Certificate No.

AJA19-0226

Topic: Personalist Biomedical Care

Reporter: Mary Nell B. Azura

Objectives:
1. Define personalism.
2. Identify biomedical ethics and;
3. Know the importance of the theoretical reflection for medical ethics.

Introduction:
The personalist approach to biomedical ethics presents itself as a typical European reaction
to the rapid changes in medicine and health care. Some call it, however, a kind of renewal of the old
Thomistic approach, whereby the concept of ‘nature’ has been replaced by the more dynamic concept
of ‘person’. In that way personalism has been situated by many observers as a ‘person’ centered
natural law tradition which focuses on the rational nature of the human person as the moral norm of
nature. This gives the impression that personalism is only a very ‘static’ variant of the natural law
approach.

Persons that will be mentioned:

 Max Scheler - (born August 22, 1874, Munich, Germany—died May 19, 1928, Frankfurt am
Main), German social and ethical philosopher. Although remembered for his
phenomenological approach, he was strongly opposed to the philosophical method of the
founder of phenomenology, Edmund Husserl.
 Paul Sporken - a Dutch Philosopher and was a priest, moral theologian and professor of
medical ethics.
 Sokolowski - Robert Sokolowski is the Elizabeth Breckenridge Caldwell Professor of Philosophy
at The Catholic University of America and a monsignor of the Roman Catholic Church. An
author published in a variety of sub-disciplines of philosophy.
 Leon R. Kass - is an American physician, scientist, educator, and public intellectual, best known
as proponent of liberal education via the "Great Books,"
 Emmanuel Levinas - was a French philosopher of Lithuanian Jewish ancestry who is known for
his work related to Jewish philosophy, existentialism, ethics, phenomenology and ontology.
 Karl-Otto Apel - was a German philosopher and Professor Emeritus at the University of
Frankfurt am Main. He specialized on the philosophy of language and is thus considered a
communication theorist.

Discussion:

What is Personalism?
A social theory of health care that stresses the importance of respect for the dignity and
individuality of those people for whom care is provided.

What is Biomedical Ethics?

A system of moral principles that apply values to the practice of clinical medicine and in
scientific research. Based on a set of values that professionals can refer to in the case of any confusion
or conflict.

2 Basic Dimensions of the Integration of Biomedical Ethics:

1. The personalist approach offers relational foundation for medicine as a healing profession
2. It presents an ethical framework for the integration of new developments in medicine
 Certificate No. AJA19-0226

The Importance of this Theoretical Reflection for Medical Ethics:

1. Moral Theory as Part of an Ethical Reflection Process

 It may be helpful to take advantage of the three-fold distinction by Max Scheler: practical
morality, ethos and ethics.
 Paul Sporken’s approach remains very powerful and offers an adequate ethical method to
present an integrated ethical reflection in the context of medicine.
 Sporken wants biomedical ethics to start where everything really begins, namely in medical
practice and clinical reality itself.

Practical Morality
 In medicine, all this can be translated in the description of the ‘state of the art’: what are (at
the moment of reflection) the scientific and clinical facts?
 In the debates on organ transplantation, reproductive technology, human genetics, end of life
decisions and so on this requires the description, understanding and awareness of the
scientific and clinical evolutions in medicine.
 This work has to be reserved for medical scientists and the physicians themselves: biomedical
ethics therefore cannot function without their participation.
 In this way, an ethical process will never neglect the basic data of medicine.

Ethos
 Scheler spoke about ‘ethos’ which symbolizes moral sensitivities functional within a particular
culture concerning medical reality.
 Valuations, intuitions, or even subjective ‘feelings’ and ideas about a particular ethical
dilemma must indeed be clarified.
 When this more subjective side is not brought under the light of an ethical clarification, the
unconscious presuppositions may remain hidden or block a rational ethical reflection.
 It is therefore necessary to have time and attention for these emotions, institutions and
sensitivities in order to have an idea about how to integrate them in the ethical process.

Ethics
 The third phase in the ethical process brings us to the core activities of the ethical reflection.
 This part of the process incorporates both previous stages wherein we try to clarify the values
and norms which are part of the problem situation we are facing.
 All references to normative theories must be banned or may only be indicated, without using
them as a matrix for problem-solving.
 It is here that we need to present personalism as one of the competing normative theories.
 These normative theories and ethical models function as a theoretical framework for ethical
decision making in biomedicine.
 For the majority of the continental European approach to bioethics, however, it remained a
weak and even narrow instrument to cover the complexities of ethical reflection in
biomedicine.

2. Personalism as a ‘Teleological’ Model

 The willingness to realize the humanly desirable (goal of our actions) is the driving force of the
personalist ethical model.
 Certificate No. AJA19-0226

 According to the teleological model, an act is good if the gain aimed at outweighs the damage
incurred.
 Personalists suggest that a concrete, material norm concerns a whole series of actions which
are comparable in so far as they have a similar material content.
 Even when that pre moral disvalue, the whole action can be morally right, when we have
proportionate reason for admitting or causing pre moral disvalue.
 If we evaluate the moral goodness or badness of the action, we must answer the question
whether motivations and intentions result from a morally good disposition or not.
 Such an approach had been called ‘teleological’: the principal argument is based on the
assumption that the goods and values that form the foundation of our actions are exclusively
conditioned, created and therefore limited goods.

Several good theories that are available for medical ethics:

 Utilitarianism - a label affixed to theories holding that actions are right or wrong according to
the balance of their good and bad consequences.
 Kantianism or obligation-based theory - a theory that some features of actions other than, or
in addition to consequences make actions right or wrong.
 Character ethics or virtue ethics - emphasizes the agents who perform actions and make
choices.
 Liberal individualism or rights-based theory - statements of rights provide vital protections of
life, liberty, expression and property.
 Communitarianism - views everything fundamental in ethics as deriving from communal
values, the common good, social goals, traditional practices, and the cooperative virtues
 Ethics of care - caring in these accounts refers to care for, emotional commitment to, and
willingness to act on behalf of persons with whom one has a significant relationship
 Casuistry or case-based reasoning - focuses on practical decision-making in particular cases.

3. The Fundamental Disposition: The Relational Foundation

 Personalism in the context of medical ethics presents a foundational clarification of the
fundamental disposition of the medical profession.
 Briefly we can present the approach of Levinas as follows: “the Face of the Other”
 Leon R. Kass described this “Medicine calls you to intrinsically self-manifesting and self-
fulfilling activity, in which your good and the patient's good coincide. In each daily encounter
with your patients, you will serve yourself exactly in your efforts to help others, as you
energetically respond to the call for help, exercising your art that makes help possible. If one
regards the patient only as objectified body, then one may take care of the patient, but one
does not yet care for the patient”.
 In other way, Sokolowski described the same foundational ethical disposition: “In acting
according to his art the physician also seeks the good of the patient. Because the art of
medicine aims at something that is a good for the patient, the doctor, in the exercise of his
art, seeks the medical, good of the patient as his own good…..The doctors profession
essentially makes him a good man, provided he is true to his art and follows its insistence.”
 Medical practice, however, regularly demands very concrete ethical decision-making,
whereby personalism again offers a clear and helpful model.

4. Personalism as an Ethical Frame of Preference for Medical Decision-making

 Personalism presents itself as ‘an ethical frame of reference’, so that those who are working
in the context of personalism can develop an ethical evaluation and structure their human
 Certificate No. AJA19-0226

 practice in light of this evaluation and their understanding of the implications in concrete
human realities.

 Personalism suggest that it is essentially important to clarify the development of some

anthropological options, which then can be used for the formation and function of the human
conscience.
 Personalism presents a multidimensional model, which at the same time refers to the human
person in all his dimensions and relationship.
 According to this vison, to be human is both to exhibit and to participate in the wonder of a
rich many sideness: to be human is to be rich in unicity and originality, but at the same time,
originality is an empty concept if it does not include openness toward the other and if it does
not involve cooperation with others for the expansion of a solidary community.

4.1 The Human Person: Unique & Original

 There was a period in which little if any attention was given to the mystery of the unique
human being. Attention was focused mainly on human knowledge or, more broadly, human
consciousness.
 However, the radical experience of the First World War opened the eyes of many European
philosophers.
 Suddenly, they discovered the unique and concrete human person with his or her own life-
project, his or her fears and expectations.
 It was discovered that the individual only becomes a self by searching for his or her own
identity.
 The initial insight clearly saw that every human being is different, a unique and proper self, a
person with unique talents, capacities, feelings and possibilities. In interaction with socio-
cultural surroundings, everything comes to be integrated towards the formation of a unique,
original personality with an individual character.

4.2 The Human Person: Relational and Intersubjective

 To grasp the whole of this mystery, we must consider as well the openness of each human
being toward his fellow humans.
 As humans, we essentially stand in an open relation, involved with the reality in which we live,
with other humans to whom we owe our existence and who continue to surround us, and
ultimately with God.
 The insights Levinas are not only crucial for the clarification of the fundamental disposition of
the medical profession, it also present clear value orientations for daily medical practice: the
physician-patient relationship must therefore be fully developed.

4.3 The Human Person: Communication and Solidarity

 We refer here to the phenomenon of living in a particular, concrete society as such, and the
ethical assignment that accompanies social living for realizing the good life.
 It has already become clear that for the first time in the history of anthropological reflection,
human beings have been explicitly placed before the task of assuming responsibility in
solidarity.
 Karl-Otto Apel’s model of communicative ethics has proven to encompass a greater ethical
range and is therefore more usable
 He therefore reflects on the way that people communicate with each other. In speaking,
taking a position, or defending a line of argumentation, one always does this in respect to
others.
 Certificate No. AJA19-0226

 The societal dimension of medicine was for a very long time extremely neglected.
 The personalist model, with the integration of the value of solidarity — besides subjectivity
and inter subjectivity — offers a comprehensive anthropological approach.

4.4. The Personalist Criterion

 With these three fundamental value orientations in mind we can articulate a moral criterion,
with a personalist meaning: we say that an act is morally good if it serves the humanum or
human dignity, that is, if it in truth is beneficial to the human person adequately considered
in these three basic value-orientations (dimensions and relationships): uniqueness, relational
commitment and solidarity
 In virtue of the historicity of the human person this criterion requests that we again and again
reconsider which possibilities we have at our disposal at this point in history to serve the
promotion of the human person.
 The personalist approach requires then essentially an adequate proportionate balancing of
these values and norms in order to promote the most humanly possible in light of the most
humanly desirable.

5. Medical Challenges for Personalism in Practice

 Several current topics in bioethics have been approached from the perspective of a personalist
model: reproductive technology, human genetics, organ transplantation, end of life decision-
making, palliative care, euthanasia and others. Some applications even lead to a kind of
personalist medicine, something that can be illustrated in a few examples

Reference:
http://www.ethical-perspectives.be/viewpic.php?LAN=E&TABLE=EP&ID=242