By:

Harold Alvarez Bartolome, RM, RN, RPT, MAN, Ph.D.

Professor
 MORALS

 Specific ways of behavior or of accomplishing ethical

principles.

 Capability of conforming to the rules of right conduct

 MORALITY

Greek word “Moralis” refers to social consen-

cus about moral conduct for human beings
and society.

Pertains to human decency, right or wrong,

good or evil, proper or improper, cruel or
benevolent acts.
 PROFESSIONAL ETHICS

Concerned with the obligation that a mem-

ber of the profession owes to the public.
 HEALTH CARE ETHICS

Division of ethics that relates to human health

that resides on human values, morals customs,
personal beliefs and faith
 BIOETHICS

• Focuses on moral issues in the field of

health care

• Result of life and death dilemmas faced by

health care practitioners
 ETHICAL PRINCIPLES
AND OTHER AP-
PROACHES
1. TELELOGICAL APPROACH
2. DEONTOLOGICAL APPROACH OR DUTY ORI-
ENTED THEORY
3. VIRTUE ETHICS APPROACH
4. DIVINE COMMAND ETHICS
 Greek word “Telos” meaning goal or end.
 The right thing to do is the good thing to do
also termed as an act utilitarianism where
the good resides in the promotion of happi-
ness or the greatest net increase of pleasure
over pain.
Ex. If the act helps people, then it is a good act
and if it hurts people then it is a bad one
DEONTOLOGICAL APPROACH OR DUTY
ORIENTED THEORY

 Greek word “deon” meaning duty.

 The basic rightness or wrongness depends on the intrinsic

nature rather than upon the situation or its consequences.

 A person is morally good and admirable if his actions are

done from sense of duty and reason and it only through
dutiful actions that people have moral worth.
Telling the truth keeping actual
implicit to promises
Righting the wrong we have
done to others
Recognizing the service other
have done for us
Right to be treated fairly
Helping to better the condition of
other beings
Bearing ourselves with respect to
virtue or intelligence
Avoiding injury to others
 Focuses on the heart of the person performing the
act.

 Focuses on the traits and virtues of a good person

such as courage, temperance, wisdom and justice.

 One must have the right motivation, disposition and

traits for being good and doing right such as
courage, honesty, justice and beneficence.
VIRTUE ETHICS APPROACH:

1. INTELLECTUAL VIRTUE
2. MORAL VIRTUE
Power to deliberate about things
good for oneself
Learning how to do things on
her own
• There is a Supreme or Divine being that
sets down the rules to provide guidance
to moral decisions
Ex. Ten Command-
ments
1. AUTONOMY
2. VERACITY
3. BENEFICENCE
4. NONMALEFICENCE
5. JUSTICE
1. AUTONOMY
• Greek word “ autos” meaning self and “nomos” mean-
ing governance
• self determination and freedom to choose and imple-
ment one’s decision, free from deceit (misleads a per-
son or which causes him to believe what is
false),duress (coercion) and constraint
• Ex. Informed consent
2. VERACITY

Bound to tell the truth to increase one’s credibil-

ity
A. Pt’s responsibility:

• To provide accurate and complete information

about his complaints, past illness, previous hos-
pitalizations, medications being taken, allergies,
religious restrictions and other matters relevant
to health
 B. Physician's re-
sponsibility:

• Tell all necessary information about his diagno-

sis, plan of care, treatment and possible risks in-
volved, the length of treatment, possible ex-
penses, and other options they may take if there
be any.
3. BENEFICENCE

• Doing acts of kindness and mercy that directly benefit

the patient.

• These acts promote the health of the patient, prevent

illness or complications, alleviate sufferings and as-
sist towards a peaceful death if the inevitable comes.
1.Considerate and respectful care
2. Right to informed consent.
3. Make decisions regarding his plan of care, in case of refusal
he is entitled to other appropriate care and service or be
transferred to another hospital.
4. Have an advance directive.
5. Every consideration of his privacy such as in case discussion,
consultation and treatment.
6. Confidentiality of communication and records.

7. Review his records concerning his medical care and have

these explained to him except when restricted by law.

8. Be informed of business relationship among the hospital, ed-

ucational institution, health care providers that may influ-
ence the patient’s treatment care.
9. Consent or decline to participate in experimental research
affecting his care.

10. Reasonable continuity of care when appropriate and be in-

formed of other care options when hospital care is no linger
appropriate.

11. Be informed of hospital policies and practices that relate to

patient care.
4. NONMALEFICENCE

• To do no harm
• Ex. Not assisting or performing abortion or
not performing euthanasia or mercy killing
5. JUSTICE

Right to demand to
be treated fairly,
justly and equally
 Sphere of Midwifery
• A midwife must be able to give necessary super-
vision, care and advice to women during preg-
nancy, labor and the post partum period, to con-
duct deliveries on her own responsibility and to
care for the newborn and infant. (Preventive, cu-
rative and rehabilitative.)
 Skills and Abilities
• Technical skills
– Diagnosing and Formulating Programs
• Communication skills
– Oral and written
• Analytical skills
– Intact strategies
– Seal of confidentiality
 Licensure Exam
Qualifications:
- good health and good moral
- graduate of midwifery in accredited in-
stitution
- Filipino citizen
- at least 18 years of age
 Scope of Exam
• Infant care and feeding
• Obstetrical anatomy and physiology
• Principles of bacteriology
• OB
• Midwifery procedures
• Domiciliary midwifery
• Community hygiene and first aid
• Nutrition
• Ethics of Midwifery Practice
• PHC
• Professional Growth and Development
• Family planning
• Others
 Requirements
• See assertions in your textbook.
 Inhibition of Practice
• No person shall practice or offer to practice Midwifery
in the Philippines without holding a valid certificate of
registration and a professional license as midwife.

• Revocation
– Cancellation of midwife’s certificate or license due to failure to
meet the condition that is inherent to her license or certificate
or any commission of act that is not within the scope of her
practice.
• Suspension
– Temporary withdrawal of rights, privilege or license to practice
midwifery profession.
 Causes of Revocation
• Criminal Offenses
• Moral Turpitude
• Negligence
• Malpractice
• Incompetence
• Ignorance
• Fraud and deceit
• Gross Misconduct
 Republic Act No. 7392

An Act Revising Republic Act No. 2644, As

Amended, Otherwise Known as the
Philippine Midwifery Act
Be it enacted by the Senate and the House of
Representatives of the Philippines in Con-
gress assembled
 Article 1
TITLE

Section 1.Title.- This Act shall be known as

the “Philippine Midwifery Act of 1992.”
 Article II
THE BOARD OF MIDWIFERY
Section 2. Composition.- There shall be a Board of
Midwifery, hereinafter referred to as the Board, which
shall be under the direct supervision of the Professional
Regulation Commission (PRC). It shall be a collegial
body composed of a chairman and four (4) members to
be appointed by the President of the Philippines from
among the recommend of the Commissioner of the
Professional Regulation Commission.
The Commission shall recommend three (3) registered
midwives from the list submitted by the association of
midwives; one (1) obstetrician from the list submitted by the
association of obstetricians; and one (1) registered-nurse-
midwife from the list submitted by the association of
midwives; Provided, That said associations in accordance with
Presidential Decree No. 223: Provided, further, That the
nominees submitted shall possess the appropriated
qualifications prescribed in Section 3 hereof.
 Section 3. Qualifications and
Disqualification of the Board Members.
 A. Each member of the Board shall at the time of
his appointment

1) Be a citizen and resident of the Philippines;

2) Be of good moral character;
3) Be at least thirty (30) years of age; and
4) Not be a member of the faculty, whether full time, part time or
lecturer, of any school, college oruniversity where a regular
course in midwifery is taught, and shall not have any pecuniary
interestdirectly or indirectly, in such institution during his term of
office as a Board member.
 B. The Chairman of the Board shall at the time of
his appointment:

1) Be a registered obstetrician; and

2) Have at least ten (10) years practice as an obstetri-

cian prior to his appointment
C. Three (3) members of the Board shall at the time
of their appointment:

1) Be registered midwives;
2) Be degree holders, preferably in the field of health
and social sciences; and
3) Have at least ten (10) years practice as midwives
prior to their appointment, five (5) years of which
are in supervisory positions
D. One (1) member of the Board shall at the time of
his appointment:

1) Be a registered nurse-midwife; and

2) Have at least ten (10) years practice as a nurse-
midwife
Section 4. Term of Office.- The Chairman and the four
(4) members of the Board shall hold office for a term of
three (3) years or until their successors shall have been
appointed and duly qualified, without prejudice to
reappointment for another term. Each member of the
Board shall qualify by taking his/her oath of office
before entering upon the performance of his/her duties.
Section 5. Duties and Functions of the Board.- The
Board shall have the following duties and functions:
1) To enforce the provisions of this Act;

2) To administer oaths in accordance with the provi-

sions of this Act;

3) To issue and, after due investigation, suspend or re-

voke certificates or registration for the practice of
midwifery;
4) To investigate any violation of this Act or of the rules and regu-
lations issued there under, as may come to the knowledge of the
Board, and for this purpose, to issue subpoena and subpoena
duces tecum to alleged violators or witnesses to secure their at-
tendance in investigations or hearings, and the production of
books, papers and documents in connection therewith and com-
pel their attendance by the power of contempt;

5) To conduct yearly board examinations to midwifery examinees

under the supervision of the Commission
6) To look, from time to time, into the condition affecting the prac-
tice of midwifery in the Philippines and adopt such measures as
may be deemed necessary for the maintenance of the standards
and ethics of the profession; and

7) To adopt an official seal to authenticate its official documents.

The Board shall exercise these powers and duties in accordance
with Presidential Decree No. 233.
Section 6. Compensation of Board Members.-
The Chairman and the Members of the Board
shall receive the same compensation granted to
the Chairman and members of the boards of
similar nature as provided for in the General
Appropriations Act.
Section 7. Removal of Board Members.- Any member
of the Board may be removed from office by the
President, upon the recommendation of the Professional
Regulation commission, for neglect of duty,
incompetence or for unprofessional, immoral or
dishonorable conduct, after having been given the
opportunity to defend himself in a proper administrative
investigation conducted by the Commission.
Section 8. Supervision of the Board and
Custodian of its Records.- The members of the
Board shall be under the general supervision of
the PRC. All records, including examination
papers, examinations results minutes of
deliberation, records of administrative cases and
investigations of the Board shall be kept by the
Commission.
Section 9. Rules and Regulations.- Subject to the
approval of the Commission, the Board shall set
ethical and professional standards for the practice
of midwifery and adopt such rules & regulations
as may be necessary to carry out the provisions of
this Act. Such standards, rules and regulations
shall take effect thirty days after publication in
two national newspapers of general circulation.
Section 10. Annual Report.-The Board shall
submit an annual report to the Commission at
the end of each calendar year, giving a detailed
report of its activities and proceedings during
the year. Other information or data may be
requested by the Commission as often as may
be necessary and practicable.
 Article III
EXAMINATION AND REGISTRATION
OF MIDWIVES
Section 11. Examination Required.- All applicants
for registration to the practice of midwifery in the
Philippines shall be required to undergo an
examination as required for in this Act