ETHICAL CONSIDERATIONS.




a. The ethical dimensions of the human act: Andrew Varga.
b. Valid criteria of morality.




THE ETHICAL DIMENSIONS OF THE HUMAN ACT.



Andrew Varga S.J. in a small paperback with the title, On Being Human, published by Paulist Press, 1978, provides a method for the analysis of that what we do. He calls this the analysis of the human act. The method is extremely useful, especially if the situation to deal with is complex and confusing. The points of analysis are the object, the motive, the circumstances, and the consequences of one’s action. The object of an act answers the question “What is being done?” The motive, “Why is it done?” The circumstances are more difficult to identify because they are the answers to many questions. Who? When? Where? To whom? How much? With whom? and perhaps many more are all question about circumstances. As to the consequences, we may or may not foresee them, but we should do our best to foresee as many of them as possible in order to act responsibly. In any case, we are armed here with an analytical tool that is simple enough and sharp enough to cut through the difficult and the confusing. How this method of analysis works may be best illustrated by examples.

The moral dimensions of the stem cell research.

Suppose that cloned an embryo to obtain stem cells for a patient with a terminal disease. The patient needs an organ replacement and we want to provide that organ without the trauma of immune rejection. We use for cloning the somatic cell nucleus of the patient and the cytoplasm of an ovum from a donor to create an embryo whose stem cells we harvest and maintain in tissue cultures. The procedure prevents the embryo to go any further in development than the production of multi-potent stem cells. The treatment of the patient results in long term cure.

The object of the act is the killing of the human embryo. The inaccuracy of the language creates a bit of confusion here. One want to say: No! the object is to cure the patient, and the killing of the human embryo is incidental. The fact, however, is that we kill the human embryo in order to cure the patient. Therefore, we may be motivated by the desire to cure the patient, but we do that by first killing the human embryo. The object is killing one, the motive is to cure another. The object is not incidental to the motive. To see this clearly is the first step in evaluating stem cell work in proper, moral terms. I do this (object), because I want to achieve that (motive). Is the embryo human? Yes. Otherwise it would be useless to us. Is it killed? Yes. Otherwise we could not harvest its stem cells.

Some people say that at such an early stage of development the embryo is not fully human because it does not feel, think, communicate and so on. This is again rather fuzzy thinking. Development is a single process. It begins when all that is needed to begin this process is there, and that is at conception, or at the time when a zygote is formed via cloning. If we would not interfere, the process would run its normal course and a baby child would be born. (By the way, we do not cease to be human when under anesthesia, and we do not feel, think or communicate.) There is really no way to get away from it, the object of the stem cell venture is the killing of a human embryo, while the motive is to cure someone ill.

What are the circumstances? They depend on the circumstances. The zygote loss in the cloning process is high, which means that the medical staff will require several embryos to proceed efficiently. The possible use of already frozen embryos, the left overs from fertility clinics, which would be destroyed otherwise, is a circumstantial factor. So is the skill of the physician or technician performing the various tasks. The seriousness of the disease to be cured, the age of the patient, the probability of success in achieving a cure, the fact that adult stem cells could also be used from placental blood or from the patient’s bone marrow and fat tissue, but may be not as efficiently as embryonic ones, and many similar situational features belong to the complex world of circumstances. Even ignorance belongs to this group. Circumstances may aggravate, modify, or alleviate moral responsibility. They are to be considered, each in its own right. Circumstances do not justify an evil act. And we are responsible for all foreseeable consequences of our actions.

Here is a short story to illustrate the complex world of circumstances. There were three guys going on a hunting trip. The plane they were flying crash landed in a vast stretch of wilderness, hundreds of miles from any human habitation. The radio was busted, and they could not expect a rescue because they did not tell any of their friends where they were going. They put their gear in order, sleeping bag, knife, gun, ammunition, water. There were some berries to eat, but they saw no deer to shoot. They did see a bear in the far distance, and a few birds. The former was way out of shot, the latter too small to waste bullets on them. After two weeks of walking they began to feel exhausted and very hungry. They heard a small noise deeper in the forest. Immediately they spread out hoping it may be a deer. One of them spotted a moving brown object deeper in the woods. He was not really sure what the object was, but hoping it was a deer, he took aim and fired. There was a cry. He rushed to the spot with a sinking feeling in his stomach and to his great dismay he realized that he shot his partner.

Now there were two of them. They sat down at the dead body of their friend and one of them said. Listen. We are close to starvation. There are not enough berries around here and it is very hard to get enough of them. We desperately need protein. Our survival depends on it. Let’s eat him. He is already dead, why should all this meat be wasted? So they ate him.

As the story goes, the very same thing happened a few weeks later. And then there was only one.
It is easy to see how much this story runs parallel with the cloned stem cell research. The object is killing, the motive is survival. The circumstances include the question Is it human I am killing? Could there have been a better solution to the problem, a different approach?


Three Practical Directives.


1. Sometimes we get ourselves into situations where we must make a choice, but unfortunately there are only two choices, neither of them good. Suppose that I am a bank manager, and the only person in the bank at this particular time, who knows the combination to the safe. The safe contains a large sum of money. One early afternoon three masked bandits enter the bank. One of the masked man puts a gun to my head and tells me to open the safe. If I refuse I will be shot. If I comply the bank will lose a large sum. I choose the lesser of two evils and open the safe. The opening of the safe at this unusual hour automatically triggers a silent alarm, and I know that within five minutes the security police will be there. The robbers are, however, fast and before the security personnel arrives, they make their escape with the cash. The situation is called a dilemma, and the principle used to resolve it is that of choosing the lesser of two evils. The conditions are that one must make a choice in a situation where there are only two choices, neither of them good. The choice is morally correct.
2. We often hear the adage that you cannot have an omelet without breaking a few eggs. The statement implies that the end justifies the means. This is morally incorrect. One cannot perform and evil act for the sake of something desirable or seemingly good. Evil means corrupt the end as well. Suppose that I have a daughter who is desperately ill. The only way to save her life is through a series of extremely expensive treatments totally beyond my financial means. Through a friend of mine I get in touch with a drug dealing organization and through several events of pure chance I become one of the agents in a very large and successful drug deal. I do not care whatever happens to me. My only concern is the recovery of my child. From the deal I get enough money to achieve that. I do not think of the possible damage I might cause to others, including teenagers of the same age as my daughter. It is clear that my action was morally wrong. The end does not justify the means.
3. The third directive is called the principle of double effect. There is one action and two consequences, one good, the other bad. The effects are not chained in sequence, one leading to the other, but are inseparably connected. Under such conditions I may perform the act for the sake of the good effect without intending the unavoidable the bad effect. Suppose that a woman has a rapidly growing cancer of the uterus, while at the same time she is also pregnant with her first child. The only solution to save her life is immediate surgery, which means that her uterus must be removed. The hysterectomy to be performed will, of course, not only terminate her cancer, but also her pregnancy. The fetus is far too young to survive after the surgery. Since the removal of the cancer and the removal of the fetus are not separable being the result of the same act, we have a situation of double effect. The surgery is performed to save the woman’s life. The death of the fetus is not intended but it is unavoidable. To chose surgery is the correct moral choice for her.

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