Health Care Ethics (Bioethics)

Moral Principles in Health Care 01

INTRODUCTION increasing its goodness or even adding new
Principle → is that from which something goodness. An evil act may also have several evil
proceeds in any manner effects and is unworthy of being chosen. Besides,
whatsoever. it may intensify its evil or even add new malice.
Example
The principle of smoke is a fire Now, there are times an act is done with two
or a cigarette butt. It is a fire effects: one is good and the other is evil.
or cigarette butt from which
smoke proceeds. The question is: is it morally permissible to do such
Moral Principle → refers to a fundamental rue an act, with both good and evil effects?
of law of moral law THE FOUR CONDITIONS
containing certain truth from 1 The act must be good in itself, or at least,
which knowledge of a morally indifferent.
definite moral action for 2 The good effect must directly proceed from
performance proceeds the act itself and not from the evil effect. At
along with the provision of the very least both effects must occur
solution to the specific moral simultaneously.
problems or issues. 3 There must be sufficient reason for the
performance of an act in its attainment of the
THE PRINCIPLE OF BENEFICENCE good effect.
1 Provides that the good must be done either 4 The motive of the agent must be holy and
to oneself or to others. honest.
2 The fundamental moral principle binds and
urges everyone to do what is good and DISTRIBUTIVE JUSTICE
perform for good as a moral obligation. It ▪ Pertains to a fair scheme of distributing
mandates the right of every human person to society's benefits and burdens to its members.
the preservation of life, promotion of quality Two alternatives:
life, physical integrity and health. Dr. A. Tan-Alora enumerates procedural
Case example: principle as alternatives on how the distribution
Despite irreversible dying moments of patient of scarce health care resources.
suffering from severe renal failure because of Utilitarian Alternative
metastasizing carcinoma of the renal organ and → Maximizing strategies to achieve the greatest
who refuses dialysis deemed useless, the amount of good or minimizing strategies to
attending nurse continues is to take care of him reduce the amount of potential harm.
and call the chaplain to administer the last
sacrament, by bathing and providing him Principle Limitation
personal hygiene and by just being there. Medical → May overlook the real
success existing need of immediate
healthcare intervention
THE PRINCIPLE OF NON-MALEFICENCE among other patients.
1 Provides that evil or harm should not be Immediate → Can be contested with an
inflicted either on oneself or on others. usefulness argument as to whether it is
2 This fundamental moral principle binds and indicative of a claim that has
urges everyone to avoid inflicting harm as to be attended to over
moral obligation. It mandates the right not to others.
be killed, tight not to have bodily injury or Conservation → Patients in dire need of
pain inflicted on oneself, and right not to bigger amount of healthcare
resources by reason of their
have ones confidence revealed to others.
serious condition are
Dr. Angeles Tan-Alora enumerates some of the excluded from healthcare
violations of this principle of non - maleficence: benefits.
→ physically harming a person as in suicide, Parental role → Can be contested with
abortion, infanticide, mutilation and violence (those who pathological condition that
→ exposing a person to physical harm as in have the necessitates instantaneous
subjecting a person to unnecessary treatment largest medical treatment.
or to a dangerous procedure without responsibility
to
commensurate important goal.
dependents)
→ harming person reputation, honor, property or
General → May convey a discriminatory
intense as by revealing confidential social value message against those who
information. are voiceless and
marginalized.
THE PRINCIPLE OF DOUBLE EFFECT
A good act mat have several good effects and
it is worthy of being performed thereby

EVANGELISTA, E.M | BSN-2 | NCM 108 (FINALS)| RN 2025

Health Care Ethics (Bioethics)
Moral Principles in Health Care 01
Egalitarian Alternatives whose effect may have an indirect bearing
→ Represent maintaining or restoring the upon it.
equality of the person in need. 5 Proximate Cooperation
→ consist of an act that is intimately linked with
Principle Limitation the performance of an evil action due to its
Saving no one → Tangible denial of health close bearing.
care to all those who 6 Remote Cooperation
need it.
→ consist of an act with a distant bearing upon
Medical → May draw waste of
or connection with the execution of an evil
neediness health care resources
when the most seriously act.
ill patients who are the
recipients are not able MORAL RULES GOVERNING COOPERATION
to recover and survive • No one should formally and directly
after all. cooperate in the performance of an evil
General → May not be expressive of action should exist as to be morally excused
neediness (gives a claim to prevail over
without
priority to the others.
• If a reason sufficiently grave exists, material
most helpless or
generally cooperation in the performance of an evil
neediest) action may be morally excused.
First come, first → Runs counter to the • If material cooperation is proximate, a reason
served basis principle of medical sufficiently graver should exist so as to be
neediness along with morally excused without which evil is incurred.
others.
→ May also take place at THE PRINCIPLE OF TOTALITY
the expense of
→ The whole implies the existence of its parts.
emergency cases.
Random selection → A "hit or miss" attempt to
Parts as such should continuously be
distribute scarce health connected with the whole of which they are
resources to those parts without which they cease to be.
whose competing
claims should prevail as Example:
necessary which may A patient with gangrenous leg that needs
redound to wasted amputation.
opportunitiy for medical
success.
MORAL PRINCIPLES AND HEALTHCARE
→ Observance of moral principles in the practice
THE PRINCIPLE OF COOPERATION
of heath care is essential. It guides and directs
Cooperation comes from the Latin word "cum"
the health care delivery system towards the
which means "with" and "operari" which means
fulfillment of the norms of morality, natural law,
"to work." Hence, cooperation is working with
and God 's Eternal Law.
another in the performance of an action.
→ If only moral principles are conscientiously
Various Degrees of Cooperation
adhered to in the field of health care, health
1 Formal Cooperation care practice will always be in proper keeping
→ consists of an explicit intention and willingness with the track of goodness for which human
for the evil act. nature is made.
Example
Hysterectomy per request of the party done POINTERS FOR A HEALTHCARE PRACTITIONER
by doctor which is evil. It is immoral to will 1 Observe and apply the different moral
and intend an evil act, under all principles to specific moral issues and
circumstances, as it contrary to the order of problems that beset the practice of health
reason and God's Eternal Law. care profession today.
2 Material Cooperation 2 Do justice by carrying out your duties and
→ consists of an act other than the evil act itself obligations inherent in your profession without
but facilities and contributes to its any mental reservations, by treating your
achievement. patient according to their needs and by
3 Direct Cooperation providing the necessary means of care that
→ consist of direct participation in the does not just address pathological problems
performance of an evil act. but also emotional and spiritual longings.
4 Indirect Cooperation 3 Consider yourself as steward of your patents,
→ consist of an act that is not intimately who will always there to look after their
connected with the performance of an evil welfare, to give due care and to avoid any
act as a formal and direct cooperation but

EVANGELISTA, E.M | BSN-2 | NCM 108 (FINALS)| RN 2025

Health Care Ethics (Bioethics)
Moral Principles in Health Care 01
health care measures that are destructive of
human life and dignity.

EVANGELISTA, E.M | BSN-2 | NCM 108 (FINALS)| RN 2025