Identify and describe the ethical principles that can be applied to healthcare practice.

Provide examples to clearly discuss the principles. *

Autonomy, as a patient advocate its our duty to support and respect decision to refuse or
accept life-sustaining treatments. In addition, to ensure that the patients receive all of the
needed information, such as risk, complication, benefits and to make well-informed decisions.
The healthcare professionals can formulate care in agreement with the patient's wishes.
There are many factors may influence a patient's approval or rejection of medical treatment,
such as financial, support system, age, culture and belief. For example, a woman who
diagnose with HIV and she doesn’t want to receive a medical treatment because of financial
so as a nurse we should respect her decision. Family members should abstain from making
decisions for the patient or causing unnecessary pressure to change her decisions except the
patient is disabled or found to be legally incompetent.

Nonmaleficence simply mean do no harm to the patient. For example, if the patient verbalizes
that he will make a scene and will hurt somebody, health care teams may be uncertain between wanting
to protect the public from the patient’s plan and to ensure the patient privacy. In this principle, this is
both the safety of the patient and the public first in all care delivery.

Beneficence it by having a mercy and compassion to the

patient. For example, communication to the grieving family by holding their hand or by tapping their
back and also by giving a medication to the patient.

Fidelity, is to keep our promises this direct us to do the

care delivery with honesty, caring and altruism. For example, when a woman diagnosed with HIV and
she doesn’t want to reveal her situation or any information with her family. To maintain the trust
between the nurse and patient relationship, we keep the information to ourselves unless there is a
patient’s consent. Moreover, consult with other other interdisciplinary team members such as social
worker, and case manager, to help the patient identify ascertain supportive services that the patient
may need as her disease progresses.

Justice it is to ensure that the care we provide is fair and

equal regardless of the patient’s financial and social status. For example, an organization that provide a
vaccine to all the center of the local or community.

Veracity, it is telling the truth. For example, the patient

asked for further explanation to the nurse regarding to his condition, as a nurse we should communicate
truthfully to the patient and say only those appropriate and accurately.

Confidentiality, it is to keep private and responsibility to

protect information of the patient. For example, someone from the family member wants to know
information about the patients situation so as a nurse should not give any information if there are no
consent by the patient and information gathered from the patient is already a property of the
institution.
Explain the principle of double effect and include its guiding elements. Under what
circumstances can one be said to act morally when some of the foreseeable effects of
that action are harmful? *

The doctrine says that if doing something good has a

morally bad side-effect, it's ethically acceptable to do it as long as the bad side-effect wasn't intentional.
This is right even if you expected that the bad effect would possibly happen. For example, pregnant
woman diagnosed with uterine cancer and the only treatment substitute is a hysterectomy which would
possible save her life, but this end the death of the child. But if there were no action done, both mother
and child are probably die. The question here is, is the death of child is acceptable? The answer is yes,
but the logic is understandable.

The answer is in between intentionally killing the child

and removing the uterus together with a child from his mother, so that her life might be saved, and
doing all this things likely to save the child’s life as well. In both cases, the child will not survive, but on
the other hand, the physician directly kills him, in addition, the doctor permits the child death, an
unintended effect of extracting a sick organ where there are no alternative act. To apply the principle in
the case of the mother is first, saving the life of mother is moral and hysterectomy is the only choice to
make. Second, saving the mother first, but this will cost the life of the child and is a consequence of
saving the mother’s life. Next is, the desired decision is to save the life of the mother, which is possible
and it sad to know that the mother will lose her child. Last is to save one’s life is next to the loss of the
other’s life.

In Principle of Double Effect, when the child’s death

comes as a foreseen but unintentional and undesirable, a consequence of an inevitable therapeutic
intervention expected at saving the mother’s life, then in itself it is not directly futile, and therefore it is
morally reasonable. Accepting the ending of a life, as an unintended effect where no other choice exists
is very different from taking a life.
As a Catholic, what is abortion and what are your stand to it? *

In some countries abortion is legal. As time pass by the number of report in abortions increases.
However, as a Catholic, I strongly disagree in abortion. Everyone should think before they act. and be
responsible to whatever consequences. It seems that some people think that a fetus is a “thing” , that is
why they think that abortion is an easy way to avoid having a baby. But for me, if they don’t want a baby
or not yet ready to have one then they should think it before they do a sexual intercourse. They act
selfishly they tend to forget that when a fetus is formed it is automatically have life and dignity to live. In
my opinion, this is because of lack of knowledge and information regarding In this topic. The baby has
the right to live. In conclusion, abortion indicates denying someone a well-deserved life. Just because
the chances are not In our favor, can we withdraw someone the chance to live. A baby is considered as a
God’s gift, and it’s supposed that every living being has a purpose behind his/her birth. By altering with a
life, people are acting in contradiction of the creator of the world. Having an abortion finished always
carries the risk of not able to become pregnant ever again. Abortion can also lead to serious health
problems, and in some worst-case scenario can be death.

Centers for Disease Control (CDC) and Prevention recognizes 5 types of Assisted Reproductive
Technology (ART). What are these and what are your ethical reflections about it? *

According to WHO, The CDC focuses national attention on

developing and applying disease control and prevention. By the use of vaccine it will prevent the disease
and protects the health. By the implementation of CDC people can do what they wanted to do without
the threat of infectious diseases, but still promote a healthy lifestyle by doing what is morally right. CDC
help also the health care professional by implementing such vaccines to prevent injury and to control of
disease.

Assisted Reproductive Technology (ART) also known as assisted reproductive technology, it refers to
associated methods and technologies used to assist people in succeeding a pregnancy. This is used by
women who cannot become pregnant and cannot bear a child without treatment. Also used for the
couple who is in treatment for infertility. Then, to decrease the chance of a child getting a inherited
disease or abnormality. 5 types of assisted reproductive technology (ART) include:

In vitro fertilization (IVF), meaning fertilization outside of the body. IVF is the most effective and the
most common form of assisted reproductive technology. Zygote intrafallopian transfer (ZIFT) or tubal
embryo transfer. This is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo
is transferred to the fallopian tube instead of the uterus. Gamete intrafallopian transfer (GIFT), involves
transferring eggs and sperm into the woman's fallopian tube. Fertilization occurs in the woman's body.
Few practices offer GIFT as an option. Intracytoplasmic sperm injection (ICSI) is often used for couples
with male factor infertility. Sometimes it is also used for older couples or for those with failed IVF
attempts. In ICSI, a single sperm is injected into a mature egg as opposed to “conventional” fertilization
where the egg and sperm are placed in a petri dish together and the sperm fertilizes an egg on its own.
Surrogacy, women with no eggs or unhealthy eggs might also want to consider surrogacy. A surrogate is
a woman who agrees to become pregnant using the man's sperm and her own egg. The child will be
genetically related to the surrogate and the male partner. (GeoSalud, 2013)

Assisted reproductive technologies (ART), encompasses the important of emotional, physical and
financial obligations as part of the couple. Some couple may experience a psychological stress. This
treatment may cost a large amount of money. ART might failed in any circumstances though the
patients have a high expectations. There are time that couples feel frustration that can lead to self-
esteem and depression, especially after a period of failed ART attempt. This action is ethically wrong
because a child must be produce by a natural process not just by a technologies but in the end some are
no choice but to commit other alternative just to have a child. There are no wrong in wanting a child.
ART can ease the burden of infertility on individuals and couples, but it can also a present encounters to
public health as evidenced by the high levels of preterm delivery, multiple delivery and low birth-weight
delivery experienced with ART.

Review the provisions 1.4, 2.2, and 5.3 in the Code of Ethics for Nurses with Interpretative Statements
(2015). What are these provisions and what do they imply?

1.4 The Right to Self-Determination

Respect for human dignity requires the recognition of

specific patient rights, in particular, the right of self-determination. Patients have the moral and legal
right to determine what will be done with their own person; to be given accurate, complete, and
understandable information in a manner that facilitates an informed decision; to be assisted with
weighing the benefits, burdens, and available options in their treatment, including the choice of no
treatment; to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion,
or prejudice; and to be given necessary support throughout the decision-making and treatment process.
(ANA, 2014)

These provision simply mean to respect the patient’s

right regarding his/her treatment, choice and concern. Nurses should encourage conversations with the
patient in order to come up with a care plan. Also the nurse should provide mediations to relieve pain.
Nonetheless, nurses may not act with intending to end life even though this action may be driven by
compassion, respect for patient autonomy, and quality of life. Nurses also have valuable experience
insights, knowledge regarding into effective care and all the action make should be involved in practice
and in policy. Nurses have a duty to be well-informed about the moral and legal rights of patients also,
to protect, and support those rights by evaluating the patient’s understanding of both the information
presented and the consequences of choices. In addition, support of patients’ autonomy also contains
respect for the patient’s way of decision-making and acknowledgement that different principles have
different understandings of health, privacy autonomy and confidentiality.

2.2 Conflict of Interest for Nurses

Nurses may experience conflict arising from competing

loyalties in the workplace, including conflicting expectations from patients, families, physicians,
colleagues, healthcare organizations and health plans. Nurses must examine the conflicts arising
between their own personal and professional values and the values and interests of others including
those who are also responsible for patient care and healthcare decisions, and perhaps patients
themselves. (ANA, 2014)

The nurse should always ensure the safety of the patient to do what is right by promoting the integrity if
the nurse. Nurses should avoid having a conflict by putting her personal from his/her profession. Based
on my understanding regarding in this provision, nurse should always think before an act and always
think of what is good not just for themselves but also for the patients, colleagues and to the workplace.
Nurses have different role but they all have the same goal or responsibilities and it is to be honest take
the responsibilities.

5.3 Wholeness of Character

Nurses have both personal and professional identities

that are integrated and embrace the values of the profession, merging them with personal values.
Authentic expression of one’s own moral point-of-view is a duty to self. Sound ethical decision-making
requires the respectful and open exchange of views among all those with relevant interests: nurses must
work to foster a community of moral discourse. As moral agents, nurses are an important part of that
community and have a responsibility to express moral perspectives, especially when integral to the
situation, whether or not those perspectives are shared by others and whether or not they might
prevail. Wholeness of character pertains to all professional relationships with patients or clients. (ANA,
2014)

In my own understanding, in this provision nurse should be like an open book. Every patients they
encounter may have their own stories to tell and as a nurse we must listen and understand but before
we fully understand the whole situation we encourage to enter or go to a different places or in a
community to have some insights and knowledge. So when a patient asked nurse, the nurse will
generally be free to express her thoughts but still be filtered or choose the right words and have a moral
boundaries. For me, when a nurse care for those in need, personal, lifestyle or condition encountered a
conflict with their own personal values, nurse still render respectful and proficient care.