ETHICAL THEORIES- Functions as

moral guides in answering the

questions “ What ought to do or
not to do”
Ethical Theories – can provide individuals
wih guidance in moral thinking and
reasoning and provide justification for
moral actions.
There is normative framework with
foundational statement for each ethical
theory and people who apply an ethical
theories and approaches should help
people discern commonplace morality and
strenghten moral judgement.
DEONTOLOGY- ( Duty oriented) is an
ethical theory based on dutiful actions not
actions based on rewards, happiness or
consequences.
Deontological perspective an ethical
system that holds the right action that
based on ethical principles known to be
right.
The act in itself would be either right or
wrong it could not be both.
Deontology theory encompasses natural
law theory such as Kantianism and Ross
prima facie duties.
Kantianism the philosopher most influencial
to the deontological way of thinking .
Immanuel Kant – a German philosopher of
the 18th century , in his classic work
Groundwork of the Metaphysics of Morals.
Kant defined a person as a rational human
being with freedom and moral worth.
A person is morally good and admirable if
action are done from sense of duty.
Because human beings are rational, they
have the freedom to make moral
judgement.
Kant stated that people ought to follow a
universal framework of moral maxims or
rules to guide right actions and duties
because it is only through dutiful action
that people have moral worth. Even when
individual do not want to act from duty, it is
Kant`s belief that they are required to do
so.
Kant held that the human mind works the
same way, regardless of who you are, where
you are,. when you are.
Kant based his moral philosophy on crucial
fact that we are rational beings, and a central
features of the rationality was that principles
derived from reason are universal. He held
that morality is derived from rationality, not
from experience, and that obligation is
grounded not in the nature of man or in
circumstances of the world but in pure reason.
The nurse informed the physician of the
effect but for the sake of the research
outcome and the anticipated bonuses, ,
they decided that it would be best if the
elderly lady remained on medication for a
full 6 weeks if possible.
In this scenario, the nurse and physician
were ot concerned with the feelings of the
patient as a person or the side effect she
was exhibiting , using the patient for their
benefit.
TELEOLOGICAL (Consequence –oriented)
theories judge the rightness or wrongness
of decision based on outcomes or predicted
outcome. The consequence –based theory
would decide that what is right also
maximizes some good.
The right thing to do , then is the good
thing to do. These theorist may argue about
what constitute the good, but once agreed
they would have no problem, theoretically,
in deciding on a right course of action.
In their work works focussed on health care
setting.
T.L. Beauchamp and L.B. McCullough offer
health (prevention, elimination or control
the spread of disease) , relief from
unnecessary pain and suffering
amelioration of disabling condition and the
prolongation of life as intrinsic goods.
UTILITARIAN ISM -promotes the highest
good that is possible in every situations in
other words “ the greatest good for the
greatest number”.
Utilitariasnism is related to real life
common sense action and their
consequences, not aristocratic privilege,
religious faith, or tradition.
According to Bentham, each form of
happiness is equal and each object should
be evaluated according to its production of
happiness, good or pleasure.
Although happiness or benefit to others is
the goal it should be kept in mind that
utilitarian is not an “all or none” theory.
Common sense approaches should be taken
seriously when individual are deciding a
couse of action to improve some part of
society.
Example No. 2
Mill stated that pleasure and happiness
should be prioritized according to a
person`s intellectual ability . In this way,
the most prioritized higher pleasure such as
applying the Golden Rule to one`s conduct
are preferable over lower pleasures such as
immediate gratification and physical
pleasure alone.
Only human being not animals possess the
mental faculty to develop the level of
happiness that result from highest
pleasures,
Because utilitarians, place great emphasis
on what is best for groups, not individual
people the focus is on acts that produce the
most good in terms of the most happiness .
By aiming for the most happiness, this
theory focuses on consequences , utility or
ends .
VIRTUES ETHICS - Deals with questions,
such as “what sort of person must I be” and
what makes an individual thought of as
purpose dispositions and character traits
that are develop throughout life. Schools,
social institutions and families help to
shape a person`s moral character.
Virtues are thought of a purposive
dispositions and character traits that are
developed throughout life.
Schools , social institutions, and families
help to shape a person`s moral character.
Most , but not all virtues, are considered a
mean between two kinds of vices, involving
either an excess or a deficiency.
Aristotle 2002, name courage as a virtue ,
the excess of courage is rashness, and the
dificiency of courage is cowardice.
We may go so far as to state that the man
who does not enjoy performing noble
actions is not a good man at all. Nobody
would call a man just who does not enjoy
acting justly, not generous who does not
enjoy generous action and so on.
The primary focus of virtue ethics is the
heart of the moral agent making the
decision rather than te reasoning to a right
action.
CASE STUDY:
ACT UTILITARIANISM: CALCULATING THE
PLEASURE AND PAIN
Mr. Jimenez is a 78 year old chronic
pulmonary disease patient (Emphysema)
who has smoked two packs a day for 40
years. He takes great enjoyment and
satisfaction in smoking and does not want
to quit.
In that his illness is exacerbated by the
smoking, his physician is demanding that he
quit. Each time he tries to quit smoking, Mr
Jimenez becomes irritable and unhappy. His
wife and family hate it when he is not smoking
because he becomes difficult to live with.
1. Consider this case from the position of act
utilitarianism and create pleasure gained and
pain avoided list to see if you can determine
whether Mr Jimenez should continue or quit.
GIVE YOUR REACTION.
Case study no.2.
VIRTUE ETHICS: SAINT OR SINNERS
Maria is the student in your clinical laboratory science
class that you as a teacher think is least likely to make a
good health care provider. Although very bright, she
comes from a rough and tumble background , and while
she is making satisfactory progress in your class, she is
also the one who appears to be cutting the most corners.
On your way out of the office you leave your office open
and the final exams on your desk. Maria a student
assistant and know your gone for the day and notice
that the door is open, enters the office and sees the
exam.
It would be so easy to copy the exam, she thinks as
she moves toward it. However, at the last moment ,
she stops and think to herself that she knows she is
prepared for the exam, and she doesn`t need the
grief if she should ace the exam and someone sees
her leave the office.
She backs out of the office, looks to be sure that no
one has seen her, and locks the dor. She thinks to
herself. If can`t see the exam. I will be sure that no
one else will either.
1. in virtue ethics, which of the following is the more
noble the tempted sinner who makes the right
choice or unconcerned saint. Defend your answer.
The primary focus for virtue ethics is the
heart of the moral agent making the
decision rather than reasoning to a right
action.
 According to the theory, an individual by
living well and practicing virtues could
develop the habit of being virtuous. Such
an individual, when confronted by an
ethical dilemma, would act according to his
heart and choose well.
BASIC Principles of Health Care Ethics
Autonomy- in health care, it has come to mean a
form of personal liberty, where the individual is
free to choose and implement her own decisions,
free from deceit, constraint or coercion.
3 Basic element of Autonomy :
1. The ability to decide- for without adequate
information and intelletual competence, autonomy
seems hollow.
The power to action your decision- could have
made all the decision they might have wished but
lacked power to implement them.
A respect for the individual autonomy of others- it is
the provision of general respect for personal autonomy
for both practitioners and patient alike that enables and
professionalizes the process.
Self determination and freedom is often used
synonymously with autonomy.
Autonomy – is the right of a rational person to self rule
and to generate personal decision independentlly.
In the domain of health care, respect for patients
autonomy includes action such as obtaining informed
consent for treatment, facilitating patient`s choice
regarding treatment option, allowing patient to refuse
treatment.
Disclosure by the provider of personal
medical information, diagnosis, and
treatment options to the involved patient,
and maintaining confidentiality.

Restriction on autonomy may occur in

cases where there is a potential for harm
off others through communicable disease
or act of violence.
Right is something of which no one may be
derived without a grave affront to justice.

Rights in moral philosophy and political

theory are thoughts of a justified claims or
demands respect.
THE BILL OF RIGHTS FOR PATIENTS FROM
THE AMERICAN HOSPITAL ASSOCIATION:
1. Right to Information Disclosure- the right to
accurate and easily understood information the
health plan, health care professionals and facilities.
2. The right to choice of Providers and Plans. The
right to a choice of health care providers that is
sufficient to provide high quality of health care
3. Right to access to Emergency Services- the right
to receive screening and stabilization emergency
service whenever and wherever needed without
authorization or financial penalty.
4. Right to participate in Treatment
Decision- the right to know your treatment
option and participate in decision about
your care. Parents, guardians, family
member or other individual that designate
can represent if cannot make own decision.
5. Right to be Respected and
Nondiscrimination- be considerate,
respectful and non discriminatory care from
your doctors, health plan representative
and other health care providers.
6. Right to Confidentiality to Health Information- the right
to talk in confidence with healthcare provides and have
your health care providers and to have your healthcare
information protected. You have the to review and copy
own medical record and request that your physician
change your record if it is not accurate, relevant or
complete.
7. Complaints and Appeals- the right to a fair and objective
review of any complaints you have against your health
plan, doctors, hospital or other health personnel. Includes
about waiting time, operating hours, conduct of health
care personnel and adequacy of health care facilities.


The 3 Fundamental rights of Patient:
1. The right to know
2. The right to privacy
3. The right to treatment
There are 3 points to emphasized about
patients right in general:
1. Having rights does not mean that one is
bound to excise them.
2. Having rights does not mean that they
are absolute and their exercise is unlimited
3. Patient`s negative rights are in general
stronger than their positive ones
For Example:
Having the right to know does not mean
that one has to exercise it. One may not
wish to know that one is dying.
One may not wish to discuss it, a particular
doctor or nurse
One has the right to asked, but one is not
obliged to accept unwanted information or
even counselling.