ETHICS Flashcards
● A philosophical and practical science.
● Seeks to determine how human actions may be
judged right or wrong.
● Different from morals and morality.
ETHICS
Guides one’s judgement concerning
the morality of human acts.
Critical reflections and rational
analysis of morality
ETHICS
● Deals with the morality of human conduct
concerning life.
● From conception to death.
BIOETHICS
Human conduct in the light of ethics.
What people believed to be right and good.
Morality
● Field of applied ethics that is concerned with the
vast array of moral decision-making situations
that arise in the practice of medicine and allied
health disciplines
HEALTH ETHICS
Division of ethics that relate to professional
behavior.
PROFESSIONAL ETHICS
IMPORTANCE OF HEALTH ETHICS
● Provides knowledge of morality of an act.
● Serves as a guiding principle for health care
practitioners in addressing health care issues.
● Gives proper direction and fundamental ways to
live an upright life in the healthcare profession
ETHICAL THEORIES
● Deontology
● Teleology/Utilitarianism
● Immanuel Kant (1724-1804)
● “Deon” - Greek (one must)
● Morality is derived from rationality, not from
experience
DEONTOLOGICAL THEORY
1.) applicable in all situations (absolute)
2.) something must be done (obligation)
1.) Categorical
2.) Imperatives
A requirement in Kantian deontological theory that
we should act only according to the ______
Maxims
CRITICISMS ON DEONTOLOGY (KANT)
● Exceptionless nature – too rigid for real life.
● Morality is not derived from reason alone.
● Disregard of consequences.
the most common form of consequence-oriented theory
UTILITARIANISM / TELEOLOGICAL THEORY
Fathers of Utilitarianism:
Jeremy Bentham (1748-1832)
John Stuart Mil
● “Telos” – Greek (final purpose, consequence of an
action)
● Morality is based on outcome.
● What is right maximized some good.
● Good resides in the promotion of happiness or
pleasure, rather than pain
TELEOLOGICAL THEORY/UTILITARIANISM
“the greatest good for the greatest number
Principle of Utility
● Aristotle (384 - 322 BC)
● “Arete” – Greek (excellence or virtue)
● Ethics is about agents, not actions nor
consequences.
● From the heart of the moral agent making the
decisions (rather than reasoning to a right decision).
VIRTUE ETHICS
● A guiding principle
composed of beliefs
and attitudes taught by
the early environment.
● Subjective and
personal.
Value
● Characteristics and
dispositions that are morally
right.
● Universally accepted.
VIRTUE
God-loving, person-oriented, and
patriotic nurturers of life
Spirit of faith
contribute to the transformation
of our communities and country through excellent
teaching, compassionate holistic healing and
scientific inquiry.
Zeal for service
- promotes the well-being
and welfare of our employees through our policies
and programs.
Communion in mission
stewards of God-given life to
the best of our ability and judgment.
Reverence for life
CORE VALUES OF A PROFESSIONAL NURSE
● Love of God
● Caring as the core of nursing
● Love of people
● Love of country
FILIPINO VALUES
● Respect for elders
● Trust in divine providence
● Patience
● Optimism
● Forbearance
● Hospitality
● Respect for womanhood
● Harmonious interpersonal relationships
● If virtues are not practiced or guarded it can lead to
the development of vices.
● Vices are negative habits or dispositions that are
against morality and ethics
VICES
A vice is evil either because of ______ or of _____
1.) Excess
2.) Defect
● Refers to a fundamental rule of moral law containing
certain truth from which knowledge of a definite
moral action for performance proceeds along with
the provision of solution to specific moral problem
or issue
ETHICS PRINCIPE/MORAL PRINCIPLE
IMPORTANCE OF ETHICS PRINCIPLES
- To allow health professionals to determine right
and wrong - From these principles, the rules found in
professional code of ethics were derived.
● Greek – autos (self); nomos (governance, rules, law)
● In health care – a form of personal liberty where the
individual is free to choose and implement his
decisions
AUTONOMY
Qualifications needed to exercise autonomy:
○ Capacity to UNDERSTAND the issue and what the
situation is all about.
○ Capacity to REASON OUT and give one’s own
opinion.
○ Capacity to DELIBERATE by weighing the pros
and cons of the issue.
○ Capacity to make an INDEPENDENT CHOICE OR DECISION
● Prior to any substantial information or research
participation, clients must have full information of:
INFORMED CONSENT (ENLIGHTENED CONSENT)
Consent forms are legal documents – ___________ (1st hand evidence) in court cases
PRIMA FACIE
Elements of Informed Consent:
○ Competence
○ Voluntariness
○ Disclosure
○ Permission Giving
WHAT DOES A NURSE DO WHEN THE PATIENT IS
NOT IN HIS RIGHT SENSE WHEN OBTAINING
INFORMED CONSENT?
1.) Patients in coma, unconscious or incapable of making a decision =
2.) In instances when there are no close relatives and
decisions must be made =
3.) Minors =
4.) In certain cultures, a patient even if competent =
1.) Family or Relative
2.) Health Professionals
3.) Parents or Family
4.) Expects and trusts a specific relative to be the consent giver
2 FUNCTIONS OF INFORMED CONSENT
1.) to safeguard against tension of integrity.
2.) To be involved in health care decision making
1.) Protective
2.) Participative
3 TYPES OF INFORMED CONSENT
1.) for routine procedures (medications, bed bath,
physical examination).
2.) for treatments that do not carry significant
risks.
3.) for treatments/procedures that are complex and carry a higher risk.
1.) Implied
2.) Verbal
3.) Written
1.) means that a person has the right to keep personal information secret
2.) when the health care professional does not disclose to others his/her patient’s personal/private information.
1.) Privacy
2.) Confidentiality
Confidentiality can be broken in the following
situations:
- If patient consents
- For the best interest of the patient
- For the best interest of the public
● Truthfulness and candor
● Patients must tell the truth in order that appropriate
care can be provided.
VERACITY
Why is veracity necessary in a health professional-patient relationship?
- The obligation of veracity is based on respect
owed to others - Veracity has a close connection to obligations of
fidelity and promise-keeping.
Obligation to act in good faith, keep vows and
promises and maintain relationship and fiduciary
responsibility.
FIDELITY
The contract of relationship a health professional
enter into with a patient
● Nurses and physicians become trustees of patient’s
health and welfare
FIDUCIARY RESPONSIBILITY
● Rendering of what is one’s due
● Evokes fairness, entitlement, what is deserved, due,
equitable or appropriate in society determined by
norms
JUSTICE
● Distributing society’s benefits and burdens to its
members
● Problems arise under conditions of scarcity and
competition
DISTRIBUTIVE JUSTICE
● Maximizing strategies to achieve the greatest
amount of good or minimizing strategies to reduce
amount of potential harm
UTILITARIAN JUSTICE
1.) for those whose treatment has the highest probability of medical success
2.) for those who have immediate service to the larger group under circumstances
3.) for those who require proportionally smaller amount of resources, thus, more lives will be saved
4.) for those who have the highest responsibility to dependents
5.) for those believed to have greatest general social worth, thus leading to the good of society
1.) Medical success principle
2.) Principle of immediate usefulness
3.) Principle of conservation
4.) Parental role principle
5.) Principle of general social value
● Actions done for the good of others
● Goes hand on hand with benevolence and
provenance
● Suggests acts of mercy, kindness, and charity
● A virtue of being inclined to do good and act for the
benefit of others
BENEFICENCE
Maintaining or restoring the quality of the person in
need
Conflict of right; paying attention to one would mean violation of other
EGALITARIAN JUSTICE
● Not to inflict harm intentionally; prevention of
harm and removal of all harmful conditions
● “Hippocratic Oath: I will never use treatment to
injure or wrong the sick”
● Florence Nightingale Pledge: “I will abstain from
whatever is deleterious or mischievous and will not
take or knowingly administer any harmful drug”
● Similar to the duty of beneficence; however
different in the following manner
NON MALEFICENCE
● Use of aggressive
modalities vis-a-vis
the financial
capabilities of the
family
● Being hooked to a
respirator, giving
third generation
antibiotic,
hemodialysis or
chemotherapy when
dying
Extraordinary Measures
● Necessities, may be
sustained until the
time of death
● Food, normal
respiration and
elimination process,
IVF, NGT, IFC
Ordinary Measures
1.) Means to end life earlier than its natural schedule
2.) Allowing patients to die by not administering any
hastening element
1.) Killing
2.) Letting Go
It is morally permissible to do an act with both good
and bad effects in the following conditions:
DOUBLE EFFECT
1.) Working with another in the performance of an action
2.) With explicit intention and willingness for the evil act
3.) an act other than the evil act itself but facilitates and contributes to its achievement
1.) Legitimate Cooperation
2.) Formal Cooperation
3.) Material Cooperation
● Expression of one’s responsibility to take care of,
nurture and cultivate what has been entrusted to us
(all creation)
● Can be personal, social, ecological, biomedical
STEWARDSHIP
1.) Direct participation in the performance of an evil act; openly, straightforwardly cooperation in the practice of an evil act
2.) An act that is not intimately connected with the performance of an evil act as informal and direct cooperation but whose effect may have an indirect bearing upon it
3.) Consists of an act that is intimately linked with the performance of an evil action due to its close bearing
4.) consists of an act with a distant bearing upon or connection with the execution of an evil act; may have a lesser accountability or morally excused as the case may
be
1.) Direct Cooperation
2.) Indirect Cooperation
3.) Proximate Cooperation
4.) Remote Cooperation
Means that what an individual, lower or smaller
groups can achieve within his/her capacity should
not be taken away and transmitted to the custody
and performance of a higher or bigger group and
vice versa.
COMMON GOOD AND SUBSIDIARY
1.) The existence of parts indicates the existence of the
whole
2.)
● Should be connected to the whole of which they are parts (without which they cease to be)
● If it becomes problematic, it affects the whole
3.)
● The whole is greater than any of its parts
● If the sick part serves as a fatal threat to the whole,
the whole is a more important than the diseased
part
1.) Totality
2.) Part
3.) Whole
