical anthropologies

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Rationale for anthropological turn of theology
- God-world relationship
- God as lover of humankind and of all
creation
- the Incarnation

- response to or nuancing of certain types of

theocentric theologies
- James Gustafson
- Scholasticism
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- response to truncated or distorted
anthropologies
- fundamental questions that
human beings ask themselves
• What are we?
• How ought we to conduct ourselves?
• What can we hope for?

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 Some currently problematic anthropologies
- Individualist

- Collectivist

- Radically Materialist

- Excessively “spiritual” (“angelism”)

- New Gnosticism

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(1) Respect for the dignity of the human
person: structural nucleus of ethics

The moral life is basically the

actualization of what it means to be a
person in relation to other persons and
sentient beings.
The person is the primary subject and
object of moral life.
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 This respect for the dignity of the human person,
however, needs to be manifested in concrete ways.
 basic characteristics (of respect for the dignity of the
human person)
 relation to the concrete dimensions of the human
person
 connection with the individual, interpersonal and
societal aspects of human existence
 integration of natural necessity and human liberty
 integration of the “sacred” and the “profane” aspects
of the human person
 its aspects as a normative ideal

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 (2) Basic characteristics of respect
for the dignity of the human person

Respect for the dignity of the human person

should be:
 concrete
 universal
 egalitarian
 unconditional
 partisan in favor of those who suffer from
dehumanizing situations
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 It is unconditional
- it inheres in human persons precisely as
persons
- not for what they possess, nor for what
they can give us, nor for their physical,
intellectual, and social capacities
- but for what they are—persons

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(3) Relation of human dignity to the
concrete dimensions of the human
person

- Corporeity
- Social nature
- Reason and liberty

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 Human beings exist corporeally. Their
bodies are the basis for their human
consciousness, and thus for their personhood,
and so they participate in the dignity of the
human person.

Human bodies are able to mediate human

consciousness probably because of their
biologically hyperformalized structure.

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 Some authors, including Catholic
Christian ones, hold a psychobiologic,
evolutive, emergentist and nondualist
anthropology.

This anthropology is psychobiologic

because it considers the human psyche
to be fully explicable as an activity of
hyperformalized biological structures.
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 form = forma (Latin) = structure:
arrangement and interconnection
of components

system = components arranged in

a specific\manner or with
a specific structure

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 As systems become more complex
they acquire systemic properties not found
in the individual components and in
simpler systems.
Human consciousness can be posited
to be a property of the highly organized
nervous and sensory system of human
beings.

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 This highly complex (hyperformalized)
system acquires such systemic properties
as the human intellect and free will.

The biological hyperformalization of

human beings is the basis for their
cognitive hyperformalization.

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 The author of these class notes is inclined to
hold this nondualist anthropology
though he is well aware that some scholars
affirm that dualist anthropologies (such as
those which consider human persons to be
“embodied spirits”) cannot be intellectually
counted out.

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 It is evolutive
- it considers the human being, with his
or her psyche, to be a product of
biologic evolution

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 It is emergentist
- it considers what is specifically human to
have emerged as a result of the
attainment of a certain type and level of
structural organization of matter, which
is not found in less structurally complex
organisms or in immature human
organisms
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 It is nondualist
- it considers the structure and functioning
of human beings to be adequately explicable
in terms of the structural organization of
matter alone, without the need to posit
a nonmaterial (spiritual) principle of life
(usually called a “soul”) for the constitution
of a human being

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 This psychobiologic, evolutive,
emergentist and nondualist anthropology
is compatible with the Christian belief in
ther existence of an almighty God able to
preserve the personal existence of human
beings in the afterlife.
See, for example, Luis F. Ladaria's book
Antropología teológica (Rome: Università
Gregoriana Editrice, 1983), 87-140.
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 This formulation of mind-body relation
is attractive to those who have sufficient
background in the neurosciences.

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Implication: changed framework for the
discussion on abortion and other questions
in which the beginning of human life and
human personal life are important
considerations
- consideration that is alternative to that of
the timing of ensoulment

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 At certain phases of human beings’ life
cycle (as for example, infancy, old age) and
in certain cases (for example, handicap)
modifications in the configuration of their
corporeity make human beings specially
vulnerable to harm, and at these times
human beings need special protection.

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(4) Relationship of human dignity with the
individual, interpersonal, and societal
aspects of human existence

 Proportionate valuing of individual,

interpersonal, and societal aspects of human
existence
 Integral humanism versus individualism,
intimism, collectivism

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(5) Human dignity integrates natural necessity
and human liberty

• Natural necessity: universal validity of

ethical principles
 versus libertinism
• Human liberty: flexibility of response to
changes in human situation in the world
 versus rigid traditionalism
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(6) Human dignity integrates the “sacral” and the
“profane” aspects of the human person

1. Rejection of false sacralization of contingent

human realities
2. Rejection of reductionism that reduces
human beings to mere objects (whatever the
kind of reductionism: of religious origin,
instrumentalization in the service of the
institution; totalitarian systems)
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 3. Affirmation of unconditional value and
personal responsibility of the human person
in a “profane” or secular situation: call to
ethical or moral integrity

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(7) Human dignity as a normative ideal
 Two aspects, a negative and a positive
• negative aspect: correcting all
possible reductionisms to which the
human being may be subjected

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  some polar forms of reductionism and
their correlative corrections
• Elitism and massification: corrected by
respectful relation with all human beings
and continual striving for excellence,
especially ethical excellence

• Privatism and completely public situation or

existence: corrected by balance between
interiority and relation

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  positive aspect
• full humanization (entailing personal
responsibility in the effort at full
humanization of self, of other persons, of
society)

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 (C) Christian Perspectives for the Moral
Dimension of the Human Person

 Christian faith enters ethics not mainly

in terms of specific innerworldly material or
concrete content, but rather mainly in
terms of its worldview.

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  An ethics can be considered Christian
because of the horizon or perspective
from which the largely and relatively
autonomous ethical normativity of the
authentically human acquires a new
dimension and new depth

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 Applying this overall principle to the concrete
theme of the human person, it is correct to affirm
that
at the innerworldly and immanent and material
level (in contrast to the otherworldly and
transcendent and “spiritual” level),
the concrete content of Christian faith is not
distinct, for the most part, from the ethical
demands upon a psychocorporeal personal
being of the type that the human person is

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 What Christian faith mainly contributes is a
new viewpoint from which to understand
and live the same human reality in a new
and specific manner.

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 Nevertheless it is also important to
acknowledge that the worldview of
Christian faith entails certain concrete
moral norms not easily arrived at from a
purely secular approach
 Examples: issues connected with:

• the defense of human life in its origins

• death and dying

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 The contribution of the Christian viewpoint
in relation to the human person can be
described as being at two levels:
 the ontic or premoral level
 the moral or ethical level

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(1) Christian viewpoint at the ontic level
of the human person
• historical contribution to the promotion of
human dignity, based on a “Biblical
anthropology”
 the human being as “person”—human beings
as unique, “ends in themselves, not merely
means”
 the human person as “image of God,” called to
an exalted destiny of union with God

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(2) Christian viewpoint at the ethical level
of the human person
- implications of a Biblical anthropology

(a) Catechesis of the Synoptic Gospels

(i) the absolute value of the human person
(even in the face of “religious” tradition)
(ii) preferential option for the weak
(iii) interiority and radicality
(iv) counterexample: hypocrisy, overweening
pride, legalism, trivialization
(v) Jesus: the ethically normative human being,
example of all that he taught
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 (b) Normative elements in Pauline
anthropology

 elements of an ethically normative image of the

human being in the Pauline writings
 the reference to Christ: through the theme of
“image”—connecting ethical normativity for
human beings with the person of Christ
 a human being reflects the image of the creator
to the measure that he or she reflects the image
of Christ (1 Corinthians 15:49; 1 Corinthians
3:18; 4:4; Colossians 1:15; 3:10).

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 In Pauline anthropology there are three
elements which we want to emphasize as
fundamentally shaping the ethically normative
image of the human being:

(i) the “new” human being

- conversion from
- pagan hopelessness, inauthenticity
(ethical inauthenticity or mediocrity)
- Jewish self-sufficiency, formalism,
legalism (“the dynamic of the law”)
- conversion to God in Christ
- living in grace and hope, that give
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confidence, joy, energy, generosity 54
 (b) Normative elements in Pauline anthropology

(ii) the human being who discerns

Discernment is the capacity to evaluate all
situations according to evangelical criteria.
- the subject of discernment: one who learns “to value
the things that really matter” (Philippians 1:10)
• - the object of discernment: what is God’s will,
what is good, pleasing and perfect (Romans 12:2)

(iii) the “free” human being

- freedom from sin, death, the Law
- freedom for love expressed in service

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 (c) Normative elements in Johannine anthropology

(i) the human being as receiving the Light

In Johannine theology Christ is presented as

an enlightening power—as Truth, as the
Word.
The Gospel according to John affirms that the
human person acquires an ethically normative
characteristic in this capacity for receiving
divine enlightenment. To be authentically
human is:
- positively, to accept enlightenment from the Word
(John 1:1-18)
- negatively, to free oneself from the inner darkness
(John 3:19-21; 8:44)

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 (ii) the human being—a being “in
communion”

 In the First Letter of John the most prominent feature is

that of communion. The human being defines and
realizes himself or herself by his or her capacity for
koinonía or communion. Only through this communion
can the Christian believer “remain in God.” This
communion has two aspects:
- diachronic or historical communion: accepting
the message of the “witnesses” (1 John 1:1-4)
- synchronic or present communion: being in fellowship
with oneanother (1 John 1:7) in order to remain [in
communion] with God (1 John 3:24)

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 (iii) the human being, seen essentially
in terms of faith and love—the “new
commandment”
To have faith and to love are two verbs in which the
life of the Christian believer are summarized. Such
a “reduction” to faith and love can be considered
another of the ethically normative features of the
image of the human being in the Johannine
writings:

- to believe is: salvation (John 3:18); life (John 5:24;

6:47); the work to accomplish (John 6:29); victory
over the world (1 John 5:4-5)
- to love is: the “new” commandment
(John 13:34-35); the commandment we have
from God (1 John 4:7-21)
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 (D) The Ethical Value of the Human Person—
Conjoint Affirmation of Civil Ethics
and Christian Ethics

 authentically humanizing ethics of

responsibility, founded on the absolute
ethical value of the human person: is
supported by Vatican II (Gaudium et
spes, no. 12: “Believers and unbelievers
agree almost unanimously that all things
on earth should be ordained to man as
to their center and summit.”)
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  An anthropologically-oriented
framework for constructing Christian
personal ethics does not at all
endanger the Christian character of
our personal ethics, since our ethics
is one of theonomous relative
autonomy.

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  Though it affirms that any ethics, to be
credible, must be found reasonable according
to the autonomous criterion of human reason,
it nevertheless holds that God is the
foundation and guarantee of human
autonomy, and that God’s will is none other
than the happiness and fulfillment of human
beings.

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  God’s glory and the happiness
and fulfillment of human beings
coincide.
God is neither our competitor
nor our slavemaster; rather, God
is our friend and the authentic
foundation of our freedom.
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  In addition our ethics, being a
relatively autonomous one (not an
absolutely autonomous one), admits
the possibility that in Christian ethics
there are concrete ethical norms at
the innerworldly level which are
justifiable only when we factor in the
content of Christian revelation.
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 (D) The Ethical Value of the Human Person—
Conjoint Affirmation of Civil Ethics
and Christian Ethics
Since our ethics, though
theonomous, also recognizes the
relative autonomy of human ethical
reasoning, it is capable of sharing in
an ethical project that is ecumenical
in the broadest sense of the word.
This project is the formulation and
propagation of a civil ethics.

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 The latter will promote a common
moral ideal open to the ethical
concerns of the advocates,
whether religious or areligious,
of the various authentically
humanist and therefore
democratic options for theory
and practice within a given
society.
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 Gaudium et spes, 55, supports the
foregoing affirmation, in the following
words:
All over the world the sense of
autonomy and responsibility
increases, . . . We are witnessing,
then, the birth of a new humanism,
where man is defined before all
else by his responsibility to his
brothers and at the court of history.
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 Such a theonomous relatively
autonomous ethics of
responsibility, because it shows
respect for human reason used
conscientiously and is committed
to the effective defense of the
dignity of concrete human beings,
makes our Christian faith more
credible to human beings of good
will.
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 We therefore see that the ethical
valuing of the human person is a
point of convergence between
civil ethics and Christian ethics.

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 (E) The Present Situation
of Bioethics

 The last few decades have seen the emergence

and development of the discipline of bioethics
or biomedical ethics.

 Bioethics may either be philosophical or

theological.

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 Whether in its philosophical or its theological
version, bioethics is defined as the branch of
ethics that, from the moral point of view,
systematically studies human conduct in
relation to human life, especially in the area of
the life sciences and of health care.

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 Philosophical bioethics does not in principle
deny that moral discernment may have religious
references.
 Nevertheless
• it confines itself to the level of ethical rationality
unaided by revelation
• It aims to offer an ethical orientation, valid for a
secular and pluralist society, for addressing moral
questions relating to human life, especially those
questions raised by the life sciences and for health
care
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 Incontrast, Christian theological
bioethics has a double task:
 to take into account the problems raised and
the solutions proposed by philosophical
bioethics
 at the same time maintain Christian revelation
as its orienting worldview

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 Bioethics is formally a branch or subdiscipline
of ethics, from which it receives its
epistemological foundation and justification.
 It derives its material content from the following:
• the data of reflection on cases in which the value
of human life is in conflict with other intrinsic
human values
• the data of health care; and the life sciences, such
as biology, psychology, anthropology and
sociology
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  Its analysis of problems, though always from
an ethical viewpoint, has to utilize an
interdisciplinary methodology.
• The natural sciences, law, political science, and
other disciplines are indispensable in the
construction of a criticorationally acceptable
bioethics.

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 For a long time biomedical moral problems
were studied and evaluated basically in the light
of two criteria: religious ethics and professional
codes of ethics.
 These criteria were indeed decisively important in
the history of biomedical ethics.

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 Bioethics should nowadays be constructed in a
manner based on the standards of moral
autonomy and of freedom from undue influence
by historically and culturally conditioned
concrete professional codes of ethics.

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  This means that bioethics should be
philosophically tenable, seeking an ethical
paradigm which transcends legal or quasi-
legal juridical and deontological formulations
as well as particular religious convictions.

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  It should be founded upon a human rationality
which is secular in the good sense of the term
and which can be shared with a tranquil
conscience by all persons of good will
engaged in the building of an authentically
humanizing world.

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  This holds true not only for a philosophical
bioethics, but for a religious or theological one
as well, at least if religious believers want to
be consistent with a theonomous relatively
autonomous ethics of responsibility.

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 (F) Various Approaches
to Constructing Bioethics

The bioethics in these class notes is a

concrete aspect of an ethical humanism
of responsibility that is approached in
three more or less complementary
ways, somewhat in tension among
themselves.
These three ways are described in the
next slides.
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 1) The virtues, entailed principles,
and combination of
deontological and teleological
approaches in normative ethics
(Ashley and O’Rourke, Ethics of
Health Care)

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 2) Natural law according to reason
(empirical metaethical
absolutism, personalist
normative ethics employing
proportionate reason)
(“practical wisdom) (Kelly,
Contemporary Catholic Health
Care Ethics, pp. 83-84)
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 Main types of metaethical theories
1. Noncognitivism or emotivism
2. Metaethical (or ethical) relativism
a) Individual metaethical relativism
b) Social ethical relativism
3. Metaethical absolutism
a) Supernatural metaethical absolutism
b) Intuitional metaethical absolutism
c) Rational metaethical absolutism
d) Empirical metaethical abolutism

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 Empirical metaethical absolutism
• ethical judgments have
“objective” (or
“intersubjective”) meaning
(not mere expressions of
feeling)

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 • ethical judgments can be verified (by
studying reality, especially the human
person and human society, and on this
basis work toward valid moral norms
and judgments by carefully noting
what attitudes and conduct lead to the
flourishing of human beings and
human society, and what attitudes and
conduct cause harm to or inhibit the
flourishing of human beings and
human society)

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 Empirical metaethical
absolutism is a form of natural law
theory. Kelly defines natural law
theory as follows:

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 Natural Law Theory is a
metaethical theory according to
which people discover [moral]
right and wrong by using their
reason and experience to
investigate, individually and
collectively, the emergent
patterns of creation as God is
creating them.
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 Metaethics is the branch of
ethics that deals with the
possibility of meaning in and
knowledge of ethics. It is
primarily the epistemology of
ethics.

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 Some metaethical questions:
- How do we know?
- How much (of what we think we know)
is really illusion?
- How much of (what we think we know)
depends on our individual and social biases
and prejudices?
- What are the sources of our knowledge?
- How much (of our “knowledge”) comes from
us and how much from “reality”?

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 3) Formal ethics of goods and
principlism of ordered priority
(Diego Gracia, Fundamentos de
bioética) (as modified by Jorge
José Ferrer and Juan Carlos
Álvarez, Para fundamentar la
bioética. Teorías y paradigmas
teóricos en la bioética
contemporánea)
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 • Reality is good insofar as it
offers possibilities (of goods)
that can be appropriated by
human beings.

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 • Basic order of priority among
ethical norms
 in terms of the bioethical

principles that are the sources

of the ethical norms
• 1. nonmaleficence, 2. justice,
3. autonomy, 4. beneficence

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 • Basic order of priority among
ethical norms
 in terms of the ambit of

concern, at the level of civil

ethics

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 1)Matters of public action or concern
(gestión pública) (ethical
minimum—the least that ought to
be done by everyone)
2)Matters of private action or
concern (gestión privada) (ethical
maximum—what individual moral
agents consider binding upon
themselves and upon others)
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