Renaissance Bioethics

FOLLOWING St. Thomas Aquinas, O.P. 16^th Century Catholic moralists affirmed

IF one of these conditions is not fulfilled, a treatment is considered extraordinary and not morally obligatory, even though certain individuals may choose it as a legitimate moral option.

Regarding a sick person, “if the decline of the spirit is so great and the alteration of appetite is much, so much that the infirm is able to take nourishment only with great trouble, then it can be considered an impossibility and one is excused from sin…” He also wrote that “even in those cases in which recourse to medicine could serve to prolong life for a short while, a person could be exempt from the moral duty to use it … for example … excessive expense… The person is not obligated to give all his patrimony to preserve life…”

IT is in connection with food, and its usefulness in preserving life, that Vitoria raises some points of special interest. Following Aquinas, Vitoria argues that a person has an obligation to preserve his life, based on the natural inclination toward self-preservation. Furthermore, the malice of suicide would arise from the non-preservation of oneself. But if this is so, then it would seem that a sick person who does not eat because of some disgust of food would be guilty of a sin equivalent to suicide. Vitoria denies that the refusal of food by the sick necessarily necessarily constitutes suicide, and, in response, makes eight important points:

(1) A sick person is required to take food if there exists some hope of life (cum aliqua spe vitae).

(2) But, if the patient is so depressed or has lost his appetite so that it is only with the greatest effort that he can eat food, this right away ought to reckoned as creating a kind of impossibility and the patient is excused (iam reputatur quaedam impossibilitas et ideo excusatur), at least from mortal sin, especially if there is little or no hope of life.

(3) Furthermore, the obligation to take drugs is even less serious. This is because food is “per se a means ordered to the life of the animal” (per se medium ordinatum ad vitam animalis) and is natural, whereas drugs are not. A person is not obliged to employ every possible means of preserving his life, but only those that are per se intended for that purpose (media per se ad hoc ordinata).

(4) Nevertheless, if one had a moral certitude that the use of a drug would return him to health, and that he would die otherwise, then the use of the drug would be obligatory . If he did not give the drug to a sick neighbor, he would sin mortally, so it seems he would have the same responsibility to save his life. Medicine is also per se intended by nature for health (medicina per se etiam ordinata est ad salutem a natura).

(5) On the other hand, it is rarely certain that drugs will have this effect, so it is not mortally sinful to declare abstinence from all drugs, though this is not a praiseworthy attitude to take since God has created medicine because of its usefulness.

(6) It is one thing not to protect or prolong life; it is quite another thing to destroy it. A person is not always held to the first.

(7) To fulfill the obligation to protect life, it is sufficient that a person perform “that by which regularly a man can live” (satis est, quod det operam, per quam homo regulariter potest vivere). Again, if a person “uses foods which men commonly use and in the quantity which customarily suffices for the conservation of strength” (quibus homines communiter utuntur et in quantitate), then the person does not sin even if his life is notably shortened thereby, and this is recognized.

(8) Thus, a sick person would not be required to use a drug he could not obtain except by giving over his whole means of subsistence . Nor would an individual be required to use the best, most delicate, most expensive foods, even though they be the most healthful. Indeed, the use of such foods would be “blameworthy” (reprehensibile). Nor would one be obliged to live in the most healthful location. In another work (Comentarios a la Secunda Secundæ de Santo Tomás), Vitoria cites as examples of “delicate foods” hens and chickens. He says that if the doctor were to advise the person to eat chickens and partridges, the individual could still choose to eat eggs and other common items instead, even though he knew for certain he could live another twenty years by eating such special foods.

In a later Relectio on the question of homicide, Vitoria summarizes his position as follows: “One is not held, as I said, to employ all the means to conserve his life, but it is sufficient to employ the means which are of themselves intended for this purpose and congruent” (ad hoc de se ordinata et congruentia). This makes clear the point also made by Aquinas: that one is not obliged to use any and every means for the preservation of life.

Furthermore, Vitoria is inclined to view the obligation to use certain means not in the abstract but in the concrete. As the second point on the above list shows, what produces a “kind of impossibility” (and no one is obliged to do the impossible) need not be the means themselves but the impact of their use on the individual patient.

Thus, the obligation to preserve life is neither absolute nor invariant, but rather can depend on the peculiar circumstances of the individual.

Vitoria raises the question of the relevance of the distinction between natural means (e.g., foods and drink) versus artificial means (e.g., drugs). It should not be surprising that Vitoria himself displays some ambivalence on the subject. On the one hand, (Point 3), the obligation to use drugs is less stringent than the obligation to use food because food is a means per se ordered to the life of the animal, and is natural, whereas drugs are neither. But on the other hand, (Point 4), medicine is also intended by nature for health. It would seem, then, that medicine is also natural.

Thus, natural means are intended by nature for the preservation of life, whereas artificial means are likewise intended, but only as means supplementing the natural, when this becomes necessary. Such a distinction may be able to explain some moral difference regarding the obligation to employ them, but it would also seem to permit calling artificial means obligatory under certain conditions.

“…no one is obligated to suffer enormous pain (ingens dolor) to preserve one’s life.”

(4) The moralists of the time, e.g., Domingo Banez, O.P. (1528-1604) thus designated the causes for moral impossibility:

BOTH FOOD and medical treatment may not be ordinary but NOT necssarily obligatory for different persons in different circumstances

Physical life is a fundamental and primary good, but not an absolute good; only eternal beatitude can be considered an absolute good. [This teaching represents an early rejection of what later became known as “vitalism.”]

CAN certain mutilations can become obligatory, as being necessary for life or health. De Lugo holds that such a mutilation is obligatory, provided that it can be accomplished without intense pain:

NOT IF IT IS ACCOMPANIED BY VERY BITTER PAIN; because A MAN IS NOT BOUND TO EMPLOY EXTRAORDINARY AND DIFFICULT MEANS TO CONSERVE HIS LIFE (media extraordinaria et difficillima ).¹²

Vitoria had insisted, (see the seventh point in summary above), that in most cases one is obliged to use only those means that are regularly (reguariter) and customarily (communiter) employed for the preservation of life. Here de Lugo seems to be making basically the same point, but he chooses to phrase his position in the negative, that one is not obliged to employ extraordinary or out-of-the-ordinary means for the preservation of life. Thus, de Lugo is saying that the difference between not-saving and overt killing is morally important if the means being refused are either difficult to employ or out of the ordinary. He uses, as an example of means difficult to employ, a mutilation causing intense or bitter pain (intenso acerbissimo dolore). Indeed, a means may be out of the ordinary precisely because it is painful to employ.

Nevertheless, it is important to recognize that there may be a number of reasons why a means may be out of the ordinary, other than that it is difficult to employ. Thus de Lugo considers many of the examples of optional means earlier mentioned by Vitoria:

Indeed, one senses in de Lugo a striking attempt to be most liberal in judging a means to be optional. Any reason that would make a means out of the ordinary suffices for de Lugo as a justification for calling it optional. And he is quite willing to relativize this element of the extraordinary (as Vitoria was with the element of the burdensome) to the particular circumstances of the individual. Thus de Lugo argues that a novice in a religious order is not bound to return to the secular world in order to eat better food to preserve his life, since such food, even though ordinary and common for the secular world, is not ordinary for those in the religious life.

De Lugo holds that the failure to employ available means necessary for preserving one’s life or the failure to avoid a potentially death-dealing natural cause can be morally equivalent to the positive taking of one’s own life. But this is true only where the means are ordinarily employed and not difficult to use, or where the death-dealing natural cause can easily be avoided.

In the previous discussion the opinion of Vitoria argued that a sick person is required to take food to preserve his life, at least if the food can be employed without great difficulty. But Vitoria adds a further qualification: for the taking of food to be obligatory, there must exist “some hope of life.” The implication there is that a person is not obliged to employ means if there is no hope of their being useful in preserving life.

De Lugo is in agreement with Vitoria on this point and employs an example which will be discussed by later moralists and will be seen to have considerable theoretical and practical significance for the present day. De Lugo considers the case of a man facing certain death in a burning building. The man notices that he has water to extinguish part of the fire, but not all of it, and that he can only delay his death by the water’s use. Is the man under an obligation to use the water? De Lugo answers in the negative, “because the obligation of conserving life by ordinary means is not an obligation of using means for such a brief conservation -- which is morally considered nothing at all” (quae moraliter pro nihilo reputatur)

On the other hand, de Lugo holds that if the person could put out the fire completely, he would be obliged to use it. In this latter case, the use of water would be analogous to eating ordinary foods. Certainly the use of water is an ordinary means of putting out a fire (and so saving a life). And, in the example, the means can be easily employed. Thus, de Lugo wished to admit the possibility that an ordinary means need not be obligatory because the benefit to the person is too slight to carry moral weight.

Alphonsus mentions the case of a woman (particularly a maiden) who might find examination by a male physician greatly abhorrent. This element of subjectivity in the assessment of the obligatoriness of means is firmly in the tradition of Vitoria and de Lugo.

... Evidently an amputation, at this period in history, was the perfect example of a terrible torture which no one ordinarily could be held to undergo....

[There were [only a very few] moralists who dissented from this opinion]... Vincent Patuzzi, an eighteenth century theologian, takes issue with de Lugo, and maintains that a maiden does possess an obligation to accept treatment from a male physician even at the cost of great embarrassment and shame... But it is the scarcity of such differences that is the most striking feature of this period.

These teachings were incorporated into the teaching of the ordinary magisterium:

Pontifical Council Cor Unum, “Ethical Questions Relative to the Gravely Ill and Dying,” 1981

II. Euthanasia	II EUTHANASIA
[...] IT is, therefore, necessary to state clearly in what sense the word is used in the present document. By euthanasia is understood an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated.	Necessarium igitur est ut plane pateat, quae notio huic voc in praesenti documento tribuatur. Nomine euthanasiae significatur actio vel omissio quae suapto natura vel consilio mentis mortem affert, ut hoc modo omni, ^,dolor removeatur.
Euthanasia’s terms of reference, therefore, are to be found in the intention of the will and in the methods used.	Euthanasia igitur in voluntatis proposito et in procedendi rationibus, quae adhibentur, continetur.
IT is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying.	Iamvero, denuo firmiter declarandum est neminem nihilque ullo modo sinere posse ut vivens humanum innocens occidatur, sive sit fetus vel embryon, sive infans vel adultus, sive senex, sive morbo insanabili affectus, sive in mortis agone constitutus.
Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly.	Praeterea nemini licet mortiferam hanc ,actionem petere sibi aut alii, qui sit ipsius responsabilitati commissus, immo in eadem ne consentire quidem potest expli^,cite vel implicite.
Nor can any authority legitimately recommend or permit such an action. For it is a question of	Nec auctoritas ulla potest eam legitime iniungere vel permittere. Agitur enim de
[1] the violation of the divine law,	legis divinae violatione,
[2] an offense against the dignity of the human person,	de offensione dignitatis personae humanae,
[3] a crime against life,	de crimine contra vitam,
[4] and an attack on humanity. [Aquin. S.T., II-II, Q. 64, Art. 5]	de facinore in hominum genus.
REQUESTS for EUTHANASIA are often PLEAS for HELP
It may happen that, by reason of prolonged and barely tolerable pain, for deeply personal or other reasons, people may be led to believe that they can legitimately ask for death or obtain it for others. Although in these cases the guilt of the individual may be reduced or completely absent, nevertheless the error of judgment into which the conscience falls, perhaps in good faith, does not change the nature of this act of killing, which will always be in itself something to be rejected.	Fieri potest ut ob diuturnos ac vix tolerandos dolores, ob rationes in animi affectibus innixas, vel ob alterius generis causas, aliqui ad persuasionem adducantur se legitime posse mortem sibi petere aut aliis afferre. Quamquam hisce in casibus hominis culpa imminui aut omnino deesse potest, nihilominus error iudicii in quem conscientia, bona fide fortasse, incidit, naturam huius actus mortiferi non mutat, qui per se repudiandus semper erit.
The pleas of gravely ill people who sometimes ask for death are not to be understood as implying a true desire for euthanasia; in fact, it is almost always a case of an anguished plea for help and love.	Gravissime aegrotantium implorationes, quandoque mortem invocantium, haud intelligendae sunt quasi veram euthanasiae voluntatem significent; etenim fere semper agitur de anxiis invocationibus auxilii et amoris.
What a sick person needs, besides medical care, is love, the human and supernatural warmth with which the sick person can and ought to be surrounded by all those close to him or her, parents and children, doctors and nurses.	Praeter medicas curas, id quo aegrotus indiget, est amor, est fervidus animi affectus humanus et supernaturalis, quo proximi omnes, pa rentes et filii, medici et aegrotorum ministri eum complecti possunt ac debent.
III. The Meaning of Suffering for Christians and the Use of Painkillers	II DOLORIS SIGNIFICATIO APUD CHRISTIANOS ET ANALGESICORUM REMEDIORUM USUS
Nevertheless it would be imprudent to impose a heroic way of acting as a general rule. On the contrary, human and Christian prudence suggest for the majority of sick people the use of medicines capable of alleviating or suppressing pain, even though these may cause as a secondary effect semiconsciousness and reduced lucidity. As for those who are not in a state to express themselves, one can reasonably presume that they wish to take these painkillers, and have them administered according to the doctor’s advice.	Nihilominus a prudentia alienum est heroicam quandam agendi rationem tanquam generalem normam imponere. E contrario humana et christiana prudentia pro pluribus aegrotis suadet usum eorum medicamentorum quae apta sint ad leniendum vel auferendum dolorem, etiamsi inde, ut secundarii effectus, torpor et imminuta animi conscientia consequantur. Quod autem ad eos attinet quibus deest facultas sensa sua exprimendi, recte praesumi potest ipsos velle haec doloris lenimenta sumere, eademque sibi ministrari secundum medicorum consilia.
ORDINARY / EXTRAORDINARY: PROPORTIONATE / DISPROPORTIONATE MEANS
IV. Due Proportion in the Use of Remedies	IV PROPORTIO SERVANDA IN REMEDIORUM THERAPEUTICORUM USU
EVERYONE has the duty to care for his or he own health or to seek such care from others. Those whose task it is to care for the sick must do so conscientiously and administer the remedies that seem necessary or useful.	Uniuscuiusque officium est consulere valetudini suae et efficere ut sibi curationes ministrentur. Ii autem quibus infirmorum cura concredita est, omni cum diligentia operam suam praestare debent ac remedia praebere, quae necessaria vel utilia videantur.
However, is it necessary in all circumstances to have recourse to all possible remedies?	Suntne igitur in omnibus rerum adiunctis cuncta prorsus remedia experienda ?
In the past, moralists replied that one is never obliged to use “extraordinary” means.	Haud multo ante moralis disciplinae cultores respondebant usum mediorum « extraordinariorum „ numquam praecipi posse.
This reply, which as a principle still holds good, is perhaps less clear today, by reason of the imprecision of the term and the rapid progress made in the treatment of sickness.	Huiusmodi responsio, quae, ut principium, semper valet, hodie fortasse minus perspicua apparet sive ob parum definitum dicendi modum, sive etiam ob celeres progressus, qui in re therapeutica facti sunt.
Thus some people prefer to speak of “proportionate” and “disproportionate” means.	Hinc est quod quibusdam potius placet loqui de mediis , proportionatis » et « non proportionatis ».
In any case, it will be possible to make a correct judgment as to the means by studying [:]	Utcumque res se habet, recta mediorum aestimatio fieri poterit,
[1] the type of treatment to be used,	si artis therapeuticae genus
[2] its degree of complexity	eiusque difficultatum
[3] or risk,	et periculorum gradus
[4] its cost	ac sumptus necessarii
[5] and the possibilities of using it,	necnon possibilitas eodem utendi,
and comparing these elements with the result that can be expected,	cum effectibus, quos exspectare licet, comparentur,
taking into account	debita ratione
[1] the state of the sick person	habita tum status aegroti
[2] and his or her physical	tum ipsius corporis
[3] and moral resources.	et animi virium.
In order to facilitate the application of these general principles, the following clarifications can be added:	Quo facilius haec generalia principia ad rem deducantur, iuvare poterunt accuratiores explicationes, quae sequuntur
- If there are no other sufficient remedies, it is permitted, with the patient’s consent, to have recourse to the means provided by the most advanced medical techniques, even if these means are still at the experimental stage and are not without a certain risk. By accepting them, the patient can even show generosity in the service of humanity.	- Si alia remedia non suppetunt, licet, ex consensu aegroti, media adhibere, quae novissima medicae artis inventa protulerunt, etiamsi haud satis adhuc experimentis probata sint nec aliquo periculo careant. Aegrotus, qui ea accipiat, poterit etiam exemplum generosi animi praebere in bonum generis humani.
- It is also permitted, with the patient’s consent, to interrupt these means, where the results fall short of expectations. But for such a decision to be made, account will have to be taken of the reasonable wishes of the patient and the patient’s family, as also of the advice of the doctors who are specially competent in the matter.	- Pariter licet horum mediorum usum abrumpere, quotiescumque exitus spem in eis repositam fallit. At in hoc capiendo consilio, ratio habeatur iusti desiderii aegroti eiusque familiarium, nec non sententiae medicorum, qui vere periti sint;
The latter may in particular judge that the investment in instruments and personnel is disproportionate to the results foreseen; they may also judge that the techniques applied impose on the [suffering] patient	hi profecto prae ceteris aequam aestimationem facere poterunt, cum sumptus instrumentorum et hominum in id impendendorum non respondet effectibus qui praevidentur, et cum medicae artis adhibita subsidia imponunt aegroto
suffering [pain] or strain [inconvenience]	dolores aut incommoda
out of proportion with the benefits which he or she may gain from such techniques.	graviora quam utilitates quae inde ei afferri possunt.
- It is also permissible to make do with the normal means that medicine can offer. Therefore ONE CANNOT IMPOSE ON ANYONE the obligation to have recourse to a technique which is already in use but which .	- Semper licet satis habere communia remedia, quae ars medica suppeditare potest. Quapropter nemini obligatio imponenda est genus curationis adhibendi quod, etsi in usu iam est,
[1] carries a risk [danger] or [2] is burdensome. [onerous]	adhuc tamen non caret periculo vel nimis est onerosum.
Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as	Quae remedii recusatio comparanda non est cum suicidio verius habenda est vel simplex
[1] an acceptance of the human condition, or [2] a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or [3] a desire not to impose excessive expense [burden] on the family or the community.	acceptatio condicionis humanae; vel cura vitandi laboriosum rnedicae artis apparatum cui tamen par sperandorum effectuum utilitas non respondet; vel denique voluntas onus nimis grave familiaee aut communitati non imponendi.
- When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted. In such circumstances the doctor has no reason to reproach himself with failing to help the person in danger.	- Imminente morte, quae remediis adhibitis nullo modes impediri potest, licet ex conscientia consilium inire curationibus renuntiandi, quae nonnisi precariam et doloris plenam. vitae dilationem afferre valent, haud intermissis tamen ordinariis curis, quae in similibus casibus aegroto debentur. Tune^, causa non est cur medicus animi angore afficiatur, quasi alicui,. qui in periculo versaretur, auxilium negaverit.

This Webpage was created for a workshop held at Saint Andrew's Abbey, Valyermo, California in 2002....x.... ’ “”.



THE CATECHISM of the CATHOLIC CHURCH ARTICLE 5 THE FIFTH COMMANDMENT *You shall not kill* (Exod. 20:13).	ARTICULUS 5 QUINTUM PRAECEPTUM « Non occides » (Ex 20,13).


You have heard that it was said to the men of old, “You shall not kill: and whoever kills shall be liable to judgment.” But I say to you that every one who is angry with his brother shall be liable to judgment.⁵⁵	« Audistis quia dictum est antiquis: "Non occides; qui autem occiderit, reus erit iudicio". Ego autem dico vobis: Omnis, qui irascitur fratri suo, reus erit iudicio » (Mt 5,21-22).
2258. “Human life is sacred because from its beginning it involves the creative action of God and it remains for ever in a special relationship with the Creator, who is its sole end. God alone is the Lord of life from its beginning until its end: no one can under any circumstance claim for himself the right directly to destroy an innocent human being.”⁵⁶	2258 « Humana vita pro re sacra habenda est, quippe quae inde a suo exordio ‘Creatoris actionem postulet' ac semper peculiari necessitudine cum Creatore, unico fine suo, perstet conexa. Solus Deus vitae Dominus est ab exordio usque ad exitum: nemo in nullis rerum adiunctis, sibi vindicare potest ius mortem humanae creaturae innocenti directe afferendi ».¹⁶⁸
[...]
EUTHANASIA_2276-2279

EUTHANASIA	Euthanasia


2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.	2276 Illi, quorum vita impedita est vel infirmata, specialem postulant observantiam. Personae aegrotae vel aliqua incapacitate (handicap) laborantes sustineri debent ut vitam degant ita normalem, quantum fieri potest.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.	2277 Euthanasia directa, quaecumque sunt eius motiva vel media, consistit in fine imponendo vitae personarum aliqua incapacitate (handicap) laborantium, aegrotarum vel morientium. Moraliter inacceptabilis est.
Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.	Sic actio vel omissio quae, ex se vel in intentione, mortem causat ad dolorem supprimendum, occisionem constituit dignitati personae humanae et observantiae erga Deum viventem, eius Creatorem, graviter contrariam. Iudicii error, in quem quis bona fide incidere potest, naturam non mutat huius interficientis actus qui semper proscribendus est et excludendus.^[(¹⁹³) Cf Sacra Congregatio pro Doctrina Fidei, Decl. Iura et bona: AAS 72 (1980) 542-552.]

2278
2278 Discontinuing medical procedures that are [:]	2278 Cessatio a mediis medicinalibus,
burdensome, dangerous, extraordinary, or disproportionate to the expected outcome	onerosis, periculosis, extraordinariis vel talibus quae cum effectibus obtentis proportionata non sunt,
can be legitimate; it is the refusal of “over-zealous” treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.	legitima esse potest. Haec est recusatio « saevitiae therapeuticae ». Hoc modo, non intenditur mortem inferre; accipitur non posse eam impedire. Decisiones suscipiendae sunt ab aegroto, si ad id competentiam habeat et capacitatem, secus autem ab illis qui ad id, secundum legem, habent iura, rationabilem aegroti voluntatem et legitimum commodum semper observantes.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity [=selfless love]. As such it should be encouraged.	2279 Etiamsi mors imminere consideretur, curae, quae ordinario personae aegrotae debentur, nequeunt legitime interrumpi. Analgesicorum medicamentorum usus ad moribundi dolores sublevandos, etiam cum periculo eius dies breviandi, potest esse dignitati humanae moraliter conformis, si mors neque ut finis neque ut medium est volita, sed solummodo praevisa et, tamquam inevitabilis, tolerata. Curae lenientes formam constituunt excellentem caritatis gratuitae. Hac ratione foveri debent.


Suicide	Suicidium


2280 Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.	2280 Unusquisque suae vitae est responsabilis coram Deo qui illam ei donavit. Ipse eius Dominus permanet summus. Tenemur eam cum gratitudine accipere et ad Ipsius honorem praeservare atque ad animarum nostrarum salutem. Vitae, quam Deus nobis concredidit, administratores sumus et non domini. De illa non disponimus.

2281 Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God.	2281 Suicidium naturali creaturae humanae contradicit inclinationi ad eius vitam conservandam et perpetuandam. Graviter iusto sui ipsius amori contrarium est. Pariter amorem offendit proximi, quia iniuste solidarietatis frangit vincula cum societatibus familiari, nationali et humanae, erga quas obligati permanemus. Suicidium amori Dei viventis est contrarium.

2282 If suicide is committed with the intention of setting an example, especially to the young, it also takes on the gravity of scandal. Voluntary co-operation in suicide is contrary to the moral law.	2282 Suicidium, si intentione committitur ut exemplo sit, praesertim iuvenibus, gravitatem etiam sumit scandali. Cooperatio voluntaria ad suicidium est legi morali contraria.
Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide.	Graves perturbationes psychicae, angustia vel gravis timor probationis, doloris vel cruciatus responsabilitatem se ipsum interficientis possunt imminuere.

2283 We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.	2283 De salute aeterna personarum, quae sibi ipsis mortem intulerunt, desperari non debet. Deus potest, viis, quas solus Ipse noscit, occasionem illis praebere salutaris poenitentiae. Ecclesia orat pro personis quae vitae suae intulerunt vim.

2296 Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good sought for the recipient. Organ donation after death is a noble and meritorious act and is to be encouraged as a expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, it is not morally admissible to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons.	2296 Organorum transplantatio legi morali est conformis, si pericula et discrimina physica atque psychica quae donans subit, bono sunt proportionata quod pro eo quaeritur cui illa destinatur. Donatio organorum post mortem est actus nobilis et meritorius atque alliciendus tamquam generosae solidarietatis manifestatio. Moraliter acceptabilis non est, si donans vel eius propinqui ius ad id habentes suum explicitum non dederint consensum. Praeterea nequit moraliter admitti, mutilationem, quae invalidum reddit, vel mortem directe provocare, etiamsi id fiat pro aliarum personarum retardanda morte.

54 Ex 20:13; Cf. Deut 5:17. 55 Mt 5:21-22. 56 CDF, instruction, Donum vitae, intro. 5. 57 Cf. Gen 4:8-12. 58 Gen 4:10-11. 59 Gen 9:5-6. 60 Cf. Lev 17:14. 61 Ex 23:7. 62 Mt 5:21. 63 Cf. Mt 5:22-39; 5:44. 64 Cf. Mt 26:52. 65 St. Thomas Aquinas, STh II-II, 64, 7, corp. art. 66 St. Thomas Aquinas, STh II-II, 64, 7, corp. art. 67 Cf. Lk 23:40-43. 68 Cf. Gen 4:10. 69 Cf. GS 51 # 3. 70 Cf. Am 8:4-10. 71 Cf. CDF, Donum vitae I, 1. 72 Jer 1:5; cf. Job 10:8-12; Ps 22:10-11. 73 Ps 139:15. 74 Didache 2, 2: SCh 248, 148; cf. Ep. Barnabae 19, 5: PG 2, 777; Ad Diognetum 5, 6: PG 2, 1173; Tertullian, Apol. 9: PL 1, 319-320. 75 GS 51 # 3. 76 CIC, can. 1398. 77 CIC, can. 1314. 78 Cf. CIC, cann. 1323-1324. 79 CDF, Donum vitae III. 80 CDF, Donum vitae III. 81 CDF, Donum vitae I, 2. 82 CDF, Donum vitae I, 3. 83 CDF, Donum vitae I, 5. 84 CDF, Donum vitae I, 6. 85 Mt 18:6; Cf. 1 Cor 8:10-13. 86 Cf. Mt 7:15. 87 Pius XII, Discourse, June 1, 1941. 88 Cf. Eph 6:4; Col. 3:21. 89 Lk 17:1. 90 Cf. DS 3722. 91 Cf. Tob 1:16-18. 92 Cf. CIC, can. 1176 # 3. 93 Mt 5:21. 94 St. Thomas Aquinas, STh II-II, 158, 1 ad 3. 95 Mt 5:22. 96 Mt 5:44-45. 97 St. Augustine, De civ. Dei, 19, 13, 1: PL 41, 640. 98 Cf. Isa 32:17; cf. GS 78 ## 1-2. 99 Isa 9:5. 100 Eph 2:16 J.B.; cf. Col 1:20-22. 101 Eph 2:14. 102 Mt 5:9. 103 Cf. GS 78 # 5. 104 Cf. GS 81 # 4. 105 GS 79 # 4. 106 Cf. GS 79 # 5. 107 Cf. GS 79 # 3. 108 GS 79 # 4. 109 GS 80 #3. 110 Cf. Paul VI, PP 53. 111 GS 78 # 6; cf. Isa 2:4. NT John Paul II, Evangelium vitae 56.	*(168) Congregatio pro Doctrina Fidei, Instr. Donum vitae, Introductio, 5: AAS 80 (1988) 76-77.* (169) Cf Gn 4,8-12. (170) Cf Lv 17,14. (171) Cf Mt 5,22-26.38-39. (172) Cf Mt 5,44. (173) Cf Mt 26,52. *(174) Sanctus Thomas Aquinas, Summa theologiae,* II-II, q. 64, a. 7, c: Ed. Leon. 9, 74. (175) Sanctus Thomas Aquinas, Summa theologiae, II-II, q. 64, a. 7, c: Ed. Leon. 9, 74. (176) Sanctus Thomas Aquinas, Summa theologiae, II-II, q. 64, a. 7, c: Ed. Leon. 9, 74. (177) Ioannes Paulus II, Litt. enc. Evangelium vitae, 56: AAS 87 (1995) 464. (178) Cf Gn 4,10. (179) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 51: AAS 58 (1966) 1072. (180) Cf Am 8,4-10. (181) Cf Congregatio pro Doctrina Fidei, Instr. Donum vitae, 1, 1: AAS 80 (1988) 79.** (182) Didaché 2, 2: SC 248, 148 (Funk 1, 8); cf Epistula Pseudo Barnabae 19, 5: SC 172, 202 (Funk 1, 90); Epistula ad Diognetum 5, 6: SC 33, 62 (Funk 1, 398); Tertullianus, Apologeticum, 9, 8: CCL 1, 103 (PL 1, 371-372). *(183) Concilium Vaticanum II, Const. past. Gaudium et spes, 51: AAS 58 (1966) 1072.* (184) CIC canon 1398. (185) CIC canon 1314. (186) Cf CIC canones 1323-1324. *(187) Congregatio pro Doctrina Fidei, Instr. Donum vitae, 3: AAS 80 (1988) 98-99.* *(188) Congregatio pro Doctrina Fidei, Instr. Donum vitae, 3: AAS 80 (1988) 99.* *(189) Congregatio pro Doctrina Fidei, Instr. Donum vitae, 1, 2: AAS 80 (1988) 79-80.* *(190) Congregatio pro Doctrina Fidei, Instr. Donum vitae, 1, 3: AAS 80 (1988) 80-81.* *(191) Congregatio pro Doctrina Fidei, Instr. Donum vitae, 1, 5: AAS 80 (1988) 83.* *(192) Congregatio pro Doctrina Fidei, Instr. Donum vitae, 1, 6: AAS 80 (1988) 85.* *(193) Cf Sacra Congregatio pro Doctrina Fidei, Decl. Iura et bona: AAS 72 (1980) 542-552.* *(194) Cf 1 Cor* 8,10-13. (195) Cf Mt 7,15. (196) Pius XII, Nuntius radiophonicus (1 iunii 1941): AAS 33 (1941) 197. (197) Cf Eph 6,4; Col 3,21. (198) Cf Pius XI, Litt. enc. Casti connubii: DS 3722-3723. (199) Cf Tb 1,16-18. (200) Cf CIC canon 1176, § 3. (201) Sanctus Thomas Aquinas, Summa theologiae, II-II, q. 158, a. 1, ad 3: Ed. Leon. 10, 273. (202) Sanctus Augustinus, De civitate Dei, 19, 13: CSEL 402, 395 (PL 41, 640). (203) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 78: AAS 58 (1966) 1101. (204) Cf Eph 2,16; Col 1,20-22. (205) Cf Concilium Vaticanum II, Const. dogm. Lumen gentium, 1: AAS 57 (1965) 5. (206) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 78: AAS 58 (1966) 1101-1102. (207) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 81: AAS 58 (1966) 1105. (208) Concilium Vaticanum II, Const. past. Gaudium et spes, 79: AAS 58 (1966) 1103. (209) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 79: AAS 58 (1966) 1103. (210) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 79: AAS 58 (1966) 1103. (211) Concilium Vaticanum II, Const. past. Gaudium et spes, 79: AAS 58 (1966) 1103. (212) Concilium Vaticanum II, Const. past. Gaudium et spes, 80: AAS 58 (1966) 1104. (213) Cf Paulus VI, Litt. enc. Populorum progressio, 53: AAS 59 (1967) 283. (214) Concilium Vaticanum II, Const. past. Gaudium et spes, 78: AAS 58 (1966) 1102. (215) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 27: AAS 58 (1966) 1048. (216) Cf Concilium Vaticanum II, Const. past. Gaudium et spes, 81: AAS 58 (1966) 1105.**

1. De Vitoria


1. FRANCISCO De VITORIA, O.P. (1486-1546) De Vitoria

2, Dominic de Soto


2. DOMINIC De SOTO, O.P. (1494-1560) De Soto

4. de Lugo


4. JUAN CARDINAL De LUGO, S.J. (1583-1660) De Lugo




1.2. JURA et BONA (SCDF) Declaration on Euthanasia, (1980)

3. Banez


3. DOMINGO BAÑEZ, O.P. (1528-1604) Banez