Principles of Totality and Integrity

As part of the “Morality Matters” column, once a month, I have been and will be writing a section on Catholic Bioethics. The intention is to call to mind the Church’s teaching on certain medical practices or procedures that may or may not be in line, morally. I have published two articles now, setting the stage for these teachings by outlining some foundational principles of medical moral ethics. The first two articles have attempted to set forth several of these principles:

  1. Revelation is the source of morality. Both Scripture and Tradition have communicated God’s design for the human person and His expectations of human morality.

  2. Morality is not “contrived” by a human institution, nor is it a mere “interpretation” of God’s law. It is an act of revelation concerning how humans ought to act.

  3. We are created in God’s image and likeness in two ways. First, we have an intellect and free will by which we are able to autonomously love God and neighbor. Second, as God is a community of persons (the Trinity), so too humans are communal by nature, in imitation of the Father, Son, and Holy Spirit.

  4. All human life is directly willed and created by God and is known by God by name.

  5. Human life begins at conception.

  6. All human life is to be treated with dignity and respect.

  7. God created human life to live, for eternity, with Him in Heaven.

  8. The human person is made up of Body and Soul: an embodied-spirit.

  9. The human body is essential to the human person.

  10. The human soul is essential to the human person.

  11. The human body cannot be manipulated as if it is not part of one’s personal identity.

  12. We are stewards, not absolute masters, of our humanity: both body and soul.

Inherent in this list that I have spoken of already are two principles that need to be explicitly defined: Totality and Integrity. St. Thomas Aquinas speaks of these two principles when he writes, “A member (part) of the human body is to be disposed of according as it may profit the whole… If a member is healthy and continuing in its natural state, it cannot be cut off to the detriment of the whole.”

The principle of Totality states that the entire body and every part of the body is to be preserved from harm or mutilation.

The principle of Integrity states that, in cases where one part is threatened, there is a hierarchical order to the importance of certain parts of the body over others.

For example, human fingers and toes are important (Totality). But in the case of gangrene, a finger or toe may be sacrificed to preserve the rest of the body (Integrity).

Practically speaking, any surgery performed on a human person must respect both principles. If surgery is essential to the life of a human person, then it is permissible. Elective surgeries, however, cannot be performed if such surgery contradicts either principle of totality or integrity.

Father Jarrod Lies, Pastor — Monthly Medical Ethics Reflection

Published: September 24, 2023