(BIOETHICS) THEORIES AND PRINCIPLES OF HEALTH ETHICS Flashcards
is the branch of philosophical study that investigates moral duties, values, andideal human character. It involved explanation into the nature of right andwrong, good and evil, promises, and moral duties
Ethics
duty-focused normative approach centered on rules from which all action isderived.
Deontological
outcome focused approach that places emphasis on results and protects theinterest of the majority.
Teleological
the guiding principle for all conduct should be to achieve the greatesthappiness for the greatest number and that the criterion of the rightness orwrongness of an action is whether it is useful in furthering this goal
Utilitarianism
a person’s standards of behavior or beliefs concerning what is and is notacceptable for them to do
Morals
an acceptance that a statement is true or that something exists.
Beliefs
a person’s principles or standards of behavior; one’s judgment of what isimportant in life.
Values
a fundamental truth or proposition that serves as the foundation for a system ofbelief or behavior or for a chain of reasoning.
Principles
philosophy is ‘the intense and critical examination of beliefs and assumptions’.(Burkhardt and Nathaniel (2002).
Philosophy
is ‘considered a character trait that is morally valued and that stems from themotivation to do right or good’. (Fry and -Johnstone,2002)
Virtues
a person’s outward bearing or way of behaving toward others.
Manners
seems to mean an ability to feel what is right and wrong in a given situation.
Conscience
defined as a “calling requiring specialized knowledge” and “a principle calling,vocation, or employment”
Profession
is a document that provides patients with information on how theycan reasonably expect to be treated during the course of theirhospital stay
Patient’s bill of rights
The term refers to every individual’s right of self-determination, independenceand freedom to make their own choices
Autonomy
is defined as: ‘…a voluntary, uncoerced decision, made by a sufficientlycompetent or autonomous person, on the basis of adequate informationand deliberation, to accept or reject some proposed course of actionwhich will affect him/her’ (Gillon 1986: 113).
Informed consent
is a moral power of performing, possessing, or of requiring something which is due.
Right
defined as making a choice between two or more equally undesirablealternatives
Ethical Dilemma
is defined as a moral obligation incumbent upon a person of doing or omitting (avoiding)something
Duty
an action is the objective goal of the action. It is the goodthat you are trying to attain through the action, and how well the action isordered toward that good
Moral Object
is the reasons why you choose to act. It may coincidewith your choice of the moral object, or you may have intentions beyond the simple object
Intention
refers to moral acceptability, not the legal meaning of conforming to a set ofstandards and requirements to be acceptable.
Legitimate
when your actions or words create a temptation to sin for others.
Scandal
refers to each individuals duty to “preserve a view of the whole human person inwhich the values of the intellect, will, conscience and fraternity are pre-eminent”.
Integrity
refers to the expression of one’s responsibility to take care, nurture andcultivate what has been entrusted to him.
Stewardship
refers to the duty to preserve intact the physical component of the integrated bodilyand spiritual nature of human life, whereby every part of the human body “ exist forthe sake of the whole as the imperfect for the sake of the perfect”.
Totality
Ethical theories that are associated with duties and rights and thatencourage judgements on the rightness of actions based on the duty of thoseinvolved, irrespective of any real or predicted consequences or outcomes.
Deontological theories
ethical theory that are much more concerned with the goals andconsequences of actions when making judgements on their appropriateness
Teleological Theory:
was developed by Jeremy Bentham(1748-1832) and John StuartMill(1806-1873).This ethical doctrines states that the rightness or wrongness of actionsis determined by the goodness and badness for their consequences.
Utilitarianism
state that consequentialism is ‘a label fixed to theoriesholding that actions are right or wrong according to the balance of their good or badconsequences’. They also state, ‘The right act in any circumstance is the one that produces thebest overall result, as determined from an impersonal perspective that gives equal weight to theinterests of each affected party’ (2009: 337).
Beauchamp and Childress (2009: 336)
is an approach that focuses on character with the assumption that a personof good character will tend to behave in ways that are consistent with their character.
Virtue ethics
“characterized by or conforming to the technical or ethical standards ofa profession” (Webster’s 1991)
professional
is a criterion for a profession
code of ethics
stresses the nurse’s obligation to the patient, and theresponsibility to be accountable to self and to the profession.
The American Nurses Association’s(ANA) Code of Ethics
ncludes statements on the responsibility of the professionalnurse regarding respect for human dignity, confidentiality, incompetent and unethicalpractice of peers, accountability for personal nursing judgments and decisions, andmaintenance of personal competence
The ANA’s Code of Ethics
are concepts and ideals that provide meaning to a person’s life. It come from the family, school, religion and the norms of community and society. Examples are honesty, integrity, and respect for others.
Personal values
Two basic values of the nursing profession are
competence and compassion
described as the integration of the attitudes, knowledge, skills required for performance in a specific setting. The concept of competency embraces the first rule of health care professionals of doing no harm, know as non-maleficence.
Competency
a. One or more instances involving failure to adhere to the applicable standard of care to a degree which constitutes gross negligence, as determined by the board;
b. Repeated instances involving failure to adhere to the applicable standard of care a degree which constitutes ordinary negligence, as determined by the board;
c. A pattern of practice or other behavior which demonstrates a manifest incapacity or incompetence to practice nursing” (Kansas Nurse Practice Act, July 2003).
Professional incompetence
described as being conscious of the feelings and concerns of others with the desire to listen and alleviate the distress. Compassion in nursing implies beneficence and the willingness to carry out professional responsibilities.
Compassion
Promotes self -determination/ freedom of choice
AUTONOMY
ability to choose and carry out ones decision without undue pressure or coercion from anyone.
Self -governance
Every person has a right to health and medical care corresponding to his state of health, without any discrimination and within the limits of the resources, manpower and competence available for health and medical care at the relevant time.
Right to Appropriate Medical Care and Humane Treatment.
The patient has a right to a clear, truthful and substantial explanation, in a manner
and language understandable to the patient.
Right to Informed Consent
The privacy of the patients must be assured at all stages of his treatment. The patient has the right to be free from unwarranted public exposure, except in the following cases:
a) when his mental or physical condition is in controversy and the appropriate court, in its discretion, order him to submit to a physical or mental examination by a physician;
b) when the public health and safety so demand; and
c) when the patient waives this right in writing.
Right to Privacy and
Confidentiality.
In the course of his/her treatment and hospital care, the patient or his/her legal guardian has a right to be informed of the result of the evaluation of the nature and extent of his/her disease, any other additional or further contemplated medical
treatment on surgical procedure or procedures.
Right to Information.
The patient is free to choose the health care provider to serve him as well as the facility except when he is under the care of a service facility or when public health and safety so demands or when the patient expressly waives this right in writing.
The Right Choose Health
Care Provider and Facility
The patient has the right to avail himself/herself of any recommended diagnostic and treatment procedures.
Right to Self-Determination.
The patient has the right to refuse medical treatment or procedures which may be contrary to his religious beliefs, subject to the limitations described in the preceding subsection.
Right to Religious Belief
The patient is entitled to a summary of his medicalhistory and condition. He has the right to view thecontents of his medical records, except psychiatricnotes and other incriminatory information obtainedabout third parties, with the attending physicianexplaining contents thereof.
Right to Medical Records.
The patient has the right to leave hospital or any other health care institution regardless of his physical condition.
Right to leave
The patient has the right to be advised if the health care provider plans to involve him in medical research, including but not limited to human experimentation which may be performed only with the written informed consent of the patient
Right to Refuse Participation In Medical Research.
The patient has the right to communicate with relatives and other persons and to receive visitors subject to reasonable limits prescribed by the rules and regulations of the health care institutions
Right to Correspondence and to Receive Visitors.
The patient has the right to express complaints and grievances about the care and services received without fear of discrimination or reprisal and to know about the disposition of such complaints. Such a system shall afford all parties concerned with the opportunity to settle amicably all grievances.
Right to Express
Grievances
Every person has the right to be informed of his rights and obligations as a patient.
Right to be Informed of His Rights and Obligations as a Patient.
an important aspect of nursing and is concerned with obtaining the client’s permission to do a procedure. This respects another person’s autonomy by allowing them to make decisions and then values the decisions that they have made.
Consent
• The Mental Capacity Act was written to protect and empower vulnerable people who may not be able to make their own decisions (Department of Constitutional Affairs (DCA) 2005).
Proxy Consent / Legally Acceptable Representative
• is the expectation that private information told in secret to another person will not be disclosed to others. The information is protected by the recipient of the information.
The literal meaning is con (Latin) meaning completeness and fidere meaning to trust, to be faithful, so confidentiality implies giving information to someone who is considered completely trustworthy and loyal
Confidentiality Keeping privileged information private
the obligation to tell the truth. Meaning TRUTHFULNESS.
Veracity
(the obligation not to deceive and to keep promises).
Fidelity
The model for fidelity
Keeping one’s word of honor
Loyalty to commitments
Reliability
refers to the contract of relationship we enter into with the patient
Fiduciary responsibilities
Seeks fairness. Treats “equals” equally. Treats “un equals” according to their differences.
Justice
refers to what is owed between individuals, e.g.
In conducting business transactions
Cumulative Justice
refer to what individuals owe to society for the common good.
Contributive Justice
refers to rights and responsibilities of citizens to obey and respect the rights of all and the laws devised to protect peace and social order.
Legal Justice
refers to what society owes to its individual members; e.g. the just allocation of resources
Distributive justice
refers to a moral principle by which certain actions are determined and deemed as just or unjust, as due or undue.
Principle of justice
DO NO HARM AND PRODUCE THE GOOD “ OR “DO GOOD AND DO NO HARM”.
Refers to action that benefits others based on the Hippocratic Oath to “apply measures that will benefit the sick”.
Beneficence (Doing Good )
Refers to prevention of harm and the removal of harmful conditions.
NON- MALEFICENCE (“DO NO HARM”)
The principle applies to a situation in which a good effect and an evil effect will result from good cause(Pahl:51-52;Bittle:44 -50;Reyes:151-1.
Principles of Double effect
comes from the latin word CUM which means “with” and OPERARI which means to work. is working with another in the performance of an action.
Principles of legitimate cooperation
consist of an explicit intention and willingness for the evil act. The one formally cooperating categorically wills and intends the evil action.
Formal cooperation
consists of an act other than the evil act itself but facilitates and contributes to its achievement. The one materially cooperating may provide means apart from the evil act itself which is used to carry out the performance of an evil act.
Material Cooperation
consists of direct participation in the performance of an evil act.
Direct cooperation
consist of an act that is not intimately connected with the performance of an evil act as in formal or direct cooperation but whose effect may have an indirect bearing upon it.
Indirect Cooperation
consists of an act that is intimately linked with the performance of an evil action due to its close bearing.
Proximate Cooperation
consists of an act with a distant bearing upon or connection with the execution of an evil act.
Remote Cooperation
- consists of an act with a distant bearing upon or connection with the execution of an evil act.
Remote Cooperation
- consists of an act with a distant bearing upon or connection with the execution of an evil act.
Remote Cooperation
• Often considered a corollary of the principle of the common good, subsidiary requires those in positions of authority to recognize that individuals have right to participate in decisions that directly affect them, in accord with their dignity and with their responsibility to the common good.
Principle of Common Good and Subsidiarity
declares that human life comes from God, and no individual is the master of his/ her own body.
Principle of Stewardship and Roles of Nursing as Stewards
• These principles dictates that the well -being of the whole person must be taken into account in deciding about any therapeutic intervention or use of technology.
• Therapeutic procedures that are likely to cause harm or undesirable side effects can be justified only by a proportionate benefit to the patient.
Principle of Totality and Integrity
• The whole is greater than any of its parts.
The principle of totality
also a form of contraception insofar as its purpose is the prevention of conception- not by the positive use of artificial methods but by cutting off the sexual capacity in a man or a woman.
Sterilization
is that which is done by order of authority of state.
Involuntary/ Compulsory sterilization
are performed for the purpose of hindering the
conception of undesirable and physical or mentally unfit offspring.
Eugenic and social sterilization
- is done as a punishment for crime or antisocial behavior, particularly rape and other sex related offenses. This is compulsory or involuntary sterilization.
Punitive Sterilization-
