A BRIEF HISTORY OF THE DEVELOPMENT OF MEDICAL ETHICS
Fr. Peter Beaulieu, Chaplain, Worcester Guild
January 12, 2008
The ancient form of medical ethics that was enshrined in the
Oath of Hippocrates was concerned with the duties of
physicians in regard to their patients. In the Hippocratic
tradition of medicine, chief among these duties was patient
benefit—the doctor had to do all in his power to help a patient
who sought his medical expertise. As paganism gave way to
monotheism, both early rabbinic practice and the developing
Christian culture found much that was noble in that earlier tradition. The great Scholastic synthesis of Saint Thomas Aquinas used the insights of Greek philosophy to articulate orthodox Christian doctrine. Following Aristotle, the ethics of St. Thomas Aquinas emphasized the cultivation of virtues proper to the human person, understanding this as the way to achieve the good and happy life.
With the work of William of Ockham in the fourteenth century, a new period in moral theology began. From Ockam until the mid-twentieth century, morality became a study of obligations. Ockham emphasized human freedom, whose only limit was divinely imposed. There were two foci to his understanding of morality: the liberty of God and the practical reason that seeks to understand and apply theoretical laws. Within these two limits, concrete, doubtful cases were minutely analyzed.
In the wake of the Protestant Reformation, the Council of Trent emphasized the adequate education of priests, with an emphasis on the proper administration of the Sacrament of Penance. This required thorough training in moral theology. The discipline was separated into fundamental (or theoretical) moral theology and special (or practical) moral theology. Thus the confessor was given all the elements necessary for analyzing cases of conscience, so that he could apply theory to actual situations and ascertain the penitent’s degree of sinfulness or culpability.
This case-based method of moral analysis (or casuistry) came to predominate Catholic moral methodology and gave rise to moral probabilism—the theory that in difficult cases, a moral agent may safely follow a merely probable opinion (e.g., one which could be defended as a position of one of the Doctors of the Church), even if the opposite opinion were more probable. The seventeenth century was the zenith of the Manuals of Moral Theology, in which cases were analyzed to determine the legitimacy of following a given course of action. Different schools of thought coalesced around the stance taken in regard to probabilism. The basic concerns in moral theology were law and liberty, and the conflicts that arise between them. It was the function of moral theology to determine what was obligatory and to delineate the limits of liberty.
At the time of the Second Vatican Council (1962-1965), the Council Fathers sought to renew moral theology by making it more Christ-centered, drawing upon the work of the Fathers of the Church, and firmly rooting it in the interior life and the theological virtues (faith, hope, and especially love). The Fathers of Vatican II also recognized that all Christians are called to holiness of life, insisted that the Magisterium must constitute a principal source for moral reflection, and held that the work of Saint Thomas Aquinas must be given primacy in theology in general and moral theology in particular.
January 12, 2008
The ancient form of medical ethics that was enshrined in the
Oath of Hippocrates was concerned with the duties of
physicians in regard to their patients. In the Hippocratic
tradition of medicine, chief among these duties was patient
benefit—the doctor had to do all in his power to help a patient
who sought his medical expertise. As paganism gave way to
monotheism, both early rabbinic practice and the developing
Christian culture found much that was noble in that earlier tradition. The great Scholastic synthesis of Saint Thomas Aquinas used the insights of Greek philosophy to articulate orthodox Christian doctrine. Following Aristotle, the ethics of St. Thomas Aquinas emphasized the cultivation of virtues proper to the human person, understanding this as the way to achieve the good and happy life.
With the work of William of Ockham in the fourteenth century, a new period in moral theology began. From Ockam until the mid-twentieth century, morality became a study of obligations. Ockham emphasized human freedom, whose only limit was divinely imposed. There were two foci to his understanding of morality: the liberty of God and the practical reason that seeks to understand and apply theoretical laws. Within these two limits, concrete, doubtful cases were minutely analyzed.
In the wake of the Protestant Reformation, the Council of Trent emphasized the adequate education of priests, with an emphasis on the proper administration of the Sacrament of Penance. This required thorough training in moral theology. The discipline was separated into fundamental (or theoretical) moral theology and special (or practical) moral theology. Thus the confessor was given all the elements necessary for analyzing cases of conscience, so that he could apply theory to actual situations and ascertain the penitent’s degree of sinfulness or culpability.
This case-based method of moral analysis (or casuistry) came to predominate Catholic moral methodology and gave rise to moral probabilism—the theory that in difficult cases, a moral agent may safely follow a merely probable opinion (e.g., one which could be defended as a position of one of the Doctors of the Church), even if the opposite opinion were more probable. The seventeenth century was the zenith of the Manuals of Moral Theology, in which cases were analyzed to determine the legitimacy of following a given course of action. Different schools of thought coalesced around the stance taken in regard to probabilism. The basic concerns in moral theology were law and liberty, and the conflicts that arise between them. It was the function of moral theology to determine what was obligatory and to delineate the limits of liberty.
At the time of the Second Vatican Council (1962-1965), the Council Fathers sought to renew moral theology by making it more Christ-centered, drawing upon the work of the Fathers of the Church, and firmly rooting it in the interior life and the theological virtues (faith, hope, and especially love). The Fathers of Vatican II also recognized that all Christians are called to holiness of life, insisted that the Magisterium must constitute a principal source for moral reflection, and held that the work of Saint Thomas Aquinas must be given primacy in theology in general and moral theology in particular.
