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Key Ethical Principles

Principle of Double Effect

An action that is good in itself that has

two effectsan intended and otherwise not
reasonably attainable good effect,
an unintended yet foreseen evil
effect--is licit, provided there is a due
proportion between the intended
good and the permitted evil.

Principle of Double Effect

The object of the act must not be intrinsically contradictory
to one's fundamental commitment to God and neighbor
(including oneself), that is, it must be a good action judged
by its moral object (in other words, the action must not be
intrinsically evil);
The direct intention of the agent must be to achieve the
beneficial effects and to avoid the foreseen harmful effects
as far as possible, that is, one must only indirectly intend
the harm;
The foreseen beneficial effects must not be achieved by the
means of the foreseen harmful effects, and no other means
of achieving those effects are available;
The foreseen beneficial effects must be equal to or greater
than the foreseen harmful effects (the proportionate
The beneficial effects must follow from the action at least as
immediately as do the harmful effects.

Principle of Beneficence

Traditionally understood as the "first

principle" of morality, the dictum "do good
and avoid evil" lends some moral content to
this principle.
The principle of beneficence is a "middle
principle" insofar as it is partially dependent
for its content on how one defines the
concepts of the good and goodness
beneficence is not a specific moral rule
and cannot by itself tell us what concrete
actions constitute doing good and
avoiding evil

Principle of Beneficence

The Principle of Nonmaleficence

commonly translated as "first, do no
harm," is often considered to be a
corollary to the principle of
As a middle principle, the principle of
beneficence (and nonmaleficence) is
the basis for certain specific moral
norms (which vary depending on how
one defines "goodness").

Principle of Beneficence

Some of the specific norms that arise from the

principle of beneficence in the Catholic tradition
never deliberately kill innocent human life
(which, in the medical context, must be
distinguished from foregoing disproportionate
never deliberately (directly intend) harm;
seek the patients good;
act out of charity and justice;
respect the patients religious beliefs and
value system in accord with the principle of
religious freedom;

Principle of Beneficence


always seek the higher good, that is, never

neglect one good except to pursue a
proportionately greater or more important
never knowingly commit or approve an
objectively evil action;
do not treat others paternalistically but help
them to pursue their goals;
use wisdom and prudence in all things, that is,
appreciate the complexity of life and make
sound judgments for the good of oneself,
others, and the common good.

Principles of Integrity and Totality

Believes the well-being of the whole person must

be taken into account in deciding about any
therapeutic intervention or use of technology.
"integrity" refers to each individuals duty to
"preserve a view of the whole human person in
which the values of the intellect, will, conscience,
and fraternity are pre-eminent" (Gaudium et Spes,
n. 61).
"Totality" refers to the duty to preserve intact the
physical component of the integrated bodily and
spiritual nature of human life, whereby every part
of the human body "exists for the sake of the
whole as the imperfect for the sake of the perfect"

Principles of Integrity and Totality

However, a part of the human body

may be sacrificed if that sacrifice
means continued survival for the
While such sacrifices are normally
justifiable under the principles of
integrity and totality, they may
sometimes be forgone under the
principle of disproportionate

Principle of Proportionate and Disproportionate Means

This principle constitutes an important

approach to the analysis of ethical
questions arising from the general
obligation to preserve human life and the
limits of that obligation
the principle addresses whether the
forgoing of life-sustaining treatment
constitutes euthanasia or physicianassisted suicide in certain circumstances
and it guides individuals and surrogate
decision-makers in the weighing of benefits
and burdens.


Principle of Proportionate and Disproportionate Means

Proportionate means is any treatment that, in the
given circumstances, offers a reasonable hope of
benefit and is not too burdensome for the patient or
others. What is a reasonable hope of benefit to the
patient should be judged within the context of the
whole person (i.e., considered holistically, not just
A disproportionate means is any treatment that, in
the given circumstances, either offers no reasonable
hope of benefit (taking into account the well-being of
the whole person) or is too burdensome for the patient
or others, i.e., the burdens or risks are
disproportionate to or outweigh the expected benefits
of the treatment

Principle of Respect for Persons

All individual human beings are

presumed to be free and responsible
persons and should be treated as such
in proportion to their ability in the
Individuals with reduced autonomy are
entitled to appropriate protection,
according to the principles of
subsidiarity, human dignity, justice,
charity, and vicarious consent.

Principle of Respect for Persons

The human person, then, can be understood in

four interrelated ways:
as a bodily subject, that is, we are not merely
spirits that possess bodies, but we are body as
much as we are spirit;
as a knowing subject for which knowledge is a
good both as an end in itself and as a means to
as a social subject whose primary context is
that of person situated in community; and
as a self-transcendent subject insofar as we
are related to God in our created nature,
through Gods loving creation and in our ability
to participate in that creation.

Principle of Respect for Persons

As a subject, and not

merely an object, a
human person must be
treated with respect in
such a way that
recognizes his or her
human dignity.

Principle of Human Dignity

The intrinsic worth that inheres in every human being .
is rooted in the concept of Imago Dei, in Christs
redemption and in our ultimate destiny of union with
Human dignity therefore transcends any social order
as the basis for rights and is neither granted by
society nor can it be legitimately violated by society.
Human dignity is the conceptual basis for human
Every human being should be acknowledged as an
inherently valuable member of the human community
and as a unique expression of life, with an integrated
bodily and spiritual nature.

Principle of Human Dignity

Is foundational for the

traditions understanding
of distributive justice, the
common good, the right
to life and the right to
health care

Principle of Informed Consent

It is the right and responsibility of

every competent individual to
advance his or her own welfare.
This right and responsibility is
exercised by freely and voluntarily
consenting or refusing consent to
recommended medical procedures,
based on a sufficient knowledge of
the benefits, burdens, and risks


Principle of Informed Consent

The ability to give informed consent

depends on:
1) adequate disclosure of
2) patient freedom of choice;
3) patient comprehension of
information; and
4) patient capacity for decisionmaking.

Principle of Informed Consent

When these requirements are met, three

conditions are satisfied:
1) that the individuals decision is
2) that this decision is made with an
appropriate understanding of the
circumstances; and
3) that the patients choice is deliberate
insofar as the patient has carefully
considered all of the expected benefits,
burdens, risks and reasonable