Professional Documents
Culture Documents
Ethics deals with moral behaviour or on how one should act. – or on how one should act
• Various universal principles have been accepted and as a guide, those related to healthcare
include – stewardship, totality, double effect, cooperation, and solidarity. These are the topics
that comprise this chapter.
Stewardship
Our bodies, our life, our human nature and everything in this earth are gifts we
have dominion over. This means we are responsible for them. We should not, as
faithful stewards, harm but rather improve and care for them. We have to treat them
with utmost respect, use originality and creativity to cultivate them, know and
respect their limits. We cannot contradict human nature.
Our bodies, our life, our human nature and everything in this earth are gifts we have
dominion over.
This means we are responsible for them
We should not harm but rather nurther respect and cultivate and improve and care for them
We have to treat them with outmost respect, we cannot contradict human nature.
Committed to selfless service
We as nurses we don’t have desire for powers,
Walang karapatan saktan ang mga bodies.
Discuss :
1. How one should care for one’s health. Examples of good habits and bad habits. Eye glasses,
tooth braces,
2. The difference between ownership and stewardship
Ownership- Pagaari stewardship- ikaw ang mag aalaga, magsisilbi.
3. Are wearing tooth braces, eye glasses, having face lift, signs of good stewardship?
Totality
Totality refers to the whole. Every person must develop, use, care for and preserve
all his parts and functions for themselves as well as for the good of the whole. If a
part or lower function harms the whole, this part or lower function, may be sacrifices
for the good or better function of the whole. The basic capacities which define
human personhood, however, are sacrificed only when there is need to preserve life
Refers to the whole
Every person must develop, use, care for and preserve all his part and functions for
themselves as well as for the good of the whole.
If a part harms the whole, this part maybe sacrifice for the good or better function of the
whole
Sacrifice only when there is need to preserve life.
Derive from all the work of st. tomas de Aquinas who synthesize the philosophy of Aristotle
with the theology of the church. Ginamit na guidline in catholic healthcare
According to Thomas Aquinas lahat daw ng organs and other parts of the body exist of the
sake of the whole person. Serve the whole, any actions that damages of the part of body or
prevents it from fulfilling its propose violates the natural order and its morally wrong.
However a single part of body may be sacrifice if it’s the law of necessary for a good of the
whole person. For ex. Totally will justify the amputation ng gangrenous limb because the
person could die if the gangrene spread. So you have to sacrifice a part of the body for the
good of the whole. Everyone should take care and preserve of every part of the body.
Sacrifice to preserve life.
• Discuss:
1. May a disease organ be remove?
2. May a healthy organ be remove? Totality to the organ donation for example kidney donation
for your father because your kidney is match wuth your father and it is healthy.
3. Artificial reproduction.
4. The principle of totality as applied to cases:
Double Effect
When act is foreseen to have both good and bad effects, the principle of double
effect is applied. In order that such at be permissible, the following conditions should
be met:
The direct freely chosen effect of the act must be morally good while the
other indirect not freely chosen effect may be physically harmful
The foreseen beneficial effect must be equal to or greater than the foreseen harmful
effect.
The beneficial effect must follow from the action at least as immediately as the
harmful effect. The good effect must not be produced by the bad effect
In some cases the principle of totality, cannot resolve of question in medical ethics on its
own. Because some medical decisions have both good effects and bad effects on the
patients. For instances, the medicine that treat the patients, patients symptoms may also
have unpleasant or even dangerous side effect so how are we going to resolve this
situation.
When an act is foreseen to have both good and bad effects, the principle of double effect is
applied
According to this principle an action with both good and bad results may under taken to 4
conditions.
1st - The action itself must be good or at least neutral – providing medicine to a sick patient
meets this requirement
2nd – the means of receiving a good result in this case negative side effects don’t cause the
medicine to work more effectively
3rd – the motivation for caring of the action must be solely to achieve the good results, yhe
doctors prescribe a medicine to help the patient not to expose them to side effects. For the
good result must be atleast as significant as the bad. So prescribing medication with side
effect is acceptable IF the health benefits to the patients will be atleast significant as the
harm from the side effect.
Direct and indirect
Indirect consequence of an act. When can agent be responsible of an evil effect of
indirectly will
If oversees in a general way
Free from doing which is the cause of evil effect
Agent knows if he is morally bound to do that whcic is cause the evil effect example a
person climbs to the top of the building and committing suicide by throwing him down. But
instend of landing on the ground he landed to the old veggar
Cooperation
Cooperation is the participation of one agent with another agent to produce a
particular effect or joint effect. Cooperation becomes a problem when the action of
the primary agent is morally wrong
Cooperation may be
B. Mediate – when the action of the secondary agent is not inherently bound to the
performance of the evil action
Is the participation of one agent with another agent to produce a particular effect or joint
effect
Cooperation becomes a problem when the action of the primary agent is morally wrong
• Decisions regarding life and health are governed by certain principles, which are the topics discussed
in this chapter, namely: Respect for person, Justice, The inviolability of life, Non maleficence,
Beneficence.
• Respect for person is the recognition of the equality possessed by every human being as a unique,
worthy, rational, self-determining creature.
• Having the capacity and right to decide what is best for himself. It is not undermined by states of
suffering, disability, or disease.
• Respect for person is the responsibility of all to treat persons as an end and never as a means. – treat
them fairly
• Respect for person is manifest in autonomy ( self governance) – self determination, freedom, own
rules, independent
• A person be allowed to determine his own destiny, to deliberate about his plan, choose according to
his own values and to act accordingly. He should be allowed to disown person without constringe from
the actions of other or from physical or psychological limitations
Learning Activities
• Discuss
2. Justice
• Justice, also termed fairness, means to give each other what he deserves or what is his due.
• But man lives in a finite world. There are limits to funds, medical supplies, healthcare services. The
needs of everyone, even if it is due, cannot all be serve.
• Justice also means to treat equally. X=Y so X and Y has equal burdens.
Creating a healthcare policy, this help decide how limited resources are to be distributed. It should
consider the principle of equality, social justice and solidarity. The policy should state in clear terms the
criteria for consideration, or rank ordering or it should be made public so the process must be judge.
though sometimes outcomes do not just appear, so if were going to apply this to healthcare, we
recognize that resources are kulang scarce
Issues arise in deciding who is equal, in the criteria to determine equality and in, who should make these
decisions.
Creating a healthcare policy helps decide how limited resources are to be distributed. It should consider
the principles of equality (distributive justice), social justice, and solidarity. The policy should state in
clear terms the criteria for consideration, rank ordering, etc., and this should be made public
The process must be just, though sometimes outcomes do not appear just.
• In dealing patients
• How to practice
Ex trainees, you are the head nurse, hindi pwedeng may tinitignan ka
Learning Activities
• Discuss
• From the Judeo Christian tradition human life has dignity because life is God’s gift. Man comes directly
from God, is created according to God’s plan and destiny. It is God who is the source, who sustains and
perfects man’s life.
• From a humanistic point of view the experience of being alive or the fear of losing life is evidence of its
sacredness. If one is not alive, discussions about the exercise of his rights become irrelevant.
• The principle of the inviolability of human life means that life, in itself is sacred. It is not to be violated,
opposed or destroyed but is to be affirmed, cherished, respected, defended, and preserved.
Commitment to the principle of the inviolability of life means choosing life and fighting to protect it.
Commitment to life overcome commitment to death. It is to be against violence, pollution of
environment, drug and alcohol addiction, treachery in human relations.
• The principle also includes measures for the survival of the human species, and the freedom to have
children
• The experience of being alive or the feeling or loosing life is evidence of its sacredness. If one is not
alive his actions on his life is irrelevant.
• The principle of the inviolability of human life means that life, in itself is sacred. It is not to be violated,
opposed or destroyed but is to be affirmed, cherished, respected, defended, and preserve.
• As healthcare provider, you have to protect human life, commitment to life overcomes commitment
to death. We should be against violence.
• Pano natin nasisira ang human life - pollution on the environment, drugs, alcohol addiction, or
trenching human relations
• The principle also includes measures for the survival of the human species, and the freedom to have
children
Discuss
• How does abortion, euthanasia, DNR (do not rerusetate – wag nasiyang gagalawin, wag na siyang
rerevive), suicide respect /violate life?
• Who have no right to take life, no matter how hard the decision is do not take life.
4. Non Maleficence
• Harm maybe physical- binubog, mental- mga naririnig, psychological, social, financial, spiritual, etc.
Learning Activities
Sinasagot ng pabalang
Favoritism
Privacy.
• DO NO HARM
• Avoiding an action
5. Beneficence
• Beneficence is the positive pole of non maleficence. It means to do good, to provide a benefit.
• Beneficence hinges on other duties such as fair play, keeping promises, role commitments, reciprocity .
Fairplay, reciprocity
• Inshort, balancing the benefit of treatment against the risk and cause that is being involve.
• Act as a charity or mercy and kindness with a strong connotation of doing good to others including
moral obligation.
• Beneficence you have to do good – you provide benefit to person and contribute to the welfare
• Ex. It may be necessary to provide treatment that is not desired in order to prevent the development
of future or more serious health problems
• Applied together with nonmaleficence it entails weighing benefits versus burdens then choosing the
action that brings the most benefit and the least burden to those affected. This is the principle of utility.
Learning Activities
• Discuss:
What a benefit is
The duty of a healthcare provider to act according to what would benefit others (the sick)
Ethical theories
• Theoretical ethics—or ethical theory—is the systematic effort to understand moral concepts
and justify moral principles and theories. Applied ethics deals with
controversial moral problems, such as questions about the morality of abortion, premarital sex,
capital punishment, euthanasia, and animal right
• Ethics concerns not what we do, but what we ought to do, whereas theories can be identified as
formal (and ideally coherent and justified) statements that explain a certain matter. Ethical
theories are thus formal statements about what we ought to do, when faced with
an ethical dilemma
1. Deontology – “duty” these are ethical theory that morality of an action should be based on
whether the action of self is right or wrong. Under the series of rules of course rather than
based in the consequences of the action. This our responsibility, duty, moral obligation
regardless of their consequences for human welfare
Ex. You are a nurse and your responsibility to duty. You were assign to covid ward. Nakakatakot
dahil baka mahawa ka or infected, hindi ka nagtake ng proper precaution. Wala kang magagawa
dahil as a nurse that is your responsibility, hindi ka pwede magreklamo
Hindi yung kakalabasa ng gagawin kung hindi iyon ang responsibility mo. For the sake of your
duty.
2. Teleology – “consequences” ito yung moral obligation mo from what is good or desirable as an
and to be achieve. It is the consequences that make an action do their bad or right or wrong.
Titignan mo ditto ay ang kalalabasan mg ginawa mo.
3. This is theory of morality that derives duty or moral obligation from what is good or desirable as
an end to be achieve. The end justify it means.
Ex stealing would be dim right or wrong depende sa consequences. Para san bat siya nagnakaw.
4. Utilitarianism
The same with teleology they are both Consequentialism. Its okay to kill one person in order to
save others.
UTILITARIAN ETHICS
Definition
Application
making a decision based on what will benefit the majority
Con: harming a minority and benefitting a majority doesn't build mutually beneficial relationships
Con: it is not always possible to predict the outcome of a decision.
DEONTOLOGICAL ETHICS
Definition
the idea that people should be treated with dignity and respect
Application
Con: there may be disagreement about the principles involved in the decision
Con: the possibility of a conflict in duties Pros: strongest model for applied public relations ethics
VIRTUE ETHICS
Definition
Application
Teleology
• Deontology – moral theory that emphasizes duty or act itself and not by its consequences
1. Empathy and Caring – a nursing school should teach student the true value of empathy and
compassionate of care. Empathy is a nursing ability to understand beware of, be sensitive,
experience the feelings thoughts and experiences of the patient and their family. It is nursing
ability and willingness to tune in focus on patients experiences that is fundamental to the
methods nurses used to manage care. Empathy based on upon the respect on the dignity on the
client and the appreciation of the independence and self-actualization of patient
3. Teaching – one of the most important roles of a nurse is to assist patient and the family with
receiving information that are necessary for maintaining a patient’s optimum health. Nurses
provide patients and families to information that is based on their assessment learning needa.
Tignan niyo yung learning ability nila, prefers nila and readiness to learn because fundamental to
the provision of patient education is nurses believes that the patients have the right to make
inform decisions about their care. It should be accurate, complete and relevant to your clients
needs. Because a nurse often clarify information that is being provided by the other member of
the health team also.
4. Critical Thinking – we nurses are constantly involve with accurate and appropriate clinical
decisions. Nurses must able to think critically and make decision that patients present problems
for which they may not be clear. We have textbooks solutions a nurse must be question,
wonder, and be able to explore our various perspective and possibilities in order to best help
the patients. Critical thinking involves active, organize, cognitive, design to allow nurse explore
challenge assumptions. We should also reflect on past experiences, think independently, take
risk based on your knowledge. Also persevere o difficult problems, curious, creative and ethical.
5. Psychomotor Skills – fundamental to nursing, laying on hands to give comfort. Paano natin
matutylingan ang patiente the use of the specifics skills to accomplish client assessment and of
course to provide evaluate nursing care. Nursing skills are utilized in a matter that maximize
client comfort and dignity, optimize client’s ability to respond positively. Provide highest level of
accuracy information and provides the most favorable patients outcomes. Psychomotor skills
are best learn through practice basic principles skills, nursing education.
6. Applied Therapeutics – dapat marunong na kayo mag bigay ng gamot, interventional interval sa
patients. You should know how to apply modalities. And of course this is based on knowledge
base regarding to therapeutic nursing as well as skills and patient’s assessment and evaluation.
Kailangan competent when you are going to perform this modality,
7. Ethical and Legal Considerations - You should know hanggang saan lang ang limitations niyo.
Scope of nursing wag lalagpas. Whatever your plans, provide, evaluate, or perform nursing
intervention. It should be guided by ethical and legal considerations. We have code of ethics.
That is an ideal framework for safe and correct practices and behavior. Wag magpapractice
beyond your scope.
8. Professionalism – involve your characteristics as a nurse. This reflects your professional status.
This characteristic involves behavior with regards to yourself, your patients and others.
Professional persons ARE KNOWLEDGABLE subject matter
• Every healthcare provider must be sensitive to fact healthcare decisions are moral decisions.
• He should take into account the scientific evidence as well as the moral values that move the
choice from what “can be” to what “ought to be”
• In approaching an issue, one has to be first determine the facts, good ethics is based on good
science then review the ethical principles,
Apply them, taking into consideration the values of different stakeholders affected by the
different options
Lastly, choose the option that serves the best interests of those most concerned
1. Clarifications: Identify
Scientific facts
2. Application:
3. Judgment :
Best solution
This doctrine says that if doing something morally good has a morally bad side-effect it's
ethically OK to do it providing the bad side-effect wasn't intended.
Double effect
An ethical principle that explains how the bad consequences of an action can be considered
ethically justified if the original intent was for good intention.
Double effect
This is the participation of one agent with another agent to produce a particular effect.
Cooperation
It translates into the willingness to give oneself for the good of one's neighbor, beyond any
individual or particular interest
Solidarity
Stewardship
Solidarity is a tool for reducing inequality and social injustice in the world.
The principle of solidarity requires that men and women of our day cultivate a greater
awareness that they are debtors of the society of which they have become part.
Exercising stewardship is caring for the gifts God has given us, including the
environment, our own personal talents and other resources.
The correct answer is 'True'.
To show principle of totality you must be eager and responsible enough to take the
obligations entrusted upon you.
The correct answer is 'False'.
Principle of cooperation is, if a friend ask you to take care of his/her possessions, you
should be responsible in taking very good care of it.
An example of stewardship is the act of making wise use of the natural resources provided
by the earth. The act of caring for or improving with time.
The principle of beneficence holds that there is an obligation not to inflict harm on others.
The correct answer is 'False'.
Deontology is a theory that suggests actions are good or bad according to a clear set of
rules.
The correct answer is 'True'.
In teleology, actions that obey these rules are ethical, while actions that do not, are not.
Select one:
Teleological ethics holds that at least some acts are morally obligatory regardless of their
consequences for human welfare. ... By contrast, deontological ethics holds that the basic
standard of morality is precisely the value of what an action brings into being.
The correct answer is 'False'.