LESSON 3.
1 strategies used by clinicians may prove critical to
HUMAN SEXUALITY AND ITS
MORAL EVALUATION
CHARACTERISTICS THAT MIGHT QUALIFY AN
INDIVIDUAL FOR PERSONHOOD
1. Consciousness of objects and events
Anything of which the mind is conscious,
including perceptions, mental images,
emotions, and so forth, as well as the observing
ego, or “I,” of subjective experience
socially and environmentally responsible
decision making is involved in the planning,
organization and implementation of, and
participation in, an event
2. The ability to feel pain
Pain perception involves a number of
psychological processes, including attentional
orienting to the painful sensation and its source,
cognitive appraisal of the meaning of the
sensation, and the subsequent emotional,
psychophysiological, and behavioral reaction,
which then feedback to influence pain
perception
3. Reasoning
Reasoning is the process of using existing
knowledge to draw conclusions, make
predictions, or construct explanations
Reasoning strategies are a key component in
many medical tasks, including decision making,
clinical problem solving, and understanding of
medical texts. Identification of reasoning
the optimal design of decision support systems
4. Self-motivated activity
Self motivation is the ability to drive oneself to
take initiative and action to pursue goals and
complete tasks. It's an inner drive to take action
— to create and to achieve
5. The capacity to communicate
Communication is the foundation of all human
relationship
And these relationships are formed when there
is enough interaction and communication.
Communicating helps people to express their
ideas and feelings, and at the same time, helps
us to understand emotions and thoughts of the
other person
6. A concept of the self
Self-concept is how we perceive our behaviors,
abilities, and unique characteristics
For example, beliefs such as "I am a good friend"
or "I am a kind person" are part of an overall self-
concept
VIABILITY
Viability has been defined as sustaining life
outside the womb, with or without medical
assistance. It is determined by gestational age,
birth weight, and the condition at birth
The age of viability occurs sometime between 22
and 26 weeks, usually when the weight is
greater than 500 grams. The probability of
survival is slim at 22-23 weeks, but increases to
approximately 85% at 26-28 weeks
women as a viable person, has a right to her own
body and therefore, she may do anything she
wants with it including the fetus inside her and in
some cases, the fetus is being removed
therapeutically to save the life of a mother and
that is called abortion
TYPES OF ABORTION
Threatened abortion
A threatened abortion is defined as vaginal
bleeding before 20 weeks gestational age in the
setting of a positive urine and/or blood
pregnancy test with a closed cervical os, without
passage of products of conception and without
evidence of a fetal or embryonic demise
Inevitable abortion
Inevitable abortion is an early pregnancy with
vaginal bleeding and dilatation of the cervix.
Typically, the vaginal bleeding is worse than with
a threatened abortion, and more cramping is
present. No tissue has passed yet
Incomplete abortion
Incomplete abortion is defined by clinical
presence of an open cervical os and bleeding,
whereby all products of conception have not
been expelled from the uterus, or the expelled
products are not consistent with the estimated
duration of pregnancy
Complete abortion
all products of conception have been passed
without the need for surgical or medical
intervention
Missed abortion
utero death of the embryo or fetus before the
20th week of gestation with retained conception
products. Missed abortions may also be referred
to as blighted ovum or an anembryonic
pregnancy
Ethical issues on the AIDS patient. We all know
that there is no cure for this syndrome but
people living with HIV face a lot of stigma
because some people think that AIDS can be
transferred to others easily like an airborne
disease and it affects not just their physical
health but their mental and social health as well.
We, nurses, must be the one to understand
what they are going through and it is our duty
to promote awareness that AIDS can only be
transferred to other via direct contact to blood,
semen and vaginal fluids
LESSON 3.2
DIGNITY IN DEATH AND DYING
MEANING OF DIGNITY IN DEATH
Dignified death, death with dignity, dying with
dignity or dignity in dying is an ethical concept
that refers to the end-of-life process avoiding
suffering and maintaining control and
autonomy
Euthanasia
The practice of ending the life of a patient to limit
the patient's suffering. The patient in question
would typically be terminally ill or experiencing
great pain and suffering. The word “euthanasia”
itself comes from the Greek words “eu” (good)
and “thanatos” (death).
 TYPES OF EUTANASIA
Active
• with intervention; request of a patient
• killing a patient by active means, for
example, injecting a patient with a lethal
dose of a drug
Passive
• omission of intervention that is useful to
patient; no participation of patient
• intentionally letting a patient die by
withholding artificial life support such as
a ventilator or feeding tube
ORTHOTANASIA
Etymology: correct dying
It is the same as passive euthanasia. It is allowing
a person to die a dignified and natural death.
DYSTHANASIA
Etymology: means faulty or imperfect death
It is the medical process through which the
moment of death is postponed by all means
available. It may be considered as an undue
prolongation of death
LESSON 3.3
NURSES’ ROLES AND
RESPONSIBILITIES AT THE END OF
LIFE CARE
According to Nambayan and Lu (2015), they
stated that every culture, traditions, beliefs,
and religion play an important part in every
Filipino's life and death. In addition to this, the
family is central and carries a significant
importance especially in healthcare decisions
making. Families are generally very involved in
caring for their loved ones who are dying and
equally expect healthcare providers to do the
same
Nurse’s Roles and Responbilities at the end of
life care according to the American Nurses
Association
o Nurses are frequently in a position to
guide patients and families confronting
difficult decisions and adapting to
painful realities
o Nurses are obliged to provide
comprehensive and compassionate
end-of-life care
o This includes recognizing when death is
near and conveying that information to
families
o Nurses should collaborate with other
members of the health care team to
ensure optimal symptom management
and to provide support for the patient
and family. Nurses and other health care
providers have a responsibility to
establish decision-making processes
that reflect physiologic realities, patient
preferences, and the recognition of
 what, clinically, may or may not be
accomplished. Establishing goals of care
for this patient at this time may provide
a framework for discussion about what
care should be provided. This process
often involves collaboration with
experts in decision making, such as
ethics committees or palliative care
teams
o Nurses are obligated to provide care that
includes the promotion of comfort, relief
of pain and other symptoms, and
support for patients, families, and others
close to the patient
o Nurses can be a resource and support for
patients and families at the end of a
patient’s life and in the decision-making
process that precedes it
o Nurses are often ideally positioned to
contribute to conversations about end-
of-life care and decisions, including
maintaining a focus on patients’
preferences, and to establish
mechanisms to respect the patient’s
autonomy
o There are times when the preferences of
the family do not represent, or conflict
with, the preferences of the patient. In
those cases, the nurse's primary
responsibility is to provide care and
support to the patient and to respect the
patient's autonomy while continuing to
support the family as they struggle to
adjust to the impending reality of the
patient's death. Standards for excellent
care for patients at the end of life should
be evidence based, and should integrate
national and international standards of
care
LESSON 3.4
ETHICAL DECISION MAKING PROCESS
When it comes down to the unexpected decision
making process in the medical community,
medical professionals will often face a dilemma
which needs to be carefully assessed to avoid
conflict at the result. According to Douglas R.
May, a professor in international ethics for
business in University of Kansas, 9 steps of
ethical decisionmaking can be applied to any
profession field, especially in medical science
because ethical principle is a universal and
general guide
THE 9 STEPS OF ETHICAL DECISION
MAKING PROCESS
1. Gather the facts
Ask yourself questions about the issue at hand,
such as the 5 whys method. Facts are not always
easy to find, especially in situations where ethics
plays an important part. Some facts are not
available or clearly demonstrable. Also indicate
which assumptions are made
2. Define the ethical issue
Before solutions or new plans can be
considered, the ethical issue is clearly defined. If
there are multiple ethical focal points, only the
most important should be addressed first
3. Identify the affected parties (stakeholders)
identify all stakeholders. Who are those primary
stakeholders? And who are the secondary
stakeholders? Why are they interested in this
issue?
4. Identify the consequences
Think about the possible positive and negative
consequences associated with the decision.
What is the magnitude of these consequences?
And what is the probability that these
consequences will actually occur? Distinguish
between short-term and long-term
consequences
9. Decide on the proper ethical action and be
prepared to deal with opposing arguments
Ethical decision-making is based on core
character values like trustworthiness, respect,
responsibility, fairness, caring, and good
citizenship. Ethical decisions generate ethical
behaviors, actions and provide a foundation for
good medical practices

5. Identify the obligations (principles, rights,

justice)

Three basic principles, among those generally

accepted in our cultural tradition, are
particularly relevant to the ethics of research
involving human subjects: the principles of
respect of persons, beneficence and justice

6. Consider your character and integrity

Consider what the community thinks would be

a good decision in this context. How would you
like it if the national newspaper wrote about
your decision? What is public opinion? How does
your character and personality influence the
decision to be made

7. Think creatively about potential actions

Are there other choices or alternatives that have

not yet been considered? Try to come up with
additional solutions or choices if a small
number is considered

8. Check your gut

Intuitive decision-making or 'gut instinct' is your

ability to instantly get an understanding of
something without needing to consider other
people's opinions about it or take time to think
it over. It is your inner feeling about something