WEEK 1: HEALTH CARE ETHICS
INTRODUCTION TO BIOETHICS
Unit I/Bioethics
DEFINITION OF ETHICS:
 Ethics is deduced from the Greek word ethos, meaning
“customs” or “behaviors”. ™
 Behavior is more attributed to human behavior and is
therefore inherent to human beings. ™
 The term ethos has an equivalent meaning in Latin word
moris which means “morals”. ™
 Ethics is not to be understood as specific to the nation but
rather as inherent human.
 Ethics is a mental-set, disposition or values.
 Ethics is defined as:
 As a science, it deals with the morality (rightness or
wrongness) of the human act.
 As a discipline, it is meant for the exercise of a
human conduct, both ethical and unethical.
 As a philosophical study, it guides the intellect in
discerning concrete human conduct.
 Ethics, when combined with the prefix bio, becomes
Bioethics, a discipline that covers all life sciences.
 Ethics in medicine is not something new. Indeed because
both medicine and ethics aim at the overall well-being of
persons, they are intrinsically connected. Though
medicine concentrated more on the physiological and
psychological well-being of the patient, it did not abstract
from, or ignore the social and creative aspect of the
patient. Good physiological function usually made it
possible for a person to pursue the other goods of life
which lead to human fulfillment.
BIOETHICS AS APPLIED ETHICS:
 ™It is an ethics of medical care, but not the same as
medical ethics.
 Bioethics investigates practices and developments in the
life sciences and biomedical fields.
 All pertinent fields of study must be pooled together in an
attempt to settle certain moral dilemmas.
IMPORTANCE OF BIOETHICS:
 It is necessary for the conduct of appropriate and
judicious healthcare procedures. ™
 It is necessary in providing humanistic care to clients. ™
 It is necessary to grasp the ethical dimension of medical
procedures. ™
 It is necessary to practice bioethics because of authority
given by the population
ETHICAL SCHOOLS OF THOUGHT (PART A)
Unit II/Bioethics
ETHICAL RELATIVISM:
 This ethical doctrine claims there are no universal or
absolute moral principles. ™
 Standards of right and wrong are always relative to a
particular culture or society. ™
 Sometimes, morality is based on someone’s moral opinion
of a certain matter.
 Strength of ethical relativism: –
 To the moral relativist, one would be considered too
ambitious in claiming that one knows absolute and
objective ethical principles that are true. ™
 Criticism and objections: –
 Ethical relativism contradicts common beliefs and
ordinary experiences in several ways. –
 It removes the essence of one’s duty in determining
whether an act is right or wrong. –
 Ethical relativism is a contradiction in itself.
SITUATION ETHICS:
 Moral norms depend upon a given situation, but whatever
situation maybe, one must act in the name of Christian
love. ™
 Three type of love exist: eros, philia and agape. ™
 Six propositions: –
1. Only love is intrinsically good. –
2. Ultimate norm of Christian decisions is love. –
3. Love and justice are the same for justice is love
distributed. –
4. Love wills the neighbor’s good whether we like him or
not. –
5. Only the end justifies the means. –
6. Decisions ought to be made situationally, not
prescriptively.
 Situation ethics makes moral decisions flexible and
adaptable to varying situations. ™
 Agapeic love serves to check selfish motive as well as
uncaring health personnel, no filial or erotic
considerations. ™
 Contextualism may encourage ethical relativism. This may
be used to justify the ends to which a medical procedure
is performed.
PRAGMATISM:
 Pragmatism took on many forms: experimentalism and
instrumentalism. ™
 For one to learn, one must reconstruct human
experiences and relate them to one’s own. ™
 Difficulties: –
 Pragmatism is materialistic. –
 Pragmatism is too individualistic.
UTILITARIANISM:
 Proponents of this school of thought are Jeremy Bentham
and John Stuart Mill. ™
 Rightness and wrongness of ethical actions is determined
by the goodness or badness of their consequences. ™
 The principle of utility is the only one principle worth
noting. ™
 “Actions are good insofar as they tend to promote
happiness, bad as they produce unhappiness.
 No action seems to be intrinsically right or intrinsically
wrong. ™
 We ought to choose the action that produces the most
benefits at the least cost of pain or unhappiness. ™
 The principle of greatest happiness: the greatest amount
of happiness for the greatest number of people. ™
 The more people that will benefit from a better moral
decision, the better.
ETHICAL SCHOOLS OF THOUGHT (PART B)
Unit III/Bioethics
KANT’S ETHICS:
 Established by Immanuel Kant, a German thinker.
 First appeared in his work, “Groundwork of the
Metaphysic of Morals.”
 Kantian ethics focuses on duty or obligation
(deontologism/intuitionism).
 Morality is exclusively within the human personality
 Morality is a matter of intent, motive and will.
 Kant maintains that one acts morally if and only one does
whatever one is obliged to do.
 Act done in accord with duty and act done from a sense of
duty; non-moral acts are those who do not have a moral
sense.
 Categorical imperative implies that an action be done
irrespective of the results.
 Act only on the maxim which you can at the same time,
will to become a universal law.
 Humans should be treated as an end and not as a mean.
 Formula of Autonomy
 Kingdom of Ends
 Two types of duties exist: perfect and imperfect.
 The concept of autonomous will.
 Difficulties include:
 Conflicting duties
 Categorical imperatives fail to establish duties.
 Conflict with the concept of human beings.
ROSS’ ETHICS:
 Established by William David Ross, an Aristotelian
philosopher.
 Rightness of an action is not determined by its
consequences.
 Ross viewed deontology as rigid and insensitive in some
cases.
 Moreover, deontological precepts sometimes conflict
each other.
 Ross believes in moral rules, however, he postulated that
it should not be absolute or inflexible.
 Moral rules serve only as guidelines
 Absolute rules are often insensitive to the consequences
of an act.
 Rightness and goodness are the only moral properties.
 Nonmoral properties need to be ascertained (why /what)
 The concept of actual duty and prima facie duty.
 Act in accordance with the stronger, more stringent or
more severe prima facie duty.
 Act in accordance with the prima facie duty which has a
greater balance of rightness over wrongness.
 Only one is a prima facie duty.
 Ross’ ethics relies more on moral intuitions.
SEVEN TYPES OF PRIMA FACIE DUTIES: ST. THOMAS AQUINAS’ ETHICS:
 Duty of Fidelity  Also known as natural law ethics/Thomistic
 Being faithful to our duties, obligation, vows or ethics/Christian ethics.
pledges.  According to St. Thomas, the source of the moral law is
 Being loyal to a worthy cause reason itself.
 Duty of Reparation  Human good is that which is suitable to or proper for the
 The duty of making amend for injuries that we human nature.
have inflicted over others.  The good is built into human nature and it is that to which
 Asking for forgiveness is insufficient. we are directed by our natural inclinations as both
 “Kung nakagawa ng masama, gumawa ka naman physical and rational creatures.
ng mabuti.”  Humans have three natural inclinations:
 Duty of Gratitude  Self-preservation ¤ Just dealings with others.
 Appreciating and recognizing the services other  Propagation of our species.
have done for us.  Natural moral law is founded on human nature itself
 Duty of Justice (unchangeable).
 We can enjoy the social benefits with others, but
we should also equally share with them the
burdens of social living.
 Example: the human rights.
 Duty of Beneficence
 The duty to do what is good.
 This type of duty enjoins us not only to bring
about what is good for others but also to help
them better their conditions with respect to duty
to virtue, intelligence or comfort.
 Duty of Self-Improvement
 This is the duty to do what is good to one’s self.
 We are encouraged to improve ourselves in
order to be serve others
 Duty of Nonmaleficence
 The duty of not causing harm/injury to others.
 We ought to avoid inflicting evil, injury or harm
upon others as we would avoid doing so to
ourselves.
 Culpable negligence is an infraction of this duty.
 “Ang masakit sa iyo ay huwag mong gawin sa
kapwa mo.”

RAWL’S THEORY OF JUSTICE:

 Postulated by John Rawls, a Harvard philosopher.
 Synthesized the deontological and utilitarian views.
 Justice is fairness in terms of the “original position.”
 If principles that would support inequalities in their
society are introduced, the outcome would be that, the
people in their original position would take advantage of
it.
 Every individual is inviolable.
 The greater good to be shared by all members should not
be justify the loss of freedom of others.
 Or, the larger sum of advantages which is supposedly to
be enjoyed by the many should not outweigh the
inconveniences to be imposed on a few.
 Equal access to the basic human rights and liberties.
 Right to vote and eligibility to public office,
freedom of speech and peaceful assembly, liberty
of conscience, freedom of thought , right of
ownership and freedom from arbitrary arrest.
 Fair equality of opportunity and the equal distribution of
socio-economic inequalities.
 A just society is one in which inequalities must be
demonstrated to be legitimate.
  Considered as subjective because it is borne out
FUNDAMENTAL CONCEPTS IN BIOETHICS of the mental process of man.
 Man has to follow his conscience.
Unit IV/Bioethics
 Follow the law
 Follow one’s cultural beliefs
 Follow one’s feelings
THE HUMAN ACT:
 Follow one’s religious beliefs.
 Human act is a conscious and free exercise of one’s
faculties, therefore, conscious and free.
PRINCIPLES OF WELL-FORMED CONSCIENCE:
 Act of man is an act beyond the control of one’s will.
 Inform themselves as fully as possible about the facts of
 Morality or ethics is more concerned with human acts
the case and about the attendant ethical norms.
rather than acts of man.
 Form a morally certain judgment of conscience on the
 Constituents of Human Act:
basis of this information.
 Knowledge – resides in the intellect and is the
 Act according to this well-formed-judgment
mindfulness of what the moral agent is doing.
 Be responsible for the actions performed.
 Freedom – quality of the freewill by which one is
 “To follow one’s conscience is properly to follow one’s
able to choose between one or more
well-formed conscience.”
alternatives.
 Voluntariness – quality of the human act
THE CONCEPT OF FREEDOM:
whereby any commission or omission of an act is
 The will is the human faculty whose function is to desire.
a result of the knowledge which an agent has of
the end.  The object of freewill is that which is good, either in itself
or as compared to other alternative good.
SOURCES/DETERMINANT OF MORALITY:  Man alone is capable of morality because of his rational
 The Object of the Act knowledge and freewill.
 The very substance of the act  Responsibility is an inherent outcome of an act done with
 “What was performed by the agent?” freedom
 Motive of the Agent
 Purpose for which a human agent does the act.
 “What specifically does the agent want?”
 The Circumstances
 What – the intended object of the act.
 Why – personal intention of the agent
 By what means – tools or procedures used
 How – modes of doing the act
 When – the time the act was performed.
 Where – the spatial setting where the act is
done.
 Who – the person who does/receive

STANDARDS/NORMS OF MORALITY:
 Natural Law and Conscience
 “An ordinance of reason promulgated by a duly
constituted authority for the common good of the
society.”
 Law is necessary to regulate acts of the freewill.
 Kinds of Law
 Natural Law/Divine Law/Human Positive Law
 Natural Law
 A system of law that is purportedly determined
by nature, and thus universal.
 The pattern of behavior of animals, plants, or
minerals follow such actions or movements in
accordance with the will of the Divine Mind.
 “Our universe is composed of an infinite variety of
beautifully arranged things. Indeed nature shows
a constant order which is the result of a universal
plan and of immutable laws.” (Panizo, 1964)
 Conscience
 The practical judgment that determines that an
act is good, therefore to be done, and evil,
therefore to be avoided.