HEALTH CARE ETHICS 2.
DUTIES OF REPARATION- we should make
ETHICAL THEORIES – are those that provide schema,
structure, or framework in order that the rightness or
wrongness , & goodness or badness of human conduct will
be determined.
IMMANUEL KANT
- ‘’ Morality is not properly the doctrine of how we may
make ourselves happy , but how we may make ourselves
worthy of happiness’’, IMMANUEL KANT.
- German philosopher
- Morality is pure philosophy and expounds his thoughts in
good will , motive & duty.
- ‘’ DUTY is the obligation to act from reverence , respect
for, and obedience to the moral law’’.
2 types of duty: ‘’ DO THE RIGHT THING BEC. IT IS RIGHT’’
1. Perfect duty- compulsory to do / one that must be
abstained.
2. Imperfect duty – one promotes / pursues certain
actions.
2 Principles:
1. PRINCIPLE OF UNIVERSALITY
- allows for the assertion of jurisdiction in cases where the
alleged crime may be prosecuted by all states (e.g., war
crimes, crimes against the peace, crimes against
humanity, slavery, and piracy).
- One should always respect the humanity in others, &
that one should only act in accordance w/ rules that
could hold for everyone.
2. PRINCIPLE OF HUMANITY
- ‘’ acts in such way that you treat humanity , whether in
your own person or in the person of any other , never
merely as a means , but always at the same time as an
end’’.
WILLIAM DAVID ROSS
- Scottish Philosopher
- Prima Facie Duties ‘’Conditional Duties’’.
1. DUTIES OF FIDELITY- we should strive to keep
promises and be honest & truthful
amends when we have wronged someone else.
3. DUTIES OF GRATITUDE - we should be grateful
to others when they perform actions that benefit
us & try to return the favor.
4. DUTIES OF BENEFICENCE - we should be kind to
others and try to improve their health ,
wisdom , security, happiness , and well- being.
5.DUTIES OF NONMALEFICENCE – refrain from
harming others either physically or
psychologically.
6.DUTIES OF JUSTICE – try to be fair & try to
distribute benefits & burdens equably & evenly.
7.DUTIES OF SELF- IMPROVEMENT- strive to
improve our own health , wisdom, security,
happiness & well- being.
- He does not yield to the idea that there are
arbitrary , absolute or categorical duties.
TELEOLOGICAL ETHICS
- Derives moral obligation from what is
considered good or desirable as an end /
purpose to be achieved.
- Focus on the consequences of the act.
- Greek words ‘’ telos’’ means ‘’ purpose ‘’ or
end , it is the study of goals, ends, purposes.
ST. THOMAS AQUINAS criteria for the act to be
morally acceptable;
1. If it is desirable to us for its own sake;
2. If it is sufficient in itself to satisfy us;
3. If it is attainable by the wise among us;
4. If it is happiness to us.
Condition that must be considered actions as
voluntary or willful:
1. If the act is in itself overt
2. If the agent acts because of a motive
that prompts him/her to act
3. If the agent is responsible for the
consequences of his/her actions.
UTILITARIANISM – is a theory of morality , w/c
advocates actions that foster happiness or pleasure
& opposes actions that cause unhappiness / harm. When
directed toward making social , economic, or political
decisions , and aim for the betterment of society as a
whole.
3 generally accepted axioms of utilitarianism state that;
1. PLEASURE / HAPPINESS , is the only thing that has
intrinsic value – Utilitarianism from the term ‘’
utility’’ w/c mean ‘’ useful’’ but rather means
pleasure / happiness. Intrinsic value contrast w/
instrumental value means to some end.
2. ACTIONs are the right if they promote happiness &
wrong if they promote unhappiness
- ‘’ actions are the right in proportion as they tend to
promote happiness, wrong as they tend to produce the
reverse of happiness’’ John Stuart Mill.
- Happiness= pleasure , & absence of pain
Unhappiness = pain & absence of pleasure.
3. Everyone’s happiness counts equally – held view that
some lives , & happiness they contained , were
simply more important & valuable than others.
TYPES OF UTILITARIANISM
1. ACT UTILITARIANISM- argues that we should always
choose our actions based on what will cause the
greatest amount of happiness.
2. RULE UTILITARIANISM- argues that we should figure
out what sort of behavior usually causes happiness
and turn it into a set of rules.
2 DIVISION OF UTILITARIANISM
1. EUDAIMONISTIC – That man should act so as to
produce the greatest happiness to the greatest
number of people.
2. HEDONISTIC - that human persons should act so
that the rule governing their actions will produce the
greatest happiness for the most number of people.
JEREMY BENTHAM
2 CLASSIFICATION OF BETHAMIAN UTILITARIANISM
1.PSYCHOLOGICAL HEDONISM- by nature, man is
capable of doing only those actions w/c give him
pleasure & that he avoids those actions that give
him pain.
2. EGOISTIC HEDONISM- man is principally
obligated to seek for his own pleasure even if this
will cause deprivation of the rest.
Sanctions that will serves as guides for people
to have healthy inclination for pleasure:
1. PHYSICAL
– explained w/c pleasure or pain is expected to
derive if:
 Its in the present life
 From ordinary course of nature
 Not purposely modified by the interposition
of human beings and superior invisible
being.
- Purely natural because no interference by
being occurs and it comes from the course of
nature.
2. POLITICAL
- Sanction of pain/ pleasure in environments
controlled by one person , or set /
community of people ruling.
3. MORAL / POPULAR – where pain &
pleasure is derived if the body is at the
hands of ‘ chance of people’ in community.
NOTE: the difference in political sanction , the
governing head has the course of action that
causes the pain & pleasure. Popular sanction
the public opinion has the course of action that
creates pain & pleasure.
4. RELIGIOUS - bringing pain & pleasure
when things and decisions come from the
direct hands of superior invisible being.
- Allows time shifts in the effects ( pain&
pleasure) of the superior being.
Pleasure- includes wealth , skill, & memory along
with others.
Pain- betham exemplifies many pains:
Disappointment ( when there is expectation,
pain of disappointment exist) ; Regret ( regret of
 things grounded on pleasure or on memory of HUMILITY - the quality / state of not thinking you are
pleasure . it occurs when looking back on the better than other people.
memory/ stance of the pleasure because the 5. RESPECT- an act of giving particular attention.
person did not supposedly act upon that 6.COMPASSION- sympathetic consciousness of other distress
pleasure to make it last. together w/ desire to alleviate it.
7. PRUDENCE –must always consider justice , fidelity & self
HEDONIC CALCULUS- a tool or criterion to determine the care; and look for opportunities to acquire more other 3
quantitative value of pleasure. virtues.
1. DURATION- how long it last? 8. COURAGE- mental or moral strength to venture , persevere,
2. INTESITY- how intense Is it ? &withstand danger , fear or difficulty.
3. PROPINQUITY- how near / remote?
ETHICAL PRINCIPLE - justifies or defends moral rules and/or
4. EXTENT- how widely it covers?
moral judgments;
5. CERTAINTY- how probable is it?
6. PURITY- how free from pain is it? 7 ETHICAL PRINCIPLES:
7. FECUNDITY- lead to further pleasure?
1. AUTONOMY 5. JUSTICE
JOHN STUART MILL 2.CONFIDENTIALITY 6. BENEFICENCE
3.VERACITY 7. NON MALEFICENCE
‘’ happiness is the most fundamental principle of
4.FIDELITY
morality and the source of moral obligation’’.

- ‘’ the greatest happiness to the greatest degree’’ AUTONOMY

- He is not interested in the issue of who gains happiness
‘’ because he is rather interested in the degree of
happiness achieved by the doer of the act.
VIRTUE ETHICS - person rather than action based and it
provides guidance as to the sort of characteristics and
behaviors a good person will seek to achieve.
‘’ a morally good person with right desires/ motivates is
more likely to understand what should be done, more
likely to perform required acts, & more likely to form an
act on moral ideals than a morally bad person’’ ,
BEAUCHAMP & WALTERS.
8 types of virtue ethics:
1. FIDELITY –requires that we treat people closer to us
w/ special care.
2. HONESTY- facet of moral character that connotes +
and virtuous attributes such as integrity , truthfulness,
straightforwardness of conduct , along with the
absence of lying , cheating , theft, etc.
3. INTEGRITY- firm adherence to a code of especially
moral/ artistic values
- ‘’ Living / acting according to one’s own rule , principle or
law’.
- Person choosing & acting on the basis of his/her own
values, principles , or ideals of conduct , goals & purpose.
 PT’S RIGHTS- THERE ARE 4 TYPES:
1. RIGHT TO SELF- DETERMINATION- The
patient has the right to avail himself/herself of
any recommended diagnostic and treatment
procedures.
2. RIGHT TO INFORMED CONSENT- The patient has
the right to a clear , truthful and substantial explanation , in
a manner and language understandable to the patient , of
all proposed procedures ,whether diagnostic , preventive ,
curative , rehabilitative or therapeutic, wherein the person
who will perform the said procedure shall provide his name
and credentials to the patient , possibilities of any risk of
mortality or serious side effects , problems related to
recuperation , and probability of success and reasonable
risk involved.
3. RIGHT TO INFORMED DECISION- pt should
be aware of the choices and treatments,
potential outcomes of these choices &
treatments & have their personal values
 considered in decision about their medical 1 OUGHT NOT TO INFLICT EVIL / HARM
care. 1 OUGHT TO PREVENT EVIL/HARM
4. RIGHT TO INFORMED CHOICE- pt may given option to 3. 1 OUGHT TO REMOVE EVIL/HARM
choose from several diagnostic test / treatments or 4. 1 OUGHT TO DO / PROMOTE GOOD
choose to have no treatment.
NON-MALEFICENCE- NON HARMING / INFLICTING THE
LEAST HARM POSSIBLE TO REACH BENEFICIAL OUTCOME.
Informed consent- it is a pt’s agreement to have medical
procedure after receiving full disclosure of risk, THEORIES & PRINCIPLES OF HEALTH ETHICS 2
benefits, alternatives , & consequences of refusal.
 PRINCIPLE OF DOUBLE EFFECT- An act desired not as an
Key elements: end itself but as a foreseen effect / consequences of an
1. Pt receive an explanation of the procedure / treatment. act.
2. Pt receives the names & qualifications of people performing 2 problems:
& assisting in the procedure.  When can the agent be responsible for the evil effect of a
3. Pt receives descriptions of the serious harm that may cause directly will.
occur as a result of the procedure & anticipated pain and When can the agent perform an act not evil in itself but
or discomfort. bears 2 effects , one good, the other ,evil.
4. Pt receives an explanation of alternative therapies to the PRINCIPLE OF BIOETHICS
proposed procedure/ treatment & risk of doing nothing.
5. Pt knows that he/she has the right to refuse w/o  PRINCIPLE PF STEWARDSHIP & ROLE OF NURSE AS
discontinuing other supportive care STEWARDS
6. Pt knows that he/she may refuse the procedure/ - ‘’ man comes from nothing for man to be something’’
treatment even after the procedure has begun. - With intellect human sought to discover truth
- w/ freedom, humans become creative and human must
PROXY CONSENT respect the sanctity of life and the world
- HEALTH CARE PROXY / DURABLE POWER OF ATTORNEY FOR - it declares that human life comes from God, & no
HEALTH CARE – Is a legal document that designates a individual is the master of his/her own body.
person/ people of ones choosing to make health care
decisions when pt is no longer able to make decisions on the  PRINICIPLE OF TOTALITY – it pursues the issues of the
basis of the pt wishes. dignity of the whole person.
PRIVACY- right of the individual client / pt to be let alone & - It demands respect for the self & respect for others
to make decision about how personal information is shared. - ‘’ do unto others what u want others do unto u’’
- The whole is greater than any of its parts’’
CONFIDENTIALITY- REFERS TO A MEDICAL OR PROFESSIONAL
SECRECY IN W/C CERTAIN INFO IS COMMITTED TO A PHYSICIAN ISSUES:
IN OFFICIAL CAPACITY FOR THE SAKE OF THE MEDICAL 1. Sterilization/ mutilation- removes, kills, or
ASSISTANCE. deactivates all forms of life.
VERACITY – TRUTH TELLING; RIGHT TO INFO 2. Preservation of Bodily Functional Integrity- practices
FIDELITY- FAITHFULNESS TO ONES OBLIGATION, DUTIES , & that violate a person’s bodily integrity can range from
RESPONSIBILITIES piercing a bby girl’s ears / being exposed to toxic
JUSTICE- RENDERING WHAT IS DUE / MERITED; PRINCIPLE OF chemicals w/o one’s knowledge , to forms of violence
EQUITY such as rape / medical treatment administered against
BENEFICENCE- DO GOOD; TAKING ACTIONS THAT WILL pt’s wishes.
PROMOTE THE WELFARE OF OTHER PEOPLE: 4 SUBSTANCE; 3. Issues on organ donation
 - Pope John II qualifies organ & tissue donations
DYSTHANASIA as a
heroic , charitable , & praiseworthy act. ORTOTHANASIA
- ‘’ as long as they are performed in ethically
ADMINISTRATION
acceptable OF DRUGS TO THE DYING
manner’’. ADVANCE DIRECTIVES
ORGAN DONATION/ TRANSPLANTATIONDNR OR END OF LIFE CARE PLAN
2 TYPES: EUTHANASIA – practice of ending life in a painless way.
1. INTER VIVOS- a transplant in w/c done among the living 2 forms
2. POST MORTERM- a transplantation refers to donation 1.Voluntary Euthanasia- with the consent of the pt
given after the death of the donor. 2.Involuntary Euthanasia- w/out the consent of the pt; against
the pt wishes
3 general principles
3 ways:
1. Informed consent must be legitimately given by the donor /
the 1 speaks before him/her 1. Passive Euthanasia = intentionally letting a pt die by
2. The physical& psychological risks incurred by the donor withholding artificial life support such a ventilator /
must be equal to the good sought for the recipient. feeding tube. Withholding( life support) while
3. The destruction of the healthy functioning / the withdrawing life support ( the pt Is on life support but
inherent beauty of one’s body is deemed morally wrong even if then removed from it).
this delays the death of another. 2. Non – active Euthanasia = person is unconscious /
otherwise unable to make a meaningful choice bet. Living
4 kinds of transplantation
& dying , & appropriate person takes the decision on their
1. AUTOGRAFT- a graft tissue from 1 point to behalf.
another of the same individual’s body. 3. Active Euthanasia = directly & deliberately causes pt’s
2. HOMOGRAFT- transplantation of an organ from1 death; when death is brought about any act.
individual to another of the same species.
3. HETEROGRAFT- tissue graft taken from species DOCTOR DEATH/ ANGEL OF DEATH
different from that of the recipient.
4. ISOGRAFT- transplantation bet. 2 genetically JACK KEVORKIAN
identical person. - INVENTED SUICIDE MACHINE
- 1990’S HE WILLFULLY ASSISTED TERMINSLLY ILL PT TO KILL
 PRINCIPLE OF ORDINARY & EXTRAORDINARY MEANS THEMESELVES.
EXTRAORDINARY MEANS- Treatments that could be PHILIP NITSCHKE
acceptably be forgone. - INVENTED THE EUTHANASIA DEVICE
ORDINARY MEANS- Those that were morally required. - HE VIGOROUSLY CAMPAIGN FOR THE LEGALIZATIONS OF
ASSISTED SUICIDE IN AUSTRALIA
 PRINCIPLE OF PERSONALIZED SEXUALITY – it takes note a - HE HAD ASSISTED @LEAST 4 PT’S TO COMMIT SUICIDE.
humanized sexuality , 1 that represents the fulfillment of JAYANT PATEL- WHO TRAINED IN INDIA WILLFULLY MADE
physical & sensual need but also evidenced w/ love & HIMSELF INCOMPETENT.
sacramental mystery. HAROLD SHIPMAN
- ‘’ THE MOST PROLIFIC SERIAL KILLER
 DIGNITY IN DEATH & DYING - A JURY FOUND SHIPMAN GUILTY IF THE MURDER OF 15 PTS
UNDER HIS CARE , W/ HIS TOTAL NUMER OF VICTIMS
1. EUTHANASIA & PROLONGATION OF LIFE ESTIMATED TO BE AROUND 250.
2.INVIOLABILITY OF HUMAN LIFE ARIBERT HEIM
3.EUTHANASIA & SUICIDE
 - AUSTRALIAN DR. WHO WAS CHARGED OF KILLING ALMOST
MILLION OF PEOPLE DURING THE NAZI GERMANY.
THEORIES ABOUT LIFE’S BEGIN
- DURING WW2 , HE SERVED AT THE MAUTHAUSEN-GUSEN
NEUROLOGICAL
CONCENTRATION CAMP IN MAUTHAUSEN , BIOLOGICALKILLING &INDEPENDENCE
TORTURING INMATES BY VARIOUS METHODS , SUCH METABOLIC
AS DIRECT
INJECTIONS OF TOXIC COMPOUNDS INTO THE HEARTS
EMBRYOLOGICAL
OF HIS
VICTIMS. 5. CONSCIOUSNESS OF THE SELF
JOSEF MENGELE 6. GENETIC
- ‘’ ANGEL OF DEATH PHYSICIAN’’
- KILLED THOUSANDS OF PEOPLE DURING THE TIMESUICIDE- OF IT IS A DIRECT, WILLFULL DESTRUCTION OF
HITLER IN GERMANY. ONE’S OWN LIFE.
- HE PERFORMED DEADLY EXPERIMENTS ON PRISONERS DYSTHANASIA=
& person to kept alive artificially in a
WAS A MEMBER OF THE TEAM OF DR.’S WHO SELECTED condition where they cannot survive
VICTIMS TO BE KILLED IN THE GAS CHAMBERS. ORTHANASIA
- Normal / natural manner of death & dying
J. GAY- WILLIAMS- RENOWED ADVOCATE OF THE - Used to denote the deliberate stopping of
IMMORTALITY & THE WRONGFULNESS OF EUTHANASIA artificial / heroic means of maintaining life.
1. IT CONTRADICTS NATURE
2. IT WILL BRING A LOT OF DISADVANTAGE ADMINISTRATION OF DRUGS TO THE DYING- is
3. MAY RESULT TO CERTAIN UNDESIRABLE LONG TERM the palliative practices of relieving distress in
CONSEQUENCES terminally ill person in the last hrs. or days of
dying person’s life .
E.J. HAYES, P.J. HAYES , & D.E . KELLY ADVANCE DIRECTIVES – it takes effect only if u
4. THE PURPOSE OF THE MEDICAL PROFESSION IS TO PRESERVE cant express ur wishes.
LIFE NOT TO DESTROY IT. DNR OR END OF LIFE CARE PLAN- if end of life care
5. MANY PT’S TODAY SURPRISE THE DR.BY RECOVERING. IF is given @ home, special non- hospital DNR, signed
EUTHANASIA IS LEGALIZED , THEY WOULD HAVE BEEN KILLED. by a dr. is needed. This ensure that if emergency
6. THE PRACTICE OF EUTHANASIA WOULD MAKE THE DR. A medical technicians ( EMT) are called the house ,
MAN FROM WHOM WE WOULD WISH TO FLEE IN TERROR the will respects ur wishes.
WHEN WE ARE SERIOUSLY ILL.

PRIMARY ENDS OF MARRIAGE ACCORDING TO

PROLONGATION OF LIFE
- An individual would like as much as possible to prolong his/ her
life amidst critical health conditions
- Life support machines and other treatments are able to
prolonged life / even save person’s life from an impending
death.
OREGON DEATH W/ DIGNITY ACT( 1994)- Dr. are permitted to
assisted their pt’s to death specifically if these pt’s have only 6
months or less to live.
INVIOLABILITY OF HUMAN LIFE
- When does human life begins? Fertilization? Still mystery?
POPE PIUS XII
1. PROCREATION – Having a children.
2. UPBRINGING OF OFFSPRING- responsibility of
both parents to give upbringing to their children.
3. MUTUAL AID - u support / help each other as a
couple
4. HEALING OF CONCUPISCENCE
METABOLIC- Governs most observed patterns in ecology.
Metabolic Theory of Ecology ( MTE) Is an extension of
metabolic scaling theory . MTE is a macro ecological theory
that aims to be universal in scope and application.
7. EMBRYOLOGICAL – studies the prenatal
development of gametes , fertilization,It is& a transplantation of an organ from 1 individual to
development of embryos and fetuses. another of the same species. ANS: HOMOGRAFT
It is transplantation bet. 2 genetically identical persons.
POST BIRTH METHOD
ANS: ISOGRAFT
1. SEX -SELECTIVE INFANTICIDE - against infants of  A transplantation refers to donations given after
undesired sex. death of the donor . ANS: POST MORTERM
2. SEX –SELECTIVE ABANDONMENT- target of abortion of  This is a transplant in which done among the living
fetus based upon its sex. This is done after a Ans: INTER VIVOS
determination is made ( usually ultrasound , rarely  This are the treatments that could acceptably be
amniocentesis etc) that the fetus is of an undesired sex. forgone . ANS: PRINCIPLE OF EXTRAORDINARY
3. SEX- SELECTIVE ADOPTION – placing children of the MEANS
unwanted sex up for adoption. 

Quizzes:

 This circumstance refers to a situation when person is

caught situation when a person is caught up in the
crossroad of 2 pleasures.
Ans:
 It refers to those pleasures that yield not only to the
seeker , but also to others. What circumstance is this
on the hedonic calculus?
Ans:
 It is a futile / useless treatment , w/c doesn’t benefit a
terminal pt. it merely extends dying process and not
life.
Ans:
 This theory is based on the notion of the capabilities &
function of gadget called an electroencephalogram to
determine one’s personhood.
Ans:
 This principle declares that human life comes from God , & no
individual is the master of his/her own
Ans: Principle of Stewardship
 This principle pursues the issues of the dignity of the whole
person . ANS: Principle of Totality
 This principle uphold’s everyone’s right to be free from acts
against their body w/c they did not consent to
Ans:

 Pope John II qualifies organ & tissue donations as a heroic ,

charitable & praiseworthy act . ANS: TRUE
 The transplantation of an organ w/in the same individual