• It came from the Greek word “ethicos”, which pertains to ethos

translated as “custom” or ‘character”.

• It deals with the study of the morality of human acts or human
conduct. (What makes an act good or evil?)
CHARACTER is defined as a trait, quality or high moral code.
Ex. Being trustworthy, kind

CUSTOM is an action or way of behaving that is usual and traditional among

the people in a particular group or place.
• Tradition, practice
• ETHICS is a practical and normative science (prescriptive, what
ought to be done) based on REASON, which studies human acts
and provides NORMS for their goodness or badness. (Moral
Philosophy)
NORMS - The rules that a group uses for appropriate and inappropriate values,
beliefs, attitudes and behaviors.
Ex. Covering your mouth and nose when sneezing, shaking hands when you
meet someone, saying 'sorry' when you bump into someone, not talking with
your mouth full,
• ETHICS as a Science because it is a systematized body of
knowledge.
• ETHICS as a Practical Science – it provides a body of knowledge
which is not only a body that enriches and sustains the intellect
with more learning but a body of knowledge which, by nature of its
learning, is applied in the performance of human conduct.
• ETHICS is based on well-founded standards of right and wrong that
prescribe what humans ought to do, usually in terms of rights,
obligations, benefits to society, fairness, or specific virtues.
• Ethics, for example, refers to those standards that
impose the reasonable obligations to refrain from rape,
stealing, murder, assault, slander, and fraud. Ethical
standards also include those that enjoin virtues of honesty,
compassion, and loyalty. And, ethical standards include
standards relating to rights, such as the right to life, the
right to freedom from injury, and the right to privacy. Such
standards are adequate standards of ethics because they
are supported by consistent and well-founded reasons.
OBJECTIVES OF ETHICS

 To make clear why one act is better than the other

 To allow persons to live an orderly social life
 To appraise and criticize intelligently the moral conduct and
ethical systems of society
 CONSCIENCE

• is a function of the human intellect making

moral judgments. To be more specific, when the
mind judges, on the basis of general principles
(such as "Thou shall not steal"), that a particular
action should be done or avoided, here and
now, then the practical judgment of the mind is
called "conscience".
CONSCIENCE
 The part of the mind that makes you aware of your actions as being either
morally right or wrong
 The practical judgement of reason upon an individual acts as good and is
to be performed or as evil and is to be avoided.
MORALITY
• The quality of human acts where the act could be good or right, evil or
wrong. This quality indicates and determines whether the kind of human
act that is performed is good or bad.
 ETHICS MORALITY
What are The rules of conduct recognized in respect Principles or habits with respect to right
they? to a particular class of human actions or a or wrong conduct. While morals also
particular group or culture. prescribe dos and don'ts, morality is
Ex. Code of Ethics ultimately a personal compass of right
and wrong.

Where do Social system – External Individual - Internal

they come
from?
Why we do Because society says it is the right thing to Because we believe in something being
it? do. right or wrong.
Flexibility Ethics are dependent on others for Usually consistent, although can
definition. They tend to be change if an individual’s beliefs
consistent within a certain context, change.
but can vary between contexts.

The "Gray“ / Conflict A person strictly following Ethical
Principles may not have any
Morals at all. Likewise, one could
violate Ethical Principles within a
given system of rules in order to
maintain Moral integrity.
Ex. Lawyer defending a murderer.
Origin Greek word "ethos"
meaning"character“, “custom”
A Moral Person although
perhaps bound by a higher
covenant, may choose to follow
a code of ethics as it would
apply to a system. "Make it fit"
Latin word "mos" meaning
"custom"
RELATION DISTINCTION
a. Both Ethics and morality deal with human act a. Ethics pertains to the knowledge of what to
or human conduct. study about- that is the goodness or evil of a
human act; Morality pertains to the
b. Ethics studies about morality. application of this knowledge in the
performance of human act.
c. Morality gives Ethics a perspective of what to
study about- that is the rectitude of whether b. Ethics provides learning about the morality
an act is good or bad. of a human conduct; Morality provides ways
in practicing what is learned.
d. Morality provides ethics with a quality that c. Ethics is the ‘word’. Morality is the ‘flesh’
determines and distinguishes right conduct d. Ethics indicates the ‘theory’, Morality
from wrong conduct. indicates the ‘practice’.
ETIQUETTE
 The rules indicating the proper & polite way to behave.
 Etiquette is defined as the formal manners and rules that are followed
in social or professional settings.
Ex. Saying sorry and thank you appropriately, being punctual, table
manners, etc. are some common acceptable social behavior or
etiquette.
LAW
 an ordinance of reason promulgated by the common good by one who has legitimate
authority. It is an authoritative order that should be just and honest.
 It has a binding and legal force (with penalty)
Ex. Laws on smoking in public places.
IMPORTANT CLASSES OF LAW
1. Eternal Law - God’s eternal plan for the Universe (10 commandments)
2. Natural Law - is the eternal law as known to man through reason. (to live, reproduce, learn,
love & seek affection)
3. Positive law - Human made law that is enacted and promulgated by proper authority (anti-
smoking)
BIOETHICS
 A science that deals with the study of the morality of human conduct concerning human
life in all its aspect from the moment of its conception to its natural end.
All aspects should be respected from existence to the time it naturally ends.

HEALTH ETHICS
 A science that deals with the study of the morality of human conduct concerning health
and health care.
 It is employed to regulate the human conduct in the practice of human care so that good
may be done and evil may be avoided thereby ensuring the purpose of health care is being
met in the light of the fundamental principles of morality.
 It is part of bioethics.
RELATION DISTINCTION
a. Both are concerned about health and a. Health ethics is concerned about life only in
life relation to health; bioethics is concerned
not just about health but also about other
b. Both regulate human conduct by
fields in relation to life.
means of moral principles in relation b. Health ethics regulates human conduct in
to health and life the practice of health care; bioethics
c. Health ethics is part of bioethics regulates in all aspects of human life.
Ex. Prohibition of death penalty, terrorism

c. Bioethics is not part of health ethics. It has

an encompassing scope of discipline.
PROFESSIONAL ETHICS
 Ethics that deals with certain moral precepts or rules by which persons behave and act in
the exercise of their calling or profession.
 It discusses the obligations which a member of a certain profession owes to the public, to
his profession, to the society, and to his clients.
 It expresses responsibility and accountability in the practice of one’s profession.
NURSING ETHICS
 Is concerned with moral principles that govern the conduct of a nurse in his or her
relationship with patients, and the community.
Ethical Dilemma
• a situation in which two moral principles conflict with one
another.
• situations in which there is a difficult choice to be made
between two or more options, neither of which resolves the
situation in a manner that is consistent with accepted ethical
guidelines. When faced with an ethical dilemma, a person is
faced with having to select an option that doesn’t align with
an established code of ethics or societal norms, such as codes
of law and religious teachings, or with their internal moral
perceptions of right and wrong.
LEVELS OF ETHICAL OR MORAL DISCOURSE

LEVEL I = CASE APPROACH OR CASUISTRY

• Begins with an issue or concrete moral question or dilemma that

one faces here-and-now, or two persons disagreeing on what in
a specific situation is the morally appropriate behavior.
• the process starts with specific and measurable facts and cases
that may support the application of the higher levels of moral
discourse.
CASUISTRY

• Is a process of reasoning that seeks to resolve moral problems by

extracting or extending theoretical rules from a particular case, and
reapplying those rules to new instances.
• Casuistry, or case based reasoning, focus on practical decision-
making in particular cases based on precedent.
• It is the use of morals or beliefs in decisions of right and wrong in
order to reach or rationalize a solution..
• derived from the LATIN noun “casus” (case or occurrence)
INPUT PROCESS OUTPUT

…CASES CASUISTRY by way …Acceptance and

…ISSUES of induction justifiable moral
(inductive reasoning or judgement
… FACTS/ EVIDENCES
analysis)
LEVEL 2 = RULES AND RIGHTS (CODE OF ETHICS)
… This level is resorted to if and when issues or cases are not resolved at
the base or first level.
… Take note that not everything that is legal is also ethical, meaning, it
could be legal BUT unethical.
Ex. Testing medicines on animals maybe legal but unethical to some people.
…Also, not all illegal are unethical, meaning it could be illegal BUT ethical.
Ex. A very hungry child stealing food.
Running a red light if someone’s life depended on it.
…There are extreme views as well as moderate views on how rules and
rights must be taken in providing moral guidance in the resolution of a
problem.

EXTREME VIEWS
EXTREME VIEWS
A) LEGALISM- holds that there are no exceptions to the rules or rights.
B) ANTI-NOMIANISM – holds that every case is so unique that no rules
or rights can never be relevant in deciding what one ought to do in a
specific situation
MODERATE VIEWS

A) SITUATIONALISM – Holds that moral rules are just guidelines or rules of

thumb that must be evaluated.
• Holds that objective moral principles are to be applied differently
depending on the circumstances.

A) RULES OF PRACTICE – holds that rules specify practices that are

morally obligatory, and which are binding in human conduct.
 RULES AND RIGHTS
VIEWS APPLICATIONS

1.Legalism 1.Rules apply rigidly

2.Anti-nomianism 2.No rules apply
3.Situationalism 3.Rules as guidelines
4.Rules of Practice 4.Rules specify practices as
morally obligatory
LEVEL 3 – NORMATIVE ETHICS

• At this level, basic norms of behavior and character are

discussed, rules and right claims are defended, and norms of
good moral character are articulated.
• investigates the questions that arise regarding how one
ought to act, in a moral sense.
 THEORIES AND QUESTIONS UNDER NORMATIVE ETHICS
THEORIES QUESTIONS ANSWERS
ACTION THEORY …What principles make actions morally Principles of:
right? …Beneficence
…Non-maleficence
…Respect for autonomy or justice

VALUE THEORY …What kind of consequences are good or … happiness, beauty, knowledge
intrinsically valuable?

VIRTUE THEORY …What kind of character traits are … compassion/sympathy, loving,

morally praiseworthy? faithfulness
 4th/HIGHEST LEVEL = METAETHICS

… It is the task of analyzing the nature of moral judgement

and theoretical systems.
…Deals with the most basic questions of ethics, the meaning
and justification of ethical terms, how people know which
principle, values, or virtues are the correct ones and the
ultimate grounding of ethics.
 METAETHICS RAMIFICATION
WHAT IS THE SOURCE OF ETHICS? HOW DO WE KNOW WHAT IS ETHICAL?
RELIGIOUS ANSWERS RELIGIOUS ANSWERS
…The Divine Will … Revelation
… The Divine Law … Scriptures
… Church Tradition
… Experience
SECULAR ANSWERS SECULAR ANSWERS
… Natural Law –what constitutes ‘right’ and ‘wrong’ … Reason
is the same for everyone. …Experience
…Hypothetical Contract … Observation
… Intuition
…Social Agreement or Contract

RELATIVIST ANSWERS
… One’s culture, personal preferences and actual social
contact
BASIC ETHICAL PRINCIPLES

1. PRINCIPLE OF STEWARDSHIP
• In health care practice, stewardship refers to the execution of responsibility
of the health care practitioners to look after, provide necessary health care
services, and promote the health and life of those entrusted to their care.
…and it entails concomitant values/virtues of RESPONSIBILTIY and
ACCOUNTABILITY.
RESPONSIBILITY – is the duty involved when one accepts the task of
management. It is the ability of one to respond freely to a call for quality
service. This response is characterized by the values/virtues of
dependability, perseverance, initiative, and effort, and being a worthy,
good servant which implies reliability and trustworthiness as a steward.

ACCOUNTABILITY - Is the obligation to explain, justify, and take

responsibility for one's actions. It is the state of being answerable or liable
for carrying out one’s right and duty.
* Both go hand in hand.
 2. PRINCIPLE OF TOTALITY
• the term “totality” connotes wholeness, completeness, or entirety.
• this principle applies to any entity that is made up of parts that
together constitute as a whole. The existence of the parts
indicates the existence of the whole.
• But the whole is greater than any of its parts.
• Ex. Amputation of a gangrenous leg
 3. PRINCIPLE OF DOUBLE EFFECT
• The principle contemplates on two effects or outcomes arising from the
performance of an action; one is good, one is evil.
• Is it morally good to perform such an act – with both good and bad effect?
• Yes, provided that the principle of double effect is invoked whose conditions must
be satisfactorily fulfilled.
FOUR CONDITIONS TO CONSIDER OR FULFILL BEFORE AN ACTION WITH
DOUBLE EFFECT IS JUSTIFIED:

1. The action done or course chosen must be morally good in itself, or at least
morally indifferent or neutral.
• The act by its very nature must be good. Its goodness proceeds from within
itself.
2. The good effect must come directly from the action itself, and not coming from
or following as a consequence of secondary evil effect.
3. The good effect must be intended or willed and the bad/harm merely
tolerated or allowed, with sufficient reason.

4. The good effect must outweigh or at least be equivalent in importance to

the evil effect
4. THE PRINCIPLE OF COOPERATION
… To cooperate means to work together, to unite in producing a result, or
to desire or wish in a common thing. It implies that one works with others
in the performance of an act to accomplish a goal.
… However, concerted acts may turn out to be either good or bad.
… Principle of cooperation poses moral problem when and where acts
done are evil, immoral and illegal
IN CONCERTED BAD ACTS…

Participants may be considered as :

•  Principal - primary actor/ leader
•  Co- principal = is someone who knows the evil design of the
principal
• Accomplice = one who cooperates in the commission of an evil act
when one does another act
5. THE PRINCIPLE OF SOLIDARITY

… To be solid means to be firmly united.

… It follows that solidarity implies unity or fellowship, arising from
common responsibility and interest
… With this principle, one-for-all and all-for-one policy is a tall
order.
 6. Prima facie duties

- is a Latin term that is commonly understood to mean “on the first appearance” or “
based on the first impression”.
...Is a duty that is binding and obligatory
... Our “actual” or “concrete” duty that we ought to perform in a certain scenario of choice
...guidelines for morality
7 CLASSIFICATIONS OF PFD BY W.D. ROSS
1. Duties of Fidelity These are duties to keep
ones promises and
contracts and not to
engage in deception.
7 CLASSIFICATIONS OF PFD BY W.D. ROSS
2. Duties of Reparation This is the duty to make
up for the
injuries/wrongdoings one
has done to others.
Professional
responsibilities/social
roles of:
>physician as physician
>nurses as nurses
>teacher as teacher
> A returns the cellphone
and says sorry to B, the
victim...C admits cheating
and accepts punishment
for the same.
3.Duties of Gratitude It is the duty to be
grateful for benefactions
done to oneself and if
possible, to show it by
benefactions in return.
4. Beneficence (Do Good) It is the practice of doing
good, or an act of
kindness.
if one has provided help
to others when they are in
need, the later stand
under a duty to
reciprocate help/service
for the former when the
same is in need.
Provision of your tender
loving care as a nurse.
Always mindful of the
patient's welfare inside the
Duties of Non- It is the act of not doing
aleficence evil or harming others.
Do No Harm) The duty includes not to
make the condition of
others being worse or
difficult.
Duties of Justice Justice connotes just
conduct, fair treatment, or
giving and receiving what
one deserves.
The duties of not to kill,
inflict corporal
punishment or to defraud
others.
...Doing your job
accordingly as a nurse
if a nurse works 8hrs plus
overtime, he must receive
the agreed legal
compensation plus overtime
7. Duties of Self- ...Include the duty to ... A nurse keeps on
mprovement make better one's studying things related to
character or the like by his profession, attends
his own effort. skills/knowledge
...The Divine Provider enhancing seminars and
helps those who help trainings.
themselves, or the sick ...Takes graduate studies
gets well if he cooperates
with the health care
provider.
 7. PRINCIPLE OF EPIKEIA- This principle states that a law can be
broken to achieve a greater good.
EPIKEIA= This principle states that a principle can be
broken to achieve a greater good.
… a Greek word meaning “reasonableness”
Major Bioethical principle:
1. RESPECT FOR AUTONOMY
…the term “autonomy” comes from 2 Greek words autos (self) and nomos
(rule or governance)= self-rule, self-governance or self-determination….
… this implies acknowledgement of the person’s right to hold views and
opinions, to make decisions and choices, and to take action based on
personal values, virtues, traditions and beliefs.
2. PRINCIPLE OF NON-MALEFICENCE
… “DO NO HARM”
… It requires health care professionals to act in such a manner as to
avoid causing harm to patients. It includes deliberate harm, risk of
harm and other harms that may happen during performance of
beneficial acts.
…application of the Golden Rule
3.THE PRINCIPLE OF BENEFICENCE

The term “beneficence” comes from 2 Latin words “bene” (well or good),
and “facere” (to do or make)= doing what is good.
… It implies the duty to actively do good for patients.
… It is associated with the concept or virtues of kindness, benevolence,
altruism or humanitarianism.
4. PRINCIPLE OF JUSTICE
… The term “justice “ is associated with the concepts of
fairness, rightfulness, deserved reward or punishment
and equity.
… It implies a sense of duty to treat all people without
bias to age to age, socio-economic status, race, or
gender.
5. PRINCIPLE OF VERACITY –
It is the principle of being honest and telling the truth .. somewhat related
to the principle of autonomy. (truth-decision)

6. PRINCIPLE OF CONFIDENTIALITY – It is the protection of

personal information. Keeping a client’s information between you and the
client.
1. THE PRINCIPLE OF
RESPECT FOR AUTONOMY:
> The principle of respect for autonomy means
acknowledgement of the person’s right to hold views and
opinions, make decisions and choices and to take action based
on personal values beliefs, virtues and traditions.
> It stresses the right of an individual decision maker to
determine for himself what will be done to his body
> As applied to health care services, this right of self
determination may limit what physicians, nurses, and other
health care providers can do to their patients
This autonomy gives rise to the notion of informed consent.
Informed consent means that the patient is given the opportunity to
autonomously choose a course of action in regards to plans of health care.
The choice includes the right to refuse interventions or recommendations
about care and to choose from other available therapeutic alternatives
Disclosure. For the patient to be well informed and to make informed
choices (i.e., autonomy), the doctor must disclose information that is
materially relevant to the patient's understanding of their condition, their
treatment options and likely outcomes. This would include, for example,
information on medical errors made in their care
Informed Consent follows from the principle of patient autonomy, and
consent is required before you may provide care. "No medical intervention
done for any purpose - whether diagnostic, investigational, cosmetic,
palliative, or therapeutic - should take place unless the patient has consented
to it"
Informed consent also serves as a significant protection to you against
possible litigation.
Consent may be expressed or implied; the former (e.g., via a signed
consent form) typically occurs in hospitals and relates to specific
procedures. Consent may be given verbally, but a consent form provides
evidence of consent. It is not a contract, however, and the patient can
withdraw consent at any time. For routine procedures such as a blood
pressure check, consent may be implied if the patient comes voluntarily
to the doctor’s office for a check-up.
For consent to be ‘informed’ the patient must receive a full description
of the procedure, its risks and benefits, the prognosis with and without
treatment, and alternative treatments.
 It includes deliberate harm, risk of harm, and other
unintended harms that may happen during procedures
done for the patient
 It prohibits experimental research that assumes negative
impact on participants and the performance of
unnecessary procedures for economic gain or self interest
 3. THE PRINCIPLE OF
BENEFICENCE
 The term beneficence comes from 2 latin words:
bene which means well or good, and facere
which means to do or make.
 Beneficence therefore means doing what is good
 It implies the duty to actively do good for
patients
 It is associated with the concept or virtues of
kindness and humanitarianism
 4. THE PRINCIPLE OF JUSTICE
 The concept of justice is associated with the concept of
fairness, rightfulness, deserved reward or punishment
and equity
 It implies a sense of duty to treat people without bias to
age, socio economic status, race, or gender
 It applies provision of necessary treatment to those in
need even though they may not have the means to pay
for such treatment
 5. THE PRINCIPLE OF
CONFIDENTAILITY
 Confidentiality forms a cornerstone of the nurse-patient
relationship, but it is increasingly hard to maintain with the
growth of electronic data.
 In order to protect the trust between nurse and patient,
the nurse should not release personal medical information
without the patient's consent.
 Like other ethical duties, however, confidentiality is not
absolute.
 It can be necessary to override privacy in the interests
of public health, as in contact tracing for partners of a
patient with a sexually transmitted disease.
 Note that you are legally obligated to report a possibly
HIV infected patient to the public health authorities.
 However, this should always be done in a way that
minimizes harm to the patient.
 There are some circumstances under which you may
choose not to disclose information to a patient, including
when the patient specifically asks not to be told (you
should still offer them the chance to know the truth);
 When a patient is incapacitated (here you typically inform
the family);
 during an emergency when the patient's condition is
unstable and immediate care is required; and the
controversial notion of 'therapeutic privilege', which
means that the doctor deems that the risk of informing
the patient is worse than not doing so
 (e.g., they might attempt suicide, or refuse necessary
treatment)
6. THE PRINCIPLE OF VERACITY

 As a member of this profession, health care providers

must recognize responsibility to patients first and
foremost, as well as to society, to other health
professionals, and to self.
 Communicating honestly. Veracity is the ethical
principle that obligates you to tell the truth. At times
the truth may be painful for the patient or his family
to hear, but honesty is a core virtue; only under
unusual circumstances is violating it acceptable.
 Communicating honestly. Veracity is the ethical principle that
obligates you to tell the truth. At times the truth may be painful
for the patient or his family to hear, but honesty is a core
virtue; only under unusual circumstances is violating it
acceptable.
Here's a six-step model to help
you discuss unwelcome news in
a competent way.
 Help the physician get the physical context right. Ask
the patient if he'd like to have any family members
present when the physician discusses the results of
tests or surgery. As much as possible, prevent
interruptions to the conversation. Encourage the
physician to sit down to deliver news to the patient
or his family.
 Find out what the patient and family already know.
For example, when the physician leaves and the
patient begins to ask you questions, you can ask,
"What do you understand about your illness?" This is
the time to assess the ability of the patient and
family to comprehend more bad news.
 Determine how much the patient wants to know (or not
know). Ask him, "Did you receive enough information to
understand your condition?" Also find out if he wants a
family member or other surrogate to communicate on his
behalf.
 Communicate the distressing information in a sensitive,
straightforward manner.
 As a nurse, you won't be the first person to break bad
news about a diagnosis, a prognosis, or test results. But
the patient may ask you to clarify the message he's
received. For example, you may need to say, "I'm sorry to
have to tell you this. Yes, your physician said the scan
did show a tumor in your abdomen."
 Then pause and wait for his reaction. Don't try to soften
or minimize the severity of the situation because this
may confuse him.