PREVALENCE OF BIOETHICAL ISSUES (PHILIPPINES)

 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

PREVALENCE
 In Epidemiology, it is the proportion of a particular population found to be affected by a medical condition at
a specific time.
 It is a statistical concept referring to the number of cases of a disease that are present in a particular
population at a given time.
**So knowing the different meanings of Bioethics, a bioethical issue arises when there are intersection between
medicine, law, public policy, religion and science.

ABORTION
 is the premature expulsion of fetus or child prior to normal birth. It is either by spontaneous or by induced
termination. The former is a miscarriage, that is the fetus or baby is born before it is able to live.The latter
implies knowing the destruction of the life of an unborn child, or the intentional expulsion or removal of the
same from the womb, other than for the principal purpose of producing a live birth or removing a dead
fetus.

A physician and a nurse, or midwife, are criminally liable for causing an abortion or assisting in causing the same by
taking advantage of their scientific knowledge and skills. However, if the abortion is done to save the life of the
mother, there is no criminal liability. This is known as Therapeutic abortion. But abortion, without medical necessity
to warrant, is legally and morally punishable, even with the consent of the woman or her husband.

Potential reasons for the phenomenon of abortion

 If the fetus is allowed to develop normally and come to term, the pregnant woman herself will die...
 It is not the woman’s life, but her health, 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 or incest...
 The pregnant woman is unmarried, and there will be the social stigma of illegitimacy...
 Having a child or another child will be an unbearable financial burden and
 Having a child will interfere with happiness of the woman or the joint happiness of the couple.

The Pros and Cons of Abortion: Their Moral Dimensions

 The abortion issue involves 2 opposing camps with divergent positions:
 Pro-life versus the Pro-choice

Pro-life position is anti-abortion. It resolves that abortion is illegal and immoral, based on the following grounds:
 human life begins at conception...
 Sanctity or value of life: the unborn child has all the rights as a human person...
 abortion starts the domino effect, ending in complete disregard for the value of human life..
 abortive methods are medically and psychologically dangerous to the oman’s life and procreativity...
 dangers in pregnancy are relatively safe due to the advances of medical science...
 economic reasons are irrelevant and unacceptable and
  viable options to abortion for unwanted babies due to deformity, born out of wedlock, or arising from rape
and incest.

Under the foregoing premises, proponents of Pro-life conclusively hold that abortion is an illegal and immoral act.
It constitutes murder of an unborn, innocent, and helpless person. Because this person possesses humanity, he/she
must be accorded all human rights, such as the right to life and live.

Pro-choice position is for abortion. It resolves that abortion is legal and moral based on reasonable grounds. Among
which are:
 Woman’s autonomy: she has an absolute power over her own body, and she should not be forced to bear a
child that she does not want.
 Human life begins at birth, actual birth determines the existence of life. If the fetus is still within the
woman’s body, it is, therefore, part of her body, and is subject to her free choice to give life or take away
from the unborn.
 Problem of unwanted or deformed child. Only really wanted children must be born; otherwise, the
unwanted add to the problems of over population, pollution and economics, and the same becomes a
burden to society.
 Abortion is relatively safe. The availability of qualified medical personnel’s guarantee safe performance and
minimal danger
 Domino effect is not justifiable. Abortion will not enhance loss of reverence in any other for human life in
any other areas. Instead, the experience of abortion makes woman more loving of their wanted children;
and
 Pregnancy poses danger to the mother’s life. In a situation where the mother and the child’s life are both in
danger; that of the mother takes precedence or priority, over that of the child. Thus, abortion is permissible
to save a woman’s life.

STERILIZATION
It is a surgical procedure designed to prevent conception. It is a medical intervention, which makes a client or a
patient incapable of reproduction. In females, the fallopian tubes are cut and tied to prevent eggs from reaching the
womb, thus, providing permanent contraception.

The methods employed includes (females):

1. ophorectomy (complete removal of the ovary, which manufactures germinal cells)
2. salphingectomy (removal of salpinx of eustachean r fallopian tube)
3. Hysterectomy (removal of uterus)

In males, sterilization can be achieved by:

1. Castration (removal of testicles)
2. Emasculation (removal of reproductive glands)
3. Vasectomy ( the vas deferens on each side is tied off and cut to prevent sperm cells from reaching the seminal
vesicles)

Sterilization may be indirect or direct. The former 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. Therefore, it is moraly licit and permissible to perform indirect sterilization.

On the other hand, the direct sterilization makes procreation not possible.It includes eugenic and contraceptive
or preventive sterilization. Eugenic sterilization is done to avoid the birth of a defective or diseased offspring, geared
towards the improvement of human race.
Preventive sterilization suppresses ovulation to avoid risk of getting pregnant, which pregnancy may aggravate a
disease of a woman.

The two immediately preceding methods are all morally illicit because they lessen the functional integrity of the
human body when such methods do not preserve the health nd life of the total well-being.

In a word, direct sterilization disables a woman from procreating.

EUTHANASIA
 is the intentional ending of another’s life from a benevolent or kind motive.
  a deliberate act undertaken by one person with the intention of ending the life of another person to relieve
that person’s suffering.
 commonly referred to as “mercy killing”

Euthanasia is either Active or Passive

 *Active E. - a person (such as a physician) directly causes a patient’s death, such as when the patient is given
a lethal injection or some pills.
 *Passive E. -a person simply allows a patient to die. This is done either withdrawing treatment, such as when
a life-sustaining machine is switched off (such as withdrawing a feeding tube or unplugging a ventilator); or
by withholding treatment, such as when a surgery that could extend the patient’s life is not performed.

Euthanasia is either:
a) Voluntary - when it is done with the informed consent of the patient whose life is being ended.
b) Involuntary - when it is done against the will of the patient, or despite the patient’s refusal to give his/her
informed consent to the procedure
c) Non-voluntary - it is done on patients who do not have the capacity, or to refuse to give, their informed consent
to the procedure. Such patients include and brain dead patients, and severely disabled newborns.

It is done, however, with the informed consent of a person (a parent, spouse, and guardian) who is
recognized by the law to make decisions on the patient’s behalf.

Assisted Reproduction (in-vitro fertilization, human insemination)

In the normal process of procreation, the woman becomes pregnant through sexual intercourse with her
male partner. If the timing is right, the woman ovulates and her ovum (egg cell) is fertilized by the man’s
spermatozoom (sperm cell). Normally, the fertilized egg, zygote, is implanted in the uterine wall that will become an
embryo and the process of gestation begins.
However, many couples end up being childless, because they are not successful in one or more of these
steps necessary in natural reproductive process. To respond to the desire of childless couples to have a child without
the need to adopt, technologies for assisted reproduction (AR) have been developed.

Assisted Reproduction (AR) Technology

- denotes “techniques for creating a baby other than by sexual intercourse between a man and a woman.
Some involve only a couple (usually married), whereas others may involve singles or unmarried couples and utilize
bodily products or services of third parties.

Kinds of AR Technologies
1. Artificial insemination with the husband’s sperm (AIH)
 this is a procedure “ in which semen with living sperms is collected from the male and introduced into
female reproductive tract at proper time with the help of instruments”.
 the technique is used to treat a form of male infertility in which the man cannot produce sufficient amount
of sperm in an ejaculation to fertilize his partner’s egg. Even when the sperm he produces may be otherwise
healthy and viable, it does not, however, reach the egg for purpose of fetilization through normal
intercourse.

AID (artificial insemination with donor sperm)

 is a variation of AIH
 the procedure is similar to AIH, only now the source of the male reproductive material is someone other
than the woman’s husband. the reason for using another man’s sperm is not fertile at all, or would likey
pass on a genetic defect to the child. The donor sperm is usually taken from a sperm bank.

2. In vitro fertilization
 “In vitro” is Latin for “under glass”, so children through this procedure are often referred to as “test tube
babies”. Others call this AR technology as “external fertilization” since fertilization occurs outside the
woman’s body. This procedure often used when the woman’s egg cannot fully fertilized by the man’s
 sperm, because there is a blockage in her fallopian tubes. The sperm and the egg cannot reach each other
because of this obstacle.
 In IVF, the reproductive materials from the man and woman are first gathered.
 In the man’s case, sperm is collected through masturbation.
 In the woman’s case, he procedure is more elaborate. First, she takes a fertility drug, usually a
powerful hormone, which makes her superovulate, that is, makes her produce several eggs at once.
Then a scope is inserted through a small incision and used to suction the eggs from her ovaries. This
procedure is called laparoscopy.

Once collected, the sperm and eggs are placed in a special solution where the sperm then fertilizes the eggs.
The resultant embryos are now ready to be inserted into the woman’s uterus, a procedure called embryo transfer
* Cryogenics - freezing of embryos for use in case further attempts are needed
Plastic Surgery
 Plastic surgery is a branch of the science of surgery that focuses on the reconstruction or repair of deformity,
defect, or bodily injury,and/or improves the appearance or function of outer parts of the body.
 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 moral and legal dimensions of surgical intervention may be anchored on the principles of totality,
autonomy with patient’s complimentary value of informed consent, and double effect.

In order for plastic/cosmetic surgery to become legally and morally permissible, it has to comply with bthe ff
conditions:
 The functional integrity of the human body of any part, 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 informedss consent.
 The intent or motives must be reasonably higher than or proportionate to the extraordinary means
employed or allowed.

ORGAN TRANSPLANTATION 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 expectaton 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.
• 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.
 1. Disturbing basic human nature, medical manipulation is playing God, which goes beyond the primary
purpose of medicine: to save life, to cure diseases and relieve suffering.
2. Routine salvaging of organs of the dead in the absence of explicit objection, donation with consent
3. Principle of social utility and principle of justice.

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,
opthalmologists, 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 involves caring for children, especially young children, caring for
those who are childlike in their dependence, such as the sick, the injured, the aged and the handicapped
• Likewise, it implies that the basic function of a nurse is identical with that of a mother who, in the latter's
absence, acts as a mother surrogate to the patient who has serious emotional needs.
• The “mother role” of a nurse, however, is limited to the nurturing component of maternal role, and is devoid
of elements of power and authority that may threaten patient's self-determination.

THE NURSE as a professional

• A professional is one who is bounded by values and standards other than those of his/her employing
organization, setting one's own rules, seeking to promote standards of excellence and being evaluated, and
looking for approval of one's own professional peers . This immediately preceding description of a
professional fits a nurse as such.
• A professional nurse is one who finished and acquired or gained a high level of specialized skills and
knowledge through long years of study in nursing academic setting.
• This expertise distinguishes him/her from non-professionals, and equips him/her to meet the needs of the
society, thus fulfilling the purpose of the nursing profession.
• Aside from the expertise, there are other defining attributes related and applicable to nursing profession
namely: autonomy, accountability, authority, and unity.

CHARACTERISTICS OF NURSING PROFESSION

ATTRIBUTES DEFINITIONS/MEANINGS/ APPLICATION/ IMPLICATION

DESCRIPTIONS TO NURSING PROFESSION
EXPERTISE Competence or special knowledge and skills in Passing Government Board Examination-
particular field of occupation/calling NLE/ Issuance of Certificte of Registration
or License to practice professional nursing
AUTONOMY Self-governing, self-regulating, independence

Self-regulation is a mark for collective professional Autonomous practice serves as safeguard

autonomy
Self-determination is a mark for responsibility,
accountability, independence, and willingness to
take risk from individual autonomy
Responsibility, liability, and answerability for
carrying out one's obligation or duty.
Grounded in the principles of Fidelity
and respect for the dignity, worth, and self-
determination of clients.
to patient and health care providers, like
the nurse, he/she is legally and ethically
required to use independent judgement in
making nursing decision affording
safeguard to the clients
Readiness of a nurse to assume
responsibility as a consequence of his/her
independent decision and free acts.

AUTHORITY Permission, legitimacy, power, and expertise on
some subject or field.
A form of permission for a profession to exist and
for its members to legitimately practice
Authority is granted through the power of
examination and issuance of license to
protect the public from the misfits and
professional's job territory by establishing
a monopoly

UNITY Oneness, union of parts forming a complex whole; Through unity, nursing is elevated to a
Relates to the ability of nurses to organize and be noble profession, which is characterized
cohesive to achieve the profession's goal. by expertise, autonomy, authority, and
 accountability.

sdl activities
• Patient's Rights and Duties (Patient's Bill of Rights)
• Patient's Duties and Responsibilities

PREVALENT ISSUES IN BIOETHICS

1. ABORTION - is the premature expulsion of fetus or baby prior to normal birth. It is either by spontaneous or by
induced termination.
♠Spontaneous A. = This is a miscarriage, that is the fetus or baby is born before it is able to live.
♠ Induced A. = Knowing the destruction of the life of an unborn child, or the intentional expulsion or remval of the
same from the womb, other than for the principal purpose of producing a live birth or removing a dead fetus.

• potential reasons for the prevalence of abortion

> If the fetus is allowed to develop normally and come to term, the pregnant man hgerself will die.
> It is not he woman's life, but her health, physical or mental, that will be severly 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 wit 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 the discussion/ presentation objective and free
from biases or prejudices.
The Personhood
 The human is a living paradox. He/she is the perennial problem, whichnphilosophers, theologians, world
leaders-managers, from ncient times to date, have focused on to understand.
 He/she is a human person who-always-exists- with-and- for-others-in-the-world.
**paradox- is a statement that contradicts itself, or that must be true or untrue at the same time.

 The personhood of man or woman is his/her distinctive personal quality, or the seat of his/her uniqueness as
human being.
 Take note, however, that not all persons are human beings and vice-versa. Duly registered and incorporated
business and service entities are persons with legal personality, but they are not human beings.
 The uncared sick, poor, slave, or destitute are human beings, but ceased to be human persons when
deprived or divested of their rights and become objects and non-existing, living subjects.
 This distinction leads us further into an inquiry on the moral dimensions of human acts.

**destitute- without the basic necessities of life... impoverished

Human Act (Its Concept)

 In its most general sense, the noun “act” signifies something done by a person. It is any bodily movement
tending to produce some effect in the external world, it being unnecessary that the same be actually
produced, as the possibility of its production is sufficient.
 In a more technical sense, it means something done voluntarily, and of such a nature that a certain moral or
legal consequences are attached to it.
  The adjective “human” modifying the noun “act” describes or suggests any quality, good or bad, belonging
to a person as part from animals or God.
 The combination of the 2 terms may imply that human act is a deed that proceeds from a conscious mind
and deliberate free will of a person. It is an act or activity that is knowingly, voluntarily, and intentionally
performed. The active agent uses his/her faculty of the intellect and free will.

 Human act is not an act of man. The latter concept is one that is instinctive. It flows from the animal nature
of man or woman. This element of animality operates under his/her reptilian brain, which utilizes the faculty
of the senses: seeing, smelling, touching, tasting, and hearing, to assert existence and survival.

 These activities are essentially animal acts.

 Moreover, under exempting circumstances, a human person is not responsible, answerable, liable, or
accountable for his/her actions due to complete absence of intelligence, freedom of action, and
voluntariness or intent.
 These are the circumstances of imbecility or insanity, minority, accident, acts under compulsion of
irresistible force, and acts under the impulse of uncontrollable fear.

Essential Elements Required For An Act to be A Human Act (KFC)

1) KNOWLEDGE
 is an act or state of awareness or understanding. When the mind is conscious, the act is deliberate.
 Deliberateness means that the doer knows what he/she is doing. Aware about the means to employ and the
ends to be achieved. With the requisite intelligence or knowledge fully operative, the morality of human act
can be determined.
2) FREEDOM
 is synonymous to liberty. It is the power of the will to follow the dictates of its unrestricted choice, and to
direct external act of the individual without restraint, coercion, or control from another person.
 When a person acts without freedom, he/she is no longer a human being, but a tool or a brute. His/her
liability is as much as that of a knife that wounds, of a drug that poisons, or of a dog that bites.
3) VOLUNTARINESS
 is the quality of being unconstrained by interference, or unimpelled by another’s influence. It is
characterized by spontaneity of action that proceeds from the free and unrestrained will of the person. A
voluntary act is a free, intelligent, and intentional act.

Human acts may be classified in terms of:

 REASON - are those acts, which reason approves or disapproves, agrees or disagrees.
- is a faculty of the mind by it distinguishes truth from falsehood, good from evil, and which enables
the possessor to deduce inferences from facts or propositions.
 WILL - it involves actions or activities, which are begun, done, and completed primarily by the will.
- it is the faculty of conscious, and specially, of deliberate actions. It is characterized by motive,
which applies to the feeling, desire, or inclination that makes a person do what he/she does.

Norms of Human Acts

 A norm is a standard, a pattern, a measure, or a rule, which serves as a basis or guide for human acts to
be morally good
 The following are the 2 basic norms of human acts:
1. LAW
 Law, in its general sense, is a body of rules of action or conduct prescribed by controlling authority, and
having binding legal force.
 The most cited definition is that of ST. Thomas Aquinas, which is, “an ordinance of reason promulgated for
the common good by one who is in-charge of community or society”.
 The law is just, honest, feasibly implemental, useful, attainable, and relatively permanent.

Classification of Laws
  Eternal Law
 is the Divine Reason and Will commanding that the natural order of things be preserved, and
forbidding that it be disturbed.
 It is a Divine Plan and Providence for all created things, directing them towards their ultimate end.
 It is otherwise called the Divine Positive Law which is emanating from God, who is its author, like the
Ten Commandments.
 Natural Law
 denotes a system of rules and principles for the guidance of human conduct, which, independent of
enacted law or of the systems peculiar to any people, might be discovered by the rational
intelligence f man/woman. These judgements express necessary and obligatory rules of human
conduct, which have been established by the author of human nature as essential to the divine
purposes in the universe, and have been promulgated by God solely through human reason.

 The immediately preceding definition may imply that Eternal Law precedes Natural Law.
 The former reveals and manifests itself in nature, in human reason.
 Both have the same end: to guide/direct human acts towards righteousness and goodness. Human
tendencies to do good and avoid evil is, inforce and effect, obeying and fulfilling the commands of
Natural as well as the Eternal Law.
 Positive Law
 is a human-made law, which is enacted and promulgated by proper authority (congress/parliament
decree) for the government of an organized society.

Positive Human Law may be divided into:

a) Public Law - which is concerned with:
 the affairs of the state in its political or sovereign capacity;
 the organization of the state
 the relations between the state and the people;
 the relations of States to one another.

b) Private Law - refers to all those part of the law which is administered between citizen and citizen, or
which is concerned with the definition, regulation, and enforcement of rights involving private individuals,
such as civil law.

2. CONSCIENCE
 Human conscience may be construed as an act of the practical judgement of reason that decides upon an
individual action as good and to be performed, or as evil to be avoided.
 More concretely, conscience is that special voice within us, prompting and whispering suggestions regarding
our conduct, telling us whether we have done right or wrong, whether the decision we are considering is a
good one or a bad one.
 It is the place within us where we feel a sense of joy and contentment when we act rightly, and a sense of
guilt if we act wrongly.
 In the Philippine context, conscience is commonly understood as “budhi” or “kunsensya”. It is an inner voice
which tells and guides the moral life of a human person.

KINDS OF CONSCIENCE
1. ANTECEDENT C. -
Is characterized by a proactive judgement. It advises, permits, or commands the human person to execute
his/her act if and when it is good, while it prohibits or forbids that which is evil. It is a preventive judgement.
2. CONSEQUENT C.
 is characterized by a reactive judgement. It reacts after an act is done, which may fear the effect of either an
inner peace for doing good or a remorse for doing bad.
 It is a moral judgement after the act.
3. TRUE OR CORRECT C.
  Sees or discerns rightly the goodness or badness of human act. It judges things as they are, that is, a
judgement of what is really good as good per se, and what is evil as evil, guided by and based on ethical
standards and principles.
4. ERRONEOUS OR FALSE C.
 Makes distorted judgement. Through misinterpretations of moral principles, it indicates or mistakes good
acts as bad and vice-versa.
Kinds of Erroneous or False C.
a. Culpable EC - the agent commits fault or wrongful act resulting from imprudence, negligence, lack of
foresight or lack of skill. Though without malice, his/her culpable act is punishable for failure to use or
exercise common sense and due reflection as she/he is duty-bound to be cautious, careful, prudent,and
sensitive

b) Inculpable EC
The human person commits an error or fault due to an absence of knowledge of the goodness or badness of
an act, and commits them unconsciously or unintentionally.

5. CERTAIN C.
Dictates a course of actions in clear terms without fear or mistakes and errors. it posits firm and categorical
judgement on an act to be done because it is good, or to be omitte/avoided as evil

6. DOUBTFUL C.
Makes or leaves the human person undecided as to the proper course of action. It suspends or holds in abeyance
judgement on an act to be done or to be avoided due to uncertainty on its morality or immorality.

7. SCRUPULOUS C.
 Dictates a person to see evil or the wrongness where there is none. it is one that is extremely strict in
morals, extraordinarily cautious, or fearful in doing or judging an act.
 The agent is always scared or afraid to commit mistakes.

8. LAX CONSCIENCE
Tends to judge things or acts as to be good, but which actually is bad. It fails to see wrong where there is wrong.
It finds excuses for an evil act as not evil, but good. Relative morality may fall under this kind of conscience.
ETHICAL THOUGHTS
 also called moral philospohy, is the discipline concerned with what is morally good and bad and morally right
and wrong.

KANTIAN ETHICS
 The proponent of this is Immanuel Kant, a philosopher and one of the Enlightenment thinkers.
 Kant’s moral theory is often referred to as the “respect for persons” theory of morality.

--> are a set of universal moral principles that apply to all human beings, regardless of context or situation, these are
Categorical Imperatives, which are defined by their morality and level of freedom.
 People have a duty to do the right thing, even if it produces a bad result .
 So for example, Kant thought that it would be wrong to tell a lie in order to save a friend from a murderer.
So a person is doing something good if they are doing a morally right action.

ST. THOMAS AQUINAS

ETHICS
 Came from a noble family in Naples.
 Known as the greatest Christian medieval theologian-philsopher.
 Studied with Albert the Great in Paris and participated in the Aristotelian revival of the Middle Ages.
 Canonized and became a saint in 1323
  Aquinas believes that we should always follow our conscience, even when it is wrong or causes great harm.
Since we have no way of knowing whether our consciences are wrong, they are the best guide of we have as
to what is the moral thing to do.

3 Important Ethical Theories of Aquinas

a) the intrinsic connection between happiness and the human good.
b)the central role of human virtue in achieving this good.
c) the importance of moral rules

RAWL’S THEORY OF JUSTICE

 John Bordley Rawls was an American moral and political philosopher in the liberal tradition.
 Received the Schock prize for Logic and Philosophy and the National Humanities Medal in 199.
 Rawls theory of “ justice as fairness” recommends equal liberties, equality of opportunity, and facilitating the
maximum benefit to the least advantaged members of society in any case where inequalities may occur.
Rawl’s principles of justice:
1. Each person should have as much liberty as possible, as long as others have the same.
2. Social and economic inequities are permitted, as lon as:
a) they relate to positions open to all under equality of opportunity, and
b) they are for the greatest expecred benefit of the least advantaged members of society.

THE CALLING OF A HEALTH CARE PROVIDER (HCP)

 The “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, skjlls, and knowledge with other in this earthly
course of human enterprise to attain quality life.
 It may further denote a vocation, which may determine what state in life a person wants to be. This vocation
includes the calling of the hcp to enter into a contract with society in the area of health as their profession.
 Taking care of the sick, the aged, the disabled, and others afflicted with infirmities is indeed, a noble
profession.

THE HEALTH CARE PROFESSION

 A profession is a complex, organized occupation proceded by a long training program.
 It is a calling in which 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. This concept of well-being marks the boundaries
of the range of options offered to a patient. It involves his/her informed consent.
 Moreover, the well-being principle must be in harmony with autonomy. Patient’s autonomy necessitates
freedom from intereference or outside control.

THE HEALTH CARE PROVIDER

 A health care provider may be considered as a professional duly authorized to engage in, and granted by
applicable law monopoly over health care services.
 Health care providers may include, but not liited to, physicians, nurses, midwives 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”.
 it implies that nursing involves caring for children, especially young children, caring for those who are childlike
in their dependence, such as the sick, the injured, the aged, and the handicapped.
 Likewise, it implies t with that the basic function of a nurse is identical to with that of a mother who, in the
latter’s absence, acts as a mother surrogate to the patient who has serious emotional needs.
 The “mother role” of a nurse is limited to the nurturing component of maternal role.
 The nurse can do nothing to influence or change the course of treatment of the patient.
THE NURSE AS A PROFESSIONAL
 A professional is one is bound by values and standards other than those of his/her employing organization,
setting one’s own rules, seeking to promote standards of excellence and being evaluated, and looking for
approval from one’s own professional peers.
 A professional nurse is one who finished and acquired or gained a high level of specialized skills and
knowledge through long years of study in nursing academic setting.
 This expertise distinguishes him/her from non-professionals, and equips him/her to meet the needs of the
society, thus, fulfilling the purpose of the nursing profession.
 Moreover, aside from expertise, there are other defining attributes related and applicable to nursing
profession, namely: autonomy, accountability, authority, and unity.

THE CLIENT
 A client is a person or group for whom a doctor, lawyer, a nurse, or other professional, person or service
acts. He/she may be any person who has a need or want, and looks for the professional (nurse, doctor,
teacher) to get and satisfy that need.