Ncm108 Lecture Course Packet

ST. MARY’S COLLEGE OF TAGUM, INC.
NURSING PROGRAM
LEARNING
NCM 108 – Healthcare Ethics
MODULE
MODULE/COURSE PACKET
Theories and Principles of Health Ethics
Prepared by:
Paula P. Leanillo, AB,RN,MN,DM(c)
D. OTHER RELEVANT ETHICAL PRINCIPLES
NCM108 - HEALTHCARE ETHICS (BIOETHICS) 2

1. DOCTRINE / PRINCIPLE OF DOUBLE EFFECT
The doctrine (or principle) of double effect is often
invoked to explain the permissibility of an action that
causes a serious harm, such as the death of a human
being, as a side effect of promoting some good end.
According to the principle of double effect, sometimes it
is permissible to cause a harm as a side effect (or
“double effect”) of bringing about a good result even
though it would not be permissible to cause such a harm
as a means to bringing about the same good end.
Doctrine of Double Effect - Stanford Encyclopedia of Philosophy
https://plato.stanford.edu
Also known as the rule of double effect:

Is invoked when an action has two effects (hence
'Double Effect'); one good and the other harmful. The
principle allows the action as morally permissible in
those circumstances in which the harmful effect is not
intended, but is a side-effect of the action.
This principle aims to provide specific guidelines for
determining when it is morally permissible to perform an
action in pursuit of a good end in full knowledge that the
actionofwill
Doctrine also
Double bring
Effect about
- Stanford bad results.
Encyclopedia of Philosophy
https://plato.stanford.edu
Example: When saving the life of a pregnant woman causes the death of
her unborn child - performing an
abortion when continuing the pregnancy would risk killing the mother -
this is a case of the doctrine of double effect.
By this argument, the death of the fetus is merely the side-effect of

medical treatment to save the mother's life.
2. MORAL PRINCIPLE OF LEGITIMATE
COOPERATION WITH EVIL
If we were to try to avoid any and all cooperation with
evil we would be unable to act. Obviously such a goal is
noble, but unreasonable. Moral reasoning guided by
moral principles and enlightened by grace can guide us
to choose the best possible good even when evil is
unavoidable.
When you are performing an action that is intertwined
with evil, you can use the following criteria to judge how
legitimate your cooperation with the evil is.
* The moral object of your action is good and
you are operating out of good intentions.
* The evil is only tolerated as a side effect of
your action
* Your cooperation is only material
cooperation, not formal
* Your cooperation is remote rather than
proximate so it causes minimal evil effects
* Your action does not cause scandal
It means working together despite disagreement about
the ends or means of the act. In other ords, cooperation
does not imply condoning the evil.

MORAL OBJECT
The moral object of an action is the objective goal
of the action. It is the good that you are trying to
attain (or the evil you are trying to avoid) through
the action, and how well the action is ordered
toward that good.
INTENTION
The intention is the reason why you choose to act.
Your intention may coincide with your choice of the
moral object, or you may have intentions beyond the
simple object. For example, you may choose to give
money to charity (the moral object to help those in
need), but your intention may be to impress people with
your generosity.
LEGITIMATE
The term “legitimate” refers to moral acceptability, not
the legal meaning of conforming to a set of standards
and requirements to be acceptable.
COOPERATION
Cooperation with evil as understood in the context of
this principle does not mean working together in
agreement with all aspects of the act. Rather, it means
working together despite disagreement about the ends
or means of the act. In other words, cooperation does
not imply condoning the evil.
https://www.fromtheabbey.com/library/moral-principle-of-legitimate-cooperation-with-evil/

3. MORAL PRINCIPLE OF COMMON GOOD &
SUBSIDIARY
The COMMON GOOD is the complete development of
all the people of the world. John XXIII describes it as
‘the sum total of conditions of social living, whereby
persons are enabled more fully and readily to achieve
their own perfection.’ Mater et Magistra – “Mother and
Teacher” (1961), paragraph 65
The pursuit of the common good entrusts, both to the

government and the Church, care for the greatest
good of all persons, not just the greatest possible
number. No individual is excluded from the common
good. It is also therefore linked to the ideas of human
dignity and authentic and integral human
development, making them central aims of all
societies.
The principle of subsidiarity reminds us that larger
institutions in society should not overwhelm or
interfere with smaller or local institutions, yet
larger institutions have essential responsibilities when
the more local institutions cannot adequately protect
human dignity, meet human needs and advance
common good.

E. PRINCIPLES OF BIOETHICS
The broad study of what we ought or ought not to do,
what is right or wrong, and what is good or bad
according to our beliefs and moral reasons is ethics. In
this field of study, there is a subdiscipline bioethics
which focuses on the interaction between ethical
principles and biological functions. Generally, bioethics
is used to more narrowly refer to biomedical ethics,
which is concerned with the interaction between
ethical principles and health.

1. PRINCIPLES OF STEWARDSHIP
a. PERSONAL STEWARDSHIP
Care for ourselves in mind, body and spirit
Each of our lives is a gift from God. By caring for
ourselves tenderly and with vigilance, we can serve
God and one another.
“We are not human beings having a spiritual
experience. We are spiritual beings having a human
experience.” Teilhard de Chardin
How do we care for ourselves?
By improving our healthful practices. Change is a
developmental process and it all starts with You. To
God every person is precious, and caring for ourselves
in mind, body, and spirit is in accordance with God's
will and purpose of our existence.
Managing God’s blessings and ways for God’s glory.
Genesis 1:28. That’s when God told Adam and Eve to
“have dominion over the fish of the sea, over the birds
of the air, and over every living thing that moves on the
earth”.
Psalm 24:1 that He owns it all: “The earth is the Lord’s
and the fullness thereof”.
And if He’s the owner, that means we’re not. Instead,
we’re His stewards—His managers. God commands
us to be stewards over everything.
He blesses us with Everything.

b. SOCIAL STEWARDSHIP
Impacting the community in many ways. We work
closely with local communities to drive meaningful
poverty alleviation and improve health and quality of life.
This is done through a range of programs that cover
education, training and skills upgrade, healthcare and
infrastructure development.
Social Awareness
Active Concern & Participation
3. ECOLOGICAL OR ENVIRONMENTAL
STEWARDSHIP
Refers to responsible use and protection of the natural
environment through conservation and sustainable
practices.
Aldo Leopold (1887–1949) championed environmental

stewardship based on a land ethic "dealing with man's
relation to land and to the animals and plants which
grow upon it."

4. BIOMEDICAL STEWARSDSHIP
The primary ethical obligation is to promote the well-
being of individual patients.
Physicians have a long-recognized obligation to patients

in general to promote public health and access to care.
This obligation requires physicians to be prudent
stewards of the shared societal resources with which
they are entrusted.
Managing health care resources responsibly for the

benefit of all patients is compatible with physicians’
primary obligation to serve the interests of individual
patients.

2. DOCTRINE / PRINCIPLE OF TOTALITY
States that all decisions in medical ethics must prioritize
the good of the entire person, including physical,
psychological and spiritual factors.
According to Thomas Aquinas, all of the organs and

other parts of the body exist for the sake of the whole
person. Because the purpose of the part is to serve the
whole, any action that damages a part of the body or
prevents it from fulfilling its purpose violates the natural
order and is morally wrong. This is called the “principle of
totality.”
However, a single part may be sacrificed if the loss is
necessary for the good of the whole person. For
example, the principle of totality would justify the
amputation of a gangrenous limb, because the person
could
Principledie if theand
of Totality gangrene
its Relevancespread.
in Bioethics - lifeissues.net
https://www.lifeissues.net

Preservation of Bodily Functional
Integrity

The Principle of Totality and Integrity
Totality directs that anatomical completeness must not
be sacrificed without proportional justification. Integrity
focuses on maintaining basic human capacities and
provides a hierarchical ordering of higher functions
over lower functions for use in decision making.
https://www.pdcnet.org › ncbq
The human body is an integral part of the human

person and is therefore worthy of human dignity. It
must be kept whole. No body part should be removed,
mangled or dibilitated unless doing so is necessary for
the health of a more essential body part or the body of
a whole. An unessential or redundant body part may be
removed for the good of another person.
Human nature is an integration of body and spirit. These

two dimensions can never be separated (in fact,
separation of the spirit from the body is the definition of
death). The human body shares in the dignity of the
human person. To dismember the body or to otherwise
deface it abuses that dignity by treating the human
person as a machine or as a thing to be used and
discarded.

APPLICATIONS
Surgeries that needlessly remove body
parts or organs are immoral
Tattoos and piercings are not inherently
immoral but they may be immoral if they
deface the body by quantity or content.
Torture is a moral evil because it seeks
to dis-integrate the body and the spirit
Self-mutilation is self-hatred expressed
through spite of the body
That chemical contraception effectively
shuts down a healthy bodily system is
part of what makes it immoral.
Even if the pro-choice argument that an
embryo is part of the woman’s body
rather than an independent human
person is true, it should not be removed
except when its presence endangers the
woman’s life.
https://www.fromtheabbey.com/moral-principle-of-totality-and-integrity/

a. ETHICO-MORAL RESPONSIBILITY
OF NURSES IN SURGERY
Each Registered Nurse (RN) has ethical and moral
responsibility to represent the patient's interests,
show humility, respect and protect patient
autonomy and preserve patient dignity (International
Council for Nurses, 2013).
Responsibility for patient care in perioperative practice - NCBI
https://www.ncbi.nlm.nih.gov
Obtain informed consent. Unless the patient is unconscious,

the nurse has a responsibility to obtain a patient’s consent prior
to any treatment or procedure. Sometimes the patient will
refuse treatment. Nurses ensure the staff follows the patient’s
wishes.
Maintain patient confidentiality. While not everyone on the
staff needs to know about the patient’s history or situation,
nurses must decide who needs to know without violating
confidentiality.
Tell the truth. Most patients trust nurses, which is one of the
reasons the profession has the highest rating for ethics and
honesty. Nurses must remain truthful even when reporting news
the patient does not want to hear. They also depend on patients
to share correct information about their medicines, conditions
and other issues.
Deal with beliefs that conflict with empirical
knowledge. Patients and their families may refuse standard
treatment that has been proven effective. For example, some
religions forbid blood transfusions. Should the nurse explain the
benefits of the recommended treatment? Or should the nurse
respect the patient’s decision? https://degree.lamar.edu

ETHICO-MORAL RESPONSIBILITIES OF NURSES IN SURGERY
1. The nurse guarantees adherence to ethical standards
and principles with compassion and respect for the
patient’s rights, inherent dignity, worth, and unique
attributes
2. The nurse leads the team for a moment of prayer
3. The nurse’s primary commitment is to the patient
and the family
4. The nurse supports the patient to counter feeling of
pain, nervousness, anxiety and fear of the unknown
5. The nurse promotes, advocates for, and protects the
rights, health, and safety of the patient
6. The nurse secures the necessary informed consent;
addresses patient queries; provides comprehensible
and detailed explanation
7. The nurse places patient in a comfortable position
and provides a calm and re-assuring environment
9. The nurse ensures patient safety and privacy

10. The nurse performs her/his duties and tasks with
dexterity, precision and accuracy
11. The nurse manifests vigilance, quick response and
sound decision-making in life-threatening scenarios
12. The nurse has authority, accountability, and
responsibility for nursing practice; makes decisions;
and takes action consistent with the obligation to
provide safe, quality and optimal patient care.

ETHICO-MORAL RESPONSIBILITY OF NURSES IN SURGERY
LEGAL SAFEGUARDS FOR NURSES

b. STERILIZATION AND MUTILATION

WHAT IS FEMALE STERILIZATION?
Female sterilization is a permanent procedure to
prevent pregnancy. It works by blocking the fallopian
tubes. This prevents women having children, or can be
an option for other reasons..
TUBAL LIGATION (SURGICAL)
The doctor inflates the abdomen with gas and makes a
small incision to access the reproductive organs with
the laparoscope. The fallopian tubes are sealed then
cut and folded removing sections of the tubes and
blocking the tubes with bands or clips.
NONSURGICAL STERILIZATION (IUD)

Called fallopian tube occlusion wherein tiny metal coils
are inserted into each fallopian tube through the
vagina and cervix. Eventually, scar tissue forms
around the coils and blocks the fallopian.
https://www.healthline.com/health/birth-control-female-
sterilization

VASECTOMY
Vasectomy is a form of male birth control that cuts the
supply of sperm to your semen. It's done by cutting and
sealing the tubes that carry sperm.
A vasectomy is a form of birth control. It prevents
sperm from being released during ejaculation. During
the procedure, a tube called the vas deferens is cut or
blocked. The vas deferens is the duct that carries
sperm from the testicles to the urethra.
https://www.healthline.com/health/birth-control-vasectomy

FEMALE GENITAL MUTILATION
Female Genital Mutilation involves the removal of the external
female genitalia or causing injury to the female genital organs
for non-medical reasons. FGM is done or practiced on girls
and young women under 18. It is not prescribed by any
religion and has no health benefits. On the contrary the
practice can cause life-lasting physical and psychological
trauma.
•Type 1: Also known as clitoridectomy, this type consists of
partial or total removal of the external part of the clitoris and/or
its prepuce (clitoral hood).
•Type 2: Also known as excision, the external part of clitoris
and labia minora are partially or totally removed, with or
without excision of the labia majora.
•Type 3: It is also known as infibulation or pharaonic type.
The procedure consists of narrowing the vaginal orifice with
creation of a covering seal by cutting and appositioning the
labia minora and/or labia majora, with or without removal of
the external part of clitoris. The appositioning of the wound
edges consists of stitching or holding the cut areas together
for a certain period of time (for example, girls’ legs are bound
together), to create the covering seal. A small opening is left
for urine and menstrual blood to escape.
•Type 4: This type consists of all other procedures to the
genitalia of women for non-medical purposes, such as
pricking, piercing, incising, scraping and cauterization .
https://www.unicef.org
St. Thomas takes mutilation to mean the “removal of a member or

part of the human body." sterilization is the " removal of a procreative
member or element of the human in order to prevent procreation."

From Wikipedia, the free encyclopedia
COMPULSORY STERILIZATION
(forced or coerced sterilization) was used in
reference to government-mandated programs
which bring about the sterilization of people.
Implemented illegally in the early 20th century for
population size control, gender
and limiting the spread of HIV.

EUGENIC STERILIZATION is defined as sterilization of
a person who is either mentally ill or mentally defective
and will either severely handicap any future offspring
through heredity or is unable to properly care for a child

Preservation of Bodily Functional Integrity
The preservation and protection of bodily
integrity is a principle frequently invoked in
both law and morality. It is a normative
principle that seeks to constrain what
we should be allowed to do to human
bodies or their constituent parts.
The principle of bodily integrity sums up
the right of each human being, including
children, to autonomy and self-
determination over their own body. It
considers an unconsented physical
intrusion as a human rights violation.
While the principle has traditionally been
raised in connection with practices such as
torture, inhumane treatment and forced
disappearance, bodily integrity has the
potential to apply to wide range of human
rights violations, which also affect children’s civil rights.
The Right to Bodily Integrity
https://www.cambridge.org

Preservation of Bodily Functional Integrity
Practices which violate a child's bodily
integrity include all forms of physical
violence, ranging from corporal
punishment to forced medical treatment,
sometimes against a child's express
wishes. Non-therapeutic and unconsented
surgeries are also violations of bodily
integrity, and include practices such as
'corrective' genital surgery performed on
intersex children, gender reassignment
surgery, female genital mutilation, routine
circumcision of male infants and boys, and
the sterilisation of people with learning
disabilities.
Children are especially vulnerable to such
practices, as these are usually performed
on people at a very young age when they
are unable to speak up for and defend
themselves, or give - or refuse - consent.
The Right to Bodily Integrity
https://www.cambridge.org

ST. MARY’S COLLEGE OF TAGUM, INC.
NURSING PROGRAM
LEARNING
NCM 108 – Healthcare Ethics
MODULE
MODULE/COURSE PACKET
Theories and Principles of Health Ethics
TOPIC: ORGAN DONATION
Prepared by:
Paula P. Leanillo, AB,RN,MN,DM(c)
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Dearest Father,
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Module 1
Organ Donation
Week 6
At the end of the lesson, the students are expected

to:
1. Evaluate the advantages and disadvantages of organ
donation.
2. Analyze the moral and ethical considerations in organ
donation.
3. Apply the concepts of ethical theories in organ
donation as a care provider.

BIBLICAL VERSES
"I tell you the truth, whatever you did for

one of the least of these brothers of mine,
you did for me" (Matthew 25:40)

Ignacian Core Values
Related Values and Social Orientation
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F gh
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NCM100 - Theoretical Foundations in Nursing 34

WARM UP
ACTIVITY
Organ Donors?

HOW HEALTHY ARE YOU AND YOUR ORGANS?
ARE YOU WILLING TO BECOME AN ORGAN DONOR?
Organ Donation: A Brief History
The first-ever organ

donation was done in 1954
when Ronald Lee Herrick,
the 1st world organ donor,
donated a kidney to his
identical twin brother.
Doctor Joseph Murray
conducted the procedure
for which he has also won
the Nobel Prize in
Physiology or Medicine in
1990 for advances in organ
transplantation.
Researchers experimented
with organ transplantation on
animals and humans in the
18th century. There were
many failures over the years.
By the mid-20th century,
scientists were performing
successful organ transplants.
Transplants of kidneys,
livers, hearts, pancreas,
intestine, lungs, and heart-
lungs are now considered
routine medical treatment.
NCM108 - HEALTHCARE ETHICS
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1954 - 1st successful kidney transplant*
1966 - First successful pancreas/kidney transplant
1967 - First successful liver transplant*
1968 - First isolated pancreas transplant
1968
• - First successful heart transplant
1981 - First successful heart-lung transplant
1983 - First successful single lung transplant*
1986 - First successful double lung transplant*
1989 - First successful living-related liver
transplant
1990 - First successful living-related lung
transplant
* Transplant was the first of its kind in the world.
https://optn.transplant.hrsa.gov/patients/about-transplantation/history/
The Organ Procurement and Transportation Network
Under the US Department of Health and Human Resources

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A CASE OF THE FIRST DECEASED
ORGAN DONOR IN THE PHILIPPINES
DURING THE COVID-19 PANDEMIC.
A 19-year-old male was brought to an
institution in Manila due to a self-inflicted
gunshot wound to the head. A severe,
irreversible, traumatic brain injury was
documented. Maximal resuscitative efforts
were done to keep his over-all neurovital
status stable however the patient still
remained unresponsive. A diagnosis of brain
death was done by two physicians with four
hours interval. Knowing the patient’s
condition, the family’s altruism led them to
decide for the patient to become an organ
donor. Written and informed consents were
secured and the patient was then placed in
a multidisciplinary team of medical and
surgical intensivists for deceased donor
management and organ procurement.
Kidney Int Rep. 2022 Feb; 7(2): S430.
Published online 2022 Feb 18. doi: 10.1016/j.ekir.2022.01.1023

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(BIOETHICS)
WHAT IS ORGAN DONATION?
Organ donation is the process
when a person allows an organ
of their own to be removed and
transplanted to another person,
legally, either by consent while
the donor is alive or dead with
the assent of the next of kin.
Wikipedia

What is organ donation and transplantation?
Organ donation is the process of surgically
removing an organ or tissue from one person
(the organ donor) and placing it into another
person (the recipient). Transplantation is
necessary because the recipient’s organ has
failed or has been damaged by disease or injury.
https://my.clevelandclinic.org

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2 TYPES OF ORGAN DONORS
Organ donors may be living, brain dead,
or dead via circulatory death. Tissue may
be recovered from donors who die of
circulatory death, as well as of brain
death – up to 24 hours past the cessation
of heartbeat. Unlike organs, most tissues
(with the exception of corneas) can be
preserved and stored for up to five years,
meaning they can be "banked".
Wikipedia, the free encyclopedia

FACTS ABOUT ORGAN DONATION
How many lives can one organ
donor save?
One deceased organ donor can
save up to eight lives!
Two donated kidneys can free two

patients from dialysis treatments.
One donated liver can be split to go
to two patients on the wait list.
Two donated lungs mean another
two patients are given a second
chance
A donated pancreas and donated
heart are two more patients who will
receive the gift of life.
When you add it all up, 1 deceased donor = 8 lives!
https://www.pennmedicine.org/updates/blogs/transplant-update/2022/march/6-quick-facts-about-organ-donation

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(BIOETHICS)
One person can save up to
eight lives from chronic illness
by pledging to donate their
heart, kidney, pancreas, lungs,
liver, intestines, hands, face,
cornea, tissues, bone marrow,
stomach, bladder and stem
cells.
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August 13 of every year is
observed as World Organ
Donation Day aimed at raising
awareness about the
importance of organ donation
and encourage people to take
a pledge for the same.

Can I be an organ donor while I am still alive?
Yes, you can a donate one kidney or a lobe of
your liver while you’re still living. Most living
donations happen between family members or
close friends; however, others choose to be
living donors for someone they don’t know,
which is known as non-directed or altruistic
donation.
There is a rising number of FIlipinos

nationwide who develop end-stage
renal disease (ESRD) that need
organ transplantation annually. In
2020 alone there are a total of 118
transplant candidates in the waiting
list and only 18 eligible deceased
donors, 11 from our local city, and
of the 11, only 1 consented to be an
actual donor. NCM108 - HEALTHCARE ETHICS
49
(BIOETHICS)
Is Becoming An Organ Donor Right For You?
Not everyone can become an

organ donor, so the choice
isn’t always available to
everyone. For those that can
donate organs, however, the
fact that up to eight lives could
be saved because of
something you chose to do
means that your gift of life can
continue to provide life, even if
you are gone. That’s why so
many people choose to
become organ donors.
https://www.hindustantimes.com/india-news/world-organ-donation-day-a-brief-history

50
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ORGANS THAT CAN BE DONATED?
LIVING DONORS can donate one
of their kidneys, or a portion of
their lung, liver, pancreas or
intestine.
Upon death, a donor can donate
major organs that can be
transplanted to up to eight
recipients, and these are the
heart, intestines, kidneys, liver,
lungs and the pancreas.
What organs can be donated and
transplanted?
Organs that can be transplanted are:
heart, kidneys, liver, lungs, pancreas,
intestine, stomach, and thymus.
Tissues include: bones, stem cells,
blood, tendons, cornea, skin, heart
valves, nerves and veins.
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PHILIPPINE ORGAN
DONATION AND
TRANSPLANT PROGRAM
•The rate of organ donation
and transplantation is
significantly low in this country.
•Inadequate knowledge of
people about organ donation
and transplant, along with
limited workforce and facilities
that can handle these
operations
•Prevalent Organ Trafficking
mainly due to poverty.
doh.gov.com.ph
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(BIOETHICS)
What is the Catholic Church's view
on organ donation?
Roman Catholics view organ and
tissue donation as an act of charity
and• love, as reported in the Catholic
publication Origins in 1994.
Transplants are morally and ethically
acceptable to the Vatican.
Theological perspective on organ and tissue donation - UNOS
https://unos.org › transplant › facts ›
Is organ donation legal in the

Philippines?
Organ donation is legal in the
Philippines as long as donors and
recipients are blood relatives. The
law allows family members who
meet specific kinship criteria to
donate organs among one another.
Oct 19, 2019
Kidney for sale: Inside Philippines' NCM108 - HEALTHCARE
illegal organ ETHICS
trade - CNA 57
https://www.channelnewsasia.com › asia (BIOETHICS)
The Philippines "Organ Donation Act of 1991"
updates the "1949 Act to legalize permissions
to use human organs". Under the new
legislation, each individual can donate all or
any part of his body by way of legacy or will.
The members of the family may also authorize
such a donation in the absence of contrary
intention by the decedent. Donations are only
valid when made for therapy, research or
medical education. International sharing of
organs is recognized but subject to approval by
the Department of Health. Regulations are
about to be formulated in order to implement
the Act which will be largely publicized to
encourage donations.
(The Organ Donation Act of 1991). (Official Gazette, 24 February 1992, Vol. 88, No. 8, pp. 965-971).
Philippines. Int Dig Health Legis. 1992. PMID: 11659648

HOW TO APPLY TO BE AN ORGAN DONOR?

In the Philippines, buyers are both
Filipinos and foreigners with end-
stage kidney disease. They
usually hire agents to recruit non-
related donors, feign a
relationship and falsify documents
to trick law enforcement officers
and medical professionals.

What drives poor people to
agree to sell their organs is
their dreams. They want to be
able to afford a house, a car
or a tricycle so they could
have a stable livelihood.
“I know it’s illegal but what

matters to donors like us is that
we can save another life as well
as our own. The money we got
from doing this is a great help,
especially when we don’t have
stable jobs. Life is good when
we have money, money to
spend on food and toys for the
kids”.
The Illegal Harvesting, Selling and Buying of Human Organs

https://www.channelnewsasia.com/asia/kidney-for-sale-philippines-illegal-organ-trade-
857551

What are the Ethical Issues of
Organ Donation?
The ethical and legal issues
related to organ and tissue
procurement and transplantation
involve the principles of:
1) Autonomy
2) Beneficence
3) Non-maleficence
4) Free and Informed Consent
5)
Fairness and Equality 6)
Respecting the dignity,
integrity of human beings,
7)and the common good.
Overview of ethical issues of organs transplantation
https://geiselmed.dartmouth.edu
https://pubmed.ncbi.nlm.nih.gov

•No religion formally forbid
donation or receipt of organs
or is against transplantation
from living or deceased
donors.
•No religion formally obliges
one to donate or refuse
organs.
•No religion formally obliges
one to consider cadaveric
organs "a societal resource"
or considers organ donation
"a religious duty" (except
some rabbis and isolated
Muslim and Christian
scholars). 66
NCM108 - HEALTHCARE ETHICS (BIOETHICS)
•No religion prefers cadaveric
over living donation. No religion
formally forbid non-heart-beating
donors (nhbd) cadaveric
donation or cross-over donation.
•Due to the sacredness of
human life, the Catholic Church
is against donation from
anencephalic donors or after
active euthanasia.
•The human body is always a
personal body, the body of a
person. The body cannot be
treated as a merely physical or
biological entity, nor can its
organs and tissues ever be used
as item for sale or exchange".
NCM108 - HEALTHCARE ETHICS (BIOETHICS) Proceed to slide# 73 67
Organ donation is the process when
a person allows an organ of their own
to be removed and transplanted to
another person, legally, either by
consent while the donor is alive or
dead with the assent of the next of
kin.
Organs may be donated by either
living or cadaveric donors (brain dead
) or dead via circulatory death.
What are your insights about organ
donation?
Advantages and disadvantages in
organ donation?
With regards to “the body being the
sacred temple of God”, is it morally right
or ethical to remove any organ or tissue
from the body of a donor?
Should a donated organ be sold or
simply donated for free?

How important is this
learning in relation to caring for
organ donors and organ
recipients?
Are you willing to be an
organ donor?

ASSESSMENT
QUIZ

Stay safe
and
healthy!


Living or Deceased Organ Donors
Republic Act No. 7170, otherwise known
as the Organ Donation Act of 1991, as
amended by Republic Act No. 7885,
permits organ and tissue donations from
donors who have been declared brain
dead.
Human transplantable organs include the

kidneys, liver, lungs, heart, intestines, and
pancreas, in addition to human tissues
such as eye tissues (corneas, sclera, etc.),
bones, skin, and blood vessels.
“The DOH recognizes the noble and altruistic act of
saving a life through committing one’s organs or
tissues upon one’s death. This can be done by signing up
as organ donor card-holders and providing consent to
organ donation. Indeed, organ donors are heroes of our
times,” according to Secretary of Health Francisco Duque.
Human Organ Preservation Effort (H.O.P.E.)

More and more Filipinos become afflicted with end-
stage organ failure, an incapacitating disease with
organ transplant as the only chance of survival.
Patients on organ waiting lists are gravely ill and
approximately one person will die each week while
waiting for the transplant. Although organ
transplantation is a universally accepted mode of
medical treatment that improves the quality of life
among these patients, the scarcity of sources for
transplantable organs plague the nation, and the
rest of the world.
Recognizing this need, the Human Organ
Preservation Effort (HOPE), formerly the Cadaver
Organ Retrieval Effort (CORE) was established in
1983.
It is the organ retrieval arm of the Institute tasked to
advocate organ and tissue donation and to source
out transplantable organs from deceased organ
donors thru its network of various government and
private hospitals in the country.
It recovers mainly kidneys, pancreas and liver but

may include other vital organs like the lungs, heart
when the proper program is put in place. It also
provides a network for tissues such as corneas,
bones, heart valves, and skin. The recovered
organs are placed among patients in the waiting list.
What Does HOPE do?

Initially, HOPE’s thrust was focused on deceased
organ recovery. But as the dilemma of the scarcity
of donors continuously haunt the entire nation, it
now considers and screens living donors, who
voluntarily donate their kidneys to patients on
the list in the spirit of true altruism. In this aspect,
it works closely with the Renal Disease Control
Program (REDCOP) following strict implementing
guidelines set by the Department of Health’s
Philippine Organ Donation Program (PODP).
Mission
HOPE envisions to be an
independent organ
procurement organization in
the future by educating every
Filipino to accept the nobility
of organ and tissue donation
and become donors to help
save lives. With total
dedication and hard work from
its people, there is room for
HOPE.
ORGAN TRANSPLANTATION

Organ transplantation is a
medical procedure in which
an organ is removed from one
body and placed in the body
of a recipient, to replace a
damaged or missing organ.
The donor and recipient may
be at the same location, or
organs may be transported
from a donor site to another
location.
 Wikipedia
 https://en.wikipedia.org › wiki › Organ_transplantation
a tissue or organ that is transplanted from one part to another of the same
body
surgical transplantation of tissue between two genetically dissimilar

individuals of the same species, such as between two humans who are not
monozygotic twins
a graft of tissue between two individuals who are genetically identical (i.e.
monozygotic twins)
a surgical graft of tissue from one species to an unlike species (or genus or
family). A graft from a baboon to a human
graft transferred to the same anatomic site in another individual.
the transfer of living organs or tissue from one part of the body to another
or from one individual to another
Xenotransplantation, or
heterologous transplant is
the transplantation of living
cells, tissues or organs from
one species to another.
Such cells, tissues or organs
are called xenografts or
xenotransplants. Wikipedia
ORTHOTOPIC TRANSPLANT
Transplant of a tissue or organ into
its normal anatomic position.
HETEROTROPIC GRAFT
transplantation of a tissue oror
gan into a position that it
normally does not occupy;
the transfer of living organs or
tissue from one part of the body
to another or from one individual
to another.
SPLIT TRANSPLANT
a single deceased donor liver is
divided into right and left
portions that are implanted into
two recipients simultaneously.
QUIZ/ACTIVITY
(Post your answers to Situations 1-4 thru Google
Classwork)

PRINCIPLE OF PERSONALIZE
D SEXUALITY
Sex is a social necessity for
the procreation of children
and their education in the
family so as to expand the
human community and
guarantee its future beyond
the death of individual
members.
Teaches that God created
persons as male and female
and blessed their sexuality
as a great and good gift.
The Principle of
Personalized
Sexuality takes note of
a humanized sexuality,
one that represents the
fulfillment of physical
and sensual need but
also evidenced with
love and sacramental
mystery.
WHAT IS SEXUALITY?
SEXUALITY is a word we
use to talk about how we
understand our bodies and
how we understand our
relationships including all
aspects of who we are –
our values and beliefs,
bodies, desires,
relationships, gender and
our thoughts and feelings
about all of these.

Sexuality is not about
who you have sex
with, or how often you
have it.
Sexuality is about
your sexual feelings,
thoughts, attractions
and behaviours
towards other people.
SEXUALITY is not just
about “sex” and certain
body parts that are
associated with males and
females. SEXUALITY
includes sexual orientation,
such as who a person is
attracted to and whether the
person identifies as
heterosexual, homosexual
or bisexual, as well as their
sexual fantasies and
attitudes and values related
to sex.
SEXUAL ORIENTATION refers to
sexual and romantic feelings for
people of the same gender, a
different gender, or more than one
gender. The three categories are:
“STRAIGHT” OR
HETEROSEXUAL” typically feel
attracted to people of a different
gender than themselves.
“LESBIAN” OR “GAY” typically feel
attracted to people of the same
gender as themselves.
“BISEXUAL” typically feel attracted
to more than one gender, such as
being attracted to both women and
men.
LGBT is an initialism that
stands for lesbian, gay,
bisexual, and transgender. In
use since the 1990s, the term is
an adaptation of the initialism
LGB, which was used to
replace the term gay in
reference to the LGBT
community beginning in the
mid-to-late 1980s.Wikipedia
HOMOSEXUALITY is
romantic attraction,
sexual attraction, or
sexual behavior
between members of
the same sex or
gender. As a sexual
orientation,
homosexuality is "an
enduring pattern of
emotional, romantic,
and/or sexual
attractions" to people
of the same sex.
MARRIAGE is the
intimate union and equal
partnership of a man and
a woman. It comes to us
from the hand of God,
who created male and
female in his image, so
that they might become
one body and might be
fertile and multiply.
(See Genesis chapters 1 & 2).
*a formal union and social

and legal contract between
two individuals that unites
their lives legally,
economically, and
emotionally.
MARRIAGE, also called
matrimony or wedlock, is
a culturally recognised
union between people,
called spouses, that
establishes rights and
obligations between
them, as well as between
them and their children,
and between them and
their in-laws. ... When
defined broadly, marriage
is considered a cultural
universal. wikipedia
FUNDAMENTALS
OF MARRIAGE
1. Love/Commitment. At its core,
love is a decision to be committed
to another person. It is far more
than a fleeting emotion as
portrayed on television, the big
screen, and romance novels.
Feelings come and go, but a true
decision to be committed lasts
forever – and that is what defines
true love. It is a decision to be
committed through the ups and the
downs, the good and the bad.
When things are going well,
commitment is easy. But true love
is displayed by remaining
committed even through the trials of
life.
2. Sexual Faithfulness. Sexual
faithfulness in marriage includes more
than just our bodies. It also includes
our eyes, mind, heart, and soul. When
we devote our minds to sexual
fantasies about another person, we
sacrifice sexual faithfulness to our
spouse. When we offer moments of
emotional intimacies to another, we
sacrifice sexual faithfulness to our
spouse. Guard your sexuality daily
and devote it entirely to your spouse.
Sexual faithfulness requires self-
discipline and an awareness of the
consequences. Refuse to put anything
in front of your eyes, body, or heart
that would compromise your
faithfulness.
3. Humility. We all have weaknesses
and relationships always reveal these
faults quicker than anything else on
earth. An essential building block of a
healthy marriage is the ability to
admit that you are not perfect, that
you will make mistakes, and that you
will need forgiveness. Holding an
attitude of superiority over your
partner will bring about resentment
and will prevent your relationship
from moving forward. If you struggle
in this area, grab a pencil and quickly
write down three things that your
partner does better than you – that
simple exercise should help you stay
humble.
4. Patience/Forgiveness. Because
no one is perfect (see #3), patience
and forgiveness will always be
required in a marriage relationship.
Successful marriage partners learn
to show unending patience and
forgiveness to their partner. They
humbly admit their own faults and do
not expect perfection from their
partner. They do not bring up past
errors in an effort to hold their
partner hostage. And they do not
seek to make amends or get
revenge when mistakes occur. If you
are holding onto a past hurt from
your partner, forgive him or her. It
will set your heart and relationship
free.
5. Time. Relationships don’t work
without time investment. Never
have, never will. Any successful
relationship requires intentional,
quality time together. And quality
time rarely happens when quantity
time is absent. The relationship with
your spouse should be the most
intimate and deep relationship you
have. Therefore, it is going to
require more time than any other
relationship. If possible, set aside
time each day for your spouse. And
a date-night once in awhile wouldn’t
hurt either.
6. Honesty and Trust. Honesty
and trust become the
foundation for everything
healthy in a marriage. But
unlike most of the other
essentials on this list, trust
takes time. You can become
selfless, committed, or patient
in a moment, but trust always
takes time. Trust is only built
after weeks, months, and years
of being who you say you are
and doing what you say you’ll
do.
7. Communication. Successful
marriage partners communicate as
much as possible. They certainly
discuss kids’ schedules, grocery lists,
and utility bills. But they don’t stop
there. They also communicate hopes,
dreams, fears, and anxieties. They
don’t just discuss the changes that
are taking place in the kid’s life, they
also discuss the changes that are
taking place in their own hearts and
souls. This essential key cannot be
overlooked because honest, forthright
communication becomes the
foundation for so many other things
on this list: commitment, patience,
and trust…
8. Selflessness. Although it will
never show up on any survey,
more marriages are broken up
by selfishness than any other
reason. Surveys blame it on
finances, lack of commitment,
infidelity, or incompatibility, but
the root cause for most of these
reasons is selfishness. A selfish
person is committed only to
himself or herself, shows little
patience, and never learns how
to be a successful spouse. Give
your hopes, dreams, and life to
your partner. And begin to live
life together.
SEX OUTSIDE
MARRIAGE
Two or more people having
sex and are not married to
each other.
Fornication is generally
consensual
sexual intercourse between
two people not married to
each other. When one of the
partners having consensual
sexual intercourse is a
married person, it is
described as adultery or
infidelity.
MISTRESS
an adulterous woman; a woman
who has an ongoing extramarital
sexual relationship with a man
(adultery)
PARAMOUR
A man who has an ongoing
extramarital sexual relationship
with a woman (concubinage)
Extramarital sex occurs
when a married person
engages in sexual activity
with someone other than
his or her spouse.
The term may be applied to
the situation of a single
person having sex with a
married person.
Premarital sex is
sexual activity practiced by
people before they are
married.
ARGUMENTS AGAINST
CONTRACEPTION
Those who say contraception is

morally wrong do so for a variety of
reasons.
Contraception is inherently
wrong
Contraception is unnatural
Contraception is anti-life
Contraception is a form of abortion
Contraception separates sex from
reproduction
CONTRACEPTION BRINGS BAD
CONSEQUENCES
These are consequentialist arguments

against contraception.
Contraception carries health risks
The "contraceptive culture" is
dangerous
Contraception prevents potential
human beings being conceived
Contraception prevents people who
might benefit humanity from being
born
Contraception is often misused in
mass population control programmes
in a racist way
Mass population control programmes

can be a form of cultural imperialism
or a misuse of power
Contraception may lead to
depopulation
Contraception leads to
"immoral behaviour"
Contraception makes it
easier for people to have
sex outside marriage
Contraception leads to
widespread sexual
immorality
Contraception allows
people (even married
people) to have sex purely
for enjoyment
Contraception is anti-life
This argument is based on the
premise that life is a good thing.
Holders of this view argue that
contraception is morally wrong
because:
*life is a fundamental good - it is
a good thing
*those who use contraception
are engaged in an intentionally
"anti-life" act because they
intend to prevent a new life
coming into being
http://www.bbc.co.uk/ethics/contraception
*it is always morally wrong to
do something with a bad
intention
On the Reproductive
Health Bill
“We are afraid of this, of
the support for same-sex
marriage, for divorce, for a
contraceptives mentality
that is not part of the
Filipino culture but is being
forced on us by foreigners.
But our government allows
this, because it means
favors for us.”
Manila Auxiliary Bishop Broderick Pabillo
https://opinion.inquirer.net/31291/contrac
eptive-morality#ixzz5zoIzGLoF
@inquirerdotnet on Twitter |
inquirerdotnet on Facebook
METHODS OF
CONTRACEPTION:
There are different methods of
contraception, including:
long-acting reversible contracep
tion
, such as the
implant or intra uterine device
(IUD)
hormonal contraception, such
the pill or the Depo Provera
injection
barrier methods, such as
condoms
emergency contraception
fertility awareness
permanent contraception, such
as vasectomy and tubal ligation
hormonal pills
ARTIFICIAL
REPRODUCTION is the
creation of new life by other
than the natural means
available to an organism.
ARTIFICIAL INSEMINATION
(AI) is the deliberate
introduction of sperm into a
female's cervix or uterine cavity
for the purpose of achieving a
pregnancy through
in vivo fertilization by means
other than sexual intercourse.
IN VITRO FERTILISATION (IVF) is a
process of fertilisation where an egg is
combined with sperm outside the body, in
vitro ("in glass"). The process involves
monitoring and stimulating a woman's
ovulatory process, removing an ovum or
ova (egg or eggs) from the woman's
ovaries and letting sperm fertilise them in
a liquid in a laboratory. After the fertilised
egg (zygote) undergoes embryo culture
for 2–6 days, it is implanted in the same
or another woman's uterus, with the
intention of establishing a successful
pregnancy.
CLONING is the process of
producing genetically identical
individuals of an organism either
naturally or artificially.
SURROGATE MOTHERHOOD, practice in which
a woman (the surrogate mother) bears a child for a
couple unable to produce children in the usual
way, usually because the wife is infertile or
otherwise unable to undergo pregnancy. In so-
called traditional surrogacy, the surrogate mother
is impregnated through artificial insemination with
the sperm of the husband. In gestational
surrogacy, the wife’s ova and the husband’s sperm
are subjected to in vitro fertilization, and the
resulting embryo is implanted in the surrogate
mother. Normally, in either procedure, the
surrogate gives up all parental rights, but this has
been subject to legal challenge.
MORAL ISSUE OF ABORTION
SUICIDE
SUICIDE
Rape is typically driven
by the offender's need
to transfer anger
toward, or wield power
over the victim.
What is Rape …
Rape is a physical
assault that
includes forced sexual
intercourse or unlawful
sexual intrusion.
NIGHTINGALE’S PLEDGE
EUTHANASIA (from Greek: εὐθανασία;
"good death": εὖ, eu; "well" or "good" +
θάνατος, thanatos; "death") is the
practice of intentionally ending a life to
relieve pain and suffering. en.wikipedia.org
 Voluntary euthanasia
The person wants to die and says so. This includes cases of:
 asking for help with dying
 refusing burdensome medical treatment
 asking for medical treatment to be stopped, or life
support machines to be switched off
 refusing to eat
 simply deciding to die
 Non-voluntary euthanasia
The person cannot make a decision or cannot make their
wishes known. This includes cases where:
 the person is in a coma
 the person is too young (eg. a baby)
 the person is senile
 the person is mentally retarded to a very severe extent
 the person is severely brain damaged
 the person is mentally disturbed in such a way that they
should be protected from themselves
EUTHANASIA is currently
conceptualized as an action that aims to
end the life of a human being taking into
account humanistic considerations in
relation to the person or society; it is
unethical and illegal in Brazil and other
Christian countries. Nurses should be
aware of their ethical code, which clearly
prohibits: "Promoting euthanasia or
participating in practice intended to
facilitate a patient's death”.
The fundamentals of professional

practice are based on four bioethical
principles of the principlist model and
corroborate the promotion of well being
for people in the dying process:
autonomy, justice, beneficence and
nonmaleficence, and should guide
professionals' practices, reflections and
attitudes
ORTHOTANASIA refers to
the art of promoting a
humane and correct death,
not subjecting patients to
misthanasia or dysthanasia
and not abbreviating death
either, that is, subjecting
them to euthanasia. Its
great challenge is to enable
terminal patients to keep
their dignity, where there is
a commitment to the well
being of patients in the final
phase of a disease(3).
ORTHOTHANASIA - A
PRACTICE THAT RESPECTS
HUMAN DIGNITY THROUGH A
DIGNIFIED DEATH; IT IS
SURROUNDED BY BIOETHICAL
PRINCIPLES THAT ALLOW THE
SUSPENSION OF CURATIVE
MEASURES, PROVIDING
SPACE FOR PALLIATIVE CARE
AS A MECHANISM FOR
REDUCING THE SUFFERING
AND PAIN OF PATIENTS IN THE
TERMINAL PHASE.
DYSTHANASIA is the term for
futile or useless treatment, which
does not benefit a terminal
patient. It is a process through
which one merely extends the
dying process and not life per se.
Consequently, patients have a
prolonged and slow death,
frequently accompanied by
suffering, pain and anguish.
When one invests in healing a
patient who has no chance of
cure, s/he is actually undermining
the person's dignity(1). Advanced
measures and their limits should
be assessed to benefit the patient
and not to hold science as an end
in itself(2).
MISTHANASIA (uncountable or
miserable death) - premature
death of a vulnerable human due
to a failure to provide appropriate
help in the context of social
injustice.
INVIOLABILITY OF
HUMAN LIFE
WE ARE STEWARDS
NOT OWNERS
PALLIATIVE SEDATION (Wikipedia)
In medicine, specifically in end-of-life
care, palliative sedation (also known as
terminal sedation, continuous deep
sedation, or sedation for intractable
distress in the dying/of a dying
patient) is the palliative practice of
relieving distress in a terminally ill person
in the last hours or days of a dying
patient's life, usually by means of a
continuous intravenous or subcutaneous
infusion of a sedative drug, or by means
of a specialized catheter designed to
provide comfortable and discreet
administration of ongoing medications via
the rectal route.
Palliative sedation is an option of last

resort for patients whose symptoms
cannot be controlled by any other means.
It is not a form of euthanasia, as the goal
of palliative sedation is to control
symptoms, rather than to shorten the
patient's life.
ADVANCE HEALTHCARE
DIRECTIVE, also known as living will,
personal directive, advance
directive, medical directive or
advance decision, is a legal document
in which a person specifies what actions
should be taken for their health if they
are no longer able to make decisions
for themselves because of illness or
incapacity.
A living will is one form of advance

directive, leaving instructions for
treatment. Another form is a specific
type of power of attorney or health care
proxy, in which the person authorizes
someone (an agent) to make decisions
on their behalf when they are
incapacitated.
DO NOT RESUSCITATE,
RESUSCITATE
also known as no code or
allow natural death, is a legal
order, written or oral
depending on country,
indicating that a person does
not want to receive
cardiopulmonary (CPR)
resuscitation if that person's
heart stops beating.
Sometimes it also prevents
other medical interventions.
Wikipedia
A DNR can be ordered by a
physician when it is
expressly requested by the
patient or, if a patient is
unable to express his or her
wishes, by the patient's
surrogate or proxy.
Beneficence, on the other

hand, means that the care
given to patient should be
care that will benefit the
patient.
MAKING ETHICAL DECISIONS:
PROCESS
Ethical decision-making refers to the process of
evaluating and choosing among alternatives in a
manner consistent with ethical principles. In making
ethical decisions, it is necessary to perceive and
eliminate unethical options and select the best
ethical alternative.
The process of making ethical decisions requires:

Commitment: The desire to do the right thing
regardless of the cost
Consciousness: The awareness to act consistently
and apply moral convictions to daily behavior
Competency: The ability to collect and evaluate
information, develop alternatives, and foresee
potential consequences and risks
Good decisions are both ethical and
effective:
Ethical decisions generate and
sustain trust; demonstrate respect,
responsibility, fairness and caring; and
are consistent with good citizenship.
These behaviors provide a foundation
for making better decisions by setting
the ground rules for our behavior.
Effective decisions are effective if
they accomplish what we want
accomplished and if they advance our
purposes. The key to making effective
decisions is to think about choices in
terms of their ability to accomplish our
most important goals. This means we
have to understand the difference
between immediate and short-term
goals and longer-range goals.
DECISION-MAKING PROCESS
Step 1: Identify the decision. You
realize that you need to make a
decision. ...
Step 2: Gather relevant
information. ...
Step 3: Identify the alternatives. ...
Step 4: Weigh the evidence. ...
Step 5: Choose among
alternatives. ...
Step 6: Take action. ...
Step 7: Review your decision & its
consequences.
BIOETHICS
AND
RESEARCH
The NUREMBERG CODE
was formulated 50 years ago,
in August 1947, in
Nuremberg, Germany, by
American judges sitting in
judgment of Nazi doctors
accused of conducting
murderous and torturous
human experiments in the
concentration camps (the so-
called Doctors' Trial).
The Nuremberg Code (German: Nürnberger Kodex) is
a set of research ethics principles for human
experimentation created as a result of the
Nuremberg trials at the end of the Second World War.
What Are The Nuremberg Code's Ethical Guidelines For

Research?
The Nuremberg Code aimed to protect human subjects from
enduring the kind of cruelty and exploitation the prisoners
endured at concentration camps.
The 10 elements of the code are:
Voluntary consent is essential
The results of any experiment must be for the greater good
of society
Human experiments should be based on previous animal
experimentation
Experiments should be conducted by avoiding
physical/mental suffering and injury
No experiments should be conducted if it is believed to
cause death/disability
The risks should never exceed the benefits
Adequate facilities should be used to protect subjects
Experiments should be conducted only by qualified scientists
Subjects should be able to end their participation at any time
The scientist in charge must be prepared to terminate the
experiment when injury, disability, or death is likely to occur
The DECLARATION OF
HELSINKI (DoH, Finnish:
Helsingin julistus, Swedish:
Helsingforsdeklarationen) is
a set of ethical principles
regarding human
experimentation developed
for the medical community
by the World Medical
Association (WMA).[1] It is
widely regarded as the
cornerstone document on
human research ethics.
The Declaration of
Helsinki is a formal
statement developed by the
World Medical Association
that provides ethical
guidelines that physicians
and other medical research
participants should adhere to
when conducting research
that uses human subjects.
Declaration of Helsinki: History & Summary |
Study.com
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helsinki-hi..
DECLARATION OF HELSINKI GENERAL GUIDING
PRINCIPLES
Protecting Patient Health
In line with the Hippocratic Oath, espousing
the belief to “First, do no harm” (Primum, non
nocere), and the Declaration of Geneva that
emphasizes “the health of my patient will be
my first consideration,” the first priority is to
act to promote the health and well-being of
patients who are involved in medical research.
The research must be designed to reduce
potential harm so that it does not exceed the
anticipated benefits and it may never
supersede these protections.
Knowledge Cannot Trample Rights
The purpose of medical research is to
generate new knowledge to better
understand the causes, development, and
effects of diseases as well as to improve both
diagnosis and treatment. According to the
Declaration of Helsinki, “This goal can never
take precedence over the rights and interests
of individual research subjects.”
Declaration of Helsinki:
Physicians involved in medical
research must protect:
•Life
•Health
•Dignity
•Integrity
•Right to self-
determination (autonomy)
•Privacy
•Confidentiality of personal
information
The BELMONT REPORT prepared
by the
National Commission for the
Protection of Human Subjects
of Biomedical and Behavioral
Research, is a statement of
basic ethical principles and
guidelines that provide an
analytical framework to guide
the resolution of ethical
problems that arise from
research with human subjects.
Belmont Report - an overview | ScienceDirect Topics
www.sciencedirect.com
The BELMONT REPORT
is one of the leading works
concerning ethics and
health care research. Its
primary purpose is to
protect subjects and
participants in clinical trials
or research studies.
This report consists of 3
principles: beneficence,
justice, and respect for
persons.
MORAL DECISION
MAKING
is the ability to produce a
reasonable and
defensible answer to an
ethical question.
MORAL DISCERNMENT:
ESSENTIAL LEARNING FOR A
PRINCIPLED SOCIETY
MORAL JUDGMENT—the
JUDGMENT—
ability to determine a course of
action in the context of what is
just;
MORAL MOTIVATION —the
ability to select an appropriate
course of action among multiple
good alternatives; and.
MORAL CHARACTER —the
courage and skills to follow a
course of action in response to a
situation.
What is a WELL-FORMED
CONSCIENCE? How do I develop
my conscience?
“Conscience is a judgment of practical reason that
helps us to recognize and seek what is good and
to reject what is evil” (Catechism of the Catholic
Church, no. 1778, 1796).
A well-formed conscience is an ongoing exercise

(Catechism of the Catholic Church, no. 1784).
The Church offers the following process in
forming one’s conscience:
•When examining any issue or situation, we must
begin by being open to the truth and what is right.
•We must study Sacred Scripture and the
teachings of the Church.
•We must examine the facts and background
information about various choices.
•We must prayerfully reflect to discern the will of
God
“CONSCIENCE is a judgment
of reason by which the human
person recognizes the moral
quality of a concrete act”
(CCC, no. 1796). “Man has in
his heart a law inscribed by
God. His conscience is man’s
most secret core, and his
sanctuary”
The STRATEGIES OF
MORAL DECISION
MAKING PROCESS
1)recognizing personal
circumstances,
2)anticipating
consequences,
3)considering others'
perspectives,
4)seeking help,
5)questioning your own
judgment,
6)dealing with emotions,
and
7)examining personal
values.
ETHICAL ISSUES
RELATED TO
TECHNOLOGY
IN THE
DELIVERY OF
HEALTHCARE
What is RA 10173?
RA 10173 or
the Data
Privacy Act
While information technology has the
potential to improve the quality and
efficiency of patient care, it also raises
important ethical and social issues.
What is RA 10173?
RA 10173, or the Data Privacy Act, Act
protects individuals from unauthorized
processing of personal information that
is (1) private, not publicly available;
and (2) identifiable, where the identity
of the individual is apparent either
through direct attribution or when put
together with other available
information.
This Act shall be known as
the “Data Privacy Act of
2012”.
It is the policy of the State to
protect the fundamental
human right of privacy, of
communication while
ensuring free flow of
information to promote
innovation and growth.
Republic Act 10173 – Data Privacy Act of 2012 »
National ...
www.privacy.gov.ph › data-privacy-act
First, all personal information
must be collected for reasons
that are specified, legitimate,
and reasonable. In other
words, customers must opt in
for their data to be used for
specific reasons that are
transparent and legal.
Second, personal
information must be handled
properly. Information must
be kept accurate and
relevant, used only for the
stated purposes, and
retained only for as long as
reasonably needed.
Customers must be active in
ensuring that other,
unauthorized parties do not
have access to their
customers’ information.
Third, personal information
must be discarded in a way
that does not make it visible
and accessible to
unauthorized third parties.
Unauthorized processing,
negligent handling, or
improper disposal of personal
information is punishable with
up to six (6) years in prison or
up to five million pesos (PHP
5,000,000) depending on the
nature and degree of the
violation.
COMPLIANCE OF THE DATA
PRIVACY ACT?
The National Privacy Commission will
check whether companies are compliant
based on a company having 5 elements:
1. Appointing a Data Protection Officer
2. Conducting a privacy impact
assessment
3. Creating a privacy knowledge
management program
4. Implementing a privacy and data
protection policy
5. Exercising a breach reporting
procedure
A. INTERNATIONAL CODE OF
ETHICS
B. CODE OF ETHICS OF NURSES

* RN AND PEOPLE
* RN AND PRACTICE
* RN AND CO-WORKERS
* RN AND SOCIETY AND
ENVIRONMENT
* RN AND PROFESSION
End of Presentation

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ST. MARY’S COLLEGE OF TAGUM, INC.

NCM108 - HEALTHCARE ETHICS (BIOETHICS) 2

Also known as the rule of double effect:

By this argument, the death of the fetus is merely the side-effect of

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NCM108 - HEALTHCARE ETHICS (BIOETHICS) 5

The pursuit of the common good entrusts, both to the

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NCM108 - HEALTHCARE ETHICS (BIOETHICS) 11

Aldo Leopold (1887–1949) championed environmental

NCM108 - HEALTHCARE ETHICS (BIOETHICS) 12

Physicians have a long-recognized obligation to patients

Managing health care resources responsibly for the

NCM108 - HEALTHCARE ETHICS (BIOETHICS) 13

According to Thomas Aquinas, all of the organs and

NCM108 - HEALTHCARE ETHICS (BIOETHICS) 14

NCM108 - HEALTHCARE ETHICS (BIOETHICS) 15

The human body is an integral part of the human

Human nature is an integration of body and spirit. These

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Obtain informed consent. Unless the patient is unconscious,

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9. The nurse ensures patient safety and privacy

NCM108 - HEALTHCARE ETHICS (BIOETHICS) 19

LEGAL SAFEGUARDS FOR NURSES

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NONSURGICAL STERILIZATION (IUD)

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St. Thomas takes mutilation to mean the “removal of a member or

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At the end of the lesson, the students are expected

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"I tell you the truth, whatever you did for

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Related Values and Social Orientation

NCM100 - Theoretical Foundations in Nursing 34

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The first-ever organ

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NCM108 - HEALTHCARE ETHICS

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NCM108 - HEALTHCARE ETHICS

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Two donated kidneys can free two

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There is a rising number of FIlipinos

Not everyone can become an

NCM108 - HEALTHCARE ETHICS

Is organ donation legal in the

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“I know it’s illegal but what

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