Simbajon, Noralyn L.

BSN 3C

Health Care Ethics

November 15, 2022

Exercises: Read and resolve the following situations from the context of Ethical Theories:
Deontology, Teleology, Utilitarianism

SITUATION 1:

1. A staff nurse working in a private hospital is told by the Medical Director who is a
gynecologist to assist him in the tubal ligation of a post D.R. case for purposes of
preventing further conception as per request of the patient on the ground of having many
children already. The said nurse knows it is immoral. Yet, she assists out of fear of losing
her job if ever refusal is made.
1. Is the nurse morally accountable for her act of assisting out of fear?
- Not accountable because duty weights more than beliefs according to kant
2. Explain within the context of the principle of Deontology.
o Divine Command Theory
- Accountable,
o The “Golden Rule”
- Not accountable
o Natural Law and Natural Rights Theories
- Accountable
o Non-aggression Principle theory
- Not accountable
o Categorical Imperative (Kantian Ethics)
- Not accountable
SITUATION 2:

1. A student nurse suspects that her clinical instructor inadvertently gives her a wrong
instruction as to the specific doctor’s order that is to be carried out to a certain patient.
However, she does not bother to validate it with her C.I. and to refer to the patient’s
chart as she is afraid of being scolded and branded for being wiser than the C.I. She
just consoles herself: “Anyway, she’s my C.I. She has to know more than I do, for all
I care!” She does what her C.I. tells her without knowing the truth of the doctor’s
order. Consequently, the patient receives wrong medication and suffers anaphylactic
shock from it.
 What makes the fear of the student an extrinsic fear?
- Because of the CI. The nursing student was just following her CI's
instructions.
 What makes the good thing good?
- She followed the of what have said the CI
 What makes a good thing bad or evil?
- The patient received wrong medicine and suffers anaphylactic shock
from it.
 What are the circumstances that can never justify the performance of an evil
act good?
- Fear
 In the context of deontology, is the wrong medication that resulted to
anaphylactic shock necessarily makes the C.I. and the student nurse
accountable?
- Yes, because they make a wrong medication that make suffer the
patients.
 To whom should accountability be the most?
- I think the both of them. The CI give a wrong instruction and then the
student nurse follow even thought she knows that is not right and yet
she didn’t tell it to the assigned physician.
SITUATION 3:

2. A certain patient is rushed to the ER as a victim of “hit and run” accident. He has no
relatives to provide any identification and sign consent forms for he is just taken by
empathetic bystanders. Emergency treatment is given without much ado as the
patient already gets unconscious.

Make the situation of the empathetic bystanders as their expression of duty-based ethics.

 Unconscious, does the patient still have voluntary nature of the act of submitting
for immediate treatment? Why?
- If the patient is in an emergency, I think it would be the patient's guardian
who would submit the immediate treatment because the patient is
unconscious. According to DOH, if any person cannot immediately be given
treatment that is medically necessary, he shall, depending on his state of
health, either be directed to wait for care or be referred to or sent for
treatment elsewhere, where the appropriate care can be provided. If the
patient has to wait for care, he shall be informed of the reason for the delay.
Patients in emergencies shall be extended immediate medical care and
treatment without any deposit, pledge, mortgage, or any other form of
advance payment for treatment.

 Are bystanders morally obliged to rush the unconscious patient to the ER?
- Yes, because bystanders have a responsibility to intervene when witnessing
a violent crime. As member of the community, we have an ethical obligation
to uphold peace in order to maintain the trust and personal freedom
necessary for our communities to survive. A free society is consumed at
from within by violent crimes. What kind the action should take is the only
genuine issue. This also to prevent death so bystander have a responsibility
to do what they can.
  Explain what is a duty-based ethics?
- Duty-based ethics teaches that some acts are right or wrong because of the
sorts of things they are, and people have a duty to act accordingly,
regardless of the good or bad consequences that may be produced.

SITUATION 4

3. A nurse whose faith differs from that of the Catholic Church refuses to assist in a
certain medical mission on family planning in a densely populated urban poor
community as her conscience certainly tells her that it is morally wrong. The Chief of
Mission also a Catholic and armed with sound moral principles and precepts explains
that the mission is much needed because statistics show that overpopulation implies
poor physical and mental health and its consequences impacts economy and
development.

Make the situation the refusal of the nurse to assist a medical mission as an expression of
her moral values against the purpose of the mission.

 Is the nurse duty bound to follow her conscience or that binding force as
explained by the Chief of Mission? Why?
- I think it would be the binding force as explained by the chief of mission
because, as a student nurse, it is our responsibility to give knowledge or
awareness to the people regardless of our superstitions. We should set them
aside because we are acting as professionals.

 Is this within the concept of Teleological Ethics? Why

- Yes, because teleological  ethics it is about the morality that derives duty or
moral obligation from what is good or desirable as an end to be achieved, as
what have the situation currently stands.

 What is the key difference between deontology and teleology ethics?

 - Teleological ethics determines the goodness or badness of an action by
examining its consequences whereas deontological ethics determines the
goodness or badness of the action by examining the action itself. Thus, this
is the key difference between teleological and deontological ethics.

SITUATION 5

4. Based on his thorough study, a medical doctor discovers a certain medicine that gives
him a well-founded reason to believe that it is probably the most effective cure whose
effect is even fastest among others for a certain sickness. Other than his discovery,
there is a medicine available at the pharmacy which is sure and definite cure for the
said sickness.
Make the situation that the medical doctor’s discovery of a certain medicine as an
expression of his altruism by examining the purpose.
 Is the doctor morally allowed to use the medicine that gives him the solidly
probable reason to be the most effective cure for the sickness? Why?
- I think yes, because it has been processed in thorough study so it is
evidence-based medicine.

 Is the concept of teleology applicable here in this case? How?

- Yes, I believe so, because if the medicine fails, the patients will suffer. So in this
case, we are determining the consequences if the medicines fail or succeed.
Discovering a certain medicine requires a thorough study, which requires a
bottom-up approach that integrates the best external evidence with individual
clinical expertise.