Basic Ethical Principles

Introduction
Ethics deals with moral behavior or on how one should act. Various universal principles have been accepted as a guide, those related to health care include: Stewardship Solidarity Totality Double Effect Cooperation

Stewardship
Our bodies, our life, our human nature and everything in this earth are gifts we have dominion over. This means we are responsible for them. We should not, as faithful stewards, harm but rather improve and care for them. We have to treat them with utmost respect, use originality and creativity to cultivate them, know and respect their limits. We cannot contradict human nature.

 Stewardship is an ethic that embodies responsible planning and management of resources. The concept of stewardship has been applied in diverse realms, including with respect to environment, economics, health, property, information, and religion, and is linked to the concept of sustainability.

TOTALITY
Refers to the whole, every person must develop , use care for and preserve all his parts and function for themselves as well as for the good of the whole.

TOTALITY
An individual can not dispose of their organs or destroy their capacity unless it is for the greater good of the entire body we have a duty to preserve the integrity of our bodies

DOUBLE EFFECT
When an act is foreseen to have both good and bad effects the principle of double effect is applied. In order that such act be permissible the following condition should be met: 1. The direct freely chosen effect of the act must be morally good while the other indirect into freely chosen effect may be physically harmful

 2. The action itself must be good or at least neutral 3. The foreseen beneficial effect must be equal to or greater than the foreseen harmful effect

 4. the beneficial effect must be equal to or greater than the foreseen harmful effect. 5. The beneficial effect must follow from the action at least as immediately as the harmful effect. The good effect must not be produced by the bad effect,

Principle of Double Effect

An action that helps but may harm a patient may be ethical if: The action itself is good. The doer intends only the good effect. The bad effect is not a means to a good end. A favorable balance exists between the good and bad effects

COOPERATION
Is the participation of one agent with another agent to produce a particular effect or joint effect. Cooperation becomes a problem when the action of the primary agent is morally wrong

Cooperation may be
1.A. Formal when the secondary agent willingly participates as when one agrees, advices, counsels promotes or condones. B. Material when the secondary agent does not willingly participate.

 2.A. Immediate when the action of the secondary agent is inherently bound to the performance of the evil action.

SOLIDARITY
Means to be one with others. In the provision of health care, it is most important for the provider to be in solidarity with the patient when seeking, always, the latters best interest.

Major Bioethical Principles

Respect for a Person

Respect for person is the recognition of the equality possessed by every human being as a unique, worthy, rational, self-determining creature, having the capacity and right to decide what is best for himself. It is not undermined by states of suffering, disability or disease. Respect for person is the responsibility for all to treat persons as an end and never as a means.

Principle of Justice
Justice, also termed fairness, means to give to each one what he deserves or what is his due. X has a right to his due. Y has the obligation not to deprive X of his due. But man lives in a finite world. There are limits to funds, medical supplies, healthcare services.

 The needs of everyone, even if it is his due, cannot all be served. Justice also means to treat equals equality. The principle of justice requires that like cases be treated alike and that different cases be treated differently.

BENEFINENCE
Beneficence is the positive pole of nonmalifecence. It means to do good, to provide a benefit. Beneficence hinges on other duties such as fair play, keeping promises, role commitments, reciprocity

Beneficence
In simple terms, the principle of beneficence requires that health providers go beyond doing no harm and actively contribute to the health and well-being of their patients. In this dictum lies many quality-of-life issues, for practitioners of medicine today possess the technology to keep some individuals alive well beyond any rational good to themselves.

THE INVIOLABILITY OF LIFE

The principle of the inviolability if life is also proposed as the sanctity, the dignity, or respect for human life. From the Judeo Christian tradition human life has dignity because life is a Gods gift.

 Man comes directly from God, is created according to Gods plan and destiny. It is God who is the source, who sustains and perfects mans life.

Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair, the cause of which can be attributed to a mental disorder such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse. Stress factors such as financial difficulties or troubles with interpersonal relationships often play a significant role.]

Abortion
is the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced. The term abortion most commonly refers to the induced abortion of a human pregnancy.

Techniques of abortion
Most abortions are done during the first three months of pregnancy. There are a number of ways a fetus can be aborted. the herbal or other manipulations done by traditional healers and back-street abortionists

Vacuum aspiration
This is used for pregnancies up to 12-14 weeks. In this technique, the cervix is dilated and a tube connected to a suction apparatus was inserted. The fetus was sucked out into a jar. The fetal body parts were examined to ensure totally removal.

D & C-Dilation and Curettage

This is the most popular technique. The cervix was dilated and a curette was inserted. The walls of the womb were scraped until the foetus was cut into pieces and removed.

Toxic solution
In this technique, a hyperosmolar solution, usually saline was introduced into the womb by means of a needle. The saline kills the foetus that will then be expelled naturally through the vagina. This is usually used in pregnancies of 12-16 weeks.

Hysterectomy
This is similar to Caesarean section by which the foetus is removed through an incision in the womb. Unlike Caesarean section, the foetus is left to die.

Contraception
Birth control, also known as contraception and fertility control, refers to methods or devices used to prevent pregnancy. Planning and provision of birth control is called family planning. Safe sex, such as the use of male or female condoms, can also help prevent transmission of sexually transmitted diseases.

Euthanasia
refers to the practice of intentionally ending a life in order to relieve pain and suffering.

 Means easy death From the Greek word eu-easy and thana tos-death More strictly, it means painless, peaceful death It is the deliberate putting to death, in an easy, painless way, of an individual suffering from an incurable and agonizing disease. Popularly known as mercy killing

Some call it the art or practice of painlessly putting to death a person suffering from a marked deformity or from an unbearable and distressing disease.

SELF Administered
it may be either active (positive) euthanasia, which in a terminally ill patient will deliberately, directly terminate his life by employing painless methods-it is an act of commission insofar as it is voluntary and deliberate -or passive (negative) euthanasia, which one allows oneself to die without taking any medicine or by refusing medical treatment.-it is an act of omission in so far as one simply refuses to take anything to sustain life.

T The Problem of Human Dignity

The moral issue of euthanasia revolves around the preservation of human dignity in death even to the individuals last breath. It states that euthanasia aims to preserve human dignity until death, not only does one have a duty to preserve life ,but has also the duty to die with dignity.
To die with dignity means that one should be able to make the decision to die when dying would be better than to goon living with an incurable and distressing sickness.

 The negative side, declares that euthanasia erodes human dignity. This is the crossroads of a moral issue: 1)Whereas the positive side insists that mercy killing preserves human dignity 2) The negative side claims the opposite since this acts hastens the death of an individual.

What is Sterilization
A surgical procedure:
Sterilizationis a surgical technique leaving a male or female unable to reproduce. It is a method of birth control.

Common sterilization methods include

Vasectomy in males. The vasa deferentia the tubes which connect, the testicles to the prostate are cut and closed, This prevents sperm produced in the testicles to enter the ejaculated semen which is mostly produced in the seminal vesicles and prostate).

 Tubal ligation in females, known popularly as"having one's tubes tied". The Fallopian tubes, which allow the sperm to fertilize the ovum and would carry the fertilized ovum to the uterus, are closed. This generally involves a general anesthetic and alaparotomy or laparoscopic approach to cut, clip or cauterize the fallopian tubes.

Other procedure that result insterility

Hysterectomy in females The uterus is surgically removed, permanently preventing pregnancy and some diseases, such as uterine cancer.

 Castration in males The testicles are surgically removed. This is frequently used for the sterilization of animals, with added effects such as docility, greatly reduced sexual behaviour, and faster weight gain (which is desirable in some cases, for example to accelerate meat production).

Moral Issues on Sterilization

The Catholic church has strongly condemned all artificial methods of Contraception (aposition also held by most Protestant churches up to 1930, when the Anglican church voted for change).

This includes the contraceptive pill, condoms and also medical procedures such as Vasectomy and Sterilisation. Infact the church regards contraception as mortally sinful. The official position is stated in the papal encyclical Humanae Vitae issued by Pope Paul VI in 1968

What is Mutilation
Mutilation or maiming is an act or physical injury that degrades the appearance or function of the (human)body, usually without causing death.

 Usage of term The term is usually used to describe the victims of accidents, torture, physical assault, or certain pre modern forms of punishment.

Moral Issues on Mutilation

1) A diseased part is harmful to the whole body. 2) Another question pertains to the predicament of a person who was ordered by a tyrant to cut off his own hand. 3) Another case is the necessity to amputate an extremity.