BIOETHICAL PRINCIPLES
It simply suggests that a patient
PRINCIPLE OF BENEFICENCE
 Duty to “Do good and produce good”
 The practice of nursing of doing acts of
goodness, kindness and charity
 Duty to help others the best we can
 Actions which are intended to prevent
harm, remove harm and promote wellness.
 All actions are meant to provide benefits
that enhances other’s welfare
 It urge every one to do what is good and
perform for good as a moral obligation.
 This is the positive end of non maleficence
PRINCIPLE OF NON-MALEFICENCE
 “ Do no harm”/ Duty to avoid evil
 Stresses that harm or pain should not be
inflicted upon others regardless of status
 Urge everyone to avoid inflicting harm as a
moral obligation
 It mandates the right not to be killed, not to
have bodily injury or pain on one self
 Anything that harms the person and his
dignity in all aspect is a lucid transgression
of the principle of non maleficence
VIOLATIONS OF NONMALEFICENCE
 Physically harming a person as in suicide,
mutilation, torture and violence
 Exposing a person to physical harm or
subjecting a person to a dangerous
procedure without a commensurate goal.
(Prostitution)
 Harming a person’s reputation, honor and
property or interest by revealing a
confidential information.
PRINCIPLE OF AUTONOMY
 “ Right to self-determination”
 Mandates strong sense of personal
responsibility for one’s life
 One should choose what one wishes to be
and should take responsibility for that
choice
 This principle involves respect of the
personal liberty or freedom of an individual
to choose and implement one’s own
decision
 In nursing profession, this principle includes
the freedom of patients to select
appropriate treatment without the
influence of fear, threat, deceit, fraud or
duress.
should give free consent upon receiving
appropriate explanation before any
procedure or treatment be done to him
 Autonomy is the prerogative of the patient
to give free consent as well as the right to
refuse a treatment or procedure
 Principle of Autonomy also involves
respecting others culture, religion or belief
insofar as it positively affects their health.
But nurses have a duty to rectify erroneous
belief and practices by reinforcing positive
health teachings.
 The only exception when informed consent
maybe dispense is during emergency cases
as when the patient life would be in danger
if consent will be first secure. This is a
reasons of immediacy and exigency in
saving the life of others.
 The other exception is when there is
implied waiver or consent by the patient.
This occurs when the patient voluntarily
submits himself to a medical procedure
without any express consent given but
without any refusal.
PRINCIPLE OF JUSTICE
 “Be Fair”
 Means rendering of what is due or merited
 Equitable distribution of resources both
men and machine
 This principle is the key to solve scarcity in
our health industry
 Give a patient he/she deserves
TYPES OF JUSTICE
COMPARATIVE JUSTICE
 An individual or groups receives is
determine by balancing the competing
claims of other individual or groups
 Ex: One pt need a kidney transplant more
than another patient because pt 1 is dying
of renal failure while pt 2 has just been
diagnose a kidney problem.
Non Comparative justice
 the distribution of medical goods or
resources is determine by certain standards
rather than the needs or claims of
individuals
 resources and therefore, more lives will be
Distributive Justice saved
 Fair scheme of distributing society’s  If a group of patients needs smaller quantity
benefits and burden to its members. of health benefits proportionate to each of
Problems to Principle of Justice them, then all members in that group are
 Unequitable distribution of health care entitled to medical intervention. Minimizing
resources and goods health care resources is equivalent to
 Scarcity of health care resources maximizing the number of health care
 Scarcity of health care providers recipients, hence more patients are treated.
Two Alternatives on How the Distribution of Scarce  Limitation. Patients in need in bigger
amount of health care resources by reason
Health Care Resources should take place in an
of their serious condition are excluded from
effort to do justice to everyone
health care benefits. More often than not,
1. UTILITARIAN ALTERNATIVES
seriously ill patients are the ones whose
 Represent maximizing strategies to achieve
condition requires more health care
the greatest amount of good or minimizing
resources than not too seriously ill.
strategies to reduce the number of harm
D. PARENTAL ROLE PRINCIPLE
A. PRINCIPLE of MEDICAL SUCCESS
 Gives priority to those who have largest
 gives the priority to those whom treatment
responsibility to dependents. The father
has the highest probability of medical
with dependent children would be given
success. If the patient shows favorable
priority over a bachelor with no
prognosis and he has the possibility of being
dependents.
cured, his right to medical treatment
prevails over others  Limitation. This can be opposed with a
pathological condition that necessitates
 Limitation. This principle may overlook the
instant medical treatment
real existing need for immediate health care
E. PRINCIPLE OF GENERAL SOCIAL VALUE
intervention among other patients. Thus. It
poses a great argument as to whether or  Gives priority to those have the greatest
general social worth leading to the good of
not it constitute a claim that has to chosen.
society. The municipal or city mayor has a
b. PRINCIPLE OF IMMEDIATE USEFULNESS
right to medical treatment deemed greater
 gives the priority to the candidate who has
than an ordinary citizen
greatest immediate service to the larger
group under the circumstances. In case of  Limitation: An ordinary citizen who urgently
needs health care services due to severe
typhoon related health problems in a
condition will have to wait in favor of one
community, the social worker or the
looked up as having a general value whose
community leader has the greatest right to
condition may not be as serious as that of
medical assistance than the community
the ordinary patient. It convey a
folks
discrimination message against those who
 Limitation. What if there are patients other
are voiceless and marginalized.
than the social worker or the community
leader whose needs require emergency
2. EGALITARIAN ALTERNATIVES-maintain and
treatment? The said principle can be
restore the equality of the person in need
contested with an argument as to whether
a. PRINCIPLE OF SAVING NO ONE
it is indicative of a claim that has to be
attended to over others.  Gives the priority to no one because not all
can be save (Pag konti wag na lang)
c. PRINCIPLE OF CONSERVATION
 If there are no enough resources for all who
 Gives priority to those candidates who
need them, then no one should receive any
require proportionally smaller amount of
 Limitation. This is tangible denial that
deprives those who need it. It deprives
 those who are in urgent needs, their right to
medical intervention.
B. PRINCIPLE OF MEDICAL READINESS
 Gives priority to the candidates with the
most pressing needs. (Una ang pinaka
nangangailangan)
 Patients who are the most seriously ill are
the ones who benefit from the limited
health care resources.
 Limitation: It may draw waste of health care
resources when the most seriously ill
patients who are the recipients are not able
to recover and survive after all.
C. PRINCIPLE OF GENERAL READINESS
 Gives priority to the most helpless and
neediest to bring them to the level of well
being equally to that enjoyed by others
 The poorest candidate would receive the
available resources.
 Limitation. What of the poorest candidate
does not have the pressing medical need as
compare to a middle class patient. It may
not be expressive of a claim to prevail over
others
D. PRINCIPLE OF FIRST COME FIRST SERVE BASIS
 Gives priority to those who arrive first
 It apparently convey a message of giving
one what is due as determine by the TIME
he arrives
 It also establish an order in the distribution
of health care goods
E. PRINCIPLE OF RANDOM SELECTION
 Gives priority to those selected by chance
or random
 The candidate chosen in a lottery receives
the resource
 Limitation: It is a “hit or miss” to distribute
the health resources to those competing
claims should prevail as necessary which
may redound to wasted opportunity for
medical success
PRINCIPLE OF DOUBLE EFFECT
 Faced in situation which have good and bad
effects where you promote good that
involve with some expected harm
 Actions that has two effects one is good and
the other is evil
 Action must be morally good
 QUESTION. Is it morally permissible to do
such an act with both good and bad effects?
YES, provided the principle of double effect
is invoked whose conditions must be
satisfactorily satisfied or some evil effect
the cause is voluntary and may permitted to
occur.
 For example: The case of a woman who is 3
months pregnant and is found to have
cancerous uterus, to save the woman’s life
her uterus must be removed at the nearest
possible time, but as a bad effect, the life of
the fetus would be sacrificed.
 In the resolution of these kinds of conflict,
four conditions of the principle at issue
must be met.
a. Good effect must not come from an evil
action.
b. The good effect must follow form the action
as immediately as the evil effect or evil
effect may follow from the bad effect.
c. The foreseen evil effect may not be
intended or approved but merely permitted
to occur.
d. There must sufficient reason for allowing
the evil effect to occur while performing the
action. The sufficiency of reason exist when
there is no other means by which the good
effect can be achieve.
e. The motive of the agent must be holy and
ones. How can the agent be honest in his
intension? By directly willing to obtain the
good effect and not the evil effect of the
act. This can be proven when the evil effect
follows after the good effect is achieved.
PRINCIPLE OF TOTALITY
- Each person should know how to care for
every parts of himself for the benefit of the
whole
- “ the whole is greater than its parts”
- The person has the right to cut off, mutilate
or remove any defective non functioning
part of his body or to destroy their capacity
only insofar as the general well being of
the whole body requires it.
- A disease organ may be amputated or
excised for the good of whole organism to
save the person’s life
 - Forbid organ donation of a healthy person
if such were weaken the health of the
donor
- It may conflict the natural inclination
toward self preservation and violate the
sanctity of the individual
NOTE: Principle of totality and Double effect are
relevant to moral issue of medical experimentation.
If the experimentation, when a sick person may
greatly benefit from participating in an experiment
then it makes the experiment justifiable
PRINCIPLE OF INVIOBILITY OF LIFE
 Duty to take care of it
 “ Respect for the life of every person”
 Avoid anything that will end or endanger
one’s life.
 States that life is god loaned to us
 Its only god who has complete control and
dominion of our life
PRINCIPLE OF STEWARDSHIP
 “ Respect for the body”
 Refers to the expression of one’s
responsibility to take care of, nurture,
cultivate what has been entrusted to him
 Taking care and being responsible for
something which is entrusted to you.
 Declares that life comes from God and no
one is the master of his own body
 As steward, man does not have absolute
ownership of his life in the sense that he
can do whatever he wishes without
corresponding responsibility before God
 Duty to take care of ourselves, to maintain a
sound mind and safeguard our dignity.
IN THE HEALTH CARE PRACTICE, STEWARDSHIP
REFERS TO
 Execution of responsibility of the HCP to
look after their patients
 Provide necessary services and promote the
health and life of those entrusted to their
care
 Just and honest with the exercise of their
duties
 treat patient with utmost care and protect
it from harm
 To make health care facility and
technologies serve the well being of
patients
 Prevent infliction of unnecessary pains
 Respect the life from the moment of
conception
NOTE: In the light of principle of stewardship and
inviolability of life, euthanasia, in all forms, suicide
is considered immoral. The outright killing of any
innocent individual whether healthy or good, even
if done at the individual request is ALWAYS
INTRINCICALLY WRONG
PRINCIPLE OF VERACITY
 The principle of “Telling the truth” and
providing truthful information to the
patient
 A nurse must not provide fraudulent facts
or provide false hope or reassurance to a
patient.
 It is a mandates a policy of full disclosure of
care to patients. It is under the Patient’s Bill
of Rights that the patient has the right to
know the truth, as explained by his own
physician, his diagnosis, prognosis,
procedure, care, etc. etc.
PRINCIPLE OF FIDELITY
 “ Keep your promises!”
 Loyalty to the profession
 Prioritizing patient’s needs and care
PRINCIPLE OF SEXUALITY AND PROCREATION
 Underscores twofold purpose of sexual
union
 (1) procreation and nurturing of children
 (2)The expression of loving and
companionship
 These purposes must be achieve only within
the conjugal bond
 It considers abortion and positive method
of contraception are morally WRONG
Principle of Legitimate Cooperation
 the participation of one agent in the activity
of another agent to produce a particular
effect or share in a joint activity. This
becomes ethically problematical when the
action of the primary agent
is morally wrong.
 Working with another in the performance
of an action
  There are human actions whose
performance is possible and feasible
because of people working together with
specific functions to play
 The magnitude and essentiality of the
function played indicate the degree of the
cooperation in the performance of an act.
The lesser the magnitude and essentiality of
the function shared, the lesser the
cooperation
 There is NO question of morality if the
action performed is good.
 Moral questions comes in when the act is
contrary to the dictates of right reason and
moral law.
PRINCIPLE OF SUBSIDIARITY
 Means that what an individual (lower or
smaller group) can achieve within his/her
capacity should not be taken away and
transmitted to the custody and
performance of a higher or bigger group
 No bigger or higher group can arrogate to
itself functions that can capably and
competently done by an individual or lower
group.
 Example: In an effort to control the rapid
population in the country, the state
formulate a program on responsible
parenthood which redounds to the
enactment of the law mandating every
family to just limit the number of its
offspring only to one or two under pain of
penalty. And so, the state through the DOH
conducts contraceptive programs and
distributes forms of contraceptive methods
to ensure that state directed the number of
children of every family ought to raise.
Principle of Epikia
 “ In every rule there is an exemption”
Solidarity
 Principle of proper collaboration
 Value of team effort
 There is strength in unity and cooperation
Confidentiality
 Keeping patient’s privacy.
 the state of keeping or being kept secret or
private.
 The ethical principle of confidentiality
requires that information shared by a
client with a therapist in the course of
treatment is not shared with others. ...
There are important exceptions to
confidentiality, namely where it conflicts
with the clinician's duty to warn or duty
to protect.
RA No. 10173 or the Data Privacy Act of
2012
- “to protect the fundamental human right to
privacy of communication while ensuring
free flow of information to promote
innovation and growth [and] the [State’s]
inherent obligation to ensure that personal
information in information and
communications systems in government and
in the private sector are secured and
protected”
Acts Covered by the DPA
The DPA and its Implementing Rules and
Regulations (IRR) apply to all acts done or practices
engaged in and outside of the Philippines if:
 If the person, either an individual or an
institution, involved in the processing of
personal data is located in the Philippines;
 The act or practice involves personal data of
a Philippine citizen or Philippine resident;
 The processing of personal data is done in
the Philippines; or
 The act, practice or processing of personal
data is done by an entity with links to the
Philippines, subject to international law and
comity.
“Personal data” refers to all types of personal
information.
“Processing” is any operation/s performed upon
personal data. These operations include, but are not
limited to the collection, recording, organization,
storage, updating or modification, retrieval,
consultation, use, consolidation, blocking, erasure,
or destruction of data.
Golden Rule
- “ Do unto others what you would like others
do unto you”
- Confucius