Human Life as a Foundation for Ethical Health Care Decisions: A Synthesis of the Work of E. D. Pellegrino and W. A. Wallace. 1

This work was supported by a faculty Summer Research Grant from Wheeling Jesuit University.

“The Metamorphosis of Medical Ethics: a 30-year retrospective,” JAMA, March 3, 1993(269: 9) 1158–1162. (p. 1162)

“The Internal Morality of Clinical Medicine: A Paradigm for the Ethics of the Helping and Healing Professions,” Journal of Medicine and Philosophy, 2001, (26: 6) 559–579. (p. 560)

“The Internal Morality of Clinical Medicine: A Paradigm for the Ethics of the Helping and Healing Professions,” Journal of Medicine and Philosophy, 2001, (26: 6) 559–579, p. 567.

“We must ascertain the ethical content of health and medical care philosophically first, and this calls for an enquiry into the two central principles of philosophical medical ethics—beneficence and justice—together with the obligations that flow from them. Then it is necessary to inquire into the transformations of the meanings of benevolence and justice, their shaping by the fact of revelation. Finally, one can then examine the central question by using the Christian concept of charity-based justice as a principle of discernment in confronting some of the concrete issues in medical-care ethics today. With these as principles of discernment, the moral commitment of Christians to love and charity is translated into concrete acts, decisions, and choices in personal and social ethics.” Helping and Healing: Religious Commitment in Health Care. Washington, D.C.: Georgetown University Press, 1997, p. 129.

This position is seen within Pellegrino's work in statements like the following: “Clinical medicine centers on the clinical encounter, the personal interaction between someone who is ill and someone who professes to be a healer. Certainly, health is the ultimate end for healing, but often the fullest functioning of the human body and mind are not attainable. A more proximate and immediate end toward restoration of the physiology and psychology disrupted by illness is to make a right and good decision for this patient.” See note 1, p. 568.

Toward a Reconstruction of Medical Morality,” The Journal of Medical Humanities and Bioethics, Spring/Summer 1987 (8: 1) 7–18. (p. 11)

Wallace has written extensively on human nature and the modeling of nature. See for example: The Modeling of Nature: Philosophy of Science and Philosophy of Nature in Synthesis. Washington, D.C.: The Catholic University of America Press, 1996; “Nature and Human Nature as the Norm in Medical Ethics.” In Catholic Perspectives on Medical Morals, ed. E. D. Pellegrino, J. P. Langan, and J. C. Harvey. Dordrecht: Kluwer Academic Publishers, 1989, pp. 23-53; and “Nature as Animating: The Soul in the Human Sciences”, The Thomist, 49,4 (October, 1985), 612-648.

“The engineer or the doctor is first a human being and then a professional person…Special moral problems are encountered in the exercise of the various professions in the present day, and these give rise to special fields of study within moral science, such as engineering ethics and medical ethics. But the findings at which these special studies arrive are intended to complement, not to replace those of individual or personal ethics.” The Modeling of Nature, 186, 7.

This content is anticipated in my article “The Philosophical Core of Imogene King's Behavioral System, in Nursing Science Quarterly, April 1999 (12: 2) 158–163. Further content about nature and practical science may be found in my article ”Human Nature as a Source of Practical Truth: Aristotelian-Thomistic Realism and the Practical Science of Nursing,” Nursing Philosophy, April 2002 (3: 1) 35-46.

Aristotle, On the Soul. In McKeon R. (ed) The Basic Works of Aristotle. New York: Random House, 1941. pp. 535–603.

Wallace , 1996, pp. 260–261.

192b21-23 Translated by R. P. Hardie and R. K. Gaye, Physica in The Basic Works of Aristotle, McKeon Richard , editor. New York: Random House, 1941.

Wallace, W. A. The Modeling of Nature: Philosophy of Science and Philosophy of Nature in Synthesis. Washington, D. C.: The Catholic University of America Press, 1996, p. 46.

There has been much discussion of this issue within Linacre Quarterly including one in my name, “On the Beginning of Human Life,” February 1998. See also, “Human Nature, Substantial Change, and Modern Science: Rethinking When a New Human Life Begins,” Proceedings of the American Catholic Philosophical Association, Vol. LXXII, 1999, pp. 305–313.

See note 2 above.

See note 2 above and the author's work, “The Philosophical Core of Imogene King” noted in 4 above.

The reader is referred to Wallace's development of these ideas in The Modeling of Nature, pp. 135–150, and 254-262.

Chapter Seven.

Wallace , 1996, p. 186.

1105a30-33.

1106b20-22.

Nicomachean Ethics, X, ch. 7 and 8.

Pegis A. (ed), Introduction to St. Thomas Aquinas. New York: Random House, 1948, p. 27

A few years ago, the maternal mRNA was found to be active in the cellular fluids outside of the nucleus. It participates in cleavage of the cytoplasm that surrounds the now replicated nucleus housing the new human genome. Within the last year, the paternal mRNA has been found active within the nucleus of the zygote and daughter cells. This content and other very helpful information may be found in the work of Derrick Rancourt, on the web site for “Virtual Embryo” http://www.ucalgary.ca/UofC/eduweb/virtualembryo/zygoticcontrol.html. Additionally, see note 9.

See for example, A Theory for Nursing: Systems, Concepts, Process. New York: John Wiley & sons. 1981; “King's theory of goal attainment,” Nursing Science Quarterly, 5, 1992, 19-26; The theory of goal attainment in research and practice. Nursing Science Quarterly, 9, 61-66, 1996. In addition the reference at note 9.

Pellegrino wrote, “From the moral point of view, the autonomy and moral integrity of both physician and patient are to be respected.” “Commentary: Value Neutrality, Moral Integrity, and the Physician,” Journal of Law, Medicine & Ethics, 28 (2000): 78–80. (p. 79)

Summa Theologica, Questions 90–97.

“The Art and Science of Medicine,” in Catholic Perspectives on Medical Morals: Foundational Issues, Pellegrino E.D. , Langan J.P. , and Harvey J.C. , eds. Dordrecht: Kluwer Academic Publishers, 1989, 263–275. (p. 269)

“Patient and Physician Autonomy: Conflicting Rights and Obligations in the Physician-Patient Relationship,” The Journal of Contemporary Health Law and Policy, Spring 1994 (10: 47) 47–68 (p. 48).

“Patient and Physician Autonomy: Conflicting Rights and Obligations in the Physician-Patient Relationship,” The Journal of Contemporary Health Law and Policy, Spring 1994 (10: 47), p. 54.

“Science and Theology: From a Medical Perspective,” Linacre Quarterly, November 1990, 19-34. (p. 23). See also, “Ethics and the Moral Center of the Medical Enterprise” Bulletin of the New York Academy of Medicine, July-August 1978 (54: 7) 625-639.

See note 2, p. 568.