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Health Care Ethics (Bioethics)
Maria Teresa Farala, RN
Ethical Principles Continuation..
OUTLINE
I Principle of Confidentiality
A Limits of confidentiality
II Principle of Veracity
A Justification of Truth Telling
B Two Approaches of Truth Telling
C Benevolent Deception
III Principle of Fidelity
Ethical Principles Continuation
B. Principle of confidentiality
- Information can be restricted to those
authorized who have access to it.
- It is mandatory when a patient submits
himself to a hospital care or admission, he
should give the correct information that is
needed for a healthcare provider to draw
correct interventions for them. This
information needs to be kept in confidence to
protect the rights of every individual.
● Is an important aspect of the trust that
patients place in health care professionals.
Once the patient opens up to us or shares
any information relating to
hospitalization, it is mandatory for the nurses
or healthcare provider to protect this
information and withhold in confidence.
● It refers to the medical or professional
secrecy in which certain information is
committed to a physician in his official
capacity for the sake of medical assistance.
● Basic ethical arguments in favor of
confidentiality:
Ethical arguments mean questions on what
limitations this patient has to give us the
information that we will need from them.
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1. The individual's right to control
personal information and protect
privacy.
Let the patient understand that if we
are not fully aware of the status and
all that information that is needed for
the healthcare provider to come up
with a good intervention and
treatment plan for them, there would
be a hassle if they will not give the
correct information.
2. Utility- if patients suspect that health
care providers reveal sensitive and
personal information they may be
reluctant to seek care.
If the patient is admitted, it is
mandatory for them to provide
specific information, especially when
we have in our physical assessment.
❖ biographical data that we
need from our patient.
the ❖ Information relating to the
chief complaint on why they
are submitting themselves for
admission. If the reason for
their admission or their
stigma, then likely our patient
will control the information
that they are going to tell us.
❖ These patients also have their fear of
suffering from stigma. For example
they have committed abortion,
suicide, or stealing that often times
draws the attention of people in the
hospital. They would be reluctant to
share this information.
❖ But if the healthcare provider carries
himself in such a way that we are
trustworthy, then the patient will
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 never be reluctant to share the
information.
❖ We should know the rights of
individuals for confidentiality.
Limits of confidentiality
- Not throughout or not absolute
- There are areas where it is not all the time
that we have to observe the rights to
confidentiality.
1. Principle of harm- applied when professionals
recognize that maintaining confidentiality will
result in preventable wrongful harm to
innocent others.
Example: when the patient is able to share
something with the nurse, when they get out
of the hospital, they will get back to the
person who did harm to them for revenge.
And what if that person is innocent, then
there is a possibility of harm. If so, if these
people are innocent, even if they have the
right of confidentiality, then we should be
able to divulge information to the right ears
to prevent harm.
2. Principle of vulnerability- the duty to protect
others from harm is stronger when the third
party is dependent on others or somehow
vulnerable.
Example: If you are a community nurse and
you know that there is domestic violence
happening in a household, and you know
already that the victim of that domestic
violence is a minor, then the principle of
vulnerability applies. If the person for that
matter cannot do anything, then:
❖ Call out the parents
❖ Or share information to proper
authority.
Example: In the hospital, if the information
speaks about a vulnerable people, then we
should draw the line when we are going to
share the information and when to fit in. This
is common to psychiatry wards because when
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you get to get the feelings of mentally
challenged individual, then they are going to
share everything. Then you would know that
the person is planning for suicide, or to do
homicide. In cases like that wherein
vulnerable
people are at tea, then we need to share or divulge
information to proper authority not to anyone
especially the healthcare team.
C. Principle of Veracity
● Veracity- relates to the practice of telling the
truth.
❖ Truth Telling- will bring about respect,
open communication, trust and
shared responsibility.
Always remember that when a
patient is admitted to a hospital, we
ask them information and not only
information, but we ask them to tell
the truth. Because when we are going
to tell us the truth, that will also give
way for the healthcare provider to
draw/manage/plan out for the
complete management of the
patient’s illness. Moreover, if we tell
the truth, we will be able to earn the
respect of the people, patient. And
through telling, the patient would
also feel that their secrets or
information are safe with us. That is
why there would be open
communication, trust, and shared
responsibility.
❖ Right to information- patients have
the right to obtain complete, current
information concerning diagnosis,
treatment, and prognosis in terms
they can easily understand.
It is not always that the patient has to
tell us everything truthfully, but we as
a healthcare provider are expected to
tell the truth to our patient.
Remember that when they submit
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 themselves for admission, they need
to know many things about their
illness. If there is information that we
are not going to share with them it
will increase or trigger the anxiety of
those patients.
Justification of Truth Telling
1. It is argued that our human and moral quality
as persons is taken away from us if we are
denied whatever knowledge is available about
our condition as a patient.
Whatever information that we are not telling
our patient, it is just like denying them the
rights to information.
2. As patients, we have entrusted to the
physician any knowledge he has about
ourselves, so the facts (findings) are ours and
not his, hence to deny them to us is to steal
from us.
This speaks about the healthcare team. When
the patient entrusted the information to the
doctor, it is in the kind sight that the patient
believes that the doctor is going to keep that
information. Indeed, after all the laboratory
sets, the doctor has the responsibility to draw
conclusions from the result. It is the right that
the doctor has to tell the patient about the
result.
3. The highest conception of the physical-patient
relationship is a personalistic one which is
based on mutual confidence and respect for
each other’s right
We need to tell the truth because the
physician or the healthcare provider and
patient-relationship is something that is
based on mutual confidence. We are not
only dealing with life but also dealing with
information relating to the patient.
4. To deny a patient pertinent knowledge about
himself, especially in a life and death
situation, is to deprive him the ample time to
prepare for his own death or to carry out
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responsibilities that are based solely on his
decisions or actions.
It might be good that you are not telling the
truth, but the problem there is that each of us
deserve or has a right to self-determination.
Self-determination is an inherent capacity of
an individual to decide what is best for us.
If the patient or the client accepts the
situation, they can start planning already on
how to live their remaining days in their
lives.
Two Approaches of Truth Telling
Person-centered- considers patient as a person with a
problem, but not as a problem himself/herself
If we tell the truth, that is because the person is the
patient and is having a problem but not
himself/herself is the problem.
You are going to tell the truth, based on the person
You may not tell the person about his condition right
away, but as the person gets better, you need to tell
the truth.
We are looking at the person as a whole.
Problem-centered- consider the patient’s condition,
illness or diseases.
We need to center our decision making of telling the
truth on the problem itself.
For example, the patient needs blood
transfusion right away, even though the
patient will get anxious, but it does not
change the fact that the person is in need of
blood transfusion, but you need to tell the
person.
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 ● Benevolent deception- practitioner is allowed
to intentionally withhold information based
on his/her “sound medical judgment” that to
divulge the information might potentially
harm the depressed and unstable patient for
an unpleasant fact.
❖ Violation of the principle of veracity

As a healthcare provider, it is okay to not tell

the truth right away if it might cause harm or
death. Wait until a certain time of recovery
and that is the time that you will tell the
truth. This is called white lies because it
means that the lie does not stay forever and
it should be divulged in the right time.

Your action especially in-favor of the patient

will be defined by the word benevolent
deception.

D. Principle of Fidelity

● Refers to the concept of faithfulness to our

duties, obligations, vows, or pledges.
● Refers to one’s loyalty to a worthy cause
● Telling the truth as the situation demands it
● Keeping actual and implicit promises, and not
representing fiction as truth.

Act of doing an obligation. Forgetting one’s

duty is a violation of fidelity.

To avoid violation of fidelity, inform the

people on the situation ahead of time.

We are to be faithful to our promise with the

patient.

As a student nurse, we need to take good care

of humanity. It is engraved already in our
person.

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Health Care Ethics (Bioethics)
Prof’s name here
PRINCIPLE of JUSTICE to DOUBLE EFFECT
OUTLINE
I. Principle of Justice
a) Comparable Justice
b) Non Comparable Justice
c) Criteria of Distribution
d) Criteria of Comparison
e) Random Selection
II. Principle of Beneficence
III. Principle of Non-Maleficence
IV. Principle of Double Effect
E. PRINCIPLE OF JUSTICE
○ Relates to fair, equitable and
appropriate treatment in light of what is
due or owed to persons, recognizing
that giving to some will deny receipt to
others
○ Distributive justice – application of the
principle focuses on distribution of
goods and services
~Relevant basic areas of health care:
1. What percentage of resources is
reasonable to spend on health care
2. Which aspects of health care should
receive the most resources
3. Which patients should have access to the
limited health care staff, equipment etc.
Refers to the fairness in the conservation of
equality when it comes to distribution of goods in
health care, it has to be fair, equitable and
appropriate, so it says there
Having a piece of cake and you have 4 siblings,
you have to divide the cake equally into 4, so the
principle of justice in health care ethics is that the
principle of justice speaks about at times the equality
or the fairness of the distribution of goods would
depend on the gravity of the need of an individual,
there is what we call fairness in the situation
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DISTRIBUTIVE JUSTICE
○ Goods and services in healthcare:
○ How many medicines you are going to give
in the barangay or who are you going to give
your only kidney that can be transplanted sa
10 who needs it in Davao or who is the
recipient number of bags of platelet
available
○ When the cases of dengue will spiral again
and the need or demand for platelet
concentrate will increase in demand
○ Medications, vaccines to the constituents of
the barangay
○ If mas daghan ang constituents sa boulevard
kaysa sa agdao, mas daghan ang sa blvd
PERCENTAGE OF RESOURCES
○ In the advent of covid, the budget and
national budget has been drained given to
people who are in need, no resources, no
food, no income, the govt has done a drastic
mode to provide
WHICH ASPECTS OF HEALTH CARE
○ Using the covid situation, the increase of
covid debt or mas evident sa Luzon, the
bigger the funds ibigay sa luzon
○ Mindanao has a big area, increasing number
of covid victims specifically in big cities,
Digos, Tagum, neighboring areas do not
receive much of the budget related to covid-
19 budget because they don’t have much
cases
WHICH PATIENTS SHOULD HAVE ACCESS
- Example: If there is only one healthy kidney
viable for transplant and there are 10 people
who need it, there has to be fairness, some
believe that all should receive equally
regardless of the need,
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 FRIEDRICH NIETZSCHE
- A German philosopher believe there are
superior individuals, so the choice of
Inclusion - who’s included?
distribution will depend on the present or
future social contribution of the person
TWO TYPES OF JUSTICE:
1. Comparable justice
- What a particular patient receives Is
determined by the gravity of the condition or
need
2. Noncomparable justice
- Distribution of goods/resources is determined
by a certain standard
COMPARABLE JUSTICE
- Nursing care: dalawa ang dumating admitted,
one due to circumoral cyanosis, labored
breathing, then the other one: mas sayo
nisulod sa er, fever and headache
- Two came in who deserve fair treatment and
fair care, you as a nurse with the scarcity of
man power working in er, you know that you
need to attend first to the one who has
circumoral, if unahon nimo ang patient na
naay fever, but the fairness in the principle of
justice speaks about that the patient care that
the person receives will be determined
depending on the gravity of the gravity of the
condition or the need of the patient
NONCOMPARABLE JUSTICE
- Standard how should the goods be distributed
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CRITERIA OF DISTRIBUTION
1. Criteria of Inclusion – Selection of Candidates
a. CONSTITUENCY – is the person a member of
the community?
a. Ex:
i. Covid vaccine – you are a health nurse
with 50 vaccines. However, there are 75
people outside, waiting for the
vaccination.
I. What happens to the 25? How will you
decide?
 Check for the person if he/she is a member
of that specific community and if he is a
recipient f that vaccine
 Prioritizing the members
ii. Two patients in SPH need a mechanical
ventilator but only one ventilator is
available.
iii.
 Choose the patient who is from davao
 If both are from davao proceed to the
next criteria
b. PROGRESS OF SCIENCE – can new knowledge
be gained from the case?
a. Ex:
i. Two patients in SPH need a mechanical
ventilator but only one ventilator is
available.
 Patient 1 (senior citizen)
 Patient 2 (teenager)
 Choose the teenager because he/she is
younger and is more able to provide
new knowledge
c. SUCCESS – chance of the treatment to be
effective
a. Ex:
i. Two patients in SPH need a mechanical
ventilator but only one ventilator is
available.
 Give the ventilator to the adolescent
because they are more likely to survive
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 2. Criteria of comparison
Comparing case scenarios
a. The likelihood of successful treatment
compared with others in the group
a. Ex:
i. There are 5 mechanical ventilators and 10
patients are in need of it. Who has the
highest possibility for survival?
 The one who does not smoke
 Drink
 No premorbid conditions (hypertension, asthma,
etc)
b. Life expectancy of the person
a. Years of life
b. Violates the human rights but we are
to come up a decision relating to
justice
c. It will be unfair for the senior citizen
but if we think about it, the
adolescents are more likely to survive
c. The person’s family role
a. A person who has important role in a
family
b. Ex: a father of five/ breadwinner and
a single man who lives alone and
only provides for himself
i. The father of 5 is going to be
prioritized
d. The potential of the person in making future
contribution
a. Ex
i. You are a consistent honor
student with a lot of potential
in terms of future
contribution VS the daughter
of the president who may also
run and take the position of
the president
e. The person’s record of services or
contribution
a. Ex
i. A group of 40 students who
need mechanical ventilators
 Prioritize those who have conducted research and
contributed in the society
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3. RANDOM SELECTION (James Childress)
James Childress is an author of a bioethics book
a. First come first serve basis
a. First to come or first to reserve a slot
b. Lottery
a. Kidney lottery in front of the people
who wished to have the kidney
transplant
Principle of Justice is also applicable to a lot of health
care services like in situations where you have to
choose who or to whom will you give your care first.
PRINCIPLE OF BENEFICENCE
○ It requires to act in ways that benefit
patients.
○ Beneficent acts are morally and legally
demanded by our professional roles.
○ Lays the groundwork for the trust that
society and individuals places in the
profession.
3 COMPONENTS
1. Do or promote good
2. Prevent evil or harm
3. Remove evil or harm
EXAMPLE FOR PROMOTE GOOD
 We give health education, what is the effects of
smoking to the health.
 Teach our client, do not smoke if you are
pregnant or beside a children because 2nd hand
smoke is dangerous to the people who doesn’t
smoke.
 When we encourage our client to avail
immunization in our health center.
EXAMPLE FOR PREVENT EVIL or HARM
 The nurses has a responsibility to report
whatever happening in the unit that is not
contributing to the mood of your patient or
the general.
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 EXAMPLE FOR REMOVE EVIL or HARM
 Guided by the Nursing Code of Ethics
 If something is going on in your unit or you
know that there is.
 Removal of whatever is dangerous in your
area.
PRINCIPLE OF NON - MALEFICENCE
○ It requires to act in such a manner as to
avoid causing harm to the patient.
○ Included in the principle are deliberate
harm, risk of harm, and harm that occurs
during the performance of beneficial acts
○ It means avoiding harm as a consequence of
doing good
○ Harm or pain should not be inflicted upon
others regardless of their social and
economic status or affiliation always avoid
harm to your client
○ Hippocratic Oath " I will never use treatment
to injure or wrong the sick"
○ Be resilient/responsible for the health of
the patient be open to any possible
complications that you may think can harm
the patient and act quickly to any
circumstances that may occur
PRINCIPLE OF DOUBLE EFFECT
○ an act is foreseen to have both good and bad
effects (to the patient)
○ Violation of beneficence
○ This lesson Will help you make decision
(what if ang steps na gagawin or actions will
yield both good and bad, what do you do?)
ETHICAL CONSIDERATIONS
a) Good effect must be directly intended
b) Good effect or bad effect must occur
simultaneously or bad effect must follow the
good effect
c) Bad effect may be permitted to occur after the
intention of good effect
CASE: ECTOPIC PREGNANCY ( is having a fetus
growing at the fallopian tube )
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- management : remove the fetus in the fallopian tube
- effect: abortion
WHY REMOVE THE FETUS?
REMEMBER:
a) The 1st intention is to save the life of the mother.
(GOOD EFFECT)
b) Pag remove ng fertilized ovum in the fallopian
tube the BAD EFFECT is the fetus will die. Pregnancy is
cancelled. So sino ang nauna? Nauna ang pag save ng
mother, to follow ang sequence ng abortion.
OR if hindi nauna ang pagsave ng mother, SABAY
nung nangyari. Nung nakuha mo ang fertilized ovum
sa fallopian tube, the mother’s life is safe while the
baby is dead already.
c) There’s a abortion. Di natuloy ang pregnancy. But
they achieved the 1st intention of good effect.
ANOTHER EXAMPLE: Giving morphine to cancer
patient.
 Cancer patient - a person who feels a great
amount of pain
 Morphine - a strong analgesic that will relieve the
cancer patient with the pain.
 Side effect of morphine: supress the respiratory
function of a person
 GOOD INTENTION: make the patient relieve the
pain BUT SOMEHOW to make the lives /
remaining days of the life of the patient more
meaningful because nabuhay sya na walang sakit
by giving morphine.
 BAD EFFECT: patient continually receive
morphine injection may result to respiratory
depression (side effect of morphine)
WILL THE DOCTOR OR NURSE LIABLENY GIVING THE
MORPHINE:
 Our action will be justified by the principle of
double effect.
 Top priority : relieve the pain of the cancer
patient to continually battle against the cancer.
 Bad effect: respiratory depression.
IS IT ETHICALLY RIGHT TO GIVE MORPHINE TO
CANCER PATIENT?
Ans. YES
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Health Care Ethics (Bioethics)
Ms. Maria Teresa Farala, RN
PRINCIPLES
OUTLINE
I Principle of Legitimate Cooperation
II Principle of Common Good & Subsidiary
III Principle of Stewardship and Role of
Nurses
IV Principle of Totality and its Integrity
V Principle of Ordinary and Extraordinary
Means
Principle of Legitimate Cooperation
Principle of Legitimate Cooperation
• Cooperation comes from the latin word cum
which means "with", and operari which means “to
work”.
• Cooperation is working with another in the
performance of an action.
 Group work, group crime, group actions
Example: The formal agent identifies itself with
purpose of evil act.
Immediate- directly does it
Agree to the act; or condole "don't worry about it,
its nothing Advising or counselling.
Example:
 E.g. There’s this video that surfaced the
internet way back before pa, This happened in
Cebu. Inside the Operating room, there was a
group of healthcare personnel (nurses,
surgeons and etc) which made an operation
with a gay man. They removed a canister on
that man’s anus. While they were performing
the surgery, a member of the healthcare team
took footage of what happened there. Some of
the people inside that room also made some
“side comments”. Then it was uploaded on
youtube.
 This example is a violation of the principle of
legitimate cooperation.
Why?
 The autonomy of the person is being violated –
they did not ask permission to the gay man
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that they were going to take a vid and post it
on the internet.
o Walang mukha ng client pero he’s a
human being. The fact that he is being
operated, means wala siyang
magawa. So, the people around him
can do what they want to do.
o And the doctor, can actually DO
something. BUT, he did not do
anything. He did not tell the one that
was taking the video to stop doing it
and such.
o The person (gay man) submitted
himself to the healthcare personnel
because that person trusts them.
o The patient believes “they (healthcare
personnel) are here for my own good”
o Even if you were just there in the
operating room and you weren’t the
one who took the video or took
pictures, you still violated it.
Why?
 Because of “cooperation”.
 You were there when that happened or you
were present there.
• Legitimate - refers to moral acceptability
 Legal
• Moral object - refers to the objective goal of the
action
• Intention - reasons why you choose to act (ex.
Giving money to charity)
 E.g. alam mo may nagnakaw tiningnan mo
lang, wala kang may ginawa so natuloy yung
pagnakaw nung tao.
• Cooperation with evil does not mean working
together despite disagreement about the ends or
means of the act. Thus, cooperation does not imply
condoning evil
• Wrongdoer - the party who initiated the wrongdoing
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• Formal cooperation - occurs when the evil end are
directly chosen by means of encouragement, praise.
Advice or any other support.
 E.g. (yung sa example earlier) lahat ng
healthcare personnel kay nandun sa place and
walang may ginawa to stop the action (pag
video).
• Material cooperation occurs when the evil end are
indirectly chosen by the person who has chosen good
end.
 Mediate cooperation - when the involvement
is only accidental.
 Immediate cooperation - the cooperators
involvement is necessary for the evil to
continue. Same as formal cooperation
Principle of Common Good and Subsidiary
Principle of Common Good and Subsidiary
• Common Good - the sum total of social conditions
which allows people, either as group or as individuals,
to reach their fulfilment more fully or more easily.
Primary goal of society is the good of the people and
of the whole person.
 When you decide for your actions, the goal of
the action should be for the good of many not
for the good of only 1 person.
 E.g. If naga duty ka then hindi ka
nagpavaccine, and then nag duty ka sa
hospital, syempre madali mahawaan ang mga
patient sa hospital. So, if sinabing compulsory
yung pagpavaccine, this is because it’s for the
common good.
• Subsidiary - Every task of society should be
assigned to the smallest possible group that can
perform it. If the smaller group is unable to resolve the
problem itself, a group at a higher level assume
responsibility
 If di magawa ang task nung nasa lower level,
the people above them or those in higher level,
can help if di kaya gawin basic needs of the
community.
Principle of Stewardship and Role of Nurses
Stewardship
• a steward is a selfless servant who manages
assets and possessions without owning them,
foresees future trends and creates plans and
interventions.
• when one is entrusted with something of value,
there is an obligation to improve on it.
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 We are all stewards of our life. Ang owner ng
life natin is the divine God. Then binigay satin.
As a steward, may responsibility tayo to take
care of our lives.
 Steward - “taga bantay”
 We have the responsibility to nourish our lives.
Role of Nurses
• Nurse leaders or stewards are finding themselves
collaborating with regulatory boards to improve on
standards of practice, certification and accreditation
• nursing managers in all disciplines of nursing will be
the chief patient and safety officers and stewards for
their organizations and institutions.
• is responsible for the welfare and interests of the
population, especially the trust and legitimacy with
which its activities are viewed by the general public
 E.g. If you are a parent, you are a steward of
your children
 E.g. if you are a teacher, you are a steward of
your students.
 Yung mga heads, leaders, they are convening
for what’s the best. They are the ones thinking
how to better the nursing life in the Philippines.
 People are placing so much regard on nurses.
That nurses are made to “care”.
Stewardship of self
 To meet the domains of stewardship in health
care and the nursing profession, it is crucial
that nurse leaders engage with:
• the development of self
 Before you aim to be a quality nurse, you
should aim first to be a “good person” so that it
will be easier for you to become a quality
nurse.
 “we can better serve others if we serve
ourselves”
 If you don’t serve yourself first, you’ll end up
burned out
• nurse leaders or stewards will need to use of
mentors and personal coaches to assist them in
refining skills and improving competencies.
 E.g Sumama ka sa head nurse and then bago
ka lang. You told her na “may bago na kaming
intervention na nalearn.” You said, “Pag
walang brown bag we can make use of our
hands.” And the head nurse responded to you
by saying na wag ka mag imbento kasi
matagal na siya as a nurse.
o It is a violation.
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 o Kasi may responsibility ka to update
yourself sa mga bago na interventions
or things in regard sa profession mo.
 You have the responsibility as a nurse to
update yourself so that your patients will
always receive an “excellent care”
• Healthy nurse leader stewards will thus become
visible and sound role models within their
institutions to maintain the balance between self
and professional fulfilment
 As a nurse, you should rest too for your own
good.
Principle of Totality and its Integrity
Definition
• The human body is an integral part of the human
person and is therefore worthy of human dignity. It
must be kept whole. No body part should be
removed, mangled or debilitated unless doing so is
necessary for the health of a more essential body
part or the body of a whole. An unessential or
redundant body part may be removed for the good
of another person.
 It’s about respecting our body as a whole.
 Each part forms part of our body and so,
removing any part is unethical or unacceptable
because each part of the body is part of the
human being.
 E.g. Pinabenta ng boy yung kidney for her sick
mother. Para may pera siya na magamit.
o Regardless for para sa mother yung
pag sell niya ng kidney, violation siya
because it violates the principle of
totality.
Principle of Totality
 by Philosopher Thomas Aquinas
• All of the organs and other parts of the body exist
for the sake of the whole person. Because the
purpose of the part is to serve the whole, any
action that damages a part of the body or prevents
it from fulfilling its purpose violates the natural
order and is morally wrong.
• However, a single part may be sacrificed if the
loss is necessary for the good of the whole person.
Ex: the principle of totality would justify the
amputation of a gangrenous limb, because the
person could die if the gangrene spread.
 E.g. a person undergo bks (below knee
amputation) because he has diabetes mellitus.
Does that violates the principle of totality?
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 It does not violates the principle of totality.
Why?
 Because it’s for the person’s own good man
rin.
Applications
• Surgeries that needlessly remove body parts or
organs are immoral
• Tattoos and piercings are not inherently immoral
but they may be immoral if they deface the body
by quantity or content.
• Torture is a moral evil because it seeks to dis-
integrate the body and the spirit
• Self-mutilation is self-hatred expressed through
spite of the body.
• That chemical contraception effectively shuts
down a healthy bodily system is part of what
makes it immoral.
• Even if the pro-choice argument that an embryo
is part of the woman's body rather than an
independent human person is true. it should not be
removed except when its presence endangers the
woman's life.
Principle of Ordinary and Extraordinary Means
• It is generally held that one can forgo extraordinary
means of continuing life but is obliged to continue
ordinary means of care.
• "Life, health and earthly actions are allocated, and
thus subordinate, to spiritual purposes. Death is
seen as an integral element of life, since according
to Christian beliefs death is not the end but
transition of new life.” -- Pope Pius XII
Ordinary vs. Extraordinary
• Ordinary means are all medicines, treatments and
operations that offer a reasonable hope of benefit and
that can be obtained without excessive expense, pain
or other inconvenience.
• Extraordinary means are all medicines, treatments
and operations that cannot be obtained or used
without excessive expense, pain or other
inconvenience or that, if used, would not offer a
reasonable hope of benefit.
 It depends on the situation if the means is
ordinary or extraordinary.
Examples:
1. An infant with Down's syndrome, who needs low-risk
surgery to correct intestinal defect, the parents refuse
surgery stating that mental retardation will mean less
meaningful life of the baby
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2. A 7 year old who meet an accident with severe
internal bleeding Her parents refuse consent of blood
transfusion because its forbidden in their religion
3. An 87 year old incompetent woman with congestive
heart and kidney failure, has primary cancer of the
intestine. Surgery is the usual management, but the
family refused and the doctor decided against it.
Health Care Ethics (Bioethics)
Maria Theresa Farala
PRINCIPLE OF PERSONAL SEXUALITY
OUTLINE
I Principle of Personal Sexuality
A Principle of Personal Sexuaty as follows:
II 2 Norms of Moral Sexuality
*NOTES
 Is based on the understanding of sexuality as
one of the basic traits of the human person
and must be developed in ways consistent
with enhancing human dignity
 The principle of personalized sexuality
speaks about the idea that sexuality can
be used, yet it will enhance human
dignity.
 This element of human character often leads
to a loss of human dignity and an inability to
pursue the truly fulfilling goals of human life.
 Loss of human dignity if sexuality is not
done with respect to human person.
 Different perspectives on common
sexuality practices, a classic example is
shades of grey, the keys of mister grey, for
some mental health inclined person, there
is a disorder. Mrs. Grey’s experienced
often times erodes human dignity,
because it is a given that we are human
person, we have to be respected and we
have complete set of rights and that
should not exclude sexuality.
 And it goes without saying, if you are
married and if the person does not agree
to have sexual intercourse that has to be
respected
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 With legality, now, wives can sue their
husbands of rape
 The goals of human life is the picking part
on the procreation. With the personalized
sexuality, the aim is to take part in the
procreation. The goal of it is fruition, or in
other words is to have a child. This backs
up the practice or the mandate of the
catholic practice which is against
contraception.
 The contraception like pills, intrauterine
device (IUD), and the stand of the church
is that this is more of abortificient than
stopping or preventing pregnancy.
 Abortificient = there can be union of the
sperm and the egg and then later, this is
stopped and the pregnancy is
discontinued
 Takes note of a humanized sexuality, one that
represents the fulfilment of the physical and
sensual need but also evidenced with love and
sacramental mystery.
 Physical and sensual satisfaction gained in
sexuality but there should be love and not
just lust.
 Lowered down sexuality as a main
commodity
 Influence of culture in Filipinos, marriage
should be done before engaging in
sexuality.
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 The Principle of Human Sexuality may be
stated as follows:
 The gift of human sexuality must be used in
marriage in keeping with its intrinsic, indivisible,
specifically human teleology.
 The consequence should be good
 It should be a loving, bodily, pleasurable,
expression of the complementary, permanent
self-giving of a man and a woman to each other,
which is open to fruition in the perpetuation and
expansion of this personal communion through
the family they beget and educate.

2 NORMS OF MORAL SEXUALITY

1. Laws or social attitude that hinder human
freedom to achieve these values in ways the
individual desires are unjust and oppressive.
 Not acceptable because it is unjust and
oppressive.
1. Sexual Behavior, at least among consenting
adults is entirely a private matter to be
determined by personal choice, free from any
moral guilt.
 With personalized sexuality, it is
acceptable as long as they are conseNting
adults and they agreed and “walang
naapakan na tao”, likely even outside the
context of marriage, that sexuality or the
practice of sexuality can be acceptable.

REFERENCES

“PROF’S LECTURE”

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