I.

ETHICAL CONSIDERATION IN LEADERSHIP AND MANAGEMENT

A. MORAL DECISION MAKING

• A moral decision is a decision made in a way so that action or inaction conforms to one’s
morals. Typically, we refer to a moral decision when the choice made is not the choice
that would be valid per some rationale, such as greater comfort, financial reward or
lower cost or elimination of some problem.
• Morals are acquired (learned or self-developed) rules of behavior categorized into ‘right’
or ‘wrong’, where the rules typically omit context and nuance.
• Curiously, morals have a high-level of culturally and socially acquired variation. Often,
this occurs for morals originating in religious rules over conduct by followers. It is also
found where there is enforced social stratification

PRINCIPLE OF MORAL DISCERNMENT

By: Cristeljune A. Leyses and Diane April Lofranco

- Many people just use discernment as a synonym for “decide.” But discernment is a
richer and deeper concept that, while related and antecedent to “deciding” is distinct
from it. The goal of discernment is to see beyond the mere external dimensions of
something, and to probe to its deeper significance.
- The word discern comes from the Latin dis- “off, or away” + cernere – “to distinguish,
separate, sift, set apart, divide, or distinguish. Thus, to discern is to distinguish or sort
out what is of God, and what is of the flesh, the world or even the devil. As such,
discernment, in its root meaning is something that ought to precede decision and aid it.
- Discernment: refer to the ability to discern the moral good, discern a moral right from
wrong, and must have the standard with measure or compare the good thing and bad
thing. Moral discernment defines the moral convictions that determine one’s behavior
and ultimately one’s life. The person with moral integrity can lives with consistent of
convictions or believes of themselves.

FOUR PRINCIPLES OF MORAL DISCERNMENT/JUDGMENT

• Principle of Formal Cooperation- it occurs when someone intentionally helps another

person carry out a sinful act.
• Principle of Material Cooperation - when a person's actions unintentionally help another
person do something wrong.
• Principle of Lesser Evil - The principle that when faced with selecting from two immoral
options, the one which is least immoral should be chosen.
 • Principle of Double Effect - This principle aims to provide specific guidelines for
determining when it is morally permissible to perform an action in pursuit of a good end
in full knowledge that the action will also bring about bad results.

TYPES OF MORAL ATTITUDE

• Callous - not feeling or showing any concern about the problems and suffering of other
people
• Strict - one who chooses the hardest way to do something
• Pharisaical - marked by INSINCERE self-righteousness
• Scrupulous - involves one who is being overly critical of himself. Such a person always
has a fear of sinning when there is no sin, or is in constant doubt, and/or is in fear of
committing a mortal sin; tends to see sins when there is none
• Lax - fails to see a sin when actually there is one, tends to minimize its seriousness.

DEGREES OF MORAL CERTITUDE

• Certain - the judgment about the goodness or evil of a particular action that is made
without fear of being mistaken
• Doubtful/Probable - the suspension of judgment on the moral goodness or evil of action
because the intellect cannot see clearly whether it is good or bad
• Perplexed - when one is compelled to choose between two evils. (Of two evils, choose
the least.)

PRINCIPLE OF WELL-FORMED CONSCIENCE

By: Ma Jessamie Magalona and Zuhaira Makadato

• The Church equips its members to address political and social questions by helping them
to develop a well-formed conscience. Catholics have a serious and lifelong obligation to
form their consciences in accord with human reason and the teaching of the Church.
• Conscience is not something that allows us to justify doing whatever we want, nor is it a
mere “feeling” about what we should or should not do. Rather, conscience is the voice
of God resounding in the human heart, revealing the truth to us and calling us to do
what is good while shunning what is evil.
• Conscience always requires serious attempts to make sound moral judgments based on
the truths of our faith.
• The formation of conscience includes several elements. First, there is a desire to
embrace goodness and truth. For Catholics, this begins with a willingness and openness
 to seek the truth and what is right by studying Sacred Scripture and the teaching of the
Church as contained in the Catechism of the Catholic Church.
• It is also important to examine the facts and background information about various
choices.
• Finally, prayerful reflection is essential to discern the will of God. Catholics must also
understand that if they fail to form their consciences in the light of the truths of the
faith and the moral teachings of the Church they can make erroneous judgments.
• As stated in the Catechism of the Catholic Church, “Conscience is a judgment of reason
whereby the human person recognizes the moral quality of a concrete act that he is
going to perform, is in the process of performing, or has already completed. In all he
says and does, man is obliged to follow faithfully what he knows to be just and right.

STRATEGIES OF MORAL DECISION-MAKING PROCESS

By: Bai Hanan Mama and Husnaira Mama

Recognizing your circumstances

• Thinking about origins of problem, individuals involved, and relevant principles, goals &
values; considering one’s own role in causing and/or resolving the problem

Seeking outside help

• Talking with a supervisor, peer, or institutional resource, or learning from others’

behaviors in similar situations

Questioning your own and others’ judgment

• Considering problems that people often have with making ethical decisions,
remembering that decisions are seldom perfect

Dealing with emotions

• Assessing and regulating emotional reactions to the situation

Anticipating consequences of actions

• Thinking about many possible outcomes such as consequences for others, short & long
term outcomes based upon possible decision alternatives

Analyzing personal motivations

 • Considering one’s own biases, effects of one’s values and goals, how to explain/justify
one’s actions to others, & questioning ability to make ethical decisions

Considering the effects of actions on others

• Being mindful of others’ perceptions, concerns, and the impact of your actions on
others, socially and professionally.

ETHICAL DILEMMAS

• An ethical dilemma (ethical paradox or moral dilemma) is a problem in the decision-

making process between two possible options, neither of which is absolutely acceptable
from an ethical perspective. Although we face many ethical and moral problems in our
life, most of them come with relatively straightforward solutions.
• On the other hand, ethical dilemmas are extremely complicated challenges that cannot
be easily solved. Therefore, the ability to find the optimal solution for ethical dilemmas
is critical to everyone.
• Every person can encounter an ethical dilemma in almost every aspect of their life,
including personal, social, and professional.

How to solve an ethical dilemma?

• The biggest challenge of ethical dilemma is that it does not offer an obvious solution
that would comply with ethical norms. Throughout the history of humanity, people
always faced ethical dilemmas, and philosophers aimed and worked to find solutions to
the problems.

By far, the following approaches to solve an ethical dilemma were deduced:

• Refute the paradox (dilemma): The situation must be carefully analyzed. In some cases,
the existence of the dilemma can be logically refuted.
• Value theory approach: Choose the alternative that offers the greater good and the
lesser evil.
• Find alternative solutions: In some cases, the problem can be reconsidered, and the
new alternative solutions may arise

Some examples of ethical dilemma examples include:

• Taking credit for others’ work

• Offering a client a worse product for your own profit
• Utilizing inside knowledge for your own profit

B. MEANING AND SERVICE VALUE OF MEDICAL CARE

 • Value-based healthcare is a healthcare delivery model in which providers, including
hospitals and physicians, are paid based on patient health outcomes. Under value-based
care agreements, providers are rewarded for helping patients improve their health,
reduce the effects and incidence of chronic disease, and live healthier lives in an
evidence-based way.
• Value-based care differs from a fee-for-service or capitated approach, in which
providers are paid based on the amount of healthcare services they deliver. The “value”
in value-based healthcare is derived from measuring health outcomes against the cost
of delivering the outcomes.

ALLOCATION OF HEALTH RESOURCES

By: Norshia Manalocon and Mylbertte Joice Medel

• Health care resources are defined as all materials, personnel, facilities, funds, and
anything else that can be used for providing health care services.
• Health care has long been a limited resource for which there has been an unlimited
demand; everyone needs health care.
• Health care is still a scarce resource, and, therefore, strategies to allocate health care
resources are challenging and ever present. Whether or not we like the term, we are
compelled to “ration” health care resources worldwide.

Allocation strategies to ration health care occur at 3 levels.

Resource allocation is the distribution of resources – usually financial - among competing

groups of people or programs. When we talk about allocation of funds for healthcare, we need
to consider three distinct levels of decision-making.

Level 1: Allocating resources to healthcare versus other social needs.

Level 2: Allocating resources within the healthcare sector.

Level 3: Allocating resources among individual patients.

ISSUES INVOLVING ACCESS TO CARE

By: Rasialyn Mokamad and Kathlene Kate Natad

• Healthcare systems are facing a myriad of problems such as growing costs, an aging a
shortage of nurse and physicians, population, differences in quality of care, a significant
population of uninsured persons, and disparities in health care outcomes. All of these
challenges affect access to health care, which is our focus. Patient access to healthcare
sets the baseline for all patient encounters with the healthcare industry. When a patient
 cannot access her clinician, it is impossible to receive medical care, build relationships
with her providers, and achieve overall patient wellness.

• Despite this importance patient care access is not really for many patients across the
country. Between appointment availability issues and troubles getting a ride to the
clinician’s office, patient care access has many associated challenges.

• Some of the top obstacle to patient care access, as well as the ways some medical
professionals are addressing them.

1.) Limited appointment availability

• Many healthcare organizations offer a typical set of office hours for patient visits. But for
the working adult or parent, a clinic that is open between 8 a.m. and 6 p.m. is not
always useful.

• Patients need convenient office hours that allow them to visit the doctor outside of their
work or school schedules.

• Aside from care quality, access to convenient care is one of the top drivers for patient
care site decisions. Patients want to be able to access their healthcare when they want
and need it.

• Healthcare organizations are overcoming these barriers by expanding their office hours.
Extending office hours is one of the fundamental pillars of the patient-centered medical
home (PCMH).

• Additionally, some organizations are utilizing health IT and connected health to allow
patients to seek medical advice without needing to come into the office.

2.) Transportation barriers

• Even when a patient had access to a provider and can schedule an appointment,
transportation barriers can keep patients from seeing their clinicians. Patients who are
physically unable to drive, who face financial barriers, or who otherwise cannot obtain
transportation to the clinician’s office often go without care.
• According to the statistics of AHA, approximately 3.5 million patients go without care
because they cannot access transportation to their providers. Transportation is a critical
social determinant of health that has recently gained nationwide attention.

3.) Limited education about care sites

• Oftentimes, patient care access issues are not about getting a foot in the door. Instead,
it’s about getting a foot in the right door. While it is essential for healthcare organization
to remove obstacles barring patients from getting to the office, it is equally important
for organizations to make sure patients are getting to the right type of facility.

• This is especially critical as health systems begin to integrate alternative treatment sites
into their repertoires. Patients can choose to access care at an urgent care center, a
retail clinic, a microhospital, a freestanding emergency department, and numerous
other emerging treatment facilities.

• While these growing care options are a positive step forward for patient care access, it is
essential that medical providers deliver the proper patient education that helps patients
identify the appropriate facility for their needs.

• Medical professionals need to educate their patients on the specific uses for different
care sites. For example, dire healthcare situations will require a visit to the ED, while
pain from a potential sprained ankle may be better off treated in an urgent care clinic.

• Clinician offices and hospitals can display this information in their own facilities and
offer patient education materials. However, access education should also be a part of
different care facilities’ marketing plans. An urgent care center should make it widely-
known which types of ailments they are best suited for treating.

• Connecting patients with the right care at the right time is an important value-based
care principle. When a patient can easily access a primary care or wellness visit, she may
see a diminished likelihood of developing a more concerning illness down the line.

• Healthcare organizations need to have the right patient-centered mechanisms in place

that ensure patients can easily access those care services.

4.) Geographic, clinician shortage issues

• Patients living in rural areas disproportionately more likely to struggle to access their
clinician than a patient living in an urban or suburban area.
 • As many as 57 million Americans currently live in a rural area, according to the American
Hospital Association. These individuals face a litany of challenges, ranging from where
they live to having enough doctors to provide care.

• “Remote geographic location, small size, limited workforce, physician shortages and
often constrained financial resources pose a unique set of challenges for rural
hospitals,” asserted by AHA in a recent rural healthcare resource.

• Healthcare organizations have been tapping telemedicine to close care gaps caused by
geographic barriers. Direct-to-consumer telemedicine allows patients to use their own
computers or smartphones to video call with a provider. Many smaller facilities in rural
areas will also use telemedicine to connect with experts in more urban areas, keeping
patients from having to travel great distances to receive intensive or specialized care.

• Patients living in rural areas must also contend with clinician shortages. As the nation
sees an impending clinician shortage even in urban areas, patients in rural regions feel
the pinch even harder.

• The patient-to-primary care physician ratio in rural areas is 39.8 physicians per 100,000
people, compared to 53.3 physicians per 100,000 in urban areas, according
to statistics from the National Rural Health Association.

• Healthcare professionals are calling for policy changes that help funnel more providers
to rural areas. Some visa waivers could incentivize foreign-born but American-educated
providers to practice in rural areas.

• Additionally, legislative fixes to expand scope of practice laws for advanced practice

registered nurses and physician assistants could help close some care gaps.

II. ETHICAL ISSUES RELATED TO TECHNOLOGY IN THE DELIVERY OF HEALTH CARE

A. DATA PROTECTION AND SECURITY

DATA PRIVACY ACT 2012 (RA 10173 series of 2012)
By: Rheynel Nietes and Jessa Mae Ohao

Section 11. General data privacy principles

 • The processing of personal information shall be allowed, subject to compliance with the
requirements of this Act and other laws allowing disclosure of information to the public
and adherence to the principles of transparency, legitimate purpose and
proportionality.

Personal information must, be:

(a) Collected for specified and legitimate purposes determined and declared before, or as
soon as reasonably practicable after collection, and later processed in a way compatible
with such declared, specified and legitimate purposes only;
(b) Processed fairly and lawfully;
(c) Accurate, relevant and, where necessary for purposes for which it is to be used the
processing of personal information, kept up to date; inaccurate or incomplete data must
be rectified, supplemented, destroyed or their further processing restricted;
(d) Adequate and not excessive in relation to the purposes for which they are collected and
processed;
(e) Retained only for as long as necessary for the fulfillment of the purposes for which the
data was obtained or for the establishment, exercise or defense of legal claims, or for
legitimate business purposes, or as provided by law; and
(f) Kept in a form which permits identification of data subjects for no longer than is
necessary for the purposes for which the data were collected and processed:
Provided, That personal information collected for other purposes may lie processed for
historical, statistical or scientific purposes, and in cases laid down in law may be stored
for longer periods: 
Provided, further, That adequate safeguards are guaranteed by said laws authorizing
their processing. 
• The personal information controller must ensure implementation of personal
information processing principles set out herein.

B. Benefits and Challenges of Technology

By: Kym Marie Ortuoste and Archie Osic

Benefits

- Technological developments in the healthcare industry have saved countless patients

and are continuously improving our quality of life.
- Technology has brought about a massive and welcome change to the healthcare
industry.
 - The ability to rapidly communicate patient information in a legible format; improved
medication safety through increased legibility, which potentially decreases the risk of
medication errors.
- Technology has made patient care safer and more realible than before. For instance,
Nurses and Doctors use hand-held computers to record a patient's medical history and
check that they are administering the correct treatment.

Challenges

- Technology has changed the way industry professionals approach the idea of
healthcare. While many of these innovations are positive — facilitating patient care and
ensuring traditional treatments are more effective — they also present some unique
challenges. Why? Because this technology is something the industry has never seen
before.

How can medical professionals recognize and avoid the challenges tech has brought to
healthcare?

1. The Challenge of Interoperability. One of the most significant selling points of

electronic health records (EHRs) is they allow practitioners to access relevant patient
data instantly. With the adoption of this technology nearly complete — around 95
percent of hospitals use EHRs — interoperability is proving to be a challenge.
2. Keeping up with Old Tech. In spite of all of these technological advances, many facilities
still use out-of-date technology. Outdated software creates security holes like the one
that allowed hackers to take down the NHS's system in 2017.
3. User-Unfriendly Interfaces. Medical technology is advancing by leaps and bounds. Yet
one thing left in the dark ages is user interface. These devices might change the world,
but it won't matter if they're too difficult to use. If there's too much data on the screen
at once, or the interface doesn't help users navigate, no one is going to use it.
4. Exacerbating Malpractice Claims. MedTech has made many practices easier, but it
overcomplicates others. One case from 2013 is an ideal example.
5. Overcomplicated Asset Tracking. Asset tracking through electronic health records can
be both a blessing and a curse. Medical workers can use it to find anything with a
barcode or RFID tracking chip. However, physicians often complain that poorly designed
systems impede their work, making them a slave to their EHRs.

C. Current Technologies: Issues and Dilemma

By: Jelina Pabillon and Love Joy Papas
 Technology and Nursing:

New developments that combine technology and nursing are known as telehealth
and telemedicine.
Telehealth - is a newer nursing career path that allows nurses to deliver exceptional patient
care in a “hands-off way.” allows people to get healthcare advice, medication, and some
treatment from a distance.

“tele” means “at a distance,” which means that telemedicine is medical care that comes
from a distance or away from the office.

Telenursing-is defined as “the use of technology to deliver nursing care and conduct
nursing practice.”

Advantages of Technology in Nursing

1. Improved Communication Leading to Improved Patient Care:

2. Better Education:

3. Improved Treatment:

4. Better Kept Records:

Electronic Health Record allow healthcare professionals to keep track of patient stats and

data in a simple and accurate way, leading to fewer medical error and better quality patient
care. Information is saved securely and easily accessible, making it simple to find certain data,
notice patterns, and more.

Disadvantages of Medical Technology:

1. Increased Cost of the Treatment for the Patients:

2. Show Wrong Result of the Patients condition:

3. Lack of Information of the Patients

4. Time-Consuming in Recovery:
5. Damaging Cells and Organs of the Body of the Patients:

6. Patients Online Treatment Through Technology:

Ethical Issues

1. Do-Not-Resuscitate Orders

2. Doctor and Patient Confidentiality

3. Malpractice and Negligence

4. Access to Care

5. Physician-Assisted Suicide