ETHICS
• MORAL PHILOSOPHY
• Derived from the Greek word ETHOS,
which means CUSTOM or CHARACTER
• Philosophical science that deals with
morality of human conduct
• Systematically establishes the standards or
norms of human acts
• Determines human acts as good or bad and
right or wrong
• Provides the principles on the morality of
human acts.
4 Major areas of Study:
• Descriptive ethics
–
this is the division of philosophical
or general ethics that involves the
observation of the moral decision-
making process with the goal of
describing the phenomenon.
– Describes the nature, essence or
substance of reality.
– reports what people believe, how the
y reason, and how they act.
• Normative Philosophy
–
concerned with criteria of what is
morally right and wrong.
– It includes the formulation
of moral rules that have
direct implications for what human
actions, institutions, and ways of life
should be like.
– 3 types of normative theories:
• virtue theories, deontological
(moral obligation) theories,
and teleological theories
VIRTUE-BASED THEORY
Virtue based theories focus on the character of the
person.
According to virtue based theories, ethics is about
what sort of person one should strive to become.
The qualities that one should develop in oneself are
called virtues (ex. honesty, fairness, kindness,
faithfulness, generosity, prudence, integrity,
bravery, etc.).
For example:
Aristotle claimed that in order to become an honest
person, one should tell the truth. (Aristotle) Eventually it
becomes a habit.
One learns how to tell the truth appropriately,
without being brutally honest all of the time or lying
whenever it is easier to do so.
It is a learning process that continues throughout
your life.
DEONTOLOGICAL THEORY
This type of theory claims that there are features
within the actions themselves which determine
whether or not they are right.
These features define the extent to which the
actions conform with recognized moral duties.
Deontological theories do not consider
consequences to be important when determining
whether or not an action is ethical.
It doesn’t matter if the drunk driver made it
home safely.
Immanuel Kant's ethical theory is deontological.
He claims that actions are only morally right
when they are done out of duty.
He sees moral duties as unchanging laws
for human conduct.
Always act out of duty, in accordance with a
good will
I.e. One does the right thing
because one recognizes that it is the
right thing to do, not because it
pleases you to do it or will promote
good consequences.).
TELEOLOGICAL THEORY
This describes an ethical theory which judges the
rightness of an action in terms of an external goal
or purpose.
According to a teleological theory, consequences
always play some part, be it small or large, in the
determination of what one should or should not do.
Theory of morality that derives duty or moral
obligation from what is good or desirable as an end
to be achieved.
• Practical Philosophy
– A division in philosophy which
reflects on truth with due recourse of
action.
– the attempt to work out the implicatio
nsof
general theories for specific forms of
conduct and moral judgment;
formerly called applied ethics.
• Critical Philosophy (Epistemology)
– is the study of the nature and scope
of knowledge and justified belief.
– It analyzes the nature of knowledge
and how it relates to similar notions
such as truth, belief and justification.
– asks questions like: "What is
knowledge?", "How is knowledge
acquired?", "What do people
know?", "What are the necessary
and sufficient conditions of
knowledge?"
 MORALITY
• Derived from the Latin word MOS or MORIS
• Applied Ethics
• Actualizes/ applies the theories and
principles provided by ethics
Postulates in Ethics
(Presumed to be true)
• The existence of God.
• The existence of intellect and free will.
• The spirituality and immortality of the
human soul.
Moral Assumptions
• As a rational and free grade of animal, man
knows that there are actions that are right
or wrong, and good or bad.
• Man knows that there are actions that he is
not obliged to do.
• Man knows that he is responsible for his
actions.
•
Man knows that those actions are
considered wrong are punishable and that
those actions that are right are rewardable.
Humans: The Sole Moral Agents
It is their being rational that makes humans
humans.
The human person’s perceptual knowledge helps
him/her draw judgements as he/she compares
ideas.
The human person, therefore, does not just
perceive things but also analyzes, assesses,
criticizes, or intellectualizing things.
Intellect Compared with Will
What does intellect do?
It knows.
Acts as the thinking faculty of the human
person.
Enables him/her to search for truth
What about the will?
It chooses.
It implements what it has chosen.
Enables him/her to choose which is good.
Concrete Basis of Morality
Morality becomes vivid when one encounters a
moral experience.
This moral experience leads him/her to a moral
problem.
The human person is duty-bound to face his/her
obligation.
Ex.
Should a person who has no money, steal?
Should a person who has no answer in an
exam, cheat?
BIOLOGY
• Natural science that deals with the issue of
life
• Important in bioethics because it deals with
the multifarious (DIVERSE) dimensions and
domains of all life forms.
BIOETHICS
•
This term was introduced by DANIEL
CALLAHAN in 1969, together with
WILLARD GAYLIN when they founded the
HASTINGS CENTER
• Popularized by VAN RENSSELAER
POTTER in 1970
• BIOETHICS
•
A discipline that deals with the ethical
implications of biological research.
• The study of ethical issues that emanate
from the changes and developments in the
•
life science technologies.
A branch of ethics that deals with the life
sciences and their impact in society.
• A branch of ethics that analyzes moral
values in the context of biomedical
sciences.
• A branch of the ethics of biological science
and medicine.
• A systematic study of the human conduct in
the areas of the life sciences and
healthcare.
• It belongs to the auspices of medical ethics
and is loosely anchored in the avenues of
life sciences.
• The study of the moral problems in
medicine and biological technology.
BIOETHICS
PREVAILING ISSUES SURROUNDING
THE AUSPICES OF BIOETHICS:
• Human life
• Health
• Research
• Science
• Technology
• Philosophy, theology, law and medicine
HEALTHCARE ETHICS
• A domain in the practice of the healthcare
profession that sets the standards or
guidelines relative to studies, inquiries, and
decisions on the part of healthcare
professionals in relation to the delivery of
healthcare.
• Deals with ethical issues such as: life-
support system, testing of diseases, access
to healthcare services, brain death, clinical
death, suicide, euthanasia, vices and
virtues, conscience and law.
PROFESSIONAL ETHICS
• The normative moral system that injuncts a
kind of behavior that is expected of a
professional.
• NOT ONLY OF AN INDIVIDUAL BUT
ALSO AS A GROUP.
CASE STUDY
Not My Job
Barbara Gonzales is a special procedures
nurse at a medium-sized community hospital. She
enjoys her position as it allows her to spend
additional time with the patients who have come in
for cardiac stress tests. In fact, she enjoys almost
all aspects of her job with the exception of dealing
with Dr. Jones, who is invariably late for procedure
appointments. Barbara understands that physicians
have full schedules and often must take additional
time with some patients, which makes them late for
all other appointments that day.
However, in this case, it is not a professional issue
that is causing the problem but rather a personal
one. It is widely known among staff that he is
having an affair with a nurse from the critical care
unit and spends time talking with the nurse while on
the job. Barbara does not care who Dr. Jones is
having an affair with and feels it is not her business
to judge. However , she resents being brought into
the matter, as the doctor directed her to tell his
waiting patients that he is being held up in an
emergency.
• Is Nurse Barbara making a big deal over a
small matter?
• Does she have a duty to cover for her
colleague?
• How would you address this issue?
• What best serves the patients?
NIGHTINGALE’S PLEDGE
was composed in 1893 by Lystra E. Gretter
and a Committee for the Farrand Training
School for Nurses, Detroit. It was called the
Florence Nightingale Pledge as a token of
esteem for the founder of modern nursing.
It was first administered to the 1893
graduating class of the Farrand Training
School, Harper Hospital, Detroit, Michigan. It
is as follows:
PREVALENCE OF BIOETHICAL ISSUES
BEGINNING OF HUMAN LIFE
When does human life , or personhood begin?
ART 41 OF THE CIVIL CODE
• “For civil purposes, the fetus is considered
born if it is alive at the time it is completely
delivered from the mother’s womb.
• However if the fetus had an intra-uterine life
of less than seven months, it is not deemed
born if it dies within 24 hours after its
complete delivery from the maternal womb.”
ART. 42 OF THE CIVIL CODE
• “Civil personality is extinguished by death.
The effect of death upon the rights and
obligations of the deceased is determined
by law, by contract and by will.”
• P.D. 603
• Issue of human personhood is determined
at fertilization or conception.
• Why should the beginning of human life
need to be determined?
Because of the serious moral problem that
pertains to abortion.
THEORIES OF THE BEGINNING OF EXISTENCE
OF HUMAN LIFE
NEUROLOGICAL THEORY
• Based on the capabilities and functions of
electroencephalogram (EEG)
• EEG recognizes the life of a fetus at
approximately 24-27 weeks
• According to HAROLD MOROWITZ and
JAMES TREFIL, that very moment when a
developing fetus starts to manifest an EEG
pattern indicates the beginning of human life
• Human life begins from 4 – 6 months after
gestation
BIOLOGICAL INDEPENDENCE THEORY
• Founded on viability and depends on the
maturation of the lungs of the growing fetus.
• Based on this theory, not until the fetus has
acquired matured lungs that can strongly
allow it to be viable, or exist outside the
uterus, only then can it be said to have
started to live, or have enjoyed the status of
human life.
METABOLIC THEORY
• Advocates that there is no such thing as
fertilization
• Believe that the concept of fertilization is
only concocted by both physicians &
biologists only for academic purposes.
EMBRYOLOGICAL THEORY
• Believes that beginning of human life
happens at gastrulation
Gastrulation – the process in which a
gastrula (an embryo in an early stage of
development) differentiates into two cell layers;
approximately starts at the third week of pregnancy
 • Advocates that from 12 to 14 days after
fertilization, the embryo is intrinsically
capable of splitting into identical twins
• Maintains that the embryo is credited of
being a human being; however it is not a
person yet
SELF-CONSCIOUSNESS THEORY
• Human life begins when the child earns
consciousness of his/her very self
• Proposed by MICHAEL TOOLEY, argues
that only when the child attains
consciousness can he/she be ascribed as a
person
GENETIC THEORY
• Fertilization or conception marks the
beginning of humanness and personhood
• Considers the conceptus a person
CURRENT REPRODUCTIVE TECHNOLOGY
SEX SELECTION
Three ways:
(1) pre-implantation method
o Sperm Sorting and Pre-Implantation
Genetic Diagnosis / Embryo
Screening
(2) post-implantation method
- Amniocentesis / ultrasound machines
(3) post-birth method
- sex-selective infanticide
- sex-selective abandonment
- sex-selective adoption
CONTRACEPTION
o Oral contraceptive pill
- Made up of hormones similar to those
found in a woman’s body.
o Intra-uterine system (Mirena)
- Guarantees straight long 5 yrs. Of
contraception.
o Contraceptive patch
- Looks like a square band-aid.
- Must be worn at all times for 3 wks.
- Uses estrogen & progesterone
o Intra-uterine device
- Usually made up of copper which is
inserted into the uterus.
• Injection or injectable contraceptive
• Vasectomy / male sterilization
• Diaphragm
• Cervical cap
• Vaginal contraceptive ring
• Emergency contraception
• Outercourse / non-vaginal sex
• Rhythm method
• Calendar-based method
• Body temperature method
• Billing’s method
- Woman has to monitor the discharges
during ovulation.
CONTRACEPTION
• Male condom
• Female condom
• Contraceptive sponge
• Withdrawal or coitus interruptus
• Tubal ligation / female sterilization
Controversial Choices
The value of self-determination is cited to support 2
decisions that have been the focus of much
controversy for many years:
Abortion
Active euthanasia
Nurses need to be very clear about their own
values regarding each of theses issues, and find a
balance between personal values & professional
obligations to patients and families.
Nurses must sort out their own beliefs about what is
right and wrong
so that they can differentiate between tasks
& roles that are consistent with their ethical
stance and those that are not.
Make responsible practice decisions
accordingly.
ABORTION
• Any premature expulsion of a human fetus,
whether naturally spontaneous, as in
miscarriage, or artificially induced, as in a
surgical or chemical abortion.
• 1973, US Supreme Court handed down a
decision on Roe v. Wade legalizing abortion
in all 50 states during all nine months of
pregnancy for any reasons---medical,
social, or otherwise
PSYCHOLOGICAL CONSEQUENCES
• Horrible nightmares of children, body parts,
blood
• Psychological pain
• Feeling of worthlessness
• Post-Abortion Syndrome (PAS)
- drug and alcohol abuse
- personal relationship disorders
- sexual dysfunction
- repeated abortions
- communication difficulties
- damaged self-esteem
- attempting suicide
▪The abortion debate sparks passionate, emotion-
laden arguments in political, social, legal, religious,
and moral arenas.
▪Issues of self-determination arise regarding the
mother’s right to control her body and her life (right
to choose), in contrast to rights of the unborn fetus
to a chance at life (right to life).
▪“Right-to-Life” Camp
➢Believe that abortion constitutes murder of
an unborn person, suggesting it is a legal as
well as an ethical matter.
▪“Right-to-Choose” Camp
The right to privacy regarding health care
decisions includes a woman’s reproductive
choices, implying that governmental
regulation is an infringement on this privacy.
▪Values in relation to life are fundamental
considerations in regard to abortion, such as:
Beliefs about when life begins
Considerations regarding quality of life for
children who are unwanted.
Concerns about the mother’s life & health.
ABORTION
▪Some believe that life starts at conception, while
others hold that life begins only when a fetus is
viable outside the womb.
▪Opponents of abortion hold the position that
because a fetus possesses humanity, it must be
accorded all human rights, including the right to life.
▪Proponents of abortion argue that based on
autonomy, a woman has a right to her own body,
and that no woman should be forced to bear a child
that she does not want
EUTHANASIA
▪Derived from two Greek words EU, which means
well or good, and THANATOS which means death.
▪The act of deliberately ending a life to relieve
suffering in a painless way.
TYPES OF EUTHANASIA
1. ACTIVE EUTHANASIA (similar to assisted
suicide)
▪A person deliberately intervenes to end
someone’s life
▪Lethal substances are used to kill a person
Ex. Sodium thiopental, pancuronium
bromide
2. PASSIVE EUTHANASIA
▪A person causes death by withdrawing or
withholding a treatment that is necessary to
maintain life
▪E.g. avoiding the intake of common treatments like
antibiotics, chemotherapy
3. NON-ACTIVE EUTHANASIA
Life-support systems shall be withdrawn from the
patient.
FORMS OF EUTHANASIA
1. VOLUNTARY EUTHANASIA
▪A person makes a conscious decision to die
painlessly and asks for help to do this
2. INVOLUNTARY EUTHANASIA
▪The patient cannot decide for himself/herself to die
painlessly so that another person will decide for
him/her.
Terminally ill
Comatose
Persistent vegetative state (PVS)
Defective newborns
ARGUMENT
AND ETHICAL CONTRADICTION
QUESTIONS:
• Must a patient who is suffering from an
extremely painful cancer of the throat and
will certainly die several days later be
allowed to die of pain? Or . . .
• Must he/she, if he/she so desires, be
assisted by a doctor to hasten his/her
death?
• Must the patient be killed painlessly? Or . .
.
• Must he/she rather be allowed to die the
natural way?
▪J. GAY – WILLIAMS
▪A renowned advocate of the immorality
and the wrongfulness of euthanasia,
condemns euthanasia for the following
reasons:
• It contradicts nature since it
is a blatant violation of the
natural inclination to
preserve life.
–All human beings are
endowed with a natural
inclination to preserve life.
–All normal human beings have fear of death.
▪He condemns euthanasia for the following
reasons:
• If practiced, euthanasia will
bring a lot of disadvantages
because it endangers the
preservation of life
inasmuch as it leads to
medical practitioners to be
less efficient.
• Accepting euthanasia as a
practice may result in
certain undesirable long-
term consequences.
▪He claims that “TO SAVE LIVES” is the
total commitment of doctors & nurses, and
other healthcare providers.
−Thus, to lose the life of a patient
must be for them a personal failure
which is an insult to their skills and
knowledge.
−If euthanasia would be practiced,
this predicament will be changed.
−Doctors & nurses might not try hard
because patients will be better off
dead
▪Experts like E. J. Hayes, P. J. Hayes, D. E.
Kelly
–“Euthanasia is immoral and therefore
ought not be legalized.”
–They based their convictions on the
following grounds:
• Legalized euthanasia would lessen
the incentive for medical research.
• It would become possible to
arrange for the death of an enemy,
or a wealthy relative.
•Voluntary euthanasia is but a step removed from •It is a blatant negation to accept the facts of life in
compulsory euthanasia. the name of courage, obligation, respect, love &
• The purpose of the medical gratitude to God and members of human society.
profession is to preserve life not to
destroy it. It is therefore the paramount duty of the healthcare
• Many patients today surprise the providers to keep track of the emotional status and
doctor by recovering; if euthanasia mental directions of their patients, especially those
is legalized, they would be killed. who are suffering from malignant diseases, to hold
• The practice of euthanasia would on to their life, no matter what.
make the doctor a man from whom Healthcare providers must always be ready to
we would wish to flee in terror when assist their patients in their spiritual, physical,
we are seriously ill. emotional, psychological, and mental
turmoils.
SUICIDE
▪Derived from the Latin word SUICIDIUM which DANGERS OF LEGAL EUTHANASIA AND
means “to kill oneself”. ASSISTED SUICIDE
▪The direct killing of oneself on one’s own authority. • Safeguards don’t prevent abuse of euthanasia
▪The intentional killing of one’s own life. laws
▪The agent of death is the person himself. • Doctors killing people becomes normalised
• It compromises palliative and hospice care
MEDICAL EUTHANASIA • People will die because of mistaken diagnosis or
prognosis
 Physician directly commits the act by medical • Euthanasia and assisted suicide don't guarantee
means a dignified death
 The physician is necessary and sufficient for • Euthanasia and assisted suicide are the ultimate
the act to be completed tools for elder abuse
 The patient's condition provides the context
DEATH
ASSISTED SUICIDE CHARACTERISTICS OF DEATH:
• It is ineffable.
 The physician provides the medical means – Incapable of being expressed in
 The physician is necessary, but not sufficient words; complex in nature;
for the act to be completed mysterious
 The patient needs to do the final act • It is inescapable.
Everybody dies
COMMON METHODS: • It is beyond experience.
▪Asphyxation One can never have a chance to have a
Deprivation of O2 by hanging oneself taste of death and later share her
▪Toxification encounter with it.
poisoning • It is personal.
▪Blunt force trauma There is no such thing as “untimely death”.
Jumping from a building, etc.
▪Self-defenestrating • It is ontological.
Making oneself killed by a train, truck, etc. – Intrinsically embedded in us at the
▪Exsanguination/Bloodletting very moment when we earned the
Slitting one’s wrist, abdomen, etc. breath of life.
▪Drowning – “As soon as man comes to life, he is
▪Electrocution at once old enough to die”.
▪Self-immolation • It is the grand equalizer.
A deliberate and willing sacrifice of oneself It is never choosy of who it seeks to take.
often by fire. Death takes anybody in a designated
▪Starvation moment as it strikes.
CAUSES OF SUICIDE: DEFINITION OF DEATH
▪Physical pain, illness MEDICAL DEFINITION
▪Anxiety, emotional pressure ▪Death is the permanent cessation of all bodily
▪Financial difficulties functions.
▪Shame, guilt, depression, desperation
▪Psychological disturbance, mental disturbance LEGAL DEFINITION
▪Death is the cessation of life as indicated by the
absence of blood circulation, respiration, pulse and
APPLIED ETHICAL THEORIES other vital functions.
▪The dead person is fit to be buried.
•Is SUICIDE immoral?
•It is nothing else but tantamount to cowardice. LEGAL AND MEDICAL PURPOSES DEFINITION
•It is a total reversion and aversion of sanctity of the ▪Death is the irreversible cessation of all the
God-given life. following:
 (1) EEG assessed flat-lined total cerebral
function
(2) Spontaneous function of the respiratory
system
(3) Spontaneous function of the circulatory
system
UNIFORM DETERMINATION OF DEATH ACT
(UDDA)
DEFINITION
▪An individual who has sustained either (1)
irreversible cessation of circulatory and respiratory
functions; or (2) irreversible cessation of all
functions of the entire brain, including the brain, is
dead. A determination of death must be made in
accordance with accepted medical standards.
BRAIN DEATH
• Patient shows total unreceptivity or
unawareness to all external stimuli and is
unresponsive to painful stimuli.
• All spontaneous muscular movement and
respirations are gone.
• The pupils loss reflexes and are dilated
and fixed.
• Still breathe with the help of a ventilator.
• Legally dead
Clinical death
A medical condition that precedes death rather than
being actually dead.
Cardiac arrest
STEM CELL TECNOLOGY
STEM CELL
▪A cell that has the ability to divide or self replicate
for indefinite periods---often throughout the life of
an organism.
▪Stem cells have the potential to develop into
mature cells that have the characteristic shapes
and specialized functions.
2 PRINCIPAL CHARACTERISTICS OF STEM
CELLS
Neural stem cells found in the
nervous system.
Their supply in the human body is so limited as
compared to the stem cells found in the embryos.
Embryonic Stem Cell
The most undifferentiated stem cell is the zygote,
embryo, or the fertilized egg.
Removal of cell from the human embryo was
initiated in August 09, 2001.
3 Kinds of Stem Cells:
Totipotent
Multipotent
Pluripotent
• Totipotent stem cells
Have the total potential to develop into
different types of cell.
• Multipotent stem cells
Are those whose potentiality to develop into
other cell types are minimal or
limited in numbers.
• Pluripotent stem cells
Can develop into any cell type except in the
potentiality to develop as a fetus.
Only the Totipotent stem cells have the intrinsic
potency to become a zygote or an embryo.
Scientists extract Pluripotent stem cells from
human embryos to come to terms with cure or
healing of various diseases.
Embryos used for this purpose are those
that are considered extra or surplus which
are generated from experiments outside the
womb of the mother.
New Method:
In 2006, scientists discovered the
production of induced pluripotent stem cells
(iPS) by using skin cells.
This method allows doctors to create stem
cells with a specific patient’s genetic code,
eliminating the risk that the body would
reject transplanted tissues or organs.

• They are unspecialized cells that renew

themselves for long periods through cell
division;
• They can be induced to become cells of
the heart muscle, or the insulin-producing
cells in the pancreas.

Stem cells are primitive cells.

They can develop into:
Blood
Bones
Nerve cells
Liver cells
Heart tissues
Brain cells

There are several kinds of stem cells in the human

body.
Example:
Hematopoietic stem cells found in
the bone marrow