The Ethics of Medical Homicide and Mutilation

by Austin O'Malley

From the relation between the Creator and the creatures arises the natural law. Violation of this law is the source of all moral evil in the world, and of much of the physical evil. Reason shows us this law, and the method of observing it; and reason and unreason, observance or disregard, of the order fixed by the natural law are the foundation of happiness and unhappiness. Whatever a human being is or does, he must seek happiness; that is an essential quality of his being. Happiness is the satisfying of our desires; but as our desires are limitless, only infinite good can satisfy them. The sole sufficient good that sates all human longing is the infinite Necessary Being, and to be happy we must be united with that Being. Obviously the only possible method of possessing this infinite God is through mental union, by undisturbable contemplation of his infinite truth, goodness, being, beauty, and his other attributes. If perfect, everlasting happiness is not in that, in what can it be? Is it in human fame, honor, riches, science, art, man, woman, or child? None of these can give lasting happiness, and no other happiness is real happiness.

Now, the only means we have to obtain union with infinite good is to follow out the condition inexorably placed by God, which is to act in life in keeping with right reason, to obey the law. Man's supreme honor is in freedom from the tyranny of unreason, and in a full obedience to external and immovable order, with the belief that his chief duty is to apprehend and to conform thereto.

This is morality. From the beginning men have held that certain acts are wrong and to be avoided, and that others are to be done. What is wrong, moreover, is such of its own nature, not from our will: we deem the fulfillment of duty, obedience to law, the first, highest, and last necessity of life. If we deny this truth we let in chaos. What is right or wrong is one or the other on its own merits, prescinding from its pleasurableness or pain.

We must seek good whether we will or not. Good is the sole object upon which the will operates, it is the raw material of the will's business. The ultimate standard of this good is God himself as its exemplary cause, but proximately the standard of moral good is our rational nature. Through our reason we judge whether a thing is good or bad; that is, whether it perfects or injures us; and as it is good or bad for us our will's tendency toward it is good or bad. Many acts are indifferent in themselves, but take on a good or bad quality from our intention; others are good or bad in themselves apart from our volition: charity is good, lying is bad, whether they are willed by us or not.

The morality of any action is determined (1) by the object of the action; (2) by the circumstances that accompany the action; (3) by the end the agent had in view.

1. The term object has various meanings, but here it means the deed performed in the action, the thing which the will chooses. That deed by its very nature may be good, or it may be bad, or it may be indifferent morally. To help the afflicted is in itself a good action, to blaspheme is a bad action, to walk is an indifferent action. Some bad actions are absolutely bad; they never can become good or indifferent—blasphemy or adultery, for example; others, as stealing, are evil because of a lack of right in the agent: these may become indifferent or good by acquiring the missing right. Others are evil because of the danger necessarily connected with their performance,—the danger of sin connected with them, or the unnecessary peril to life. An action, to have a moral quality, must be voluntary, deliberate; and mere repugnance in doing an act does not in itself make the act involuntary.

2. Circumstances sometimes, though not always, may add a new element of good or evil to an action. The circumstances of an action are the Agent, the Object, the Place in which the action is done, the Means used, the End in view, the Method observed in using the means, and the Time in which the deed is done. If a judge in his official capacity tells a sheriff to hang a criminal, and a private citizen gives the same command, the actions are very different morally because of the circumstance of the agent giving the command. The object—it changes the morality of the deed whether one steals a cent or a thousand dollars. The place—what might be an offensive action in a residence might be a sacrilege in a church. The means—to support a family by labor or thievery. The end in view—to give alms in obedience to divine command or to give them to buy votes. The method used in employing the means—kindly, say, or cruelly. The time—to do manual labor on Sunday or on Monday. Some circumstances aggravate the evil in a deed, others excuse or attenuate it. Others may so color the deed that they specify it, make it some special virtue or vice. The circumstance that a murderer is the son of the man he kills specifies the deed as parricide.

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.

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.