ETHICS
 The term ethics is equivalent to the Greek
word “ethicos”, which pertains to ethos
translated as“custom” or ‘character”.
 Custom is mos or moris in Latin from which
morality is derived.
= is a philosophical science dealing with morality of
Human conduct or action.
 Morality- these are principles concerning the
distinction between right and wrong or good
and bad behavior
 Philosophical Science- it is concerned with
the foundations, methods, and implications of
science.
BIOLOGY
 The science of living things.
• These living things may refer to plants and
animals
• The biological perspective on the essence of
the human person takes him/her as ‘the
highest form of animal life, whose being and
activities are determined by the same laws
that govern all other matter.
BIOETHICS
• Is derived from two words “bio” and “ethics…
• …”Bio” is a combining form and short form for
biological or biotic. It means life or having to
do with living things.
• …”Ethics” is the science of human conduct or
characteristics of rational animal.
= is viewed as a living study of the conduct of human
life. It focuses on the study of the ethical problems
involved in biological research and others…
OTHER DEFINITIONS OF BIOETHICS
• The ethics of medical and biological research
• Study of the ethical issues emerging from
advances in biology and medicine.
• It is the application of ethics and philosophical
implications of certain biological and medical
procedures.
HEALTH ETHICS
• Is concerned with the type of conduct or
character that is approved or disapproved of
in terms of right and wrong, good or bad
relative to health-care service. Specifically, it
may refer to nursing ethics.
• NURSING ETHICS- Is concerned with moral
principles that govern the conduct of a nurse
in his/her relationships with patients,
physicians, colleagues, the nursing profession
and the community or public.
PROFESSIONAL ETHICS
• Branch of moral science, which treats of
obligations that a member of a profession
owes to the public, his/her profession,
colleagues, and clients.
• It enables the basic principles of right action,
or norms of conduct, which are exemplary
and honorable in the practice of a profession.
LEVELS OF ETHICAL OR MORAL DISCOURSE
LEVEL I = CASE APPROACH OR CASUISTRY
• Begins with an issue or concrete moral
question or dilemma that one faces here-and
now, or two persons disagreeing on what in a
specific situation is the morally appropriate
behavior.
• The analysis is inductive, that is, the process
starts with specific and measurable facts and
cases that may support the application of the
higher level of moral discourse.
CASUISTRY – Is a process of reasoning that seeks to
resolve moral problems by extracting or extending
theoretical rules from a particular case, and
reapplying those rules to new instances. This method
occurs in applied ethics and jurisprudence.
• It is the use of morals or beliefs in decisions of
right and wrong in order to reach or
rationalize a solution.
• derived from the LATIN noun “casus” (case or
occurrence)
INPUT PROCESS OUTPUT
CASES CASUISTRY by Acceptance
way of and Justifiable
ISSUES induction moral
(inductive judgment
FACTS/EVIDENC reasoning or
E analysis)
LEVEL 2 = RULES AND RIGHTS (CODE OF ETHICS)
• This level is resorted to if and when issues or
cases are not resolved at the base or first
level.
• Take note that not everything that is legal is
ethic, or illegal, unethical
…There are extreme views as well as moderate views
on how rules and rights must be taken in providing
moral guidance in the resolution of a problem
A) LEGALISM- holds that there are no exceptions to
the rules or rights.
B) ANTI-NOMIANISM – holds that every case is so
unique that no rules or rights can never be relevant in
deciding what one ought to do in a specific situation
MODERATE VIEWS
A) SITUATIONALISM – Holds that moral rules are just
guidelines or rules of thumb that must be evaluated.
B) RULES OF PRACTICE – holds that rules specify ‘wrong’ is the same for - Observation
practices that are morally obligatory, and which are everyone - Intuition
binding in human conduct. - Social Agreement or
RULES AND RIGHTS Contract
VIEWS APPLICATIONS RELATIVIST ANSWERS
1. Legalism 1. Rules apply rigidly -One’s culture, personal
2. Anti-nominalism 2. No rules apply preferences and actual
3. Situationalism 3. Rules as guidelines social contact
4. Rules of Practice 4. Rules specify practices
as morally obligatory BASIC ETHICAL PRINCIPLES
1. Principle of Stewardship
LEVEL 3 – NORMATIVE ETHICS  A stewards or stewardess is a person
• At this level, basic norms of behavior and appointed in the place or stead of another.
character are discussed, rules and right claims Takes charge of representing and protecting
are defended, and norms of good moral another’s interest, and sees to it that the
character are articulated. service is carried out faithfully
 Stewardship is the management and
THEORIES AND QUESTIONS UNDER NORMATIVE supervision for others
ETHICS  And it entails concomitant values/ virtues of
THEORIE QUESTIONS ANSWERS RESPONSIBILITY and ACCOUNTABILITY
S RESPONSIBILITY
ACTION What principles Principles of:  Ability to act independently and make
THEORY make actions - beneficence decisions without authorization
morally right? - non-maleficence ACCOUNTABILITY
- respect for  Is the obligation to explain, justify, and take
autonomy or responsibility for one’s action
justice
VALUE What kind of - happiness, 2. Principle of Totality
THEORY consequences are beauty,  The term “totality” connotes wholeness,
good or knowledge completeness, or entirety
intrinsically  This principle applies to any entity that is
valuable? made up of parts that together constitutes as
VURTUE What kind of - compassion/ a whole. But the whole is greater than any of
THEORY character traits sympathy, loving, its parts
are morally faithfulness 3. Principle of Double Effect
praiseworthy?  The principle contemplates on two effects or
outcomes arising from the performance of an
4th/HIGHEST LEVEL = METAETHICS action
 It is the task of analyzing the nature of moral  The first or primary effect results from the
judgment and theoretical systems. agent’s intent, desire, wish or will, while the
 Deals with the most basic questions of ethics, secondary effect is only allowed, tolerated, or
the meaning and justification of ethical terms, permitted.
how people know which principle, values, or  The principle distinguishes performance of a
virtues are the correct ones and the ultimate good act that has both good and bad effects,
grounding of ethics. from performance of a bad act so that good
METAETHICS RAMIFICATION effect may result therefrom.
What is the source of How do we know what
Ethics? is ethical? FOUR Conditions to consider or fulfill before an
RELIGIOUS ANSWERS RELIGIOUS ANSWERS action with double effect is justified
- The Divine Will - Revelation  The action done or course chosen must be
- The Divine Law - Scriptures morally good, or at least morally indifferent or
- Church Tradition neutral
- Experience  The good effect must come directly from the
SECULAR ANSWERS SECULAR ANSWERS action itself, and not coming from or following
- natural Law- what - Reason as a consequence of secondary bad effect
constitutes ‘right’ and - Experience
  The good effect must be intended or willed
and the bad/harm merely tolerated or
allowed, with sufficient reason
 The good effect must outweigh or at least be
equivalent in importance to the evil effect
4. The Principle of Cooperation
 To cooperate means to work together, to
unite in producing a result, or to desire or
wish in a common thing. It implies that one
works with others in the performance of an
act to accomplish a goal.
 However, concerted acts may turn out to be
either good or bad
 Principle of cooperation poses moral problem
when and where acts done are evil, immoral
and illegal
IN CONCERTED BAD ACTS
 Participants may be considered as:
 Principal – primary actor/ leader
 Co-principal – is someone who knows the evil
design of the principal
 Accomplice- one who cooperates in the
commission of an evil act when one does
another act
5. The Principle of Solidarity
 To be solid means to be firmly united
 It follows that solidarity implies unity or
fellowship arising from common responsibility
and interest
 With this principle, one for all and all for one
policy is a tall order
6. Ross Ethics = (Self- Directed Learning)
 Prima Facie Duties
7. Epikeia
 This principle states that a principle can be
broken to achieve a greater good
• a Greek word meaning “reasonableness”
 applies only to positive law
WILLIAM DAVID ROSS
 Was a British philosopher (Scotland) known
for his important contributions to moral
philosophy
 Introduced the idea of Prima Facie Duty
which he calls it also as Conditional Duty
PRIMA FACIE
 A Latin term that is commonly understood to
mean “on the first appearance” or “based on
the first impression”
PRIMA FACIE DUTIES
 A duty that is binding and obligatory
 Our “actual” or “concrete” duty that we ought
to perform
 Guideline for morality
CLASSIFICATIONS OF PFD BY ROSS
1. Duties of Fidelity
 These are duties to keep ones promised and
contracts and not to engage in deception
 Professional responsibilities/social roles of:
 Physician as physician
 Nurses as nurses
 Teacher as teacher
2. Duties of Reparation
 This is the duty to make up for the
injuries/wrong doings one has done to others
 A returns the cellphone and says sorry to B,
the victim. C admits cheating and accepts
punishment for the same
3. Duties of Gratitude
 The duty to be grateful for benefactions done
to oneself and if possible, to show it by
benefactions in return
 If one has provided help to others when they
are in need, the latter stand under a duty to
reciprocate help/service for the former when
the same is in need
4. Beneficence (do good)
 The practice of doing good, or an act of
kindness
 Provision of your tender loving care as a
nurse. Always mindful of the patient’s welfare
inside the ward
5. Duties of Non Maleficence (Do No Harm)
 It is the act of not doing evil or harming
others. The duty includes not to make the
condition of others being worse or difficult.
 The duties of not to kill, inflict corporal
punishment or to defraud others.
 Doing your job accordingly as a nurse
6. Duties of Justice
 Justice connotes just conduct, fair treatment,
or giving and receiving what one deserves.
 ___If a nurse works 8hrs plus overtime, he
must receive the agreed legal compensation
plus overtime pay.
7. Duties of Self-improvement
 Include the duty to make better one's
character or the like by his own effort.
 The Divine Provider helps those who help
themselves, or the sick gets well if he
cooperates with the health care provider.
  .. A nurse keeps on studying things related to
his profession, attends skills/knowledge
enhancing seminars and trainings.
 ...Takes graduate studies
MAJOR BIOETHICAL PRINCIPLES
1. Respect and Autonomy
 The term “autonomy” comes from 2 Greek
words autos (self) and nomos ( rule of
governance) = self-governance or self-
determination
 This implies acknowledgement of the person’s
right to hold views and opinions, to make
decisions and choices, and to take action
based on personal values, virtues, traditions
and beliefs
2. Principle of Non Maleficence
 “DO NO HARM
 It requires health care professional to act in
such a manner as to avoid causing harm to
patients. It includes deliberate harm, risk of
harm and other harms that may happen
during performance of beneficial acts
 Application of the golden rule
3. Principle of beneficence
 “beneficence” comes from 2 latin words
“bene” (well or good), anf “facere” )to do or
make) = doing what is good
 It implies the duty to actively do good for
patients
 It is associated with the concept or virtues of
kindness, benevolence, altruism or
humanitarianism
3 major Components of the Principle of Bene
 Do or promotes good
 Prevent harm
 Remove evil or harm
4. Principle of Justice
 “justice” is associated with the concepts of
fairness, rightfulness, deserved reward or
punishment and equity
 It implies a sense of duty to treat all people
without bias to age to age, socio-economic
status, race, or gender.
 It may be concluded by the saying:
 “JUSTICE DELAYED IS JUSTICE DENIED”
OTHERS
Principle of Veracity
 It is the principle of being honest and telling
the truth, somewhat related to the principle
of autonomy (truth-decision)
Principle of Confidentiality
 It is the protection of personal information.
Keeping a client’s information between you
and the client
REVALENCE OF BIOETHICAL ISSUES
 ABORTION
 EUTHANASIA
 SUICIDE
 DETERMINATION OF DEATH (Biological and
Clinical death)
 IN-VITRO FERTILIZATION
 STEM-CELL TECHNOLOGY
Other bioethical issues
• Plastic Surgery
• Organ Transplantation and Donation
• Sterilization
PLASTIC SURGERY
• Plastic /Cosmetic Surgery is a branch of
science that focuses on the reconstruction or
repair of deformity, defect, or bodily injury.
• The surgery may entail the use of bone,
cartilage, tendons, and skin being taken from
other parts of the body or applying artificial
substitutes.
• The legal and moral dimensions of surgical
intervention may be anchored on the
principles of totality, autonomy with patient's
complementary value of informed consent,
and double effect.
In order for plastic surgery to become legally and
morally permissible, it has to comply with the ff
conditions:
• The functional integrity of the human body
must not be lessened, unless a sacrifice of any
part, through surgery, is an extreme necessity
to preserve the health and life of the whole
body.
• Both surgeon and patient must have good
intention.
• Surgeon must respect patient's autonomy and
obtain the latter's informed consent.
• The intent or motives must be reasonably
higher than or proportionate to the
extraordinary means employed or allowed.
ORGAN TRANSPLANTION AND DONATION
• This involves the removal of a major or minor
part of the human body from one person, and
then surgically implanted in another person's
body to replace a lost or diseased organ.
• This immediately preceding description
implies an interplay between a giver and a
beneficiary, or between a donor and a done
• A donation is an act in which the owner of a
thing voluntarily transfers the title and
possession of the same from himself/herself
to another person, without any consideration.
 • By the civil law, donations are either
INTERVIVOS (between living persons) or
Mortis Causa (in anticipation of death).
• INTERVIVOS= is a gift made by one living person to
another. It is a rule that a fee cannot pass by grant or
transfer without appropriate words of inheritance.
• MORTIS CAUSA = is a gift that is made in expectation
of approaching death. It is intended that it shall take
effect only in the case of the giver.
MORAL DIMENSIONS OF ORGAN TRANSPLANTATION
1. The fundamental morality of transplanting body
parts.
2. The ethics of organ procurement.
3. The ethics of allocation.
STERILIZATION
• Is a surgical procedure designed to prevent
conception. It is a medical intervention, which
makes a client or patient incapable of
reproduction.
• In females, the fallopian tubes are cut and
tied to prevent eggs from reaching the womb,
thus, providing permanent contraception.
DIRECT STERILIZATION
• Makes procreation not possible.
• includes eugenic and contraceptive or
preventive sterilization
• eugenic sterilization is done to avoid the birth
of a defective or diseased offspring
• Preventive sterilization suppresses ovulation
to avoid risk of getting pregnant
INDIRECT STERILIZATION
• Is the outcome of a therapeutic intervention
on a diseased part of the human body. The
removal of which, cure the same and serve
the whole organism.
• The intervention is anchored on the principle
of totality so it is morally licit to perform it.
1. OPHORECTOMY - complete removal of the ovary
which manufactures germinal cells.
2. SALPHINGECTOMY - removal of salpinx of
eustachean tube or fallopian tube.
3. HYSTERECTOMY - removal of uterus
4. CASTRATION - removal of testicle
5. EMASCULATION - removal of reproductive glands
6. VASECTOMY- the vas deferens on each side is tied
off/cut off to prevent sperm cells from reaching the
seminal vesicle.
THE CALLING OF THE HEALTH CARE PROVIDER
• The term “calling” signifies occupation,
profession, or trade. It may imply a response
of a human person to a demand, need, or
invitation to share in talents, expertise,
knowledge, and skills with other in this earthly
course of human enterprise to attain quality
of life.
• This may further denote a vocation, which
may determine what state in life a person
wants to be.
• This vocation includes the calling of the health
care provider to enter into a contract with
society in the area of health as their
profession.
• Thus, taking care of the sick, the aged, the
disabled, and other persons afflicted with
infirmities is, indeed, a noble profession.
CALLING is a strong urge to become religious while
VOCATION is an inclination (tendency, “posibilidad”)
to undertake a certain kind of work, especially a
religious career, often in response to a perceived
summons; a calling.
THE HEALTH CARE PROFESSION
• PROFESSION = is a complex, organized occupation
preceded by a long training program. It is a calling in
which its members profess to have acquired special
knowledge, by training, or by experience, or both, so
that they may guide, advise, or serve others in their
specialized field.
• HEALTH CARE (modifying the term profession)
May refer to watchful keeping of the
condition of being well or not sick. It is a means of
promoting the patient's well-being marks the
boundaries of the range of options offered to a
patient.
• HEALTH CARE PROFESSION
May operate within all branches of health
care, including medicine, surgery, dentistry,
midwifery, pharmacy, psychology, nursing or allied
health professions. Also in the public/community
health working for the common good of the society.
THE HEALTH CARE PROVIDER
• A health care provider may be considered a
professional duly authorized to engage in, and
granted by applicable law monopoly over
health care services.
• Health care providers may include, but not
limited to, physicians, nurses, therapists,
dentists, ophthalmologists, pharmacists,
dietitian nutritionists, and medical
technologists.
THE NURSE: A Mother surrogate
• The word “nurse” is derived from the latin
verb nutrire, which means “to feed, nourish,
or suckle”.
• As a noun, a nurse is “one who suckles a child
not her own.
 • As a verb and noun, it implies that nursing independence, and judgement in making
involves caring for children, especially young willingness to take risk nursing decision
from individual affording safeguard
children, caring for those who are childlike in autonomy to the clients.
their dependence, such as the sick, the Responsibility, liability, Readiness of a nurse
injured, the aged and the handicapped and answerability for to assume
• Likewise, it implies that the basic function of a carrying out one's responsibility as a
obligation or duty. consequence of
nurse is identical with that of a mother who,
Grounded in the his/her independent
in the latter's absence, acts as a mother principles of Fidelity decision and free
surrogate to the patient who has serious and respect for the acts.
emotional needs. dignity, worth, and
• The “mother role” of a nurse, however, is self- determination of
clients.
limited to the nurturing component of
AUTHORITY Permission, Authority is granted
maternal role, and is devoid of elements of legitimacy, power, and through the power
power and authority that may threaten expertise on some of examination and
patient's self-determination subject or field. A issuance of license to
form of permission for protect the public
THE NURSE: as a Professional a profession to exist from the misfits and
• A professional is one who is bounded by and for its members to professional’s job
legitimately practice territory by
values and standards other than those of
establishing a
his/her employing organization, setting one's monopoly
own rules, seeking to promote standards of UNITY Oneness, union of Through unity,
excellence and being evaluated, and looking parts forming a nursing is elevated
for approval of one's own professional peers . complex whole; to a noble profession,
which is
This immediately preceding description of a Relates to the ability characterized by
professional fits a nurse as such. of nurses to organize expertise, autonomy,
• A professional nurse is one who finished and and be cohesive to authority, and
acquired or gained a high level of specialized achieve the accountability.
profession's goal
skills and knowledge through long years of
study in nursing academic setting.
• This expertise distinguishes him/her from SDL activities
nonprofessionals, and equips him/her to meet • Patient's Rights and Duties (Patient's Bill of Rights)
the needs of the society, thus fulfilling the • Patient's Duties and Responsibilities
purpose of the nursing profession. PREVALENT ISSUES IN BIOETHICS A
• Aside from the expertise, there are other 1. ABORTION - is the premature expulsion of fetus or
defining attributes related and applicable to baby prior to normal birth. It is either by spontaneous
nursing profession namely: autonomy, or by induced termination.
accountability, authority, and unity.
♠ Spontaneous A. = This is a miscarriage, that is
CHARACTERISTICS OF NURSING PROFESSION the fetus or baby is born before it is able to live.
♠ Induced A. = Knowing the destruction of the life
ATTRIBUTES DEFINITIONS/MEANINGS APPLICATION/IMPLICA of an unborn child, or the intentional expulsion or
/ DESCRIPTIONS TION TO NURSING
PROFESSION
removal of the same from the womb, other than
EXPERTISE Competence or special Passing Government for the principal purpose of producing a live birth
knowledge Board or removing a dead fetus
and skills in particular Examination-NLE/ ♠ Therapeutic A. = It is an abortion done to save
field of Issuance
occupation/calling of Certificate of
the life of the mother (there is no criminal liability
Registration in here). But an abortion, without medical
or License to practice necessity to warrant, is legally and morally
professional nursing punishable, even with the consent of the woman
AUTONOMY Self-governing, self- or her husband.
regulating,
independence POTENTIAL REASONS FOR THE PREVALENCE OF
Self-regulation is a Autonomous practice
mark for collective serves as safeguard
ABORTION
professional to patient and health  If the fetus is allowed to develop normally and
autonomy. Self- care providers, like come to term, the pregnant man herself will
determination is a the nurse, die.
mark for he/she is legally and
 It is not he woman's life, but her health,
responsibility, ethically required to
accountability, use independent physical or mental, that will be severely
 endangered, if the pregnancy is allowed to
continue.
 The pregnancy will probably or surely produce
a severely impaired child.
 Pregnancy is an outcome of rape and incest.
 The pregnant woman is unmarried, and there
will be the social stigma of illegitimacy.
 Having a child or another child will be
unbearable financial burden.
 Having a child will interfere with the
happiness of the woman, the joint happiness
of the couple or the family as a unit.

THE HUMAN PERSON

 To be gender sensitive, the term “human
person” is used in lieu of man or woman to
give both sexes justice in the treatment of the
subject matter. Such usage will make
discussion/ presentation objective and free
from biases or prejudices.