BIOETHICS

AND
ITS
APPLICATION
IN
VARIOUS HEALTH SITUATIONS
TOPICS to DISCUSS

• Human Sexuality and its Moral Evaluation

• 1.2. Marriage
• a. Fundamentals of Marriage
• b. Issues on Sex Outside Marriage and Homosexuality
• c. Issues on Contraception, its Morality, and Ethico-moral
Responsibility of Nurses
• 1.3 Morality of Abortion, Rape and other Problems Related to
Destruction of Life
LEARNING OBJECTIVES
• 1. Articulate moral perspective towards sex and marriage.
• 2.Enumerate moral norms regarding sexual morality.
• 3. Define Contraception and its types.
• 4. Articulate moral valuations of contraception.
• 5. Relate justifications of Abortion, Rape and other problems related
to destruction of life using contraceptive measures.
Eeeewww…Yikes…OMG…You’re crossing
beyond the line… Let’s change the topic…
• The significant and vital role that SEX plays in
an individual’s desire to be fully human has ,
to some extent remained :
• Undisclosed
• Dubious
• Sinful
• …. Due to :
• CULTURALLY PATTERNED NEGATIVE ATTTUDE
OF FILIPINOS TOWARDS HUMAN SEXUALITY.
SEXUALITY AND HUMAN
REPRODUCTION
Human sexuality is the way
people experience and
express themselves sexually.
This involves biological,
erotic, physical, emotional,
social, or spiritual feelings
and behaviors.
• Traditional Filipino sex attitudes are :
• CONSERVATIVE and STRICT

• FACT :
• EVERY INDIVIDUAL IS BORN OUT OF
HUMAN SEXUALITY EITHER BY :
• Choice
• By chance
• By design
• By accident
Meaning of Sex to the Individual
• Permeates one’s bodily presence to the other
• Humans become conscious of their life situations, imperfections and
limitations. ( alone, empty, hopeless, inadequate, weak)
• Makes one realize the need for some measure of fulfillment that only
another person can give.
• It unfolds either one’s worth, or lack of it , to another person.
• Sexual meaning makes one aware of his/her meaningfulness to
others.
• Sexual love enhances one’s perception and give’s an insight into
his/her meaning for another and his/ her destiny for the other.
Thomas Merton on Reciprocity In Sexual
Love
• A happiness that is sought for ourselves alone can
never be found ; for a happiness that is
diminished by being shared is not big enough to
make us happy.
• There is a false and momentary happiness in self-
satisfaction , but it always deadens our spirit.
• True happiness is found in unselfish love , a love
which increases in proportion as it is shared.
Pain of unrequited Love
• The man who loves himself too much is
incapable of loving anyone effectively including
himself. ( Thomas Merton)

• It is true that selfish persons are incapable of

loving others, but they are incapable of loving
themselves either . (Erich Fromm)
Moral Discipline
• One’s freedom of sexuality
implies a MORAL DISCIPLINE.

• “ It is better to be a human
dissatisfied than a pig satisfied;
better to be Socrates dissatisfied
than a fool satisfied. ”
• - John Stuart Mill
The Moral Issues of Contraception and Sterilization
• SEXUAL INTERCOURSE

• The expression of the conjugal will of a man

and a woman to parenthood which is the
celebration of physical, mental and spiritual
intimacy. ( Overduin and Fleming )
Meaning of Contraception
•Contraception
• The voluntary prevention of
conception by the positive use
of artificial means that hinder
the generative cells from
uniting during the sexual act.
STERILIZATION
• Also a form of contraception insofar as its purpose is
the prevention of conception.

• It is the method of cutting off the sexual capacity of a

man or a woman .
• The mutilation of sexual power in a man or woman to
render conception impossible.

• Permits coitus but hinders conception.

Types of STERILIZATION
• VOLUNTARY - a person wills and
requests that the procedure be
done on himself/herself.

• INVOLUNTARY ( compulsory ) –
done by the order of a public
authority of a state.
Vasectomy
Purpose of STERILIZATION

•1. THERAPEUTIC
•2. CONTRACEPTIVE
•3. EUGENIC
•4. SOCIAL
•5. PUNITIVE
• 1. THERAPEUTIC
• The removal of a reproductive organ or a portion thereof to save
one’s life or to promote bodily integrity.

• Governed by the principle of Totality, which declares that an

individual has a right to dispose of his/her organ or to destroy their
capacity to function only to the extent that the general well-being of
the whole body demands it.
• Ex. Scarred or weakened Uterus
• 2. CONTRACEPTIVE STERILIZATION
• The intentional prevention of conception through sterilization.
• Justifications :
• A. a serious illness of either a husband or wife who may have
tuberculars, epilectics, syphilitics and lepers.
• B. The probability of genetic abnormality
• - carrier of defective genes
• C. Severe financial burdens
• D. When childbearing puts one’s health in danger.
• 3. EUGENIC and SOCIAL STERILIZATION

• Performed to hinder the conception of undesirable and physically and

mentally unfit offspring.

• A sort of social engineering

• 4. PUNITIVE STERILIZATION

• Done as a punishment for a crime or antisocial behavior, particularly

rape and other sexual related offenses.

• Compulsory or involuntary.
JUSTIFICATIONS for CONTRACEPTION

• 1. PARENTHOOD and Birth are matters of social responsibility and intelligent

choice.
• 2. An individual should be the one to determine his/her fertility and control
his/her fecundity.
• 3. One should be able to decide how many children he/she is able to bear and
support.
• 4. Contraceptive technology makes men and women persons of will and
decision and not merely inert and powerless bodies subject to church
proscriptions or divine will.
• 5. Contraception can prevent the transmission of recessive disorders ot
genetically linked diseases.
Methods of Contraception or Family
Planning
• 1. FOLK Methods
• A. Precoital or Postcoital douche
• B. Prolonged Lactation
• C. Withdrawal
• 2. MECHANICAL METHODS
• A. Condom
• B. Diaphragm( Cervical Cap or Intracervical pessary )
• C. Sponge –a cervical object with a string attached for easy removal.
• -covers the entrance of the uterus to keep sperm out
• 3. HORMONAL METHODS
• A. Contraceptive Pills ( combination
of estrogen and progestin)
• B. Injections and Implants – a
biodegradable pill implant which is
about 3 cm long , can be injected
using a large bore needle right
through the woman’s skin.
• A combination of hormones that
work up for up to 3 years and does
not require surgery for insertion.
• 4. ABORTIFACIENTS
• A. Intrauterine device
• -placed inside the uterus, made of plastic or metal and often comes in
the shape of a T.
• Does not prevent ovulation but it can prevent conception and
discontinue a pregnancy by irritating and inflaming the lining of the
uterus in such a way that is lethal to sperm.
• B. DES ( diethylstilbestrol )

• A morning after pill , a synthetic hormone that forces the

endometrium or uterine lining to shed.

• If the zygote has already burrowed itself in the endometrium, it will

be destroyed.

• Can prevent ovulation and some recommend it for incest and rape
cases.
C. Prostaglandins
- A Powerful hormone drug.
- When taken by mouth, injection or as a vaginal suppository , it causes
a violent contraction of the uterus, pushing out a whatever is inside it.
- The fetus will be forcibly expelled alive and will subsequently die due
to exposure or premature delivery.
- This drug is used in second-trimester abortions.
• D. ANTI-PREGNANCY VACCINE
• Makes a woman produce antibodies that
neutralize human chorionic gonadotropin.

• Induces the early abortion of a fetus

• E. LOW DOSE TYPE OF CONTRACEPTIVE

PILL
5. SURGICAL METHODS • 6. NATURAL OR BEHAVIORAL
A. TUBAL LIGATION METHODS
B. VASECTOMY • A. RHYTHM or Calendar
C. HYSTERECTOMY • B. Temperature Method (Basal )
• C. Ovulation Method ( mucus)
• D. Symptho-thermal =
combination of temperature and
mucus method
E. Sex relations during
menstruation
• When couples, by means of recourse to contraception, separate these
two meanings that God the Creator has inscribed in the being of man
and woman and in the dynamism of their sexual communion, they act
as “arbiters” of the divine plan and they “manipulate” and degrade
human sexuality—and with it themselves and their married partner—
by altering its value of “total” self-giving. Thus the innate language
that expresses the total reciprocal self-giving of husband and wife is
overlaid, through contraception, by an objectively contradictory
language, namely, that of not giving oneself totally to the other. This
leads not only to a positive refusal to be open to life but also to a
falsification of the inner truth of conjugal love, which is called upon to
give itself in personal totality. (John Paul II 1981)
The Moral Issue of Abortion
• History :
• The practice of abortion is as old as mankind itself.
• In ancient Greece, Plato and Aristotle recommended abortion to
avoid excess population in the small Greek city-states.
• In early Philippine society, women who had an unplanned
pregnancies would drink a bitter solution of certain tree leaves and
roots to induce abortion.
• Others sought the help of a local hilot to massage a pregnant
woman’s abdomen to induce abortion.
• In the Philippines, ABORTION is ILLEGAL.
• Article II, Section 12 of the 1986 Philippine
constitution provides :
• “ The state recognizes the sanctity of life and
shall protect and strengthen the family as a basic
autonomous social institution.
It shall equally protect the life of the mother
and the life of the unborn from conception.
Meaning and types of Abortion
• Abortion
• Refers to the expulsion of a living fetus from a
mother’s womb before it is viable.
• Abortion is defined as the termination of pregnancy ,
spontaneously or by induction before viability. – Dr.
Andre E. Hellegers
• Viability
• Has to do with the
child’s capability to live
independently of its
mother after it has left
the womb.
• Normally a child is
considered to be viable
at about the 28th week
5 types of Abortion

• 1. Natural Abortion ( Spontaneous Abortion) ( Miscarriage )

• The expulsion of a fetus through natural or accidental causes.
• Unintentional or involuntary , devoid of Moral Significance.

• It assumes a MORAL BEARING if and when it becomes voluntary.

• Ex. A pregnant woman willfully steps on a banana peel to slip.
• 2. Direct or Intentional Abortion
The pregnant woman makes her act intentional and
voluntary.
example :

Jogging, horseback riding, biking, scrubbing the floor

which may cause the inflammation of the uterine wall.
• 3. Therapeutic Abortion
• The deliberate induced expulsion of a living fetus to save the mother
from the danger of death brought on by pregnancy.

• Example :
• Heart Condition
• 4. EUGENIC ABORTION
• ( selective abortion or Abortion on fetal indications)
• Recommended in cases where certain defects are
discovered in the developing fetus.
• It is termed as eugenic because it meant to get rid of
abnormal babies and decrease the occurrence of
undesirable heritable consequences.
• 5. INDIRECT ABORTION
• The removal of the fetus occurs as a secondary effect of a legitimate
or licit action , which is the direct and primary object of the intention.
• This is an instance of the double- effect principle

• Example :
• Cancerous Uterus
• Ectopic Pregnancy
The Moral Issue of Abortion

• When does life begin?

• Is the fetus a person?
• When does the human soul
fuse or unite with the body?
• 1. The Theory of Hominization
• -a new human person exists immediately upon conception.
• 2. Plato
• - The soul enters at conception.
• 3. St. Gregory of Nyssa
• - The soul is infused at the first moment of conception.
• 4. Theory of Delayed Animation
• - upholds that ensoulment occurs at a later time after the moment of
conception.
• 5. Aristotle
• - taught that ensoulment occurs at about the 40th day for males and the
80th day for females following conception.
• 6. St. Thomas Aquinas
• - The rational soul is not infused until some time later.
• The soul is in the embryo from the beginning, then the sensitive
soul and lastly the intellectual soul.
General viewpoints of Abortion

• 1. Conservative Position
• - declares that :
• Abortion is never permissible or at most , is permissible if and only if
it is required to save the pregnant woman’s life.

• The fetus has FULL ONTOLOGICAL STATUS, AN INDIVIDUAL PERSON

WITH MORAL STATUS WHO POSSESSES THE RIGHTS AS THOSE WHO
ARE BORN.
• 2. LIBERAL POSITION
• States that abortion is always permissible , whatever the state of fetal
development may be.

• This stand stresses the rights of a woman to make decisions that

affect her own body.
• A woman has the right to control her own body as her personal
property within the context of the right to Self-determination.
• The fetus is not an individual human person but only a tissue. It
possess no rights and no moral values.
• 3. Moderate/Intermediate Position
• Holds that abortion is morally permissible up to a certain stage of
fetal development or for a limited set of reasons sufficient to justify
the taking of life in that special circumstance.

• The fetus attains ontological status at quickening or viability.

• Abortion before quickening is morally legitimate.

Related topics on Human Sexuality
• LGBTI people have an increased risk of depression, anxiety, substance abuse,
homelessness, self-harming and suicidal thoughts, compared with the general
population. This is particularly true of young LGBTI people who are coming to terms
with their sexuality and experiencing victimization and bullying at school.

• Some of the stressful experiences that can affect the mental health of an LGBTI person
are:

• feeling different from other people

• being bullied (verbally or physically)
• feeling pressure to deny or change their sexuality
• feeling worried about coming out, and then being rejected or isolated
• feeling unsupported or misunderstood. (betterhealthChannel)
• Discrimination based on sexuality
• Equality and freedom
from discrimination
are fundamental
human rights that
belong to all people.
St. Thomas Aquinas’ View

• In his Summa Theologiae he writes about

chastity :
• If the human mind delight in the spiritual union
with that to which it behooves it to be united,
namely God, and refrains from delighting in
union with other things against the requirements
of the order established by God, this may be
called a spiritual chastity, according to 2 Cor.
11:2, "I have espoused you to one husband, that
I may present you as a chaste virgin to Christ."
• If, on the other hand, the mind be
united to any other things
whatsoever, against the prescription
of the Divine order, it will be called
spiritual fornication, according to Jer.
3:1,
• "But thou hast prostituted thyself to
many lovers." Taking chastity in this
sense, it is a general virtue, because
every virtue withdraws the human
mind from delighting in a union with
unlawful things.
• The Catholic Church defines chastity as the virtue that moderates the sexual
appetite. It refers to the successful integration of sexuality within the
person.Everyone is called to chastity.
• Unmarried Catholics express chastity through sexual abstinence.
• Sexual intercourse within marriage is considered chaste when it retains the
twofold significance of union and procreation.
• Pope John Paul II wrote:

• At the center of the spirituality of marriage, therefore, there lies chastity

not only as a moral virtue (formed by love), but likewise as a virtue
connected with the gifts of the Holy Spirit—above all, the gift of respect for
what comes from God (donum pietatis).
• Marriage is a sacrament, and a public commitment
between a man and a woman.
• Marriage builds the family and the society. The
Church considers the expression of love between
husband and wife to be an elevated form of human
activity, joining husband and wife in complete, mutual
self-giving, and opening their relationship to new life
• . As Pope Paul VI wrote in Humanae vitae, “The sexual
activity, in which husband and wife are intimately and
chastely united with one another, through which
human life is transmitted, is, as the recent Council
recalled, ‘noble and worthy.’”
• ( Humanae Vitae)
• Because sex is considered chaste only
within context of marriage, it has come to
be called the "nuptial act" in Catholic
discourse.
• Among Catholics, the nuptial act is
considered to be the conjoining of a man
and a woman through sexual intercourse,
considered an act of love between two
married persons, and is considered in this
way, a gift from God.
• The two partners commit adultery when they have sexual
relations, even transient ones, while at least one of them is married
to another party.
• There, adultery is defined as an injustice because it is an injury of the
covenant of the marriage bond, a transgression of the other spouse,
an undermining of the institution of marriage and a compromising of
the welfare of children who need their parents' stable union.
• (The Catechism of the Catholic Church )
• The Catechism specifies that all marriage
acts must be both unitive and procreative.
• use of artificial birth control
• mutual masturbation
• anal sex are ruled out as ways to avoid
pregnancy
• Prohibited acts with contraceptive effect
include sterilization, condoms and other
barrier methods, spermicides, coitus
interruptus (withdrawal method), the Pill,
and all other such methods.
 • Restricting sexual activity to times when
conception is unlikely (natural family
planning and similar practices) is not
deemed sinful.

• The Catechism of the Catholic Church says

that the spacing of births may be practiced
for "just reasons" and not "motivated by
selfishness".
• The Catholic Church disapproves of pornography and says that civil
authorities should prevent the production and distribution of
pornographic materials.
• The Catholic Church disapproves of masturbation.

• Thomas Aquinas, one of the most prominent Doctors of the Catholic

Church, wrote that masturbation was an "unnatural vice" which is a
species of lust", but that it is a less serious form than bestiality, which
is "the most serious", and than sodomy, which is the next most
serious
 • The Catholic Church
disapproves of fornication
(sexual intercourse between
two people not married to each
other), calling it "gravely
contrary to the dignity of
persons and of human
sexuality".
Other Related topics on Perspectives
of Sexuality