ETHICS: General Morals

Objectives
 -         Analyze the problems affecting the voluntary nature of human acts
through case discussion
 Illustrate the Morality of human acts and relate it to Actual Patient Care
after lecture discussion
Ethics is….
 Isthe science which guides our judgment concerning
the morality of human acts

 Came from the Greek word “ethos” meaning

character or custom; or characteristic way of acting

 Refers to those characteristics belonging to man as a

rational being, endowed with intellect and free-will
 Is the science of human acts with reference to right and wrong

 Is the study of the rectitude of human conduct

 Is the scientific inquiry into the principles of morality

 Is the practical science of the morality of human actions

Morality is….

Therightness or the wrongness of the

human act
The Nature of Ethics….

 Ethics is philosophical.
 Highly related to Logic (science that guides man’s
intellect in the acquiring the truth)
 Ethics on the other hand, guides the intellect in
acquiring and applying moral principles AND it
compels man to follow his ultimate destiny which is
“REUNION WITH GOD”
Science of Ethics

There is only one Good,

Knowledge
There is only one Evil,
Ignorance.
. . . . . . . . Socrates
 Importance of Ethics to Nursing

Remember:
1. Without morality, man as a rational being is
a failure
2. Moral integrity is the only true measure of
what man ought to be
3. When moral foundations of a nation are
threatened, that society itself is threatened
(Sr Leticia Shahani)
 Importance of Ethics to Nursing
Remember:
1. Without morality (nurse), man as a rational being is a failure (being a
professional nurse is a failure)
2. Moral integrity is the only true measure of what man ought to be (_____)
3. When moral foundations of a nation are threatened, that society itself is
threatened (_____)
Basis of Ethics
 1. Human reason is capable of discovering
some truths.
 2. God exists.
 3. God is just.
 4. A good life shall merit God’s reward.
 5. An evil life shall merit God’s punishment.
 6. Man has a soul
 7. Man’s soul is immortal.
 8. Man’s soul has the faculties of intellect
and will.
 9. The object of the intellect is truth.
 10. The object of the will is goodness.
 11. Man’s will is free and is therefore
capable of both good and evil.
 12. Good must be done and evil must be avoided.
 13. An act is good when it is in conformity the right reason.
 14. An act is evil when it is not in conformity with the right reason.
Ethics and the Catholic Church

The importance of human rights in

nursing was made explicit in a
statement adopted by
the Catholic Church
About Abortion -The Church says that deliberately
causing an abortion is a grave moral wrong.
About contraception -Artificial birth control being
"intrinsically evil", Catholics are only permitted
to use natural methods.
About Euthanasia - The Church believes that the
sacredness of human life is incompatible with
any 'right to die'.
About organ donation - The Vatican strongly
supports organ donation.
 The Morality of Human Act
Acts when they are proper to man as man
ACTS – thought, words, desire, omission
Performed by human being when he is
responsible
Act perfectly done with full knowledge and
consent
Act of a person – done w/o knowledge and
consent
Essential Elements of
Human Acts
1. Knowledge – act done in
ignorance
2. Freedom -has no control
3. Actual Choice or Voluntariness –
does not will
Elements in Determining Morality

1. The Act Itself – the nature of the act

Ex.
~taking vital signs
~writing v/s in v/s sheet even if not
taken
~ Lying to one’s mother etc.
 Purpose/Object/Motive – the reason
for which the act is performed or
made ; the end of an act; the
intention of the agent

 Circumstance – the condition

prevailing at the time the act was
made/performed
 Types of Act
• Intrinsic Evil Act – an act which is
evil by nature such as administering
wrongful medications; malpractice
1. Extrinsic Evil Act – an act which is in
itself is not evil but is made evil on
the account of something else such
as we let the patient eat even w/
order NPO or for OR
 Question on Motives….The End
does not justify the means

 Intentions
do not remain to be good
when achieved using evil ways….

 Example:writingin your nurses notes

interventions which you did not do…
to have a good impression
 Principles of Circumstance
 1. Circumstance may either increase or
decrease the wrongfulness of an evil act.

 2. Circumstance also may either increase

or decrease the merits of the good act

 3. Some circumstances may alter the

nature of the act.
 Classifications of Circumstance
 1. Who – refers primarily to the doer
of the act.
 2. What – refers to the act itself and
to the quality and quantity of the
results of the act
 3. Where – refers to the circumstance
of place where the act was committed
 4. With Whom – refers to the
companion or accomplices in an act
performed
 5.
Why – refers to the motive of the
doer

 6.How – refers to the manner how

the act is made possible

 7.When – refers to the time of the

act
Conditions Affecting Morality or
Modifiers of Human Act
1. Ignorance – lack of knowledge in a
person capable of knowing
2. Fear – agitation or disturbance of
mind resulting from some present or
imminent danger.
3. Concupiscence – human impulses or
passions against reason (love, hatred,
anger, fear, courager)
 4.
Violence – external force
applied by someone on another in
order to compel him to perform
an action against his will

 5.Habit – inclination to perform

some particular action acquired
by repetition and characterized by
a decreased power of resistance
 6.Temperament – sum total of
those qualities which mark an
individual (also called as
personality)

 7.Mental Disorders – pathological

condition that deprives a person
from exercising intellect/ proper
reasoning
 Moral Guides and Maxims
 1.One who acts through an agent
is himself responsible.

 2.
No one is obliged to betray
himself.

 3.
In doubt, one may do what is
generally done.
 4. An object cries out for its owner.

 5.
No one can give what he does not
have.

 6.Possession is nine-tenths of the

law.

 7.
The end does not justify the
means.
 Defects of nature may be
 8.

corrected.

 9.
No one is a judge in his own
case.

 10.Accessories belong to the

principal object.
 11.If one is willing to cooperate
in an act, no injustice is done to
him by the act.

 12.
A very little is equal to
nothing.

 13.
A little more or less does not
change the substance of the act.
 14.Laws imposing an obligation
may be given as narrow an
interpretation as possible.

 15.
No one is held to the
impossible.

 16. A doubtful law does not bind.

 17. Passion does not usually arise
from things to which we are
accustomed.

 18. Sacraments were meant for

the good of souls.

 19. The salvation of souls is the

highest law.

Natural Law
 Is the code of moral conduct which reason indicates as conformable to
human nature.
 Ex. Man’s natural ability to live with others/society
Man’s natural ability to be rational or to act
with reason.
(Man’s actions are purposeful or well-intended)
Positive Law
 Is a precept imposed by one in authority.
 Sometimes this ‘authority’ is GOD which defines it as “Divine Positive
Law” through the 10 Commandments
 Sometimes this authority is MAN which defines it as “ Human Law”
through the statutes, constitution, ordinances etc.
Eternal Law
 This states that, “Man is created to unite with his Creator”

 This means that Man is created to be with GOD and to be ONE with GOD
( to be like Him and be with HIM whether during man’s natural life or life
after death)
Therefore……
 When we study ethics, we are guided on how to
acquire moral principles, how to apply them in our
daily lives for the purpose of living a life in
conformity with ‘righteousness’.

 These are accomplished by (1) deep introspection of

man’s works, actions or behaviors called “human
acts” and (2) by coming up with moral judgments.
If….
1. Man is created with intellect capable of reason.
2. Man is created with free will to choose his actions.
3. Man is bound to exercise righteousness to unite
with his Creator

WHY IS IT THAT WE DIFFER IN

MORAL JUDGMENTS?
Ethical Principles
1. Principle of Totality of Human Person
or Principle of Human Dignity
- in community, requires self-respect as
well as respect for others
- in medicine, it is not merely to have higher
functions but to have basic human
functions to have harmonious order.
2. Principle of growth through Suffering
- in any teleological ethics, ultimate criterion of morality is happiness
 sufferings or bodily death when endured with courage can & should be used to
promote growth
 E.g. writer – masterpiece
scientist – great discovery
student nurse – registered nurse
- they may feel exhausted at time, yet envied
 3. Beneficence – moral obligation to
act for the benefit of others
- act of mercy, kindness, charity
4. Non-Maleficence – asserts an
obligation not to inflict harm
intentionally
-e.g. do not kill, do not cause pain
do not allow dangerous employee
to stay
 5.Principle of Two-fold effect/Double
effect – an act w/c has two effects
good or evil
-
Moral Guides and Paulinian
Values

5 Core Values
1. Christ-centeredness
2. Charity
3. Community
4. Commitment to the mission
5. Charism
Health Care Profession

 Health Care Professionalism

 Code of Ethics - A set of ethical principles that are accepted
by all members of a profession

 Set forth ideals of conduct

 Nurse Code of Ethics
Autonomy – right to have their own
choice in health care
Informed Consent -
Confidentiality – strong basis for
effective working prof-pt rel.
6. Truth/Veracity (quality of being
truthful)
7. Justice-
The Standards of Morality

1. Norms are purely internal/subjective.

~ Man’s actions lie on the feeling of the
“self”.
~ The “self” feeling may change from time to
time or maybe influenced by a lot of factors
but they always spring from
personal/subjective judgment.
 2. Norms maybe based on current opinions and customs.
~ Some derive their judgments or actions by the number of people who do the
same
~ “Everybody is doing it!” as they say
~ There are people who base their morality on the rule of the majority (or the
majority’s opinion)
 3. Norm of expediency.
~ Other people regulate their actions in accordance with what
is useful for them at the moment rather than what is
objectively right or wrong.

~ The famous lines related to this are:

“Let’s just see what happens next.”
“ I’ll just cross the bridge when I get there.”
“ We’ll worry about it in the future.”
 4. Norm of preference
~ There are others who act in accordance with what is desirable or
“prefers” to be doing rather than what is right or wrong.
~ These people often come up with judgments that would merit their
“acceptability” or their judgment’s acceptability
 5. Situation Ethics
~ There are people who would act/judge depending on the situation OR there are
some who would base their judgments on the premise that…

“ I must always do what I feel is right for me. You must not impose your views
on me, in as much as I cannot impose my views on you.”
 6. Evaluation
~ Righteousness is in conformity with human nature, right reasoning and
God’s commandment

~ Any action in violation of these are considered to be wrong

The Morality of the Human Act

Human acts – the one that proceeds from

the deliberate free will of man
It is an act that is knowingly performed
by one having the use of reason.
Both the intellect and the free will are
in play
Essential Attributes of the Human Act
 1.It must be performed by a conscious agent who is
aware of what he is doing and of its consequences.

 2. It must be performed by an agent who acting

freely, that is, by his own volition and powers.

 3.It must be performed by an agent who decides

willfully to perform the act.
Elements in Determining Morality

1. The Act Itself – the nature of the act

Ex.
~Visiting a sick friend
~ Stabbing one’s father;
~ Raping an 18 year old adolescent
~ Lying to one’s mother etc.
 Purpose/Object/Motive – the reason for which the act is performed or
made ; the end of an act; the intention of the agent

 Circumstance – the condition prevailing at the time the act was

made/performed
Types of Act

1. Intrinsic Evil Act – an act which is evil by nature

such as stealing a purse, robbing a bank, adultery,
administering wrongful medications; malpractice
etc…

2. Extrinsic Evil Act – an act which is in itself is not

evil but is made evil on the account of something
else such as eating meat during Lent, giving alms to
beggars which is prohibited by law
Question on Motives….The End does
not justify the means
 Intentions do not remain to be good when achieved using evil ways….

 Example: cheating to pass the exams, faking documents to get employed,

lying so as not to be scolded etc….
Principles governing the Motive
 1. An evil act which is done on account of an evil motive is wrong.
 A good action done on account of an evil motive becomes evil in itself.
 A good action done on account of a good purpose acquires merit.
 4. An indifferent act may either be good or bad depending on the motive of
doing such.
Classifications of Circumstance
 1. Who – refers primarily to the doer of the act.
 2. What – refers to the act itself and to the quality and quantity of the
results of the act
 3. Where – refers to the circumstance of place where the act was
committed
 4. With Whom – refers to the companion or accomplices in an act
performed
 5. Why – refers to the motive of the doer

 6. How – refers to the manner how the act is made possible

 7. When – refers to the time of the act

Principles of Circumstance
 1. Circumstance may either increase or decrease the wrongfulness of an
evil act.

 2. Circumstance also may either increase or decrease the merits of the good
act

 3. Some circumstances may alter the nature of the act.

Conditions Affecting Morality
 1. Ignorance – lack of knowledge in a person capable of knowing
 2. Fear – agitation or disturbance of mind resulting from some present or
imminent danger.
 3. Concupiscence – rebellion of the passions against reason (appetites of
human nature)
 4. Violence – external force applied by someone on another in order to
compel him to perform an action against his will

 5. Habit – inclination to perform some particular action acquired by

repetition and characterized by a decreased power of resistance
 6. Temperament – sum total of those qualities which mark an individual
(also called as personality)

 7. Mental Disorders – pathological condition that deprives a person from

exercising intellect/ proper reasoning
Moral Guides and Maxims
1.One who acts through an agent is
himself responsible.

2. No one is obliged to betray himself.

3.In doubt, one may do what is generally

done.
 4. An object cries out for its owner.

 5. No one can give what he does not have.

 6. Possession is nine-tenths of the law.

 7. The end does not justify the means.

 8. Defects of nature may be corrected.

 9. No one is a judge in his own case.

 10. Accessories belong to the principal object.

 11. If one is willing to cooperate in an act, no injustice is done to him by
the act.

 12. A very little is equal to nothing.

 13. A little more or less does not change the substance of the act.
 14. Laws imposing an obligation may be given as narrow an interpretation
as possible.

 15. No one is held to the impossible.

 16. A doubtful law does not bind.

 17. Passion does not usually arise from things to which we are accustomed.

 18. Sacraments were meant for the good of souls.

 19. The salvation of souls is the highest law.

Deontological ethics

(Greek: Deon meaning obligation or

duty) is a theory holding that
decisions should be made solely
or primarily by considering one's
duties and the rights of others.
. Deontology posits the existence of
a priori moral obligations, further
suggesting that people ought to
live by a set of defined principles
that do not change merely as a
result of a change in
circumstances (ie.
situational ethics).
• praiseworthy goals can never
justify immoral actions.

• The end doesn’t

justify the means.
Utilitarianism

(from the Latin utilis, useful) is a

theory of ethics that prescribes
the quantitative maximization of
good consequences for a
population. It is a form of
consequentialism.
This good to be maximized is usually
happiness, pleasure, or
preference satisfaction. Though some
utilitarian theories might seek to
maximize other consequences, these
consequences generally have
something to do with the welfare of
people (or of people and nonhuman
animals). For this reason,
utilitarianism is often associated with
the term welfarist consequentialism.
• everybody's interests should be
considered equally when making
decisions -- is a core tenet of
utilitarianism.

• The end justifies

the means if it
will benefit the
majority
Teleology
• an approach to ethics that studies
actions in relations to their ends
or utility
• philosophical study of design,
purpose, directive principle, or
finality in nature or human
creations.
• teleology judges the morality of
an action by its consequences.
• The end justifies
the means.
Bioethical Principles
 1. Beneficence
 2. Non-Maleficence
 3. Autonomy
 4. Principle of Totality
 5. Justice
 6. Truth/Veracity
 7. Professional Communication
 8. Confidentiality
 9. Privacy
 10. Legitimate Cooperation
 11. Informed Consent
 12. Principle of Two-fold effect/Double effect