Virtue ethics should be judged on the result of the act and not the character of the actor.

1I will limit this paper to physicians, but similar questions arise for hospitals and for pharmacists and other healthcare personnel.

2Similarly, should pharmacists be allowed to refuse to fill contraception prescriptions in the name of conscientious objection or should they be forced to fill them? Should employers be forced to provide contraception in their prescription drug insurance plans? See, for example, Curlin et al. (2007) and Stein (2006a, 2006b).

3Some call this “value neutrality”; for a discussion of this, see Pellegrino (2000).

4Ricoeur (1992, 119). This, he says, is “the overlapping of ipse by idem” (Ricoeur 1992, 121).

5See Merriam-Webster Dictionary, s.v. “character,” http://www.m-w.com/dictionary/character.

6Ricoeur (1992, 122): “the aspects of evaluative preference … define the moral aspect of character.”

7Taylor (1964, 21). See also Melina (2001, 46): “[According to St. Augustine] for happiness, subjective satisfaction (to have everything one wants is not enough; it is also necessary that there be rectitude of the will (not to want anything evil) … . ‘To desire happiness is nothing other than to desire the satisfaction of the will,’ but then he affirms that only the true Good can fully satisfy the will.”

8Rather than “vicious,” which is how W.D. Ross translates Aristotle's word, I will use “vice-filled.” Aristotle uses φαύλος (low in rank, mean, and common) vs. ε̉πιεικης (reasonable, fair, kind, gentle, and good); with related terms κα˘κός (bad, evil, and wicked) vs. α̉γα˘θός (good); and αι̉σχρόν (shameful, disgraceful, base, and infamous) vs. καλόν (well and rightly). See Aristotle (n.d.), for example, bk. 3, n. 5 (1113b10).

9See especially bk. 7 in the Nicomachean Ethics; and Thomas Aquinas's discussion of bk. 7 in Aquinas (1993). There are also two more categories: the godlike and the brutish, but, Aristotle says, such persons as these are rare. See Aristotle (n.d., bk. 7, chap. 1, 1145a15–30).

10Other examples are assisting in euthanasia, writing prescriptions for euthanasia drugs, referring for abortions, etc. I will use the contraception example throughout. Also, contraception can be prescribed to treat medical conditions such as endometriosis. In this example, I will be discussing it purely as contraception, leaving aside medicinal uses.

11Aquinas (1975, bk. 3, chap. 106, n. 7); Ratzinger (1984, 10): “Moral behavior is a response to reality and therefore requires a knowledge of reality.”

12Stein (2002, 429–30). See also Wojtyla (1979, 158–59).

13See Aquinas (1993, bk. 3, lec. 8, n. 474), on ends; also Audi (1991, 313), on changing beliefs.

14This also is Pope John Paul's point about the fundamental option: one bad act can change one's orientation to the good. Each action must orient one towards the good. See John Paul II (1993, n. 70).

15Keep in mind that character does not go from good to neutral to bad, but all along the scale the good and the bad overlap. On the side of good character, the person is mostly good and maybe a little bad, and on the bad side, the person is mostly bad and maybe a little good.

16See, for example, Gal 2:20 and Eph 4:15. See also John Paul II (1993, n. 73) and Clarke (1993, 96): “No one can reach mature development as a person without the experience of opening oneself, giving oneself to another in self-forgetting love of some kind.” For more on this self-transcendence, see Clarke (1993), esp. “Personal Being as Self-Transcending,” 94–108: the loss of oneself in becoming united with God, a movement from self-centeredness to God-centeredness, is a “finding of one's true self at a deeper level” (Clarke 1993, 99). It would be interesting to see how Stein's thoughts, in Stein (2002, esp. 510–27), on the unity of human beings in Christ relate to this.

17See, for example, CNN (2000) and Wright and the Associated Press (2006).

18Aquinas (1948, III, q. 63, a. 2, s.c.; q. 72, a. 5, obj. 2).

19Though this is limited more or less by one's DNA, environment, and other factors as discussed above. Some interesting comments on the formability of character have been made, which cannot be explored in detail in this paper but are worth mentioning. Aquinas says, in Aquinas (1948, I-II, q. 96, a. 4), that “a law that inflicts unjust hurt on its subjects” (ad 3) that is “wicked laws,” “often bring loss of character” (obj. 3). Leo XIII (1878, nn. 14–15) said that character is “reformed” through teaching, “pursuit of virtue,” and obedience; and weakened by “seeking after self-interest alone”; also Leo XIII (1893, n. 15), “discover[ing] the true relation between time and eternity … form[s] strong and noble characters.” And Vatican Council II (1975) said, in Gaudium et spes, n. 61, that understanding of others “refines man's character.”

20Aquinas (1948, I-II, q. 1, a. 1, c.) and John Paul II (1993, n. 71). See also, Wojtyla (1979, 207–19).

21Von Hildebrand and Von Hildebrand (1966, 88). Even what seem to be purely mental acts, such as believing in God, manifest themselves bodily (e.g., worship, prayer, almsgiving, and admitting one's faith to others). When the mental act does not manifest itself physically, one is labeled either deluded about oneself or a hypocrite. More on this later.

22Even something seemly mundane such as choosing which color dress to buy is still a moral act: I am choosing a purple dress because my sister hates purple (choosing the evil or uncharitable) vs. because purple looks good on me or it is my favorite color (choosing the good).

23Schmitz (1993, 66). Schmitz continues: “The basis and source of action is … the whole person … . The whole person is caught up in and fully engaged through his or her own action.” See also Von Hildebrand and Von Hildebrand (1966, 87–92).

24Wojtyla (1979, 11), quoted in Schmitz (1993, 66).

25See Aquinas (1948, I-II, q. 1, a. 1, c.; q. 8, a. 1) and Wojtyla (1979, 124–39, 161).

26For this discussion of intention, see Anscombe (1981, 75–82) and Anscombe (1963, nn. [19–20], 21–28b, 45–49).

27See Wrathall (2005, 111–12); also, the body is “a third term in between mind and matter” (113).

28Aristotle (n.d., bk. 3, ch. 1) and Aquinas (1993, bk. 3, lec. 1).

29Aristotle (n.d., bk. 3, ch. 1), Aquinas (1993, bk. 3, lec. 3), and John Paul II (1993, n. 52).

30Maurice Merleau-Ponty says that to even consider the relationship of soul to body is to engage in dualism. See Wrathall (2005, 111–12).

31Finnis (1998, 41). Schmitz (1993, 83): “Through our human acts (actus humanus) we effect ourselves and other persons and things; and in this efficacy lies the root of our responsibility.”

32Finnis (1998, 41 note 68): “Even though a single choice (Aquinas thinks) cannot form a habitual disposition in the strict sense (which is formed by reiteration of acts: I-II q. 51, a. 3), still a choice lasts in, and shapes, one's will(ingness) until one repudiates or repents of it (see e.g., Ver. q. 24, a. 12, c.).”

33Stein (2002, 429): “[Human beings'] free modes of action are not co-extensive with the soul's total being but are rather an exertion of influence on something that is engaged in a process of evolution, and these free modes of action leave certain traces in the soul by virtue of which the soul attains to its final structural formation and firm contour.”

34Schmitz (1993, 85–86). See also, John Paul II (1993, n. 52).

35Schmitz (1993, 89). Wojtyla (1979, 99): “The becoming of man in his moral aspect that is strictly connected with the person is the decisive factor in determining the concrete realistic character of goodness and badness, of the moral values themselves as concretized in human acting. Without in any way constituting the content of consciousness itself they belong integrally to the personal, human becoming. Man not only concretizes them in action and experiences them but because of them he himself, as a being, actually becomes good or bad. Moral conduct partakes of the reality of human actions as expressing a specific type and line of becoming of the man-subject, the type of becoming that is most intrinsically related to his nature, that is, his humanness, and to the fact of his being a person.” See also, John Paul II (1993, nn. 39, 71).

36Audi (1991, 311–12). See also Aquinas (1948, III, q. 63, obj. 1 and 2, and c).

37Wojtyla (1979, 162): “Without truthfulness (or while out of touch with it) the conscience or, more broadly speaking, the whole specific system of the moral function and order cannot be properly grasped and correctly interpreted.”

38Aquinas (1948, I, q. 63, a. 1, ad 4; I-II, q. 10, a. 1; q. 74, a. 1, ad 1; q. 75, a. 1, ad 3).

39John Paul II (1993, n. 72): “The morality of acts is defined by the relationship of man's freedom with the authentic good … . Acting is morally good when the choices of freedom are in conformity with man's true good. The rational ordering of the human act to the good in its truth and the voluntary pursuit of that good, known by reason, constitute morality. Hence human activity cannot be judged as morally good merely because it is a means for attaining one or another of its goals, or simply because the subject's intention is good. Activity is morally good when it attests to and expresses … the conformity of a concrete action with the human good as it is acknowledged in its truth by reason. If the object of the concrete action is not in harmony with the true good of the person, the choice of that action makes our will and ourselves morally evil.” See also Vatican Council II (1975, n. 17).

40McInerny (2004, 100): “The moral task is to acquire a character which enables us to maneuver through the contingencies of life in such a way that we act well and thus achieve what is perfective of us. The desire for the good is a given, that is what is meant by calling it natural. However, reflection not only reveals the notion of ultimate end, but makes clear that we must do those things which truly constitute our fulfillment and perfection. The criteria for the true good must be sought in our nature as rational agents.”

41Melina (2001, 43): “When one speaks of the ‘moral good’ one understands, first of all, the moral good that is the very person who chooses, that is, it is the ‘good of the person’—what makes the person good—insofar as he becomes good by means of his choices. This is only possible because his will has the unique characteristic of being ‘sealed’ by the way in which the subject freely realizes himself with respect to different intelligible human goods … the moral goodness of the person is determined not only by the subjective intentionality of ‘willing the good’ but also by the adequate relationship that the will establishes regarding these concrete good objects of choices, on the basis of a rational knowledge that has a connotation specifically practical.”

42See John Paul II (1995, n. 4), Ashley and O'Rourke (1997, 47–48) (Ashley and O'Rourke word it a little too strongly, physicians can make some ethical judgments autonomously just based on the ends of medicine), Hauser (2005), Pellegrino and Thomasma (1993, 38), and Melina (1998, 392): “the act of recognizing the value of life is laden with consequences for the subject who performs it. Not only does it immediately reveal definite moral obligations that he is bound to observe, but it also dramatically mirrors the very human identity of the person who makes a judgment about life's value … . To recognize the personal dignity of a nascent human embryo or fetus, or of a terminally ill person, means at the same time to perceive definite moral obligations towards him.”

43Taylor (1964, 21–23) and Audi (1991, 304 note 1) (and other places): “See, e.g., Nicomachean Ethics, bk. 1, in which Aristotle says that moral virtue is formed by habit … , and that we are praised and blamed for virtues and vices … . Compare his remarks, in bk. 3, that our character is determined by our choosing good or evil … , and that the virtues ‘are in our power and voluntary.’”

44John Paul II (1993, n. 78). See also Caffara (1987, 162): “To say, then, that an act is good by its nature is to say that it has in itself the capacity to realize the human person as such, so that a properly ordered will can choose to perform it without destroying the will's rectitude. The act is in itself able to mediate, to concretize, a true self-determination of the person.”

45Melina (2001, 44). See also Wojtyla (1979, 124–39).

46Melina (2001, 51), see also 51–53.

47Catechism of the Catholic Church (1994, n. 1810) and Leo XIII (1891, n. 50).

48Caffara (1987, 167). See also Finnis (1998, 84–85) and Melina (2001, 44): “by means of a connaturality of the subject with the true Good, they [the virtues] make it possible for what really is good in itself and in accordance with the truth also to appear good to the virtuous person. By means of a virtuous connaturality, that which is good ‘in itself’ (bonum simpliciter) is perceived also as good ‘for me’ (bonum conveniens).”

49Aquinas (1993, bk. 7, lec. 8, n. 1431), see also n. 1432.

50Finnis (1998, 84–85 note 114): “[All human] virtues pre-exist in one's natural orientation towards the good of virtue [naturali ordinatione ad bonum virtutis], which exists in one's reason in so far as one is aware of this kind of good, and in one's will in so far as one is naturally interested in that good, and also exists somehow in one's lower powers in so far as they are naturally subject to one's reason.”

51Caffara (1987, 168) and Finnis (1998, 119).

52Aquinas (1948, II-II, q. 47, a. 1, s.c.). See also, Ratzinger (1984, 10): “It was not without reason that the ancients placed prudence as the first cardinal virtue: They understood it to mean the willingness and the capacity to perceive reality and respond to it in an objective manner.”

53Melina (2001, 53–54). See also Aquinas (1948, I-II, q. 65, a. 4, ad 1).

54Aquinas (1948, I-II, q. 73, a. 1): “the intention of every man acting according to virtue is to follow the rule of reason, wherefore the intention of all the virtues is directed to the same end, so that all the virtues are connected together in the right reason of things to be done, namely, prudence.”

55John Paul II (1993, n. 67): “Judgments about morality cannot be made without taking into consideration whether or not the deliberate choice of a specific kind of behavior is in conformity with the dignity and integral vocation of the human person. Every choice always implies a reference by the deliberate will to the goods and evils indicated by the natural law as goods to be pursued and evils to be avoided. In the case of the positive moral precepts, prudence always has the task of verifying that they apply in a specific situation, for example, in view of other duties which may be more important or urgent. But the negative moral precepts, those prohibiting certain concrete actions or kinds of behavior as intrinsically evil, do not allow for any legitimate exception. They do not leave room, in any morally acceptable way, for the “creativity” of any contrary determination whatsoever. Once the moral species of an action prohibited by a universal rule is concretely recognized, the only morally good act is that of obeying the moral law and of refraining from the action which it forbids.” I am leaving aside here, as beyond the scope of this paper, a discussion of whether or not writing a prescription for contraception (as opposed to using contraception) is intrinsically evil and allows for no legitimate exception.

56John Paul II (1993, n. 67). See also Stein (2002, 367).

57Schmitz (1993, 77); see also 79, 85–86, 118.