Name: VERAZON, JAYLORD B.

Course and time: BSN 2A BIOETHICS

7:30-9:00 AM

A. Explain the meaning of the following:

1. Stewardship or accountability
-Humans must respect the sanctity of life and the world. This means that they are
bereft of any speck of authority over life and the world. Any act therefore, that
would define the blessedness of life and the world is against the principle of
stewardship.
2. Principle of totality in the context of human dignity
-It demands respect for the self and respect of others. Respect of the self in others
in a condition sine qua non in a given social order. Every individual is duly
accountable for the whole society.
3. Principle of totality in the context of the human body
-Some parts of the human body do not actually deter everyday human life. Thus, a
person has the right to cut off or remove any defective or worn-out, non-
functioning part of his or her body on the premise that the intention is to
safeguard totality of well-being and is acceptable.
4. Principle of totality in the context of human life journey, from the conception to
death
-This journey is indubitably nourished by the unique and amazing experiences of
the varied facts of existence. In this regard, the lives of babies produced through
test tubes may lack the issue of this totality.
5. Principle of totality in the context of human behavior using the theories
developed by fetal psychologists
-Human behavior does not begin at birth, but five weeks after conception. As
early as 5 weeks, the fetus’ cerebral cortex is already showing signs of
development. It gives way for a person to grow, move, think, speak, plan, and
create as a human being.
B. Explain the meaning and significance of the following to the healthcare profession:

1. Autonomy
-The notions of individuality, uniqueness, freedom, and responsibility are given
paramount importance in civil societies. Undoubtedly, the concept of autonomy
implies independence and firmness in one's conviction perspective or personal
stance. In moral philosophy, autonomy grossly refers to personal self-governance
or those that pertain to personal rule of the self by adequate understanding while
remaining free from being controlled by others or by one's own limitations that
may prevent one from making choices. Autonomy on individuals is shown when
they, not others, make decisions that affect their lives. Healthcare providers are
duty-bound to acknowledge the autonomy of their patients; they have to recognize
and appreciate the views, decisions, choices, beliefs and values of their patients.
2. Beneficence
-Require abstention from harm and positive assistance. It requires nurses to
abstain from injuring others, specifically the patient, and to protect the patient's
legitimate interest like the prevention and expulsion of harm. It also means the
practice of doing good deeds, or showing kindness and charity to others. Further,
it means taking actions that will promote the welfare of other people.
3. Nonmaleficence
-Nonmaleficence is understood as the overriding principle through which
everyone is required to undertake the caring of the patient. It is capsulized in the
phrase “do no harm”. When a nurse belabors to do good to his or her patient such
an act can be interpreted as one that safeguards the patient from harm or danger.
The postulated knowledge and skill on the part of the nurse can be accounted in
nonmaleficence. If a nurse is deficient in a certain skill or experience, but he or
she pretends to be skillful and knowledgeable so that his or her patient suffered
some injuries caused by his or her pretension, the nurse is guilty of failing the
demands of the principle of nonmaleficence.
4. Justice
-Beauchamp and Childress define justice as the rendering of what is due or
merited. Their definition is based on Plato's understanding of justice as the giving
of what is due to or from a person. Justice can be taken to mean as the habit that
enables one to give each and every human person his or her due or his or her own
right. It is derived from the Latin word jus which means “right”. Justice is
realizable only in the context of man's relational existence with his or her fellow
humans. Let us take the nurse-client relation. The nurse does justice to the patient
if he/she cares for the patients in the manner he/she is required of his/her duty.
The patient, in turn, can reciprocate what he/she gets from the hospital by paying
all his or her hospitalization bills, otherwise he/she becomes unjust to the just
gains he/she got from the hospital through the nurse.
5. Casuistry
 -In casuistry, paradigm and analogy are used in handy. Simply put, the rule of
precedence places well enough in casuistry. Thus, cases that have been handled and
resolved before serve as paradigms for analogical considerations. In casuistry, the
rule of precedence becomes a potent source of making a sound decision in healthcare
practice. For instance, a patient with a medical case called by a doctor as a Persistent
Vegetable State (PVS) that the person's brain is extremely damaged that it cannot
exhibit any sense of awareness or maintain any reaction to external stimuli. In this
condition, the physician and the patient’s relatives will undoubtedly be thrown into a
quandary of what to do with the patient. Casuistry may help those concerned to
resolve the problem. By critically, religiously, and conscientiously studying an
analogous case that had happened in the past, may find relief in the burden of making
a blameless decision since previous cases can offer great help as paradigms.
6. Communitarianism
- Callahan maintains that in communitarianism, the following points have to be
emphasized: (1) individual rights are coupled with communal responsibility; (2)
communal good is more important than individual good; (3) there should be a
balance between the welfare of the community and that of the individual; and (4)
solutions to important questions necessitate a distributed communal deliberation
or understanding. A closer look at the communitarian method can easily lead one
to see its bitter antagonism against principlism, specifically autonomy. Whereas,
communitarianism demands communal decision, autonomy asserts that the
individual's decision be given more weight.

C. Answer the following:

1. Discuss when a moral agent is responsible for the evil effect of an act that he/she
has directly willed. Present all the conditions and provide some concrete
examples.
-For the first problem, Glenn argued that there are three conditions that make the
agent responsible for the evil effect of an act directly willed. All of these
conditions, however, must be present, otherwise, the agent cannot be ascribed for
any moral liability. These conditions are as follows: (1) if the agent foresees the
evil effect, at least in a general way; (2) if the agent is free to refrain from doing
that which is the cause of the evil effect; and (3) if the agent knows that he is
morally bound not to do that which is the cause of the evil effect.

It is good to take a look at this example. A person climbed atop a building to

commit suicide by throwing himself down. In executing the app an irony
occurred. Instead of landing on the ground, he landed right on top of an old
beggar. Conditions number 2 and 3 can be strictly enforced over the act. The
deficiency lies on condition number one since the person who wished to kill
himself must have kept no other interest but to kill himself. His act is, per se,
immoral, but the consequence dictates that his act is classified as frustrated
 suicide. The evil effect of killing the beggar is something adverse to the will of
the person. However, morally exempted he may be, he will not be exempted
criminally, as he is legally responsible for the beggars death.
2. Discuss when a person can perform an act that is not evil in itself but has two
effects, i.e, one good and the other evil. Present all conditions and provide some
examples.
-For the second problem of indirect voluntariness, four conditions must be present
for the agent to be allowed to perform the so-called double effect act. They are as
follows: (1) the action must be morally good in itself, or at least morally different;
(2) the good effect of the act must precede the evil effect which is morally
allowed to happen as a regrettable consequence; (3) there must be a grave or
sufficient reason in doing the act; and (4) the evil effect should not outweigh the
good effect, or at least the good effect has a tantamount importance over the evil
effect.
A good example could be that of a woman who is three months pregnant. The
mother, however, is suffering from cancer of the cervix. After a consultation with
her physician, she was informed that an immediate operation must be done to
protect her from the disease. The operation however, means the death of the baby
in her womb. Based on the conditions, the mother may have an operation despite
its regrettable evil effect to safeguard her health. The operation is morally good,
because it will somehow protect her from the cancerous part of her body. The
assurance of her good health precedes the death of the fetus. The safety of her
health condition is the grave or sufficient reason why the operation must be done.
Obviously, the death of the fetus fails to outweigh the good health condition of
the mother.
3. Discuss the importance of the principle of cooperation in the practice of
healthcare profession. How can a healthcare provider protect the dignity of the
healthcare profession through this principle? Give specific examples.
- This principle is very sensitive, especially in the relation to the duties and
responsibilities of healthcare providers. Cooperation indispensable needs
prudence on the part of the nurses. They are mandated to pursue this principle
only on matters that would protect the integrity of the healthcare profession, and
the interest and welfare of their patient. So, on matters requiring the nurses’
cooperation will result to her personal and integral scandal or immorality of the
healthcare profession, the nurse must dispense herself from such cooperation. For
this situation, the health care provider must categorically refused to cooperate. For
example, in cases of abortion, if the cooperation of the health care provider is
required by a woman, perhaps to hide a scandalous pregnancy, the nurse must and
firm to refuse cooperating. The refusal, of course, is morally good and a
praiseworthy decision.
4. Present and discuss the justifying conditions for a healthcare provider to resolve
conflicts that may arise in the choice of the Four Principles Approach. Give
concrete examples.
-In bioethics, the four principles refers to the duties of the physicians to
their patients. Even if, there is an equal weight on all of the four
principles, a dilemma may still ensue in many instances. This is why
bioethicists offer some justifying conditions to resolve a situation wherein
one has to make a choice from the various methods. They are as follows:
1. Choose one principle over the other. This refers to an act of infringing
one over the rest of the four principles.
2. The moral purpose must be attainable or capable of being realized.
This means that it should be understand by all individuals. For
example, the purpose of insertion of IFC to a post-operative client
must be rationalized to the client and S/O so that all of them will have
a common understanding.
3. There is no possibility of giving preference or importance to
conflicting prima facie duties. Thus, there is an absolute necessity to
choose one over the other.
4. The opted solution must yield to the lowest degree of infringement.
This refers to the decision that must only result to lowest possibility of
violation in the profession.
5. The minimal effect of infringement should be seriously undertaken.
The violation could still somehow after the profession and the patient,
so it shouldn’t be neglected but rather give much attention to it.
The above conditions are reliable sources for healthcare professionals and
other concerned persons in drawing a valid decision in case a dilemma
ensues.
5. What do you think is the impact and importance of the Patient’s Bill of Rights to
the clients: Do you think these rights are indispensable for the clients to have
security, peace, and privacy?
- A Patient’s Bill of Rights is a document that provides patients with information on
how they can reasonably expect to be treated during the course of their hospital stay.
These documents are, in almost all cases, not legally-binding. They simply provide
goals and expectations for patient treatment. Although a Patient’s Bill of Rights may
not be legally binding in all aspects, these rights are indespensable. Doctors and
nurses do have certain legal obligations, such as the obligation to provide high-quality
care, involve their patients in the decision-making process, and ensure the
confidentiality and privacy of clients.
6. What do you think are the merits of the principle of paternalism in the
healthcare profession? Do you think it shows more favor to the client or to the
healthcare provider?
-I think one of the merits of the principle of paternalism is that the interference has
limitations on the individual's autonomy justified by reasons referring exclusively to
 the welfare or needs of the person whose autonomy is being interfered with. This
means that healthcare professional could interfere with the decision of a particular
patient about a certain phenomena because of the reason that they are more
knowledgeable and that they know exactly what to do. Another is that it is intended to
keep individuals from harm. Like for example, coercing a patient to take medication
since the patient refuses to take them could keep the patient from harm. at the same
time, the coercion benefits the patients by perhaps, elevating the pain brought about
by the disease he or she is suffering, or curing his or her illness.

7. Discuss how Mappes and DeGrazia compare paternalism per se with extreme
paternalism. Do you think they are right?
- They have distinguished the principle of paternalism and extreme paternalism by
stating that the former refers to actions intended to keep individuals from harm, while
the latter refers to actions intended to benefit the doer of the action. The primordial
intention of interference in autonomy, be it the principle of paternalism or principle of
extreme paternalism, is always the benefit of the individual and those of others.
This means that the two principles moves to the same direction which is to keep the
individual from harm.
8. Discuss how William Frankena argue relative to the four elements that capture
the essence of the principle of beneficence. Do you think these ideas can help
protect the welfare and well-being of the patient?
- William Frankena maintains that there are four elements that help express the
substance of the principle of beneficence, namely, (a) one ought not to inflict evil or
harm; (b) one ought prevent evil or harm; (c) one ought to remove evil or harm; and
(d) one ought to do or promote good. Yes, because the four elements adhere the
person, specifically, the healthcare professionals to cause no harm or evilness to the
client, thus, this protects and assures the welfare and well-being of the patient.
9. How do Kong Zi and Lvinas view beneficence? Do you think that their views are
far-off better than those of Frankena? Why? Discuss with reasons.
- The Chinese believe that everyone shares the same nature; hence, they assert that
others are as human as they are. This leads Kong Zi to preach his signature doctrine
called The Golden Rule, the affirmative citation of which goes “do unto others what
you want others do unto you,” and the negative expression, “do not do unto others
what you don't want others do unto you.” This doctrine of sameness of others
otherness is also well elaborated in Emmanuel Levinas’ insights on altereity. To
Levinas, The epiphany of the face reflects the kind of responsibility or moral
obligation which each one of us is duty-bound to do to others. However, he made it
clear that we have no right to review others according to our bias and prejudice
approach to their other ness of the others.
I think their views imply different ideas based on their own mere understanding.
Frankena, in summary, have stated that “a person must avoid evil/harm and rather
shall promote good.” While, Kong Zi and Lvinas viewed beneficence as “do good to
others, so that they will do good to you,” and “do harm to others, and they shall also
 do it to you.” Their ideas were somehow correlated because as you do no harm to
other and promote good, you will benefit from it because you are less likely to be
harmed.
10. How about the Hindus and the Chinese, how do they see the doctrine of
beneficence? Explain with reasons.
- Chinese believes that everyone shares the same nature; hence, they assert that others
are as human as they are. This simply means that they treat human being Just as how
they treat themselves. If they tend to respect themselves, of course, they also respect
others. If they care too much for themselves, then, that is also how they care for
others. On the other side, Hindus have long nourished a doctrine called ahimsa which
means non-hurting of all forms of life. This means that whether it is a plant or an
animal, or even a human being, you should not/ you are not allowed to hurt that
particular matter or simply hurt that person.
11. Do you think that the principle of nonmaleficence can be easily broken or rather
maintained in the healthcare profession? Why? Give concrete examples.
- I think the principle of nonmaleficence cannot be easily broken. However, there are
certain circumstances that a healthcare professional fails to follow the principle. For
example, the nurse administered the wrong medication to a client and it created an
adverse reaction to his or her body. Due to the negligence of the nurse, it resulted to
the harm of his or her client. Therefore, nonmaleficence should always be maintained
in the profession because this ensures the patient’s safety and security.
12. How can the principle of justice be fully exercised in the healthcare profession?
Discuss with reasons.
- I believe that justice can be fully exercised or can be fully achieved by rendering
what is due to the other be it merit or its opposite, meaning, you should give what a
person deserves. Let us take the nurse client relation as an example for the healthcare
profession. The nurse does justice to the patient if she cares for the patients in the
manner she is required of her duty. The patient, in turn, can reciprocate what she gets
from the hospital by paying all her hospitalization bills.