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Autonomy - "Freedom to CHOOSE"

Beneficence - "Do only what's GOOD", respect, privacy
Nonmaleficience - "Do NO harm", e.g. side rails up
Veracity - "Tell the TRUTH"
Justice - "Be FAIR"
Fidelity - "Keep your word", keeping promises "LOYALTY"

MIDWIFERY ETHICS - the code governing the NURSE'S BEHAVIOR, especially towards
patients, employing authority and to the profession.

Beneficence - any action that would BENEFIT others. The principle that imposes upon the
practitioner to seek the good for the patients under all circumstances. Beneficence connotes
positive action toward preventing or removing harm and promoting good such as:
(1) One ought to prevent evil or harm
(2) One ought to remove evil or harm
(3) One ought to do or promote good.

Nonmaleficence - states the idea to REFRAIN from inflicting harm. "one ought NOT to inflict
evil or harm. The admonition of nonmaleficence is stated in the negative manner while the
beneficence is in the positive.

Justice - The basic principle that deals with FAIRNESS, just deserts, and entitlements in the
distribution of goods and services.

Some methods of distributing goods and services in our society are as follows:
(1) To each, an equal share
(2) To each, according to need
(3) To each, according to effort
(4) To each, according to contribution
(5) To each, according to merit
(6) To each, according to ability to pay

Autonomy - In health care, it means the form of personal LIBERTY, where the individual is
free to choose and implement ones' own decisions, free from deceit, duress, constraint, or
coercion. Three Basic elements involved:

(1) ability to decide

(2) power to act upon your decisions
(3) a respect for the individual autonomy of others.

Stewardship - refers to the actions made for by the health practitioner IN BEHALF of the
patient and for the greater benefit of the patient.

Truth Telling/Veracity - The patient must tell the truth in order that appropriate care can be
provided. The health practitioner needs to disclose FACTUAL INFORMATION so that the
patient can exercise personal autonomy.

Confidentiality - is also known as PRIVILEGED COMMUNICATION which refers to any

information obtained by the nurse or the health team during the course of caring for the
patient. The information gathered may only be disclosed under the following:
(1) the patient agrees to divulge such information with written consent
(2) the information is material in a criminal case investigation
(3) if public safety is jeopardized (communicable disease)
(4) such information is relevant to his care to be utilized by other health team

Privileged Communication may be divided into two classes:

(1) Absolute privileged communication - is one made in the interest of the public service or
the due administration of justice and is practically limited to legislative and judicial
proceedings and other actions of the state.
(2) Qualified privileged communication - is a slanderous statement uttered in good faith, and
made on a proper occasion, from a proper motive, based upon a probable cause and in
honest belief that such statement is true.

MORAL PRINCIPLES

· GOLDEN RULE - " Do unto others what you would like others do unto you". It is a basic
moral principle that if you want others to respect you, you must also accord respect to them.
· THE TWO FOLD-EFFECT - facing a situation which would have good and bad effects
requires the following basis for arriving a decision:
a. that the action must be morally good
b. that the good effect must be willed and the bad effect merely allowed
c. that the good effect must not come from an evil action but from initial action itself directly;
and
d. that the good effect must be greater than the bad effect.

THE PRINCIPLE OF TOTALITY - states that the whole is always greater than its parts. To
save the patients' life as a whole, it is justified under this principle to surgically cut-off a
disease body part of the patient.
EPIKIA - "exception to the general rule". It is reasonable presumption that the authority
making the law will not wish to bind a person in some particular case, even though the case
is covered by the letter of the law.
If a mentally ill patient becomes berserk and the doctor could not be contacted, the patient
may be restrained by virtue of epikia.
Another example of this is allowing a relative to see a seriously ill patient who expresses the
desire the relative although it is not yet visiting hours
THE END DOES NOT JUSTIFY THE MEANS - giving a sleeping tablet to a chronically ill
person so he/she can de in peace is morally wrong.
THE GREATEST GOOD FOR THE GREATEST NUMBER - during an epidemic,
immunization against communicable diseases is administered to the people. Although there
may be some who may have slight reactions to the vaccine, the greater majority of the
population shall be considered.
NO ONE IS HELD TO THE IMPOSSIBLE - the doctors and nurses are not guarantors of life.
They cannot be held liable as long as they have done everything that modern medicine can
afford to save a patient from dying.
THE MORALITY OF COOPERATION - formal cooperation in an evil act is never allowed. A
nurse shall not participate upon immoral operations such as abortion even if the doctor
commands it.
PRINCIPLE RELATING TO THE ORIGIN AND DESTRUCTION OF LIFE - mercy killing or
euthanasia is not allowed because it will lessen the incentive to medical research. The state
recognizes the sanctity of life. It shall protect the life of the mother and the unborn since
conception.
Any direct attack on the life of a fetus for whatever cause is immoral. A fetus shall be buried
in consecrated grounds. If it is dead and came from dead mother, it shall be buried with the
mother.

Privacy - the right to be left alone or be apart from others. This right is guaranteed by most
civilized state laws and enshrined also in the patients' bill of rights. The patient has the right
to every consideration of his privacy concerning his own medical care program. Case
discussion, consultation, examination and treatment are confidential and should be
conducted discreetly. Those not directly involved in his care must have the permission of the
patient to be present. This right also includes privacy of one's thoughts, opinions and
physical presence and privacy of one's records.

Informed Consent -The patient UNDERSTANDS the reason for the proposed intervention,
with its benefits and risks, and agrees to the treatment by affixing his signature in the
consent form. It generally contains the following elements:
(1) disclosure
(2) understanding
(3) voluntariness
(4) competence
(5) permission giving

· In our present jurisdiction under the 1987 Constitution, the age of majority is 18 years old. It
means that only 18 years old and above can sign for themselves in legal matters such as the
signing of consent (hospital admission, contracts, will etc..)