QUIZ #2 Flashcards
What is the other term of Abstinence?
Celibacy
Other term for Withdrawal of the penis before Ejaculation?
coitus interruptus
Other term for Fertility awareness?
Calendar method/rhythm method
Examples of Mechanical barriers?
- vaginal diaphragm
- vaginal ring
- cervical cap
- condom
Intrauterine devices (IUDs)
Katung T something, insert sa uterus
Examples of Chemical barriers?
- insertion of spermicidal
foams - creams
- jellies
- suppositories into the vagina before intercourse
Hormonal Contraceptives
- oral contraceptives (birth control pills)
- subdermal implants of synthetic progestin
- transdermal patches
-Emergency contraception: hormonal: levonorgestrel pill
Example of Emergency contraception: hormonal
levonorgestrel pill
Example of Surgical Sterilization
tubal ligation and vasectomy
Types of Contraception
● Abstinence
● Withdrawal of the penis before Ejaculation
(coitus interruptus)
● Fertility awareness
● Mechanical barriers
● Chemical barriers
● Intrauterine devices (IUDs)
● Hormonal
● Surgical sterilization
What is the main argument against the use of
contraception is based on?
Natural law theory
The main argument against the use of contraception is based on the natural law theory
- Cancer cells, sperm, and ova all have a
human genetic code, and on the least
restrictive definition of genetic humanity,
such cells would have a right to life,
implying that if abortion is impermissible,
then so is contraception and
chemotherapy
● to express respect for autonomy in ways
that are less conflicting with human dignity,
which is preferable to forcing people to act
against their preferences;
● expanding education about contraception,
thereby reducing the situations in which
abortion may be considered and chosen.
AUTONOMY vs. HUMAN DIGNITY
to express __________ in ways
that are less conflicting with __________ ,
which is preferable to forcing people to act
against their preferences;
respect for autonomy; human dignity
expanding education about contraception,
thereby reducing the situations in which
abortion may be __________ and __________
considered; chosen
is that patients possess rights to
contraceptive treatment to reduce
unplanned pregnancy and their resort to
abortion
Utilitarian view
emphasize that unless a woman can control
her reproductive capacities, she will not be
able to pursue her personal and
professional interests as well as a man can
FEMINISTS’ ETHICS view
An act of “access to family planning devices such as
contraceptives and sterilization”
Responsible Parenthood and Reproductive
Health Act of 2012
defined as the premature termination of a
pregnancy resulting in the death of the
embryo or fetus, it is generally understood to refer to the deliberate termination of an
unwanted pregnancy
Abortion
◦it is distinguished from miscarriage
Abortion
sometimes described as the intentional
termination of a pregnancy
Abortion
is the termination of a pregnancy before the
infant can survive outside the uterus
Abortion
is the interruption of a pregnancy
before the 20th week of gestation at
the woman’s request for reasons
other than maternal health or fetal
disease
Elective Abortion
is the interruption of a pregnancy
before the 20th week of gestation
because it endangers the mother’s
life or health or because the baby
presumably would not be normal
Therapeutic Abortion
the expulsion of the products of
conception before the 20th week of
gestation without deliberate
interference
spontaneous abortions/miscarriage
refers to the point at which the fetus
is able to survive independently of
the mother
Viability
What is under the Revised Penal Code of the Philippines?
● abortion has been banned entirely for over a
century
● mandate imprisonment for women who
undergo abortion, as well as for any person
who assists in the procedure
● abortion has been banned entirely for over a
century
● mandate imprisonment for women who
undergo abortion, as well as for any person
who assists in the procedure
Revised Penal Code of the Philippines
The debate on abortion focuses on the
____ of the fetus.
moral status
This care has been recognized as one of the most basic of ethical responsibilities
valued, loved, and protected their children
● the implication that abortion is permissible in
some cases but not in others
Judith Jarvis Thomson
_________ argues that the right to life does
not always outweigh the right to decide what
happens in and to one’s own body or, more
generally, that the right to life is not a right to
whatever one happens to need to go on
living.
Judith Jarvis Thomson
the fetus only has the right to the use of
its mother’s body if the woman has
given it that right, and at least in some
cases of pregnancy – for example, those that are the result of rape or failed contraception – the woman has
not given it that right.
Judith Jarvis Thomson
12 reasons why abortions might be considered
● the woman is herself virtually a child
● the woman already has more children than
she can manage
● having a child at this time will interfere with
a career
● having a child at this time will involve loss of
earnings
● the woman is a rape victim
● the woman is a sexually abused
eleven-year-old
● the woman has already had three children
by Caesarian section
● the woman was deserted by her partner
when he learned of the pregnancy
● the woman is severely mentally defective
● the woman is homeless
● the fetus is believed to be defective
● the woman’s life or health is seriously
threatened
The oldest, well established procedure in
cases of untreatable male infertility which
has been regulated and submitted to
standard medical guidelines in most
developed countries
Artificial Insemination
- When the husband’s semen is used
- homologous or from the husband
AIh (Artificial Insemination by Husband)
- Artificial Insemination by Donor
- Donor’s sperm is used
AID (Artificial Insemination by Donor)
● Practice of non-anonymous sperm donation
is becoming popular because many
donor-conceived persons have a desire and
interest in finding out about where they
came from
● donor sperm should not be used before
fertilization attempts with the husband’s
sperm have failed following application of
micromanipulation methods.
Anonymous & non-anonymous sperm donations
donor sperm should not be used before
fertilization attempts with the husband’s
sperm have failed following application of
___________ methods
micromanipulation
Practice of ______________
is becoming popular because many
donor-conceived persons have a desire and
interest in finding out about where they
came from
non-anonymous sperm donation
Issues on AID, an attempt to reproduce while
simultaneously rendering _______ not
an act of _______ but a
_______.
reproduction; personal union; technological procedure.
artificial insemination ignored not only the
_______ of the couple, but the
______ of the child
moral integrity; rights
What is fundamental to the well-being of
any human person?
person’s own sense of identity
What issues on the type of artificial insemination, is this part of?:
● an attempt to reproduce while
simultaneously rendering reproduction not
an act of personal union but a
technological procedure.
- solutions that violate the most
fundamental human relationships.
● artificial insemination ignored not only the
moral integrity of the couple, but the
rights of the child
- Fundamental to the well-being of
any human person is the person’s
own sense of identity
AID (Artificial Insemination by Donor)
What issues on the type of artificial insemination, is this part of?:
● theologians have argued for the morality of
AIH, since they regard it simply as an
assistance of nature
● But since the natural marital act is not
performed and hence is not the cause of
fertilization, AIH violates the principle of
inseparability and has been explicitly
rejected by the Church
AIh (Artificial Insemination by Husband)
Who argues the morality of
AIH, and regard it simply as an
assistance of nature?
Theologians
What principle does AIH violates?
principle of inseparability
But since the natural marital act is not
performed and hence is not the cause of
fertilization, AIH violates the principle of
inseparability and has been explicitly
rejected by the Church
AIh (Artificial Insemination by Husband)
But since the natural marital act is not
performed and hence is not the cause of
fertilization, AIH violates the principle of
inseparability and has been explicitly
rejected by the Church
AIH
The principle of the inseparability of the
unitive and procreative meanings of
sexuality demands that:
a. the procreative purpose of the sexual
act not be deliberately destroyed so as
to render a naturally fertile act sterile;
b. that the procreative purpose of the
sexual act not be achieved in isolation
from the unitive expression of the
couple’s love
the procreative purpose of the sexual
act not be ________ so as
to render a ________ act sterile;
deliberately destroyed; naturally fertile
that the procreative purpose of the
sexual act not be achieved in _______
from the unitive expression of the
couple’s love
isolation
● a more radical erosion of the natural bond
between parent and child than AIH because
it also involves a violation of the
nontransferable and inalienable rights to
procreation that married partners give one
another
● does not justify her obtaining a child by an
act of adultery
● semen donor himself is being sexually
exploited like a prostitute
AID (Artificial Insemination by Donor)
● a process whereby egg cells are fertilized
by sperm outside the womb.
● involves removing a ripe egg from a woman
and in a glass (in vitro) mixing it with some
semen so that fertilization takes place
● the resulting embryo is then transferred to a
woman’s uterus where it is hoped it will
implant and subsequently develop
In Vitro Fertilization (IVF)
a deviation from natural reproduction
In Vitro Fertilization (IVF)
the first country to allow
so-called three-person IVF for women with
mitochondrial disease
United Kingdom
What is the process of three-person IVF for women with
mitochondrial disease?
allows healthy mitochondria from a woman donor
to be combined with the DNA of the parents.
What situations might IVF be used?
● if tubal surgery has not corrected a previous
difficulty with the fallopian tubes, IVF allows
the possibility of overcoming this problem by
bypassing the tubes
● if a woman cannot produce an egg, an egg
or eggs could be donated by a donor
● if both partners are infertile, eggs and
semen could be donated
The creation and gestation of
a human baby outside the maternal womb
Ectogenesis
A term for the developing human
being during the first 8 weeks after
fertilization
Embryo
A term for outside the human uterus
In vitro
giving people the freedom to choose their
children in this way could lead to further
ethical problems
Sex Selection
The bearing of a child by a woman with the
aim of turning it over to another woman
Surrogate Motherhood
The embryo may have been conceived by
the surrogate mother and a man (usually
the partner of the woman who is to receive
the child after birth) either by sexual
intercourse or by artificial insemination, or it
may have been conceived in vitro and
transferred to the womb of the surrogate
mother, who then carries the pregnancy to
its termination.
Surrogate Motherhood
a woman who gives birth after carrying the
fertilized ovum of another woman or, more
commonly, after being artificially
inseminated with sperm from the biological
father.
Surrogate Motherhood
thought to be a ‘treatment’ option for the
infertile
Surrogacy
fulfill people’s desires to be parents
Surrogacy
an alternative to adoption
Surrogacy
Problems & Issues regarding Surrogate Motherhood
● Question of morality
● Payment
● Exploitation
● Surrogate motherhood vs. conventional
motherhood
● Conflict of rights
Problems & Issues regarding Surrogate Motherhood: concern about surrogate mother hood involves the true
nature of mothering
Question of morality
Problems & Issues regarding Surrogate Motherhood: raises an ethical question around
whether surrogacy is different from other
kinds of paid work
Payment
Problems & Issues regarding Surrogate Motherhood: The infertile couple and the
surrogate mother are highly vulnerable to
exploitation; “Womb renting”
Exploitation
Problems & Issues regarding Surrogate Motherhood: Is “motherhood” merely the
biological act of bearing children?
Surrogate motherhood vs. conventional
motherhood
Problems & Issues regarding Surrogate Motherhood: dispute revolves around
who has the strongest claim to the child
Conflict of rights
● a rapidly developing field that combines the
efforts of cell biologists, geneticists, and
clinicians and offers hope of effective
treatment for a variety of malignant and
non-malignant diseases.
● predominant methods being used to derive
or attempt to derive human embryonic stem
cells require destruction of the embryo
Stem Cell Technology
Issues and concerns in Stem cell technology
● Embryo destruction
● Oocyte harvesting: raises concerns related
to safety of the donor
● issues relate to informed consent of both
donors of gametes and embryos as well as
recipients of stem cells and stem cell
products
● concern related to the commercialization of
the process, justice, and the responsible
conduct of research
● is the crime of forcing somebody to have
sex with one especially with violence.
● It is the crime of forcefully having sex with
someone against the person’s wish (Chiedu,
2012).
● is an act of sexual violence that involves
intercourse without consent or against
someone being willing to engage in the act
(Brigneti and Egbonimali, 2002).
Rape
Sexual intercourse with a person below the
age of consent.
Statutory rape
Effects of rape
● Physical trauma, possible infection, possible
pregnancy
● has long-term health consequences for
survivors both psychologically and
physiologically.
long-term health consequences for
survivors both psychologically and
physiologically?
- social stigma associated with rape
- survivors frequently experience
depression, anxiety, PTSD, sense of
diminished self-worth and negative
sexuality issues
Issues of rape
● Violation of basic human rights
● Violation of personhood
● Violation of sexuality as an expression of
mutual love for the sexual act to be
performed
● prevention of pregnancy raises special
ethical problems
- Ethical problems arise in the
treatment of rape victims when
methods are proposed that probably
prevent conception but that may be
abortifacient if conception has taken
place
Care of rape victims?
- To offer the psychological support and
counseling - To provide medical care for injuries
- gather evidence to be used if the rapist is
apprehended and prosecuted. - To provide treatment to prevent possible
venereal disease and pregnancy
● ending ones’ life
● An act, whether of commission or omission,
and whether performed by himself or others,
by which an individual autonomously
intends to bring about his death because he
wishes to be dead, either in order to avoid a
life he does not wish to live or as a means
to achieving some other purpose.
Suicide
A feigned act of suicide (which may, but
need not, involve self-harm), at the end of
which the protagonist wishes, intends, and
expects to be alive
Gestured Suicide
person who believes that in general we
should intervene in the suicidal acts of
others because suicide can never be in a
person’s best interests and/or because it is
morally wrong.
Suicide Conservative
person who believes that in general we
should not intervene in the suicidal acts of
others because autonomy is centrally
important in the life of persons, and thus we
each have the right to do what we will with
our lives, even if we wish to give them up.
Suicide Liberal
Is suicide morally right?
No, because it involves killing.
Moral discussions of suicide center
on the significance of the Principle of
the _____________
Sanctity of Life
a general term that refers to documents that
“formally convey an individual’s wishes
about medical decisions to be made in the
event that he or she loses decision–making
capacity”
Advance Directives
Meant to ease anxieties and moral
distress from difficult decisions about
which care to use and when to
initiate or stop advanced medical
treatment
Advance Directives
Types of Advance Directives
● The living will
● Durable power of attorney for health
care/Medical power of attorney
(DPOA-HC)
● Physician Orders for Life-Sustaining
Treatment
● Do not resuscitate (DNR) orders
A Types of Advance Directives in which it is defined as a legal document used to state
certain future health care decisions
only when a person becomes unable to make the decisions and choices
on their own
- only used at the end of life if a
person is terminally ill (can’t be
cured) or permanently unconscious.
The living will
A Types of Advance Directives in which it is defined as a legal document in which you name
a person to be a proxy (agent) to
make all your health care decisions
if you become unable to do so.
Durable power of attorney for health
care/Medical power of attorney
(DPOA-HC)
A Types of Advance Directives in which it is defined as helps describe
your wishes for health care (not an
advance directive)
Physician Orders for Life-Sustaining
Treatment
A Types of Advance Directives in which it is defined as medical staff will try to re-start your
heart and breathing using methods
such as CPR (cardiopulmonary
resuscitation) and AED (automated
external defibrillator).
Do not resuscitate (DNR) orders
Does the Philippines have a law on Advance
directives?
NO
To be legally valid, a ________ must comply with
state law requirements such as those regarding
how the document is signed and witnessed or
what must be included in the text of the
document.
living will
Limitations and issues of living wills &
DPOA-HC
● Address only a narrow range of
end-of-life decisions
● Preferences often change as they develop
a progressive illness or as their values or
priorities change over time
● When DPOA-HC have joint appointments
can create conflicts and complications
● autonomy gives patients’ a right to control
their treatment according to their
preferences
is a medical order written by a doctor where
it instructs health care providers not to do
cardiopulmonary resuscitation (CPR) if a
patient’s breathing stops or if the patient’s
heart stops beating
DNR (Do Not Resuscitate)
sometimes referred to as passive
euthanasia
DNR (Do Not Resuscitate)
created, or set up, before an emergency
occurs
DNR (Do Not Resuscitate)
allows you to choose whether or not you
want CPR in an emergency
DNR (Do Not Resuscitate)
● It does not have instructions for other
treatments, such as pain medicine, other
medicines, or nutrition.
● may be a part of a hospice care plan
DNR (Do Not Resuscitate)
DNR order is generally ________ when the
client or proxy has expressed the wish for
no resuscitation in the event of a respiratory
or cardiac arrest
written
Some Issues on DNR
● DNR discussions are delayed until it is too
late for the patients to participate in
decisions regarding resuscitation
● Physicians do not provide adequate
information to allow patients to make
informed decisions
● Physicians inappropriately estimate the
value of DNR orders to limit other
treatments
● Issues for those relying on religion as the
main source for their moral and ethical
codes
● DNR was construed as either the patient
was not worth to saving his/ her life or the
family did not care enough to save the
patient’s life.
Nurse’s responsibilities -Do not resuscitate
(DNR)
● Clinical nurses actively participate in timely
and frequent discussions on changing goals
of care and initiate DNR discussions with
patients and their families and significant
others
● Clinical nurses ensure that DNR orders are
clearly documented, reviewed, and updated
periodically to reflect changes in the
patient’s condition
● nurses ensure that, whenever possible, the
DNR decision is a subject of explicit
discussion between the health care team,
patient, and family (or designated
surrogate), and that actions taken are in
accordance with the patient’s wishes.
● nurses facilitate and participate in
interdisciplinary mechanisms for the
resolution of disputes among patients,
families, and clinicians’ DNR orders.
● also known as mercy killing, and assisted
suicide
● Deliberately bringing about the death of a
person who’s suffering from an incurable
disease or condition, either actively or
passively
Euthanasia
Euthanasia – PRO
● Beneficence: should allow people to die in
dignity and without pain
● Rights-based argument: our bodies are our
own, and we should be allowed to do what
we want with them
Euthanasia – CONS
● The sanctity of life: life is given by God, and
only God should decide when to end it
● Euthanasia as murder: principle of
autonomy forbids the voluntary ending of
LIFE
● The role of palliative care
- often argued that pain and suffering
experienced by patients can be
relieved by administering
appropriate palliative care
● The rights of vulnerable patients
- coercion of patients receiving costly
treatments to accept euthanasia
● The doctor-patient relationship and the
physician’s role
- undermine the doctor-patient
relationship, destroying the trust and
confidence built
● if euthanasia was made legal, the laws
regulating it would be abused
“difficult or painful death, used to indicate
the extension of the dying process through
treatment that only prolongs patients’
biological life
Dysthanasia
a term generally used when a person is kept
alive artificially, in a condition where
otherwise they cannot survive
Dysthanasia
● It has neither quality of life nor dignity.
● slow and painful death without the quality of
life
Dysthanasia
Also Called:
- Therapeutic intensification
- therapeutic obstinacy
- therapeutic fierceness
- futility therapy or medical futility
Dysthanasia
What’s Wrong with Dysthanasia?
● to optimize the treatment of patients and not
to waste resources
● treatment stubbornness & prolong the
process of Death
● implies the unreasonable and ethically
unacceptable lengthening of the process of
death with the help of technology
Efficient means to prevent
dysthanasia?
Palliative care and respect for patients’
rights
● A normal or natural manner of death and
dying
- correct dying, or allowing to die or
letting die.
ORTHONASIA (ORTHOTHANASIA /
ORTHOTANASIA)
● Sometimes used to denote the deliberate
stopping of artificial or heroic means of
maintaining life
● death is neither directly caused nor intended
or postponed. It merely happens.
ORTHONASIA (ORTHOTHANASIA /
ORTHOTANASIA)
Possibilities for Orthonasia
- when the treatment to prolong life is useless
or futile - when the prolongation of life or the
postponement of death is unduly
burdensome in the first place for the patient
and the family. - when the patient needs painkillers or
medical sedation, which does not intend the
death of the patient
Orthonasia (pros)
● Death with dignity
● Less sufferings
Orthonasia (cons)
● Not respecting the sanctity of life
● Allowing patient to die
● patient who has decision-making capacity
appropriate to the decision at hand has the
right to decline any medical intervention or
ask that an intervention be stopped, even
when that decision is expected to lead to his
or her death and regardless of whether or
not the individual is terminally ill.
Termination of Life-Sustaining Treatment
When is it justifiable to discontinue
life-sustaining treatments?
● If the patient has the ability to make
decisions & fully understands the
consequences
● If the treatment no longer offers benefit to
the patient
Who are qualified to refuse treatment? And be
justifiable
● patients that have serious illness with
limited life expectancy (doesn’t have to be
terminally ill)
- Patient must be competent
- Depends on the law of the land
● Patients with advance directives (for
patients who are no longer competent)
- With surrogate decision-maker
Nurse must ensure patient’s capacity to make
decisions; considered intact if the patient is:
● understands the clinical information
presented
● appreciates his/her situation, including
consequences with treatment refusal
● is able to display reason in deliberating
about their choices
● is able to clearly communicate their choice
Is food and fluid part of basic humane care?
- This includes intravenous fluids,
parenteral nutrition
Is it justifiable to withdraw or Withhold Food
and Fluids?
● Is food and fluid part of basic humane care?
● If options and guidelines are available,
legally
- If (state, federal, national) laws are
available to support its legality
- If it’s legal, is it ethical?
Is it justifiable to withhold or withdraw care
because of costs?
● avoid costly treatments that offer little or no
benefit, but the obligation to the patient
outweighs the obligation to save money for
health care institutions
● There are rare situations in which costs
spent on one terminally ill patient could be
clearly better used on another, more viable
patient
- To apply the ethical principle of
justice
