Serrano, Alyssa Marie C.

BSN-II/19-1527
Health Care Ethics: Moral Principles

What moral principle/s were violated?

First is the principle of non-maleficence, as an HCPs, the physicians/surgeons primary obligation
is to make sure that there is no harm inflicted on their patient, in whatever form.
Second is the principle of stewardship, as HCPs is their sole duty and responsibility to give
proper treatment and making sure that the procedure that was given is just and honest, since their
patient give their entrusted their life to them. They should have executed their responsibility as
healthcare practitioner that will promote the health and life of their patient, not the other way
around.
Third is the principle of justice, they also violated this principle by not protecting the bodily
integrity from harm. Since the missing gauzes are announced to the surgeon, they should have
check properly the site of operation for the left foreign material in the patient’s body. What they
did was, they wrapped up the operation not checking where the missing gauzes are placed. It is
undue and unjust for the patient.
Fourth is the principle of cooperation, from what point the procedure became an evil act as
shared? It is when the surgeons have ignored that there were actually missing two pieces of
gauze used during the surgery. It violated the principle as there were two surgeons performed the
procedure, as well as the HCPs with them in the operating room, that resulted to unknown placed
of the gauzes as their evil act/practice. They have formally and directly cooperated in the
performance of evil action, even if the attending nurse announced that there were missing after
the closure of the incision site.
Principle of subsidiary was also violated, as the petitioner complaint to the PSI (owner of the
Medical City), denied that Dr. Ampil and Dr. Fuentes, the surgeons performed the procedure was
not their employee. But the petitioner believes that Dr. Ampil was a member of the hospital staff
since his name and other physicians were displayed in the public directory at the lobby of the
hospital. This act shows that the PSI takes away the right of the petitioner to complaint to the
medical city, since they denied that the surgeons are their staff. And in addition, they did not
conduct immediate investigation on the reported missing gauzes after the procedure to the wife
of the petitioner.
What should the nurse do in when the physician is engaged in malpractice? 
As a nurse and a healthcare provider, he/she should report the incident happen to his/her
supervisor or in the administrative department which is the human resources. With the report,
they will be the one to take the appropriate action for the physician’s malpractice. And if there
will be an investigation, they will be the one accountable, and the nurse will be as the witness,
for he/she announced the missing gauzes but ignored by the physician. The incident happened
was out of her control since he/she was just assisting during the procedure in the operating room,
and did her duty to check the post-surgery materials/equipment.

If you were the healthcare provider who knew that there was sponges missing, what would you
have done?
Like what the attending nurse did, I will announce the missing gauzes, and will insist to the
physician to properly check or assess the patient. That they can run test to determine if there is
still a foreign material inside the patient’s body, like CT scan, just to make sure where these
gauzes were placed. And it is the physician’s obligation to remove the foreign material in the
patient’s body since they are the one who performed a flawed surgery.