George A. Blair

Copyright © 1996

NOTE: The first five chapters of this book are identical with Human Conduct, and so the contents link to the chapters of that book.


This is a scientific and objective approach to ethics. First, it establishes that everyone in fact believes that morals are objective, and that all moral codes derive from "Do not deliberately act as if you weren't what you really are."

First, the general implications of this are developed, discussing why people feel necessitated to obey this command, and secondly its implications for the choice one makes rather than the act itself one performs: how morality depends on one's knowledge of one's reality, and is modified by constraints on one's freedom.

Then, the book explores the various aspects of health-care delivery: the relation between the practicioner and the patient, the profession and business of health care, the patient's life, the patient's physical integrity, and then issues dealing with other types of providers: nurses, psychologists, and researchers.



Part One: General Principles
Chapter 1: The Moral Command
1.1. A science of ethics?
1.1.1. A self-contradictory moral position
1.2. The two basic observable facts
1.3. The question to investigate
1.4. Observed characteristics of the fact
1.4.1. How to use the observed data
1.5. Association from early training
1.6. Social pressure
1.6.1. Examples of "immoral=inhuman"
Chapter 2: The Real Issue
2.1. The true moral norm
2.1.1. A note on "natural-law" ethics
2.1.2. The moral command
2.2. The real issue
2.2.1. The problem
2.2.2. The reason people are afraid of immorality
Chapter 3: The Consequences
3.1. Can this theory be scientific?
3.2. Evidence dealing with life after death
3.3. Nature of the life after death
3.3.1. Relation of this theory to others
3.3.2. Happiness and enjoyment
3.3.3. No forgiveness
3.3.4. The afterlife and God Theological note on salvation
3.4. The meaning of life
3.4.1. God as the "real" goal of life?
Chapter 4: Freedom and Responsibility
4.1. The choice as free
4.1.1. Characteristics of free choice
4.2. The general moral rule
4.3. Morality and emotions
4.3.1. Morality and emotional problems
4.3.2. Habits: virtues and vices
4.4. Responsibility
4.4.1. Responsibility and guilt
Chapter 5: Moraliity and Knowledge
5,1, Morality and knowledge: conscience
5.1.1. Clear and unclear conscience
5.1.2. Clearing an unclear conscience
5.2. Act and situation
5.2.1. The motive
5.2.2. The means
5.2.3. Side effects
5.2.4. The Principle of the double Effect
Part Two: Applications to the Field of Health Care
Chapter 6: Provider and Patient
6.1. Applying ethics
6.1.1. Informing the ignorant
6.2. Health
6.2.1. The health-care provider
6.3. The provider's own humanity
6.3.1. Lying Lying by implication: the placebo Public-health propaganda
6.4. Relations to others: rights
6.4.1. The right to privacy
6.4.2. Concealing information
Chapter 7: The Profession and Business of Health Care
7.1. Health care as a profession
7.1.1. Expertise Malpractice
7.1.2. Referrals
7.2. Health care as a business
7.2.1. The value of the service
7.2.2. Values and necessities
7.3. Pricing health care
7.3.1. Government and insurance
7.4. Control over the service
7.4.1. Experimental treatment
7.4.2. Mutual respect
7.5. Quackery
Chapter 8: The Patient's Life
8.1. The physician
8.2. What human life is
8.2.1. Abortion
8.2.2. Fetal tissue experimentation
8.2.3. "Test-tube babies"
8.2.4. Monsters and mutants
8.3. Death and dying
8.3.1. When death occurs
8.3.2. Respect for the corpse
8.3.3. Suicide
8.3.4. Postponing death The "living will"
Chapter 9: The Patient's Physical Integrity
9.1. The Principle of Totality
9.1.1. Mutilation Removing diseased organs Removing healthy organs Organ transplants Fetal transplants Sterilization "Sex changes"
9.1.2. Non-mutilations Cosmetic plastic surgery
9.2. Suppression of functions
9.2.1. Irrelevant use of parts
9.2.2. Recreational drugs
9.2.3. Multi-dimensional functions Sexual inconsistencies
Chapter 10: Other Providers
10.1. The nurse
10.1.1. Immoral and unjust commands
10.1.2. Morally correct commands
10.1.3. Responsibility of the assistant
10.1.4. Cooperation in evil
10.2. The psychologist
10.2.1. The mind Mental unhealth and immorality Implications for treatment
10.2.2. Methods of treatment
10.3. The researcher


Just a word or two before we begin. If you're looking for a book on "values clarification" in the ethical field, I'm afraid you'll have to look elsewhere. If you want a book on the history of ethical theory, this is not your book. If you want "discussions" on the issues which lay out both sides of controversial topics, and leave it up to you to make up your mind, then don't bother reading this. This book lays out what the facts are in the moral aspect of the health-care field.

"What nonsense!" you say. "Who are you to say that you "know what the facts are" and can presume to tell other people what they should do!" There are no "facts" in ethics, anyway—if there is such a thing as a "fact" that can be absolutely known at all."

Oh yes? Is that a fact? Is it a fact that there are no facts in ethics? How do you know? And who are you to presume to tell me that there aren't? And what do you mean by "presume"? That it's somehow wrong of me to dare to say that my position is correct and that anyone who disagrees with it is wrong?

But how can you say that? Aren't you trying to tell me that my position is wrong? Isn't it wrong of you to dare to say that, based on your own principles? How do you know that it's an absolute fact that no one can know absolute facts? (You seem to know this one.)

The moral disease I discuss at the beginning of the book is a symptom of the intellectual disease that is infecting our whole culture: that no one "really knows" the actual facts, and that everyone "has a right to his own opinion"—meaning that you're "dissing" someone, somehow, if, instead of saying, "I disagree with you," you say, "Nope. Things aren't that way. You're mistaken."

That attitude kills learning. All it means is that we "share" our opinions, and if you happen to like mine, you'll adopt it. But if it doesn't grab you, then you'll stand on your "right" to your own opinion, and denounce me as a sinner for claiming that I'm objectively right and you're objectively wrong.

But that position is sustainable only if it is objectively true that no position is objectively true—in which case, that position (that no position is objectively true) isn't true. So it's not a wise position, it's a stupid one, not because I disagree with it, but because it disagrees with itself. And it's not a tolerant position, because it refuses to tolerate anyone who knows what he's talking about; it's not open-minded, but closed-minded, because it insists, "I've got a right to my opinion, so don't bother me with facts!"

Besides, you yourself know at least one fact that can't be doubted by anyone: There is something, meaning that there's not just absolutely nothing at all. Try to deny it. There's the denial, and that's something, and you know it. Doubt it. There's the doubt, and that's something, and you know it. Disagree with it. There's the disagreement. No matter what you do, you know with absolute certainty this fact, and you also know that it's certain for anyone, because no matter who denies it, there's the denial, which is something.

So we can know facts; we can find evidence that shows that one position is correct and its opposite is incorrect. Hold onto that. There are no "facts for" someone. You may or may not know what the fact is, but a fact is a fact is a fact.

So don't tell me I can't come up with the facts in ethics. Challenge me to do it. The rest of the book is an attempt to meet the challenge. Sometimes I may not succeed; but don't kill the attempt before I even start by declaring without any evidence that it can't be done.

[For more on this see Modes of the Finite, Part One, Section 1, Chapter 1 and following.]

Feast of St. Alphonsus Liguouri,
August 1, 1996