|BIOETHICS
1ST SEMESTER
A.Y. 2023-2024
I.
INTRODUCTION TO BIOETHICS
A. Review: Health and Determinants of Health
B. Ethics and Morality
C. Relevant Division of Ethics
REVIEW: HEALTH AND
DETERMINANTS OF HEALTH
• Health is a basic human right, hence as part of
the health team, we are bound to ensure the good
health of our client.
• The focus on the review of health and
determinants of health would be on relating it
with the actual scenario in our daily life and also
looking into the implication to us as a health care
provider.
• According to the World Health Organization
(WHO constitution, 1946), Health is a state of
complete physical, mental, and social well-being,
and not merely the absence of disease or
infirmity.
FACTORS AFFECTING HEALTH OF
CLIENTS
(National League of Philippine Government Nurses,
Inc., 2007)
• Income and Social Status – Higher income and
social status are linked to better health.
• Education – Low education level are linked with
poor health, more stress, and lower selfconfidence.
• Physical Environment – Safe water and clean
air, healthy workplaces, safe houses,
communities, and roads all contribute to good
health.
• Employment and Working Conditions – People
who are employed are healthier, particularly
those who have more control over their working
conditions.
• Social Support Network – Greater support from
families, friends, and communities is linked to
better health.
• Culture – Customs and traditions, and beliefs of
the family and community all affect health by
applying the multi-factorial approach.
• Genetics – Inheritance plays a part in
determining lifespan, healthiness, and the
likelihood of developing certain behaviors.
• Personal Behavior and Coping Skills –
Balanced eating, keeping active, smoking,
drinking, and how we deal with life stresses and
challenges all affect health.
• Health Services – Access and use of services
prevent and treat diseases influence health.
• Gender – Men and women suffer from
different ages.
• The situation and condition of the community
affect the health of the people. Health is affected
not only by microorganisms but the many
factors, which are the determinants of health.
Therefore, to solve the problem in health, it is not
merely removing the microorganism but looking
into the situation of the society as a whole by
applying the multi-factorial approach.
• HPN & DM MULTIFACTORIAL ETIOLOGY:
Attributed to genetic, environment, and personal
behavior.
➢ INTERVENTIONS: Multi-factorial approach to
respond to the genetic, environmental and
personal behavior.
DETERMINANTS OF HEALTH
• Biological Determinants – Factors relating to
the body that impact health, such as genetics,
hormones, body weight, blood pressure,
cholesterol, and birth weight.
• Behavioral Determinants – Actions or patterns
of living of an individual or group that impact
health, such as smoking, sexual activity, and
eating practices.
• Social Determinants – Aspects of society and
the social environment that impact health such
as poverty, early life experiences, and social
networks.
• Physical Environment – The physical
surroundings in which we live, work, and play
such as water, air, housing, and roads.
1
BIOETHICS 1ST SEMESTER | Prevalence of Bioethical Issues
HEALTH is a BASIC HUMAN RIGHT as affirmed
IMPORTANCE OF ETHICS
by the following:
• According to the Universal Declaration of Human
Rights Article 25 sec 1:
“Everyone has the right to a standard of living
adequate for the health and well-being of
himself and of his family including food,
clothing, housing, and medical care and
necessary social services and the right to
security in the event of unemployment, sickness,
disability, widowhood, old age or other lack of
livelihood in circumstances beyond his control.“
• As stated in the Philippine Constitution Article XIII
sec 11:
“The State shall adopt an integrated and
comprehensive approach to health development
which shall endeavor to make essential goods,
health and other social services available to all
the people at affordable cost. There shall be a
priority for the needs of the underprivileged sick
elderly, disabled, women, and children. The
State shall endeavor to provide medical services
to paupers.“
• It teaches us to distinguish what is right from
what is wrong.
• It helps to make the right judgments and
decisions in a given situation.
ETHICS AND MORALITY
ETHICS
• Comes from the Greek word “ethos“ which
means moral duty.
• Refers to making choices that are best for the
individual or society at certain times and in
particular situations and then evaluating such
choices and outcomes.
• Ethics has several meanings (Kosier and Erbs,
Chapter 5):
➢ It is a method of inquiry that helps people to
understand the morality of human behavior
such as the study of morality.
o It studies how people make judgments in
regard to right or wrong.
➢ Refers to practices or beliefs of a certain
group such as nursing ethics and medical
ethics.
➢ Refers to the expected standards of moral
behavior of a particular group as described
by the professional code of ethics.
MORALITY
• The Greek work “moralis“ refers to a social
consensus about moral conduct for human being
and society.
• It also refers to private, personal standards of
what is right and wrong in conduct, character,
and attitude.
• Morality is not the same as law.
• Law reflects the moral value of a society and
offers guidance in determining what is moral
but an action may be legal but not moral.
RELEVANT DIVISION OF ETHICS
BIOETHICS
• A science that deals with the study of the morality
of human conduct concerning human life from
the moment of its conception to its natural end.
• Originally, bioethics was concerned with ethical
issues described with medical practice, it has
expanded to issues surrounding health and
biological sciences and social issues including
environmental concerns.
NURSING ETHICS
• It is the examination of all ethical and bio-ethical
issues from the perspective of nursing theory
and nursing ethics.
• It includes duties or behavior of the members of
the nursing profession toward their co-nurses, to
their profession, to other health care workers, to
the patients, and to the public in general.
PROFESSIONAL ETHICS
• Includes the moral duty or obligation which a
member of the profession owes to the public, to
his profession, to his colleagues, and to his
clients.
2
|BIOETHICS
1ST SEMESTER
A.Y. 2023-2024
II. PREVALENCE OF BIOETHICAL ISSUES
A. Abortion
B. Organ and Tissue Transplant
C. End-of-Life Decisions
1. Euthanasia and Assisted Suicide
Euthanasia
2. Termination of Life-Sustaining Treatment
D. Cost-Containment Issues
E. Breaches of Client Confidentiality
ABORTION
• The expulsion of the human fetus before the
period of viability which is 24-48 weeks or
towards the end of 7 months.
• Viability is the period when the human fetus can
have the ability to survive outside the uterus with
or without medical assistance.
• Abortion is generally classified as direct or
intentional such as induced abortion and indirect
or unintentional such as miscarriage.
• There are different types of abortion which are
either intentional or unintentional.
TYPES OF ABORTION
COMPLETE
• All the parts of the pre-born child and placenta
are expelled.
INCOMPLETE
• Some parts of the pre-born child and placenta
remain in the uterus.
INDUCED ABORTION
• Intentional either through mechanical or
chemical means such as injecting a chemical
consisting of either saline, urea, or prostaglandin
through the abdomen into the amniotic sac.
• The chemical solution induces uterine
contractions that expel the fetus.
INFECTED OR SEPTIC ABORTION
• It is associated with an infection of the uterus or
genital tract.
SPONTANEOUS ABORTION
• Miscarriage, unintentional cause by diseases or
accidents.
➢ Toxoplasmosis, a protozoal infection, and
listeriosis, a bacterial infection could cause
miscarriage, death of the fetus, and serious
birth defects.
THERAPEUTIC
• Deliberately inducing expulsion of a living fetus
to save the mother on death brought about by
pregnancy.
EUGENIC ABORTION
• Recommended in cases where certain defects
are discovered in developing fetus.
GENERAL POINT OF VIEW TO CONSIDER
CONSERVATIVE
• Abortion is never permissible however it may be
allowed if the reason outweighs the action like
saving the mother’s life.
LIBERAL
• Abortion is always permissible.
• It gives the right of a woman to make a decision
that affects her own body.
• It advocates the right of women to selfdetermination.
MODERATE POSITION
• Abortion is permissible in certain stages of fetal
development.
• Some believe that ensoulment occurs from the
moment of conception, therefore, a newly
fertilized ovum is already a person, and abortion
in this stage is considered morally wrong.
• Some also believe that ensoulment occurs later
stage of fetal development, therefore eugenic
abortion may be morally right.
PRO-LIFE AND PRO-CHICE
• Pro-Life – Disapproves abortion because of the
physical, psychological, and spiritual effects.
• Pro-Choice – Approves abortion because of
personal, social, and fetal reasons.
• Debate occurs opposing the principle of sanctity
of life against the principle of autonomy and
woman’s right to control her own body.
• Abortion in the Philippines is a crime.
• The human being is to be respected and treated
as a person from the moment of conception and,
therefore from the same moment his right as a
person must be recognized and safeguarded.
3
BIOETHICS 1ST SEMESTER | Prevalence of Bioethical Issues
ORGAN AND TISSUE-TRANSPLANT
• The organ or tissue transplantation may come
from the human living or the dead donors and
also from other species like pigskin (xenograft).
• Ethical issues include the allocation of organs,
selling of body parts, involvement of children as
potential donors, consent, clear definition of
death, and conflicts of interest between potential
donors and recipients.
• Organs that can be donated include the liver,
kidney, pancreas, heart, and etc.
ORGAN DONATION AND
TRANSPLANTATION
• Organ Donation – Process of surgically
removing an organ or tissue from one person
(the organ donor) and placing it into another
person (the recipient).
• Transplantation – Necessary because the
recipient’s organ has failed or has been
damaged by disease or injury.
• Organ transplantation is one of the great
advances in modern medicine. Unfortunately,
the need for organ donors is much greater than
the number of people who actually donate.
• Every day in the United States, 21 people die
waiting for an organ and more than 107,380
men, women, and children await life-saving
organ transplant.
WHAT ORGANS AND TISSUES CAN BE
TRANSPLANTED?
• Liver
• Lung
• Bone
• Kidney
• Intestine
• Bone marrow
• Pancreas
• Corneas
• Heart valves
• Heart
• Middle ear
• Connective tissue
• Vascularized composite allografts
WHO CAN BE AN ORGAN DONOR?
• People of all ages should consider themselves
potential donors.
• When a person dies, they are evaluated for
donor suitability based on their medical history
and age. The organ procurement organization
determines medical suitability for donation.
HOW DO I BECOME A DONOR
• You might join a donor registry.
• Sign and carry an organ donor card.
• Let your family members and loved ones know
you’d like to be a donor.
• You might also want to tell your family
healthcare provider, lawyer, and religious
leader that you’d like to be a donor.
PHILIPPINE ORGAN DONATION AND ITS
TRANSPLANT PROGRAM
• The organ donation and transplantation are
significantly low in this country.
• The inadequate knowledge of people about
organ donation and transplant, along with limited
workforce and facilities that can handle these
operations are factors that result in the low rate.
• Moreover, organ trafficking is prevalent mainly
due to poverty. Hence, this program aims to
facilitate and oversee all organ donation and
transplantation activities in the country with a
goal of National Self-Sufficiency in Organ
Donation and Transplantation and Prevention of
Organ Trafficking.
WHAT ORGANIZATION ACTUALLY MANAGES
THE DISTRIBUTION OF ORGANS?
• UNOS maintains the national Organ
Procurement and Transplantation Network
(OPTN).
• Through the UNOS Organ Center, organ donors
are matched to waiting recipients 24 hours a
day, 365 days a year.
• UNOS then generates a list of potential recipients,
based on such factors as:
➢ Blood type.
➢ Tissue type.
➢ Organ size.
➢ Medical urgency of the patient’s illness.
➢ Time already spent on the waiting list.
➢ Geographical distance between the donor and
the recipient.
END-OF-LIFE DECISIONS
EUTHANASIA AND ASSISTED SUICIDE
EUTHANASIA
• Euthanasia – Deliberate putting to death in an
easy, painless way of an individual suffering
from an incurable and agonizing disease
(mercy killing).
• Assisted Suicide – Giving the client the means
to kill himself if requested.
4
BIOETHICS 1ST SEMESTER | Prevalence of Bioethical Issues
• 2 Major Types of Euthanasia:
➢ Euthanasia by Commission or Active
Euthanasia
o It is the conduct of a measure to end the
life of a suffering person with or without
the patient’s consent.
o E.g., Giving lethal dose injected into the
terminally ill patient.
➢ Euthanasia by Omission or Passive Euthanasia
o It is the withdrawal or omitting measures
necessary to sustain the life of a suffering
person with or without the patient’s consent.
o E.g., Water and food are withdrawn to
terminally ill patients.
CASES OF EUTHANASIA
SELF-ADMINISTERED
• Active Euthanasia – The patient deliberately
ends his life.
➢ E.g., The client drug pesticide to end his life.
• Passive Euthanasia – The patient refuses to
take anything to sustain life which will hasten his
death.
➢ E.g., The client refuses to eat and drink food
to hasten his death.
OTHERS ADMINISTERED
• Active and Voluntary Euthanasia – The act of
commission by another person with the patient’s
consent.
➢ E.g., The family gave an overdose medication
to the client to hasten his death with client’s
consent.
• Passive and Voluntary Euthanasia – The act
of omission by another person with the patient’s
consent.
➢ E.g., The family removed the oxygen supply
of the client with client’s consent.
• Active and Involuntary Euthanasia – The act
of commission to terminate a patient’s life by
others without the patient’s consent.
➢ E.g., The family gave an overdose medication
to the client to hasten his death without the
client’s consent.
• Passive and Involuntary Euthanasia – The act
of omission to allow terminally ill patient to die
as requested by others without the patient’s
consent.
➢ The family removed the oxygen supply of the
client without client’s consent.
EUTHANASIA revolves around the preservation of
human dignity in death even to the individual’s last
breath but also erodes human dignity because it
hastens the death of an individual.
TERMINATION OF LIFE-SUSTAINING
TREATMENT
• Antibiotics, organ transplants, and technologic
advances help to prolong life but not necessarily
to restore health.
➢ Clients may request the withdrawal of lifesustaining treatment or the client may have it
withdrawn through his advance directive or
his appointed surrogate decision-maker.
➢ The patient and families of the patient must
understand the life-sustaining treatment.
➢ Nurses must understand that a decision to
withdraw life-sustaining treatment is not a
decision to withdraw care.
➢ Nurses must ensure to provide care and
comfort measures as the patient’s illness
progresses.
COST-CONTAINMENT ISSUES/
ALLOCATION OF SCARCE HEALTH
RESOURCES
• Allocation of limited supplies of health care
goods and services, including organ transplants,
test kits, and medicines has become an
especially urgent issue as medical costs continue
to rise and more stringent cost-containment
measures are implemented.
• The principle of justice could be utilized by the
health care provider to choose what is most fair
to all.
• Nursing care is also a health resource in which,
some hospitals have an inadequate number of
nurses to give the level of care patients need.
• Despite the shortage, the nurses must continue to
provide the quality care needed by the clients.
BREACHES OF CLIENT
CONFIDENTIALITY
• Nurses are obligated to respect the client’s
privacy and confidentiality but, in some
circumstances, some information about the
patient is divulged to avoid epidemiological
impact.
5
|BIOETHICS
1ST SEMESTER
A.Y. 2023-2024
III. THE HUMAN PERSON
A. Personhood
B. Human Act and Acts of Man
C. Elements Determining Morality
D. Criteria for Moral Judgment
E. Conditions Affecting Morality
➢ The act is intentional and willfully done.
➢ E.g., The student nurse administered the
medication since she knew that it will help her
patient recover.
PERSONHOOD
• An act that does not proceed from the deliberate
free will of man.
• Person – Composed of physical, intellectual,
biochemical, and psychosocial needs.
2 RATIONAL FACULTIES TO CONSIDER
• Intellect – It emphasizes that man tends
towards the truth as his objective. Man is a
rational being, acts with a purpose.
• Freewill – Man tends towards the good as his
objective. Man assumes to possess the ability to
freely do his action, thoughts and has the power
to refine, renew, or even restrain his actions and
thoughts
ACT OF MAN
3 ELEMENTS OF ACT OF MAN
• No Element of Knowledge
➢ The act is not deliberately done.
➢ The person is not aware or conscious of what
he is doing and what it means.
➢ E.g., A toddler placing dirty objects into his
mouth.
• No Element of Freedom
➢ Act not freely done.
➢ E.g., An act was done during daydreaming
• No Element of Voluntariness
➢ No involvement of the will to decide the intent
and to willfully do the act.
HUMAN ACT AND ACTS OF MAN
ELEMENTS DETERMINING MORALITY
HUMAN ACT
• Actions that man performs knowingly, freely
and voluntarily to the control of the will.
• Actions are deliberate, intentional, or voluntary.
ELEMENTS OF HUMAN ACT
• Knowledge
➢ The act is done based on the knowledge of
the person.
➢ E.g., A student nurse learned how to do an
intramuscular injection, then, later applied
correctly to a patient in the clinical area.
• Freedom
➢ The act is performed in accordance with the
will.
➢ The will cannot decide to do a certain act
without the intellect/knowledge.
➢ E.g., The student nurse decided to administer
the IM injection to the patient as per doctor’s
order considering the rights of the patient that
she learned in class.
• Voluntariness
➢ The act is a product of his knowledge and will,
which help him make a decision.
• The morality of an act is affected by the motive
of the act and the circumstances it has
happened.
• The following criteria for moral judgment are
recommended to consider either the act is good
or evil.
➢ Act – Deed done or performed.
➢ Motive – End or purpose or goal to be
achieved by utilizing the act.
➢ Circumstances – Condition at which the act is
done affecting its morality in one way or
another.
CRITERIA FOR MORAL JUDGMENT
• A good act which is done for a good motive
becomes doubly good.
➢ E.g., A nurse performed a tepid sponge bath
to a patient with a body temperature of 38°C
to lower his body temperature.
6
BIOETHICS 1ST SEMESTER | The Human Person
• An evil act which is done for evil motives
doubly evil.
➢ E.g., A student nurse who documented the
wrong blood pressure of the client to avoid
discussion with the clinical instructor.
• A good act which is done for an evil motive
becomes evil.
➢ E.g., A student nurse volunteered to get the
blood pressure of the patient of his classmate
to show to the clinical instructor that his
classmate is not doing well in the clinical area.
• An evil act which is done for a good motive
does not become good. The end does not
justify means.
➢ E.g., A student nurse copied the previous
nursing care plan of his classmate to be able
to pass the subject.
• Circumstances can make an act either good
or evil.
➢ E.g., Singing to calm your pediatric client is
either good or evil. It could be good if may be
done in the day time where other pediatric
clients may join but it could be evil if done at
night when other clients are disrupted on their
sleep.
• Circumstances can never make an evil act
good.
➢ E.g., Not wearing a facemask in public
transportation during the COVID 19 pandemic
because his facemask was misplaced.
• Circumstances can make good or evil act
better or worse.
➢ E.g., A nurse performed a sponge bath to a
patient with a fever to decrease his body
temperature and feel better but if the patient
is currently having a seizure, performing the
sponge bath may cause more injury to the
client.
CONDITIONS AFFECTING MORALITY
IGNORANCE
• Lacks required knowledge which human beings
should have of his moral duty.
INVINCIBLE IGNORANCE
• When we do not know something that is
impossible for us to know.
• The person makes decisions out of ignorance but
in good conscience having taken every
precaution needed.
• If fully informed, the person may have not
performed the act.
• E.g., The nurse on duty was not able to
coordinate the change of diet of the patient to
the dietary from soft to Diet as Tolerated since
the oral order of the doctor was not endorsed by
the outgoing nurse. The nurse on duty had
contacted the doctor in-charge of any update of
the doctor’s order but no mention of the change
of diet that was previously ordered through a
telephone call.
VINCIBLE IGNORANCE
• When we do not know something that we ought to
know.
• The knowledge could be acquired through
ordinary effort but the person was not able to
acquire it due to negligence or intentionally not
acquired it.
• E.g., The nurse has a strong doubt about the
medicine ordered by the doctor and yet the
nurse did not consult the doctor.
CONCOMITANT/ AFFECTED IGNORANCE
• When we do not know something but we would
have done it anyway.
• Ignorance occurs when the person positively
wanted to be ignorant in order to plead innocent
to a charge of guilt.
• E.g., The nurse intentionally does not read
notices to avoid certain regulations that are
opposed to her plan.
FEAR
• A disturbance of the mind of a person who is
confronted by an impending danger to himself
or to his loved ones.
• Acts done out of fear are voluntary but if fear is
enormously great such in a situation between life
and death wherein the person momentarily
insane at the time the act is done out of intense
fear or panic, the act may be considered as
involuntary.
• E.g., Killing someone in the act of self-defense
in a life and death situation.
7
BIOETHICS 1ST SEMESTER | The Human Person
VIOLENCE
• It refers to any physical force exerted on a
person by another person for compelling said
person to act against its will.
• E.g., A nurse who defended herself from the
rapist and applied all physical powers to resist.
The act of the nurse may be considered
involuntary hence, no or lessened moral
responsibility.
HABITS
• It is a lasting readiness, born of the frequently
repeated act.
• A habit could be bad and become vices while
good habits will become virtues.
• Habits are voluntary thus it does not destroy the
voluntariness of the act.
• E.g., A nurse who develops a habit to perform
handwashing before handing a patient becomes
a good quality of the nurse but a nurse who does
not observe all the time proper handwashing is
responsible for the cross-contamination as a
result of his action.
8
|BIOETHICS
1ST SEMESTER
A.Y. 2023-2024
IV. ETHICAL THOUGHTS
A. Kantian Ethics
B. Rawl’s Ethics
C. Ross Ethics
D. Natural Law Ethics
KANTIAN ETHICS
IMMANUEL KANT
• Russian philosopher and had a major impact on
the idealist philosophies of the 19th century.
• He was born in April 1724 and died in February
1804.
• He was more concerned with duty and reason.
• He believed that the intentions behind an action
are more important than the consequences
because we cannot predict the consequences
thus, we cannot judge a person good or bad
based on the consequences of their action.
MORAL PHILOSOPHY
REASON/ GOODWILL
• Goodwill is having a good intention.
• An action cannot be good unless performed out
of good intention or reason.
• A person’s inward motive must be good for the
action to be good.
DUTY
• A person is acting well if he performs his duty.
• A person’s duty can differ depending on the
situation they are in.
• A person performs her duty as a teacher while
in school then as a mother when at home.
CATEGORICAL IMPERATIVE
PRINCIPLE OF UNIVERSALIZABILITY
• Kant argued that if a moral rule cannot be
applied to all people at all times, then it is
meaningless.
• It should be applied equally to all people in all
situations.
• If stealing is wrong then anyone stealing wrong
regardless of the consequence.
RESPECT
• Each person is a rational being, thus capable of
making his own decision and respond to his
action.
• Each person is unique, irreplaceable, and
deserves respect.
• Respect yourself and all others as a person of
worth and dignity.
• Always treat humanity whether in ourselves or
another person as an end in itself and never
merely as a means to an end.
AUTONOMY
• It refers to the capacity of a rational individual
to make an informed, un-coerced decision.
• It is respecting a person’s capacity for acting
freely.
• Patient autonomy is the moral right on the part
of the patient to self-determination concerning
one’s own health care.
• In the care of the patient, the health practitioners
should respect the patient’s moral right to
autonomous decision-making after the various
and alternative medical treatments or remedies
were presented to him.
RAWL’S ETHICS
JOHN RAWLS
• One of the most prominent American
philosophers of the 20th Century that introduces
social justice.
• He was working primarily in the areas of
political philosophy and ethical theory.
• He was a defender of political liberalism with
the idea that government should be neutral with
regards to the question of what constitutes a good
life.
• Rawls introduced social justice to recognize our
duties to ourselves and to others.
• He assumes that rational people would choose a
strategy by which they could select from many
alternatives that will elicit a result that would be
better.
• Kant’s ethics are about right and wrong actions.
➢ Is it ethical to lie on a job application to
preserve legitimate privacy?
9
BIOETHICS 1ST SEMESTER | Ethical Thoughts
• Rawls’ theory is about distributive justice.
➢ What is the ethically correct way to distribute
benefits and burdens in society?
THEORY OF JUSTICE
• Every individual is inviolable (sacred/valued)
that not even the general welfare of the society
can override and supersede it.
➢ Each one is unique from the other.
➢ The greater good to be shared by all
members, should not be used to justify the loss
of freedom of others.
➢ Not to exploit or oppress other’s benefit.
• An erroneous theory is tolerable in the absence
of good ones.
➢ When given 2 erroneous alternatives, one
should choose the better and the less
erroneous one.
➢ Amputation of the gangrenous leg to avoid the
spread of the cancer cells to the body.
• Individual liberties should be restricted in order
to maintain equality of opportunity.
➢ Restrictions are intended not to destroy but to
preserve freedom; and amidst these
restrictions, equality of opportunity among the
citizens to develop themselves.
➢ Regardless of the socio-economic, cultural,
political, and physical status of the patient,
each is required to undergo an assessment
before referred to the medical doctor.
SOME PRINCIPLES OF JUSTICE THAT A
NURSE SHOULD CONSIDER:
• Every person has an equal access to basic
human rights and liberties such in the following:
➢ Right to vote and to be eligible for public office
➢ Freedom of speech and peaceful assembly
➢ Liberty of conscience
➢ Freedom of thoughts
➢ Right of ownership
➢ Freedom from arbitrary arrest and seizure
• Every person has fair equal of opportunity and
distribution of basic services.
➢ Everyone should be given an opportunity for
self-development or receive medical
treatment.
4 DUTIES WHEN APPLYING JUSTICE IN
HUMAN RELATION
• Fairness in dealing with others – Consider that
one person is unique from the other.
• Fidelity – The nurse must be faithful and true
to
their
professional promises
and
responsibilities by providing high quality, safe
care in a competent manner. Do not give false
assurance to the client.
• Respect for person – You have to consider the
uniqueness of the person. Consider the capability
and abilities of the client in the provision of
interventions.
• Beneficence – It emphasizes that one should do
well for other people.
ROSS ETHICS
WILLIAM ROSE
• British Aristotelian scholar.
• He considers Kant’s ethics’ absolute principles to
be too rigid.
• According to Ross, an action is wrong unless
there is a good reason to do it.
• Ross introduces the concept of prima facie duties
which means that duties might have justified
exceptions that are not so strict as compared to
Kant’s categorical imperative.
DISTINCTION OF ACTUAL DUTY AND
PRIMA FACIE DUTY
• Actual duty – It is the real duty in a given
situation.
• Prima facie duty – Moral code of six duties that
Ross believes all humans would recognize as
unwritten, socially binding contracts. These are
not rules, but guidelines for moral action.
7 TYPES OF PRIMA FACIE DUTY
• Duty of Fidelity – Being faithful to our duties,
obligations, or vows.
➢ Telling the truth as the situation demands it,
keeping actual and implicit promises, and not
representing fiction as truth.
• Duty of Reparation – The act of making
amends, righting the wrongs we have done to
others.
• Duty of Gratitude – Appreciating and
recognizing the services others have done for
us, which may be either be a favor, kindness,
good fortune, a great help, or saving one’s life.
10
BIOETHICS 1ST SEMESTER | Ethical Thoughts
• Duty of Justice – Stresses the proper
distribution of social benefits and burdens.
• Duty of Beneficence – To bring about what is
good for others but also to help them better their
conditions with respect to virtue, intelligence, o
comfort.
• Duty of Self-Improvement – To improve and
develop ourselves with respect to virtue,
intelligence, and happiness.
• Duty of Nonmaleficence – Avoiding inflicting
evil, injury, or harm upon others as we would
avoid doing so to ourselves.
ULTIMATE GUIDE
• Learn and discern the facts in the case.
• Consider the possible consequences of our
actions.
• Reflect on our prima facie duties.
• Decide on the best course of action under the
circumstances.
NATURAL LAW ETHICS
(THOMISTIC ETHICS)
ST. THOMAS AQUINAS
• Italian Dominician philosopher.
• Natural law ethics claims that there exists a
natural moral law that is manifested by the
natural light of human reason.
• It says that human beings possess intrinsic
values that govern our reasoning and behavior.
NATURAL LAW ETHICS UNDERSCORE
MAN’S THREEFOLD NATURAL
INCLINATION
SELF-PRESERVATION
• An individual has the tendency to care for his
health and not to kill himself or put others in
danger.
• Any act that promotes health, vigor, vitality
(physical exercise, walking) is considered as
good while suicide and self-immolation is
considered as evil.
JUST DEALINGS WITH OTHERS
• Treat others with the same dignity and respect
that we accord ourselves, like the golden rule:
“Do unto others, what you want others to do unto
you.“
• Exploitation, oppression, seduction, abduction,
deception, swindling, cheating, kidnapping for
ransom, murder, harassment, and intimidation
are against human nature and considered evil.
PROPAGATION OF OUR SPECIES
• We are naturally inclined to perpetuate our
species which is viewed as a natural good thus
we are obligated not to pervert or thwart this
natural inclination.
DOUBLE EFFECT PRINCIPLE
• The principle applies to a situation in which a
good effect and an evil effect will result from a
good action/cause.
PRINCIPLE OF TOTALITY
• Under natural law ethics, we have a natural
obligation not only to preserve lives but also to
preserve the integrity of our body.
• The principle of totality would forbid the donation
or selling of a healthy organ if such were to
weaken the health of the donor. It is also in
conflict with the natural inclination toward selfpreservation and would violate the sanctity of the
individual person.
PRINCIPLE OF STEWARSHIP
• Declares that human life comes from God and
no individual is the master of his/her own body.
• Human is only merely stewards or caretakers
with the responsibility of protection and
cultivating spiritual and bodily function.
PRINCIPLE OF THE
INVIOLABILTY OF LIFE
• States that life is God’s and has been loaned to
us hence it is inviolable and sacred.
• Only God has complete control and domination
over life and our duty is to take care of it until
God takes it back from us.
PRINCIPLE OF SEXUALITY AND
PROCREATIOR
• It emphasizes the responsibility of husband and
wife in the procreation and nurturing of children
and it is also an expression of loving union and
companionship.
11