Question — Noldin, Summa of Moral Theology
Question First. On the Obligation of Preserving Life
326. On the obligation itself. 1. Everyone is bound to preserve his own life, health, and integrity of members; and this precept is of itself grave, but as to health and integrity of members it admits smallness of matter.
a. The same precept which prohibits the killing of oneself by that very fact also commands the preservation of one's own life, since virtually it is the same thing not to preserve life and to take life from oneself.
b. Among natural goods entrusted to us by God, bodily life occupies the first place, since it is the foundation and condition of all other goods. But a good committed to us by God as to guardians we ought carefully to protect until He Himself demands it back.
c. From revelation we know that temporal life is the time of preparation in which we merit eternal life; the time of sowing for the day of harvest;1 the time of working in the vineyard of the Lord;2 the time of gathering interest from the talents committed to us by God;3 the time of storing up treasures in heaven;4 the time of running in the stadium to receive the prize and of contending in the contest to receive an incorruptible crown.5 By divine disposition this time obtains its end with death. From these things the supreme importance of the whole of life and of any particle of it shines forth.
- Therefore everyone is bound to procure for himself those things which are necessary for preserving life and health: food, clothing, habitation; to ward off those things which harm life and health; and to restore impaired health by suitable means, namely physician and medicines.
Those sin who voluntarily do not procure for themselves food, clothing, and habitation necessary for the preservation of life and for other ends, even if this demands hard labor (66, 2).
- We are indeed bound to preserve life and health by ordinary means, but not by extraordinary means; for he who is bound to the end is also bound to employ the ordinary means which are required for obtaining it, but not of himself also extraordinary means. Therefore not to employ ordinary means would be the same as to inflict death on oneself; but not to employ extraordinary means is the same as to permit death, which is sometimes licit. Which means are judged extraordinary must be judged by the common estimation of men.
a. Sick persons sin who in grave illness, where hope of recovery shines forth, do not wish to call a physician and employ the remedies prescribed to them,6 which by reason of their condition can easily be procured and employed. But those do not sin who in a dangerous disease do not wish to employ a remedy very costly by reason of their state and condition, or a remedy very difficult on account of great pains. Therefore no one, not even the richest, is bound of himself to call the most skilled physicians to drive away a grave disease, nor is anyone bound of himself to leave his domicile and seek healthier air elsewhere, because all these things are extraordinary.
b. From this same reason it must be said that there does not exist an obligation of undergoing a grave surgical operation or a notable amputation. For although today the pains of many operations, on account of numbed senses, are not sharp, nevertheless the obligation is not to be imposed, both because most people greatly dread it, and because the success, especially lasting success, is ordinarily uncertain, and finally because it is a grave inconvenience to lead life with a mutilated body.7 That no one of himself is obligated to undergo a grave surgical operation which he vehemently dreads, because this very dread is an extraordinary difficulty, is suitably confirmed from this, that St. Alphonsus (n. 372), following several authors, judges that a virgin is not bound to suffer an operation by the hands of a surgeon, even if life cannot otherwise be preserved, when on account of modesty she dreads this handling more than death itself. Accidentally, however, someone can be obligated to undergo an operation or amputation, namely where the matter concerns a person very necessary to the family or to the public good and the success is morally certain.
c. Those do not sin who for a reasonable cause do not wish to employ a remedy against a light illness, because light care in recovering health can be neglected from a just cause, just as a light shortening of life admitted from a reasonable cause is licit.
d. A monk bound by rule to perpetual abstinence from meats does not sin if in grave illness he refuses to eat meats by which he could preserve life; for it is licit to omit the preservation of life for obtaining a great good. But it conduces to a great common good of the order that the rule of abstinence be strictly observed even with danger to life.
Whether a superior can command a grave surgical operation. If the sick person is necessary for the good of others and the success of the operation is morally certain, a superior, father or superior, can obligate a son or subject to undergoing an operation whose pains are not very sharp. But if some one of these conditions is lacking, the superior does not seem able to command so arduous a matter.8
Note. Concerning drunkenness and concerning the influence of drunkenness on health and the life of the body, cf. De principiis, n. 344.
1 Matt. 13:24 ss.
2 Matt. 20:1.
3 Matt. 25:14 ss.
4 Matt. 6:20.
6 Cf. Ecclus. 38:1, 4.
7 Cf. Capellmann, Medicina pastor., p. 23 s.
8 Cf. Sanchez, Consilia mor., l. 5, c. 1, dub. 34, n. 6; Lugo, De iustitia, disp. 10, n. 33; St. Alphonsus, n. 370.