The Ethics of Medical Homicide and MutilationO'Malley, Austin
Religion
The Ethics of Medical Homicide and Mutilation
O'Malley, Austin
Medical ethics
3. The end also determines the morality of an action. Since the
end is the first thing in the intention of the agent, he passes
from the object wished for in the end to choosing the means for
obtaining it. Without the end the means cannot exist as such. There
are occasions when an end is only a circumstance: for example, if
it is a concomitant or extrinsic end. When this extrinsic end is in
keeping with right reason or when it is discordant thereto, it may
become a determinant of morality. In every voluntary, or human, act
there is an interior and exterior act of the will, and each of these
acts has its own object. The end is the proper object of the interior
act of the will; the exterior object acted upon is the object of
the exterior act of the will; both specify the morality, but the
interior object or end specifies more importantly, as a rule, than
the exterior object does. The will uses the body as an instrument on
the external object, and the action of the body is connected with
morality only through the will. We judge the morality of a blow not
by the physical stroke, but from the intention of the striker. The
exterior object of the will is, in a way, the matter of the morality,
and the interior object of the will, or the end, is the form.
Aristotle said: "He that steals to be able to commit adultery is more
of an adulterer than a thief."[1] The thievery is a means to the
principal end, and this principal end chiefly specifies or informs
the action.
[1] _Ethics_, v, c. 2.
The means used to obtain an end are very important in a consideration
of the morality of an act. There are four classes of means--the
good, bad, indifferent, and excusable. Good means may be absolutely
good, but commonly they are liable to become vitiated by
circumstances,--almsgiving is an example. Some means are bad always
and inexcusable--lying, for instance. The excusable means are those
which are bad, but justifiable through circumstances. To save a man's
life by cutting off his leg is an excusable means. The end sometimes
may vitiate or hallow indifferent means, but it does not in itself
justify all means. Means, like other circumstances, are accidents
of an action, but they are in the action just as much as color is
in a man. Color is not of a man's essence, but we cannot have a man
without color.
The effect of an action, the result or product of an effective cause
or agency, may in itself be an end or an object or a circumstance,
and it has influence in the determination of morality. Sometimes
an act has two immediate effects, one good and the other bad. For
example, ligating the blood-vessels going to the uterus to stop a
hemorrhage and so save a woman's life, a good effect, has also in
ectopic gestation while the fetus is living another immediate effect,
namely, to shut off the blood supply from the fetus and so kill it, a
bad effect. To make such a double-effect action licit there are four
conditions which are explained in the chapter on Mutilation.
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