ETHICAL PRINCIPLE

Ethical Principle – is a framework used in bioethics, known as principlism.

• Principlism- the principle function as guidelines in making justified moral decisions
or evaluating an action or policy.
• Assist the health professionals to determine right or wrong in regard to value issues
involving the pursuit of health, alleviation of suffering, and assisting patients towards
peaceful death.
ETHICAL PRINCIPLE

1. Autonomy
2. Confidentiality
3. Veracity
4. Fidelity
5. Justice
6. Beneficence
7. Non-maleficence
1. AUTONOMY

• Comes from Greek word autos meaning self and nomos meaning governance.
• It involves self-determination and freedom to choose and implement one’s decision, free
from deceit, duress, constraint or coercion.
• Healthcare providers need to respect patient’s rights to make choices about healthcare,
even if the healthcare providers do not agree with the patient’s decision.
 PATIENT’S BILL OF RIGHTS ADOPTED BY
AMERICA
• Rights to:

1. Considerate and respectful care;

2. Upon request, the name of the physician responsible for coordinating your care
3. The name and function of any person providing healthcare services
4. Obtaining from the physician complete, current information concerning diagnosis and prognosis in terms that
can be understood.
5. Receiving from the physician information necessary to give informed consent prior to the start of any procedure
or treatment, or both and which, except for an emergency situation not requiring an informed consent, shall
include as a minimum the specific procedure or treatment, or both, the medically significant risks involved, and
the probable duration of incapacitation, if any
 PATIENT’S BILL OF RIGHTS

6. Refusal of treatment to the extent permitted by law and to be informed of the medical consequences of
such action
7. Privacy to the extent consistent with providing adequate medical care.
8. Privacy and confidentiality of all records pertaining to treatment, except as otherwise provided by law or
third party payment contract
9. A response by the hospital in a reasonable manner to the patient’s request for services customarily
rendered by the hospital consistent with his/her treatment
10. Information by the physician or his delegate for the patient’s continuing healthcare requirements
following discharge, and notice before transferring to another facility if there is a need for such a transfer
PATIENT’S BILL OF RIGHTS

11. The identity, upon request, of other hospital care and educational institutions that the
hospital that the hospital has authorized to participate in the treatment
12. Upon request, an explanation of the patient’s bill, regardless of source of payment
13. Information of the hospital rules and regulations as they apply to the patient’s conduct
14. Treatment regardless of race, color, religion, sex, national origin or source of payment.
 THE RIGHTS OF THE PATIENTS

1. Right to Appropriate Medical Care and Humane Treatment 9. Right to Leave

2. Right to Informed Consent 10. Right to Refuse Participation in
3. Right to Privacy and Confidentiality Medical Research
4. Right to Information 11. Right to Correspondence and to
5. The Right to Choose Health Care Provider and Facility Receive Visitors
6. Right to Self-Determination 12. Right to Express Grievances
7. Right to Religious Belief 13. Right to be Informed of His Rights
8. Right to Medical Records and Obligations as a Patient
 PATIENT’S RESPONSIBILITIES

1. Providing information- accurate and complete information about the patients complaints, past illnesses,
hospitalization, medications and other matters relating to his/her health.
2. Complying with instructions- patient is responsible for complying the treatment plan recommended by
the attending physician or health care team that is primarily responsible for his/her health care. Patient is
expected to keep his/her appointments, abide by the hospital rules, and inform those concerned if he/she
cannot keep them.
3. Informing the physician of refusal to treatment- patient who refuses treatment or to be compliant with
the treatment regimen must inform the physician of his decision.
 PATIENT’S RESPONSIBILITIES

4. Paying hospital charges- if patient is in Pay Service, he/she is responsible for ensuring that
financial obligations of his/her care are fulfilled as promptly as possible.
5. Following hospital rules and regulation- patient is responsible for following the hospital’s rules
and regulations and shall advise his/her family to do so, too.
6. Showing respect and consideration- must considerate of the rights of other patients and hospital
personnel and shall assist in the control of noise, and or playing loud music. The patient must
respect the property of other persons and that of the hospital.
INFORMED CONSENT

• It is established principle of law that every human being of adult years and sound mind
has the right to determine what shall be done with his own body. He may choose whether
to be treated or not and to what extent, no matter how necessary the medical care, or how
imminent the danger to his life or health if he fails to submit to treatment.
INFORMED CONSENT

• Essential Elements of Informed Consent

1. The diagnosis and explanation of the condition;
2. A fair explanation of the procedures to be done and used and the consequences;
3. A description of alternative treatments or procedures;
4. A description of the benefits to be expected;
5. Material rights if any;
6. The prognosis, if the recommended care, procedure, is refused.
INFORMED CONSENT

• Proof of Consent- a written consent should be signed to show that the procedure is the one
consented to and that the person understands the nature of the procedure, the risk involved
and the possible consequences.
• Who Must Consent- the patient is the one who gives the consent in his own behalf.
However, if he is incompetent or physically unable and is not emergency case, consent must
be taken from another who is authorized to give it in his behalf.
• Consent of Minors- parents, or someone standing in their behalf, gives the consent to
medical or surgical treatment of a minor.
• Consent of Mentally Ill- a mentally incompetent person cannot legally consent to medical or
surgical treatment. The consent must be taken from the parents or legal guardian.
 INFORMED CONSENT

• Emergency Situation- no consent is necessary because inaction at such time may cause greater
injury. However, if time is available and an informed consent is possible, it tis best that this be
taken for the protection of all the parties concerned.
• Refusal to Consent- a patient who is mentally and legally competent has the right to refuse the
touching of his body or submit to a medical or surgical procedure no matter how necessary, nor
how imminent the danger to his life or health if he fails to submit to treatment.
• Consent for Sterilization- the husband and wife must consent to procedure if the operation is
primarily to accomplish sterilization. When the sterilization is medically necessary and
sterilization is an incidental result, the patient’s consent alone is sufficient.
• Confidentiality- nondisclosure of information, involves limits on the communication of
“any information a nurse obtains about a patient in the context of the nurse-patient
relationship”.
- An individual’s right, within the law, to personal and informational privacy,
including his or her health care records.
• Privileged Communication- privilege relief from having disclose information in court proceedings.
• patients are threat to themselves or to identifiable other.
• Statutes requires disclosure, such as those involving the reporting of child abuse, rape, or other crime
• The patient consents to release of the information
• A court mandates the release
• The information is needed for other caregivers to provide care to the patient.

* Can nurses disclose patient information to unidentified or unauthorized telephone callers or to relatives,
significant others, or friends of the patient without the patient’s consent?
• Privacy- person’s right to be protected by limited physical and informational access by
others.
• 4 types of Privacy that address limited personal access:
• Informational privacy: communication of information
• Physical privacy: with regard to personal access
• Decisional privacy: with regard to personal choices
• Proprietary privacy: property interest, including interest with regard to bodily tissues, one’s
name
2. CONFIDENTIALITY

• Anything stated to nurses or health care providers by patient must remain confidential.
• The only times this principle may be violated are:
• If patients may indicate harm to themselves or other
• If the patient gives permission for the information to be shared.
3. VERACITY

• To maximize the efficiency of health care, the patient and the health care providers are
bound to tell the truth.
• “truthfulness”
4. FIDELITY

• Loyalty
• The promise to fulfill all commitments
• The basis of accountability
• Includes the professional faithfulness or loyalty to agreements and responsibilities.
5. JUSTICE

• Refers to the right to demand to be treated justly, fairly and equally.

• Every individual must be treated equally
• This requires nurses to be nonjudgmental
 6. BENEFICENCE

• Principle of “doing good” for others.

• Promotes doing acts of kindness and mercy that directly benefit the patient.
• These acts promote the health of the patient, prevent illness or complications, alleviate suffering and
assist towards peaceful death if the inevitable comes.
According to William Frankena- there are 4 elements to help express the principle of beneficence:
1. one ought not to inflict evil or harm
2. one ought to prevent evil or harm
3. one ought to remove evil or harm
` 4. one ought to do or promote good
7. NONMALEFICENCE

• Do no harm
• One not to injure or harm others