BIOETHICS INTRODUCTION (PART 1)  Ex.

Medical profession expresses

responsibility in medical and ethical
Ethics codes.
 greek word ethicos, which means
moral duty, pertaining to ethos 3. BIOETHICS
meaning custom or character.  relatively a new term.
 Originally coined in America.
 study of human actions or conduct  Ban Reusselaer Poter, a cancer
from a moral perspective which is researcher claims to have invented the
good or bad word .
 Published the book entitled
 Employs reasoning in tackling Bioethics: Bridge to the Future
questions of what makes an upright
life. BIOETHICS
 comes from the terms bios w/c means
 Custom is Mos or Moris in Latin from
life and ethics.
which morality is derived
 Used to describe the application of
1. ETHICS is associated with the ff:
ethics tio biological sciences, medicine.
 According to M.T. Reich, it is a
1. CUSTOMS
systematic study of human behavior, in
 long established practices common to
the fields of sciences & health care, as
particular race, class and community.
examined in the light of moral values
 Custom is Mos or Moris in Latin from
and principles.
which morality is derived
2. HABIT-
 applied to an individual and implies the
repetition of the same action as to SCOPE OF BIOETHICS
develop perform it.  In the initial stage, Bioethics was
3. PRACTICE concerned with ethical problems
 applies to a regularly folled procedure associated with medical practice.
or pattern in conducting activities.  Latent stage, Include social issues
 Ex.to practice to verify all statements. related to health, animal welfare,
4. ETIQUETTE environmental concerns.
 observance of social norms as required  BIOMEDICAL ETHICS remains central
by good breeding. Ex. table manners, to this paradigm discipline.
dress code.
SIGNIFICANCE OF BIOETHICS
1. Every member of the health profession
2.PROFESSIONAL ETHICS must get acquainted with ethica principles
 branch of moral science concerned involve in medical procedures.
with obligations w/a a member of The trend towards development in
profession owes to the public, to his biomedical sciences cannot be altered.
profession and to his clients.
2. Seeks to keep members of the health
 It enables the basic principles of right profession aware of the dos and don’ts of
action or norms of conduct w/c are medical practice.
exemplary and honorable in the
practice of profession. 3. It enhance their competence by
understanding that the client is a person
and a holistic being.
CODE OF BIOETHICS LEVEL OR APPROACH
 Nurse have several codes of ethics that 1. Case Approach- (Casuistry)
are used to guide nursing practice  begins with an issue or concrete moral
 Code of ethics is recognized by other question or dilemma that one faces
profession as a standard with which here-and-now, or two persons
others are compared disagreeing on what specific situation,
what is morally appropriate behavior
1. AUTONOMY Example:
 Right of self determination Input: Cases,Issue, Facts,Evidence
 Independence and freedom Process: Casuistry by way of induction
 Client’s right to make decision for Output: Accepted and justifiable, moral
himself or herself judgment

2. JUSTICE 2. Level of Rules and Rights

 Obligation to be fair to all people  when cases are not resolved in the first
level
3. FIDELITY  This involves existing rights and claims,
 Obligation of an individual to be which are in force and effect.
faithful to commitments made to  These codes may not be telling what is
myself or herself and to others legal, but also what I ethical.
 Take note that not everything that is
4. BENEFICENCE legal is also ethical----or illegal
 One of the oldest requirements for unethical.
health care providers
 Views the primary goal of health care Extreme views
as doing good for clients under their Legalism
care  no exceptions to the rules or rights
 In Christianity, it is the act of putting
5. NONMALEFICENCE law above the gospel for salvation.
 Requirement that health care Nomianism-
providers do no harm to their clients  holds that every case is so unique that
either intentionally or unintentionally no rules or rights can ever be relevant
in deciding what one ought to do in a
specific situation.
4 levels or approach of  Any view that rejects laws and legalism
Ethics: Veatch (2007) .
Moderate views
1. Level of the case  situationalism and rules of practice

2. Rule and Rights or Code of Ethics a. Situationalism

3. Normative Ethics  holds that moral rules are just
guidelines or rules of thumb that must
4. Metaethics be evaluated in each situation.
 The theory that behavior is chiefly
response to immediate situations.

b. Rules of practice
 the latter holds position that rules
specify practices that are morally
obligatory, and which are binding in
human conduct
Examples of rules of practice  conduct of a nurse, patients, physician,
1. Communication collegues, community and public.
2. Concerns
3. Dignity Moral principles guiding the nurse in the
4. Accreditation practice of profession:
5. Justice
6. Practice 1. Devotion to duties for the promotion of
7. Control public welfare.
8. Honesty
9. Confidentiality 2. Employ utmost diligence, skill, solitude to
10. Autonomy conserve human lives.

3. Normative Ethics 3. Morally bound to fulfill civil obligations,

 basic norms of behavior are discussed law abiding citizen and contribute KSA to
 rules and right claims are defended promote health.
 norms of good moral character are
articulated. 4. Protect and preserve the reputation and
 Three questions involved in normative dignity of the profession and that of his
ethics: colleagues.
1. What principles make actions morally
right? Examples of METAETHICS
2. What kinds of consequences are good or  If we could prove, empirically and
intrinsically valuable? provide proof,that women make better
3. What kinds of character traits are morally parents than men (i.e if this was
praiseworthy? fact)

Examples of normative ethics  Then we could argue than men should

normative ethics question the good or bad not be single parents (moral
of an action judgement)

4. Metaethics  Meta-ethics is concerned with what we

 highest level of moral discourse mean when we use words like “good”
 Answers of source of ethics from ”bad” ”right” “wrong”
religious, secular and relativists
 It is not a normative system of ethics-
4. BIOLOGY it does not tell us what we can and
 Science of living things can’t do
 Bioethics- bio a combining and short
form for biological or biotic Difference of Bioethics from morality,
 may refer to plants and animals. professional ethics, legal ethics and health
Animal domain includes man and ethics
women.  Bioethics is that part of morality which
relates to life
5. HEALTH ETHICS
 concerned with the type of conduct or  Professional ethics follows the dictates
character approved by right and of the profession
wrong, good or bad relative to health
care service  Legal ethics follows secular law

 Refer NURSING ETHICS - concerned

with moral principles that govern
Overlapping of Bioethics, Professional PREVALENT ISSUES IN BIOETHICS
Ethics and Legal ethics Abortion- premature expulsion of fetus or
 Example- a doctor ethically refuse to child prior to normal birth. It is either
give his/her patient a contraceptive, spontaneous or by induced termination.
but legally, he/she may be bound to do
so TYPES OF ABORTION
1.SPONTANEOUS ABORTION- occurs
 Bioethics is critical for professional naturally with no artificial means a the fetus
development of healthcare provides is usually lost in the first trimester.
and researchers who deal with living
persons CAUSES OF SPONTANEOUS ABORTION:
1. Related to abnormal development of
 Bioethics committee is an ad hoc embryo or fetus due to drugs or genetic
committee authorized or mandated to make up, faulty implantation due to
systemically address the ethical abnormalities, placental abnormalities,
dimensions of health sciences, the life chronic maternal diseases.
sciences, and innovative health
policies. 2. Related to sperm and ova imperfections
or effects of teratogenic drugs.
PURPOSES OF BIOETHICS
 Protect a competent patient’s decision 3. Uterine fibroid tumors.
and ensure the well- being of a patient
4. Incompetent cervix- cause of habitual
 Guard health care institutions and abortion at the 2nd trimester
those who practice in them from legal
liability; 5 Endocrine imbalance,retard the growth of
the endometrial lining of the uterus.
 enhance public benefits Facilitate
acquisition and use of new 6. Chronic maternal disease such as
developments hypertension, ABO incompatibility, Kidney
disease and syphilis.
 Search for:
1. an equitable distribution of health care CLASSIFICATION OF SPONTANEOUS
resources through education, ABORTION
2. consultation and policy development, 1. Threatened
3. review and approve research  unexplained bleeding, cramps and
4. promote community projects backache.
 Bleeding persist for days and cervix is
What Controls are Available to Ensure closed. Followed by partial and
Ethical Action? complete expulsion of pregnancy.
 The vigilant conscientious person:
1. healthcare provider 2. Imminent abortion
2. patient  is manifested by increase bleeding
3. family member cramping.
4. researcher
 International bodies, national 3. Complete abortion
government, professional societies,  all products of conception are
institutions and their ethics expelled.
committees
4. Incomplete
 part of the products of conception are LEGAL, MORAL, ETHICAL CONSIDERATIONS
retained.  Article II, Sec.12 of the 1986
 Cervix is dilated and admit one finger. Constitution provides that “ The
state recognizes the sanctity of life and
5. Missed abortion shall protect the strengthen the family
 fetus dies in the utero but is not as a basic autonomous social
expelled. institution.
 Uterine growth ceases, cervix is closed.
 It shall equally protect the life of the
6. Habitual abortion mother and the life of the unborn from
 abortion occurs consecutively in three conception.”
or more pregnancies.
 Despite this position, illegal practice of
2. INDUCED ABORTION abortion continues and formal
 result of artificial or mechanical complaints against violators have to be
interruption or due to voluntary filed in Phil. courts.
human intervention.
1. Sought as an end or means  According to NEDA, no. of cases of
2. Therapeutic abortion induced abortion ranges from 150,000-
3. Evil and considered homicide. 750,000 per year.

TECHNIQUES OF INDUCED ABORTION:  ect for human life and radical

1. ABORTION D & C ( Dilatation and condemnation of abortion as
Curettage) intrinsically evil is not an exclusive
 accomplished in a period bet. 7-12 position of Catholics.
wks, utilizing curved blade into the
cervix until it reaches the endometrial  Abortion destroys life and violates the
wall. right to life.
 It is performed under general
anaesthesia. EFFECTS OF ABORTION:
Physical effects:
2. ABORTION BY CS 1. habitual miscarriage
 Abdominal incision is followed by 2. ectopic pregnancies
extraction of the fetus from the uterus 3. menstrual disturbance
 Abortion of this type is undertaken 4. still births
during the last trim. 5. Bleeding
6. Shock
3. ABORTION BY SUCTION 7. intense pain
 was pioneered by communist 8. loss of appetite.
abortionist who utilized the suction
apparatus Psychological effects:
 Abortion is accomplished within 2 1. Guilt
minutes. 2. Suicidal
 Done during 12week of gestation 3. loss of sense
4. loss of confidence
5. self-destructive
6. Anger
7. Rage
8. Helplessness
9. inability to forgive herself
  Pregnancy is an outcome of rape or
ABORTION UNDER THE LAW incest
 Certain laws even permit abortion with
a maximum limit.  The pregnant woman is unmarried,
and there will be social stigma
 Abortion is possible only to certain
stage during pregnancy and should be  Having a child or another child will be
at the woman's request an unbearable financial burden

 Abortion is allowed only for medical  Having a child will interfere with the
reasons ex. to save the mother's life happiness of the woman, the joint
happiness of the couple or family as a
 Task of law is to protect the rights of unit
defenseless being
Moral Dimensions of Abortion
 Criminal abortion is a grave crime in Pro- Life Ground:
Penal code  Human life begins at conception

 Accdg. to WHO summarizes the  Sanctity or value of life: the unborn

conditions in which legislation of diff. child has all the rights
countries authorize the practice of
abortion. Such as:  Abortion starts the domino effect
ending in complete disregard for the
1. Mother is authorized to safeguard her value of human life
physical and mental health.
 Abortive methods are medically and
A physician and a nurse or a midwife are psychologically dangerous to a
criminally liable for causing an abortion or woman’s life and procreativity
assisting in in causing the same by taking
advantage of their scientific knowledge and  Dangers in pregnancy are relatively
skills. However, if the abortion is done to safe due to advances of medical
save the life of the mother, there is no science
criminal liability (therapeutic abortion).
 Economic reasons are irrelevant and
Potential Reasons for Phenomenon of unacceptable
Abortion (Mappes and de Gracia)
 Viable options to abortion for
 If the fetus is allowed to develop unwanted babies due to deformity,
normally and come to term, the born out of wedlock, or arising from
pregnant woman herself will die; rape and incest

 It is not the woman’s life, but her Pro- choice ground:

health, physical or mental, that will be  Woman’s autonomy
severely endangered, if the pregnancy
is allowed to continue  Human life begins at birth

 The pregnancy will probably or surely  Problem of unwanted child- only really
produce a severe impaired child wanted children must be born
 With the availability of qualified Allowing someone to die
medical practitioners, abortion is  implies withdrawal of treatment, an
relatively safe acceptance of the fact that a patient’s
illness has reached a point where there
 Domino effect is not tenable. Abortion is no possible cure.
will not enhance loss of reverence for  In this situation, he/she should be
human life in any other areas. Instead, allowed to die a natural death in
the experience of abortion makes comfort, peace, and dignity
woman more loving of their wanted
children. CLASSIFICATION OF EUTHANASIA:
Active Euthanasia
 Pregnancy poses danger to a woman’s  intentional and voluntary.
life. In a situation where the mother  It is an act in which the physician,
and child’s life are both in danger, that nurse or other health care providers
of the mother takes precedence or not only provide the means of death
priority over that of the child. Thus, but also administer.
abortion is permissible to save a  (invoke the sanctity of life and such act
woman’s life violates the mandate not to kill
humans)
EUTHANASIA
Euthanasia Passive Euthanasia
 comes from two Greek words “eu”,  an act which the patient receives the
meaning good and “thanatus” meaning means of death from the physician, or
death, or a good death. nurse but activate the process
 Implies mercy killing themselves.
 Hastening or causing the death of a  (invoke respect for the patient’s
person suffering from an incurable autonomy)
disease as an act of mery.
 Painless killing to end one's life as a SUICIDE
matter of right. Egoistic
 It is allowing someone to die in an easy  low social interaction with others
death, without using death without
using medical technology to keep Altruistic
client's alive.  social group involvement is too high, as
in the case of a cult or religion
THREE CONCEPTS
Mercy killing Anomic
 involuntary or unintentional  happens during considerable
termination of life of a patient by loss/stress/frustration
someone.
 It does not require his or her Fatalistic
permission or request  when people are kept under tight
regulation
Mercy Death
 someone takes direct action to UNDERSTANDING SUICIDE
terminate a patient’s life upon his or  A suicidal person may not ask for help,
her request. but that doesn’t mean that help isn’t
 It is an assisted suicide or murder. wanted.

 People who take their lives don’t want

to die—they just want to stop hurting.
 distress and emotional pain are not
 Suicide prevention starts with necessarily signing of mental illness.
recognizing the warning signs and
taking them seriously. Myth:
 If a person is determined to kill
 If you think a friend or family member him/herself, nothing is going to stop
is considering suicide, you might be them.
afraid to bring up the subject. But Fact:
talking openly about suicidal thoughts  Even the most severely depressed
and feelings can save a life. person has mixed feelings about death,
wavering until the very last moment
 The World Health Organization between wanting to live and wanting
estimates that approximately 1 million to die.
people die each year from suicide.  Most suicidal people do not want
What drives so many individuals to death; they want the pain to stop.
take their own lives? To those who are  The impulse to end it all, however
not in the grips of suicidal depression overpowering, does not last forever.
and despair, it’s difficult to understand
what drives so many individuals to WARNING SIGNS OF SUICIDE
take their own lives. But a suicidal 1.Talking about suicide
person is in so much pain that he or  Any talk about suicide, dying, or self-
she can see no other option. harm,
 such as “I wish I hadn’t been born,” “If
 Suicide is a desperate attempt to I see you again…” and “I’d be better off
escape suffering that has become dead.”
unbearable.
2.Seeking out lethal means
COMMON MISCONCEPTIONS:  Seeking access to guns, pills, knives, or
other objects that could be used in a
Myth: suicide attempt.
 People who talk about suicide will not
really do it. 3.Preoccupation with death
Fact:  Unusual focus on death, dying, or
 Almost everyone who attempts suicide violence.
has given some clue or warning.  Writing poems or stories about death.
 Don’t ignore even indirect references
to death or suicide. 4.No hope for the future
 Statements like “You’ll be sorry when  Feelings of helplessness, hopelessness,
I’m gone,” “I can’t see any way out,”— and being trapped (“There’s no way
no matter how casually or jokingly said out”).
—may indicate serious suicidal  Belief that things will never get better
feelings. or change.
Myth:
 Anyone who tries to kill him/herself 5.Self-loathing, self-hatred
must be crazy.  Feelings of worthlessness, guilt,
Fact: shame, and self-hatred.
 Most suicidal people are not psychotic  Feeling like a burden (“Everyone would
or insane. be better off without me”).
 They are upset, grief-stricken,
depressed or despairing, but extreme 6.Getting affairs in order
 Making out a will.
 Giving away prized possessions.  (2) irreversible cessation of all
 Making arrangements for family functions of the entire brain, including
members. the brain stem, is dead.
 A determination of death must be
7.Saying goodbye made in accordance with accepted
 Unusual or unexpected visits or calls to medical standards.
family and friends.
 Saying goodbye to people as if they GUIDELINES:
won’t be seen again.  Areas of general consistency among
country specific guidelines for brain
8.Withdrawing from others death 5,8-11 include:
 Withdrawing from friends and family
 Increasing social isolation  unresponsive coma with an established
 Desire to be left alone etiology

DETERMINATION OF DEATH  absence of reversible conditions

Death:  absence of cortical or brainstem

1. The end of life. The cessation of life. mediated motor responses
(These common definitions of death
ultimately depend upon the definition of  absent brainstem reflexes
life, upon which there is no consensus.)
 loss of the capacity to breathe
2. The permanent cessation of all vital
bodily functions. (This definition depends  procedural aspects of apnea testing
upon the definition of "vital bodily
functions.") See: Vital bodily functions.  impact of therapeutic medications that
may depress central nervous system
3. The common law standard for function
determining death is the cessation of all
vital functions, traditionally demonstrated  observation time
by "an absence of spontaneous respiratory
and cardiac functions."  required level of physician expertise

4. The uniform determination of death.  provisions for anoxic-ischemic brain

The National Conference of Commissioners death
on Uniform State Laws in 1980 formulated
the Uniform Determination of Death Act.  effect of therapeutic hypothermia

Clinical Death  confirmatory, supplemental or testing

 when a person has stopped breathing
Biological death  Time of death
 when the brain has been deprived of
blood and oxygen, long enough and
the cells began to die

 Determination of Death. An individual

who has sustained either
 (1) irreversible cessation of circulatory
and respiratory functions, or
IN VITRO FERTILIZATION(IVF) MORAL CONSIDERATIONS IN IVF
 Successfully done in the US for the first  'Is IVF morally acceptable or not?
time in 1981.  IVF is the process in an attempt to get
 Means “ within a glass”. pregnant through F , making up 6-10
 Known as “ laboratory fertilization.” embryos in the lab.Only 2-3 embryos
 Called “test tube fertilization”since it is maybe used to achieve pregnancy.
performed in a petri dish or test tube. What happens to the rest of the
 Involves conception outside the womb embryo?
by artificial means. Moral issue: Leftover embryos
FACTS: Moral issue: Involvement of third party
 Estimated total cost of a single Drug donor, can be thought as an adulterous act,
Free IVF Cycle is around Php and cannot be morally acceptable.
200,000.00. Moral issue: Single woman seeking
 However if pregnancy is not achieved pregnancy thru IVF.
couples only pay Php 60,000.00 – Ref. page 59 ( CIABAL)
70,000.00.
 The cost covers egg retrieval, IVF with SURROGATE MOTHERHOOD
or without ICSI, embryo culture, and  Biomedical technique whereby
embryo transfer. fertilized ovum is implanted into the
uterus of another woman who will
FACTORS TO CONSIDER WITH IN VITRO carry the baby to term either as a favor
FERTILIZATION or fee.
 Referred as “ the “ rent womb” or “
1. AGE uterus for rent”.
 a woman below 35 have the greatest
chance STEM CELL TECHNOLOGY
2. Multiple births Stem cells-
 63% single babies, 32% twins, 5 %  biological cells that can differentiate
triplets into other types of stem cells and can
3. Cost divide into same type of stem cells
 not covered by health care insurance  Stem cell technology- is a rapidly
4. Reduced need for surgery developing field that combines the
 IVF has reduced surgeries by half efforts of cell biologists, geneticists,
5. Safety and clinicians and offers hope of
effective treatment for a variety of
malignant and non-malignant diseases
GOALS OF IVF:
1. Observe and evaluate the process of
ABOUT STEM CELLS
fertilization.
 Stem cells are undifferentiated,or
“blank” cells
2. Test effectivity of auto-agents  This means they’re capable of
developing into cells that serve
3. Evaluate fertilization of the ova with numerous functions in different parts of
infertility problems. the body
 Most cells in the body are differentiated
4. Assess structural normality of conception cells
in clients who have repeated abortion.  These cells can only serve a specific
purpose in a particular organ
5. Increase knowledge that is useful in  Example: red blood cells are specifically
contraceptive tech. and alleviate genetic designed to carry oxygen through the
problems. blood.
 All humans start out as only one cell. TYPES OF STEM CELLS AND WHERE THEY
This cell is called a zygote, or a fertilized COME FROM:
egg.
 The zygote divides into two cells, then 1. TISSUE STEM CELLS
four cells, and so on.  Tissue stem cells allow us to
develop,grow,heal and replace worn
 Eventually, the cells begin to out cells
differentiate, taking on a certain function
in a part of the body. 2. EMBRYONIC STEM CELLS
 This process is called differentiation.  These cells are created from the inner
cell mass of a blastocyst
 Stem cells are cells that haven’t
differentiated yet. 3. IPS CELLS
 Induced pluripotent stem cells
 They have the ability to divide and make
an indefinite number of copies of
themselves.
THE HUMAN PERSON
 Other cells in the body can only replicate  It is used in lieu of man or woman to
a limited number of times before they give both sexes justice in the
begin to break down. treatment of the matter

 When a stem cell divides, it can either PERSONHOOD

remain a stem cell or turn into a  A human person is a living paradox.
differentiated cell, such as a muscle cell
or a red blood cell.  He/ She is a perennial problem which
philosophers, leaders-managers from
POTENTIAL USES OF STEM CELLS ancient times to date have focused on
 Since stem cells have the ability to turn
to understand.
into various other types of cells,
scientists believe that they can be useful
 delved into his origin, composition,
for treating and understanding diseases.
 According to the Mayo Clinic, stem cells essence and searched out for the
can be used to: meaning of existence.

1. grow new cells in a laboratory to replace  According to Philosophy and Theology

damaged organs or tissues study.

2. correct parts of organs that don’t work  Human person- is the individuality of
properly man or woman. He /she is a human
person-who-always-exist-with-and-for-
3. research causes of genetic defects in cells others-in-the-world.

4. research how diseases occur or why certain  According Filipino philosophical

cells develop into cancer cells perspective,

HOW MUCH DOES IT COST?  Human person -distinctive personal

As stated by CBC Canada, the cost of stem cell quality, seat of uniqueness as human
therapy is $5,000 to $8,000 per stem cell
beings.
treatment for patients. According to a Twitter
poll by BioInformant, the cost can be even
higher. Our May 2018 poll found that stem
cell treatments can cost as much as $25,000
or more.Nov 21, 2018
HUMAN ACT CLASSIFICATION OF HUMAN ACTS:
 Signifies something done by a person. 1. REASON
 faculty of the mind by w/c
 It is any bodily movement tending to distinguishes truth from falsehood,
produce some effect in the world. good or evil, which enables the
possessor to deduce inferences from
 In moral use, it means something done facts and propositions.
voluntarily ( such nature that moral or
legal consequences are attached to it.) 2. WILL
 faculty of conscious and deliberate
 The combination of two terms suggest actions. Characterized by motives by
that HUMAN ACT is a deed that w/c applies to the feeling, desire,
proceeds from a conscious mind and inclination that makes a person do t
deliberate free will of a person. *** he/she does.
p. 15 Joven
TYPES OF ETHICAL THOUGHTS
ESSENTIAL ELEMENTS OF HUMAN ACT Kantian Ethics (Emmanuel Kant, 1724-
1. KNOWLEDGE 1804)
 act or state of awareness or  Develops his imperatives, the basis on
understanding. which human beings ought to act“ we
 When thing is conscious , the act is should act so as to treat humanity
deliberate. never only as a means but also as an
end”
2. DELIBERATENESS  There are many examples that
 the actor, performer or doer knows demonstrate why Kantian ethics fails
what he/she is doing. to be a universally applicable guide for
 Aware about the means to employ & human morality
the ends to be achieved.  For instance;You have a duty not to
steal.
3. FREEDOM  Stealing is always wrong, without
 synonymous to liberty exception.
 It is the power of the will to follow the  Stealing food to save your starving
dictates of unrestricted choice & to children's lives is wrong.
direct act of the individual w/o  You have a duty to allow your children
restraint or control from another to starve to death, if stealing is the
person. only option available that would save
their lives.
4. VOLUNTARINESS
 quality of being unconstrained by A. Categorical imperative
interference by another's influence.  supreme principle of duty; act
Char. according to the maxim that you would
 by spontaneity of action, proceeds wish all other rational people to follow,
from free will. as if it were a universal law ( an
improvement of the golden rule)
VOLUNTARY ACT is free, intelligent and  Although your specific duty involves
intentional act. different things,there are compulsory
moral laws which everyone has a duty
to follow
 These are “imperatives”
 The categorical imperative is a moral EXAMPLES:
law that should apply equally to all Consequentialism
people in all situations= universalisable  is an ethical theory that judges
EXAMPLE 1 whether or not something is right by
 Kant said that an "imperative" is what its consequences are.
something that a person must do.
For example: if a person wants to stop  For instance, most people would agree
being thirsty, it is imperative that they have that lying is wrong. But if telling a lie
a drink. Kant said an imperative is would help save a person’s life,
"categorical," when it is true at all times, consequentialism says it’s the right
and in all situations. thing to do.

C. Deontological Ethics
EXAMPLE 2  based on absolute values
 Perfect duty to others predominantly derived from religion
 Someone wants to borrow money
on the promise that they will pay it Deontology
back, but they know that they will  is defined as an ethical theory that the
morality of an action should be based
never be able to afford to pay it
on whether that action itself is right or
back within the agreed time limit of
wrong under a series of rules, rather
the loan. Kant believes the than based on the consequences of the
categorical imperative to show that action
making false promises cannot be
universalised; it cannot be a duty Deontologists
and is morally wrong  believe that the goal of moral
philosophy should be to figure out the
“rules” for living a moral life and that
EXAMPLE 3 once people know those rules they
 Imperfect duty to ourselves should follow them.
 Someone with natural talents lets
them go to waste because they are  “The Golden Rule” (do unto others as
lazy. Here Kant uses the categorical you would have them do unto you) is
imperative to show that it is wrong for an example of deontology; it’s a moral
us to waste our natural talents-- we rule meant to be followed in all
must at least choose to develop some situations, for everyone to live moral
of them ( this is why it is an imperfect lives.
duty, because we can choose to let
some of our talents rust) EXAMPLES:
 An example of deontology is the belief
B. Consequentialism (John Stuart Mill, that killing someone is wrong, even if it
1806- 1873) was in self-defense.
 Rightness or wrongness of an action
depends on its consequences.  If you’re a Hindu you might believe
that it’s wrong to eat beef; this rule
 The dominant version of this is would be part of your deontology.
utilitarianism (morally right action is
the action that produces more good),  If you thought it was wrong for anyone
particularly associated with Jeremy to eat beef, you’d be a deontological
Bentham (1748- 1832) and John Stuart universalist.
Mill (1806-1873)
Theory of justice (John Rawls)  The difference principle governs the
 Principle of equal liberty- each person distribution of income and wealth,
has an equal right to the most positions of responsibility and power,
extensive liberties compatible with and the social bases of self-respect.
similar liberties for all (Egalitarian)  It holds that inequalities in the
Four basic liberties: distribution of these goods are
1. political liberty, freedom of speech and permissible only if they benefit the
assembly; least well-off positions of society.
2. liberty of thought;
3. liberty of property ownership; ROSS’S ETHICS
4. liberty against arbitrary arrest  Developed by William D. Ross, who
focused on his distinction between
EXAMPLES: rightness and goodness and the two-
 As such, it is linked to fairness, fold principle by which to resolve
entitlement and equality conflicting duties.
 In health care ethics, this can be
subdivided into three categories: fair  Rightness belongs to acts, independent
distribution of scarce resources of motives, and so we speak of right or
(distributive justice), respect for wrong acts
people's rights (rights based justice)
and respect for morally acceptable  Moral goodness belongs to motives,
laws (legal justice) and so we speak of bad and good
motives
Difference Principle
 social economic liberty are to be  According to Ross, what makes an act
arranged in such that they are to the good is if it is done with a good motive
greatest benefit of the least ( ex. Giving the right drug through an
advantaged injection)
 Focus on primary goods
> social goods such as rights  Clearly enough, in making moral
>Liberties decisions, we should stress the good
>Opportunities etc and motive and right act, and not the
> natural goods such as health consequences.
>intelligence
 Ross’s Actual and Prima Facie duty
 The difference principle is the second A. Actual duty- one’s real duty
part of the second principle of John B. Prima facie Duty- directs command what
Rawls’s theory of justice. one ought to perform
C. Moral intuition- ultimate guide in
 The first principle requires that citizens particular case of conflicting prima facie
enjoy equal basic liberties. duties

 The first part of the second principle EXAMPLES:

requires fair equality of opportunity  According to Ross, a prima facie duty is
a duty that is binding or obligatory,
 These rules have priority over the other things being equal
difference principle; the difference
principle cannot justify policies or  Common examples include the duty to
institutions that abrogate them. tell the truth, obey the law, protect
people from harm, and keep one's
promises.
The 7 prima facie duties are: ST. THOMAS AQUINAS (CHRISTIAN
ETHICS)
1.Fidelity: duties of fidelity are duties to
keep one’s promises and contracts and not  Otherwise known as natural law,
to engage in deception. manifested by the natural light of
human reason, demanding the
2.Non-injury/non-maleficence: the duty preservation of the natural order and
not to harm others physically or forbidding its violation.
psychologically: to avoid harming their
health, security, intelligence, character, or  Christian ethics confesses that the
happiness. It also includes a duty to prevent norm of morality is no less than the
injury to others. voice of reason

3.Gratitude: the duty of gratitude is a duty  An act is good when suitable to human
to be grateful for benefactions done to nature.
oneself and if possible to show it by
benefactions in return. The duty to thank Three Natural Inclinations of Man:
those who helped us. 1. Self preservation
2. Just dealing with others
4. Beneficence:the duty to do good to 3. Propagation of Species
others: to foster their health, security,
wisdom, moral goodness, or happiness. SELF-PRESERVATION
This duty, says Ross, "rests upon the fact  the protection of oneself from harm or
that there are other beings in the world death, especially regarded as a basic
whose condition we can make better in instinct in human beings and animals.
respect of virtue, or of intelligence, or of
pleasure DEALING WITH OTHERS
 Here is how you can become the most
5. Self-Improvement:The duty of self- successful at dealing with people at
improvement is to act so as to promote work.
one’s own good self. we have an obligation  Demonstrate Respect at Work.
to improve our own virtue, intelligence and  Trust and Be Trusted.
happiness, health, security, wisdom  Provide Feedback With an Impact.
 Receive Feedback With Grace and
6. Justice: justice does not have to do with Dignity. Show Appreciation.
the amount of good produced but with its  Build Necessary Alliances.
distribution. We have the duty to try to be  Play Well With Others to Develop
fair and distribute benefits and burdens Effective Relationships.
equably and evenly.
PROPAGATION WITH SPECIES
7. Reparation: doing restitution ie duty to  the act or action of propagating: such
make amends when we have wronged as.
someone else. (Duty to make up for the  a : increase (as of a kind of organism)
injuries one has done to others). Ross in numbers.
describes this duty as "resting on a previous  b : the spreading of something (such as
wrongful act“. a belief) abroad or into new regions.
 Simply stated, the natural law guides  The first word is eros, from which we
human beings through their get the English word erotic.
fundamental inclinations toward the  Eros was the word often used to
natural perfection that God, the author express sexual love or the feelings of
of the natural law, intends for them. ... arousal
Therefore, by means of synderesis a AGAPE
man would know that the act of  Agape is the kind of love by which one
adultery is morally wrong and contrary should act and settle what is right and
to the natural law. wrong, just and unjust, in any
complicated situation.
SITUATION ETHICS CHRISTIAN LOVE
 Developed by Joseph Fletchner,  Christian love is literally benevolence,
American Ethicist and Theologian  it is a matter of loving the unlovable,
 the unlikable,
 Situationalism states that the moral  the uncongenial,
norm depends upon a given situation,  the unresponsive; it wills the
but whatever the situation may be, neighbor’s good whether we like it or
one must always act in the name of not
Christian love.
UTILITARIAN
EXAMPLES:  John Stuart Mill and Jeremy Bentham
 Well, situational ethics are where
actions change depending on the  Actions are good insofar as they tend
situation, making something that to promote happiness, bad as they
might have been immoral before, now tend to promote happiness
moral.
 We should consider the possible
 A good example is killing a mass effects of each action
murderer before they are going to kill
hundreds of people, such as if they had  Mill defines utilitarianism as a theory
them held hostage. based on the principle that "actions
are right in proportion as they tend to
Three Types of Love: promote happiness, wrong as they
1. Eros- sexual love tend to produce the reverse of
2. Philia- affection that binds a parent, happiness
brother or sister
3. Agape- one’s care concern, and kindness  " Mill defines happiness as pleasure
towards others. and the absence of pain.

EROS  We ought to choose the action that

produces the most benefits (comfort
 Eros was a primeval god,
or happiness) at the least cost of pain
 son of Chaos,
and unhappiness. Alternative
 the original primeval emptiness of the
formulation of the utility principle is
universe
known as the principle of greatest
 but later tradition made him the son
happiness.
of Aphrodite, goddess of sexual love
and beauty, by either Zeus (the king of
 Hence, faced with moral decisions, one
the gods).
should not just consider one’s
happiness or benefit, or the happiness
of a particular group of persons.
Virtues, Vices, Habits of a Health List of Virtues
Care Provider  In the health care profession, his/her
personal life must be characterized by
 The Health care profession does exist the VIRTUES of:
only by operation of law, but also by 1. FIDELITY
application of valued -based ethics and 2. HONESTY
the practices of virtues. 3. INTEGRITY
4. HUMILITY
 In legal based-ethics, profession has to 5. RESPECT
meet minimum requirements of 6. COMPASSION
applicable laws that define s a person 7. PRUDENCE
administrative, civil and criminal 8. COURAGE
liabilities
1. FIDELITY
 Value- ethics maybe observed to spell  STEADFAST FAITHFULLNESS
out in resolving moral dimensions.
 Associated with pledge of loyalty and
 Ques: If an act is legal, is it moral? If it practice of keeping promises.
is moral ,is it spiritual?
 Is the relationship that exists between
ANS: acting legally is not necessarily acting individuals
ethically, but it is necessary for acting
ethically. The law is the minimum  Fidelity is about:
requirement, but morality may require 1. Being faithful
people to go above and beyond their basic 2. Keeping promises
legal obligations. 3. Always doing what is right
4. Being trust worthy
Virtues of a Health Care Provider 5. Confidential
6. Showing respect and dignity
VIRTUE 7. Respecting autonomy
 is referred to as a moral excellence
8. Acting in their best interest
 uprightness & integrity
2. HONESTY
 Praise worthy trait of human character
 quality of being honorable
 ( Veatch,2007), character trait. That is
morally valued
 upright in character and actions
 way of actions, disposition or a good
 It emphasizes fairness and uprightness
habit (Rowan & Zinaich, 2003).
with others, refusal to steal, telling a
lie or making misinterpretation.
 a habit, acting in moderation ( Aristotle
). Distinguishes moral virtues from non
 To be fair, upright and straightforward
moral. The former are habits that are
is to be honest with one’s self.
necessary for being a morally good
human person such as honesty,
 SELF-HONESTY- demands that he/she
generosity, fairness, kindness, courage
must not fake or try to be something
or somebody else.
 The latter virtues are practices that
make a human person good such as
 Morally, incorruptible, principled,
optimism, cleanliness & possess
truth-loving, real, good and genuine.
talents.
3. INTEGRITY RESPECT FOR AUTHORITY
 uprightness in character & actions  due regard to a person with the right
to give commands and power to
 It means wholeness, completeness enforce obedience.
 In the Phil. Context, person in
 Applies more directly to character than authority includes parents, teachers,
to actions, & means soundness of govt. officials. The juridical includes
character , possession of very high Congress as the case who enacts the
standards of right and wrong. laws like the Phil.
 Nursing Act of 2002 ( R.A. 9173), BON
 Choosing your thoughts,words and promulgates the Nursing Code of
actions based on what’s right rather Ethics or the PNA.
than what’s in it for you
RESPECT FOR OTHERS
4. HUMILITY  due regard to immediate family,
 meekness of heart neighbors, peers, classmates, friends
and non-friends, clients whom they
 Acts with a gentle spirit. It calls for respect with utmost care
submission, docility, courtesy
RESPECT WITH TOLERANCE
 Implies freedom from pride,  willingness of one to be client towards
arrogance, accepting of one’s own others, whose opinions or ways differ
imperfection, sinfulness. from him or her.

 Nursing, means rendering HUMBLE 6. COMPASSION

SERVICE to the sick & needy.  signifies sympathy.

5. RESPECT  It implies feeling for another’s sorrow

 esteem or honor or hardship that leads to help or pity

 Esteem is a quality by which a person  To be compassionate is to be of help to

shows recognition or high regard to: those who suffer & who are in need of
1. self-worth service
2. self respect with dignity
3. respect for authority  An act to truly feel the difficulties &
4. respect for others with tolerance. hardships of another person

SELF-WORTH  Characterized by related virtues of

 signifies favorable estimate or opinion love, care, sympathy, kindness and
of oneself concern for others.
 When one knows well of who he/she
is, strength & capabilities, as well 7. PRUDENCE
his/her weakness or limitations, can be  carefulness, precaution, attentiveness
worthy instrument with others. and good judgment as applied to
action or conduct .
SELF-RESPECT  This is commonly associated with
 appropriate regard for oneself. “CARE” & “ DILIGENCE”.
 Proper regard for the dignity of one’s
character or position , with recognition
of its obligations of worthy conduct.
 It emphasizes cautious good sense in In relation to the Nursing Profession, nurse
giving thought to one’s actions & their maybe guilty of and penalized for fraud as
consequences. defined by the PNA of 2002 in the ff:
instances:
 To be prudent means to be sensitive,  Practices nursing in the Philippines
discreet, wise. without a certificate of registration /
license and PRC card or temporary
 To act with wisdom is to think with permit.
foresight.
 Uses the PRC or special temporary
8. COURAGE permit of another.
 signifies bravery and fearlessness
 Uses an invalid certificate of
 Applies to moral strength that makes a registration/ PRC/ suspended or
person face any danger, trouble, or revoked certificate of registration or an
pain without showing fear. expired or cancelled temporary permit.

 Gives any false evidence to the Board

Vices of Health Care Provider in order to obtain a certificate of
Vices registration/ PRC license.
 is an evil fault
 an imperfection  Falsely poses or advertises as a
 an immoral conduct, tendency registered and licensed nurse, or uses
 practice or habit any other means that tend to convey
 As applied to an animal nature of a impressions that he/ she is a
person, it is a bad habit or failing. registered.

1. FRAUD  Appends BSN, RN to his or her name

 bad faith without having conferred to said
 Dishonesty degrees or registration.
 deceit
 infidelity  RN abets or assist the illegal practice of
 unfairness a person who is not lawfully qualified
 perfidy to practice nursing.
 unfaithfulness
 Fraud is either actual or constructive 2. PRIDE
 The former consist of deceit, trick  anonymous of HUMILITY.
 Synonymous to conceit which both
 Actual- something said, done or mean a high opinion of oneself.
comitted by a person with the design  Refers to vanity; too much pride in
to perpetrate what he/ she knows to one’s looks, abilities or
be a cheat or deception. accomplishments. It suggests proper
self-respect nor personal dignity
 Constructive- any act of commission or because of excessive self-love and
commission contrary to legal duty, arrogance because of imagined
trust, confidence reposed. superiority.
 Conceit- high opinion of one’s own
abilities & accomplishments.
Unpleasant assertive manner.
Examples: What is a Habit?
 A proud or conceited person does  A disposition or condition of the body
not recognize human limitations or or mind acquired by custom or usual of
weakness. the same act or functions.
 He/she does not accept mistakes.
 He/she thinks that he is always  Perform particular action, acquired by
right and never goes wrong. repetition, characterized by a decrease
 He/she points to others the culprit, power of resistance and an increase
the sinner, the guilty, and not him facility of performance.
or her.
 He/she is just perfect.  It is not inborn. It will either make one
 THINK !!! or break him\her , for he\she becomes
 How about a health care provider what he\she does repeatedly.
like a nurse, is he/she is prone to
this vice of pride? Watch your THOUGHTS
Ans: For they become WORDS

3. GREED Watch your WORDS

 quality of wanting more than one’s For they become ACTIONS
share.
 Synonymous to avidity, cupidity. Watch your ACTIONS
 To be greedy means to want or For they become HABIT
desire to get for oneself.
Watch your HABITS
 A greedy person is : miser who is For they become CHARACTER
eager to accumulate money
/wealth, glutton who wants to eat Watch your CHARACTER
food excessively, coveter who For it becomes your DESTINY
wants more things, wives,
husbands, more lovers, a dictator Samuel Smiles
who has an avid desire for more
power, raven who desire to get Types of a Habit:
more things through stealing, A.BAD HABIT:
robbery, kidnapping, carnapping  negative behavior pattern.
and corrupt means.
 Referred to a VICE when it has moral
 GREED is antonymous to the virtue implications due to intimate relation to
of simplicity, which is the absence moral behavior ex. Drug addiction,
of freedom from luxury, vanity or excessive drinking, smoking, gambling
any form of greed. & glutony.

 Simplicity must be integrated in the  When these bad habits becomes vices?
personal and professional life of
health care provider, he/she
becomes an epitome of a simple
life that the sick, deprived, disabled
or needy will look up with hope.
7 Common Bad Habits or
Characteristics: B. GOOD HABITS:
 positive behavior pattern.
1. REACTIVE
 It is analogous to a VIRTUE.
 Tends to act in response to influence
 VIRTOUS PERSON: live persistently
or force.
with good habits.
 Does not take responsibility of his life.
 Concerned of his rights, never his
duties. 7 COMMON TYPES OF GOOD
 Blames everybody HABITS OR CHARACTERISTICS:
1. BE PROACTIVE
2. BEGIN WITH NO END IN MIND  Makes choices based on values &
 One does not believe in planning or in virtues.
having vision-mission goals ;whatever  Anticipates trends & works to promote
will be. development.
 Concerned only of the here-and –now  Active in advance.
existence & not tomorrow .  He prevents or keeps a person or thing
from doing something or setting an
3. PUT FIRST THINGS LAST obstacle to stop him.
 One does not have priorities.  Takes responsibility for his life.
 He does whatever comes, & important  Thinks before he\she acts.
things can wait tomorrow.  Make things happen.
 It is mañana habit attitude or
procastination. 2. Begin with the END in Mind.
 Defines his vision-mission goals.
4. THINK WIN-LOSE  Visionary, mission oriented & goal –
 One sees life as survival for the fittest directed to guide him in discovering
 He competes to win and make sure the meaning and purpose of life.
others lose by all means  SMART GOALS-your goal should be
 Does not accept defeat match to SMART:
1. Specific Goal
5. SEEK FIRST TO TALK, THEN PRETEND 2. Measurable Goal
TO LISTEN 3. Attainable Goal
 Monopolize the talking. 4. Result-Oriented Goal
 Impresses others that he knows best 5. Target-Dates Goal
with incomparable ideas.
 Evident of superiority complex, w\c 3. PUT Things FIRST
may give way to a vice of PRIDE.  One prioritizes & does important
things first.
6. Do not COOPERATE  Manages time so that actions comes
 One who does not see the importance first in order of importance.
of teamwork.  Learns to overcome fears.
 He sees that nobody can do it, except  Courageous.
himself.
4. THINK WIN-WIN
7. Wear YOURSELF OUT  Belief that everybody can succeed.
 One thinks that he is an institution,  Justice and Equity.
and doe not need to improve, learn  Theres’s no sad and angry losers, ALL
new things for he has vast reservoir of are happy and satisfied winners.
stocked knowledge.
5. SEEK FIRST TO UNDERSTAND, then 1. Principle of Stewardship.
to be UNDERSTOOD  Steward or stewardess is a person
 One opens himself & listen to others appointed in the place or stead of
genuinely to understand who they are. another.
 Listens with his eyes, heart, ears,  Takes charge of representing and
stands in their shoes. protecting another’s interest, sees to it
 Practices mirroring or reflection. that the service is carried out faithfully.
 Healthy dialogue
 PRINCIPLE: Values or virtues of
6. Synergize responsibility & accountability.
 Harmonizer  RESPONSIBILITY: duty involved when
 Provides unity & support. one accepts the task of management.
 Encourages people to work together to  ACOUNTABILITY: state of being
achieve more. answerable or liable for carrying out
 KEY: TEAMWORK one’s right and duty.. Goes hand in
hand with responsibility.
7. Sharpen the Saw
 Take a break or rest. Examples:
 Receives back what he has given in  NURSES are charged by society as
work. stewards in the health services.
 Resting is receiving.  Mandated to take care or look after
 It is a good habit to rejuvenate, the sick, disabled & psychological
unleash, take a lateral move, relax, infirmities.
treat yourself to a little TLC.  Equipped with KSA to restore & help
sustain good health of the clients.
Basic Ethical Principles
 Principle is a truth that is a foundation 2. Principle of Totality
for other truths.  TOTALITY- connotes wholeness,
 What constitutes truth? completeness or entirety.
 Truth- it is conceived as an agreement  Applies to any entity that is made up of
of thought and reality, eventual parts that together constitute as a
verification, & consistency of thought whole.
with itself.  Whole physical body is important &
 Law & moral ethics are principles. valuable than its parts.
 It maybe ethical and legal to sacrifice a
part of one’s body for the good of his
Legal and ethical principles are basic truths whole body.
that guide decision analysis & decision
making. EXAMPLE:
 Amputation of cancerous leg
 For nurses, knowledge of & interest in  Mastectomy
legal and ethical truths are  Examples :Removing body part
indispensable conditions in the unecessarily & out of vanit that is
practice of their profession. contrary to moral integrity and God’s
creation.
 Transexual operation&plastic surgery
3. Principle of DOUBLE EFFECT 4. Principle of COOPERATION
 Contemplates on two effects or  Means to work together, to unite in
outcomes arising from the producing a result, desire, intend, or
performance of an action. wish in a common thing.
 PRIMARY EFFECT:results from the  Participation of a secondary agent
agents intent, desire, wish, will. (cooperator) with the primary agent
 SECONDARY EFFECT:is only allowed, ( wrongdoer) in the performance of an
tolerated or permitted. evil action/ effect is classifies as:

THE PRINCIPLE OF DOUBLE EFFECT  1. Accdg. To the intention of the

1) The action must be good in itself cooperator:
2) The agent must have the right intention  a. Formal: when one willingly intends
3) Good action must be the means of good the evil effect: agrees, advices,
effect counsels, promotes or
4) The good effect must be proportional to  b. material: when one does not
the evil effect willingly intend the evil act or
participate in the action.
Application of the Principle of DOUBLE
EFFECT to an ACTUAL CASE:  FORMAL COOPERATION: It is not
Case 1: allowed,. If present, the cooperator is
 Ces Drilon of ABS-CBN was kidnapped morally responsible for the evil act.
for ransom. As a policy, pmt. Of Material cooperation maybe allowed
ransom money is absolutely when the cooperator is ignorant of the
prohibited. However, non payment immorality of the act, or has no
would mean loss of her life. The family freedom to refuse.
of the victim allegedly pay secretly
despite the prohibition and she was  2. Accdg. To the action of the
released alive. Did the family of the cooperator:
victim act morally?  a. immediate: if it is inherently bound
 Analysis: to the performance of the evil action
 The action had effects: it violated the or
no-ransom policy and saved human  b. Mediate: if distinguishable from the
life. performance of the evil action.
 First the action of saving human life is
in itself, morally good.  MATERIAL IMMEDIATE
 Second, such good effect is a direct COOPERATION: is usually not allowed
result of the action itself and not a but be acceptable under duress.
result of violation of the policy.
 Third, the intent, desire or wish of the  3. Accdg. to distance of cooperation
family is to save the life of the victim, from the act:
& not to go against the policy, violation  a. proximate if close
of which is merely allowed or  b. remove if distant
tolerated.
 Fourth, saving of the victim’s life
outweighs or is in proportion to the
violation of the no-ransom policy. LIFE
IS MORE VALUABLE OR IMPORTANT
THAN PROPERTY ( MONEY).
 Double Effect
 For an ACTION OF A COOPERATOR to Major Bioethical Principles
be legitimate it must have the ff:  The many Ethical issues in the last 50
conditions: years have led philosophers and
1. Cooperation is material,mediate & as a academicians to develop principle of
remote Bioethics.
2. Significant proportionate reason for the
action  The 1st four were described by
3. Scandal is avoided; Beauchamp and Childress in their
4. No alternative lesser evil action is book Principles of Biomedical Ethics.
available ( to prevent greater harm.)
 They remain cited in both academic
Example: and training centers.
 The spouses H and W have been legally
married for more than a decade, but  I. RESPECT FOR PERSON:Persons have
not blest with a child. They have had inherent dignity which must be
regular check up in the clinic of Dr. X respected.
and nurse Y. The conclusive medical
finding is :. Low blood count of H is  They cannot be denatured or
incurable. X and Y knowing the feeling destroyed.
and eagerness of the couple to have a
child , suggested tubal insemination. W  They can & should decide what is best
prefers the latter option with consent for them without constraints from
of or approval of H, who even goes his others.
way to look partner who may have
carnal knowledge or act with his wife.  Related in a respectful courteous
manner with modesty, privacy and
5. Principle of SOLIDARITY confidentiality protected.
 To be with others; to have unity of
interest, responsibility or goal. 1.RESPECT FOR PERSON:
 Based on the common good, love of EXAMPLES:
neighbor.  In health issues this relates to
reproductive technology:
 Examples:  Care for the elderly
 In Health , this is manifest in the  Organ donation
healthcare provider’s acting kindly,  Exploitation of patients
compassionately towards the patient.  Principle of free & informed consent is
an exercise of respect for person.
 Cooperation among members of the 2. Concept of JUSTICE
health team.  Terms fairness, deserts ( what is
deserved) & entitlement( that to which
 Advocating for health policy/ avoiding entitled) explains JUSTICE.
profit making from health services as  JUSTICE is giving each one his/her due.
well as manipulating or exploiting its EXAMPLE:
disadvantaged.  Someone who has been working hard
on the job does not get the needed
 Volunteering to be an organ donor. promotion while the another one gets
promoted without merit.
 Expert nurses guiding the novice  INJUSTICE- involves wrongful act or
nurses. omission that denies people benefits
to which they have the right to.
Type of Justice according to 3. LIBERTARIAN
Beauchamp & Childress (1994):  For as long there are no restraints on
individual liberty, justice is served.
1. DISTRIBUTIVE JUSTICE
 Procedure is important than outcome.
 refers to fair, equitable, appropriate
Libertarians risk the rich buying too
distribution of responsibilities; s
much and leave nothing for the poor.
 hare of rights and roles.
 Problems arise under scarcity &
competition. 4. COMMUNITARIAN
 stresses the principles and practices of
2. CRIMINAL JUSTICE justice that evolve through traditions
 refers to the just infliction of in community.
punishment or penalty proportionate
to the crime committed. 5. EQUITY
 What is due depends on what has
3. RECTIFICATORY JUSTICE been given/ received. It’s paying back.
 refers to just compensation for  It is very limited; IF NOTHING IS
transactional problems such as breach GIVEN FIRST THEN NOTHING WILL BE
of contract and practice based on civil GIVEN IN RETURN.
law.
6. NATURAL LAW
Principle of Distributive Justice  Justice is doing to others what one
would have them do to one self , with
according to Engelhardt, Keusch, preference for the poor.
Wildes( 1995)  This is fair for the poor and the
To each person an : recipient.
1. Equal share
2.According to need 2. NON- MALEFICENCE
3. According to effort  asserts an obligation not to inflict harm
4.According to contribution intentionally.
5.According to merit  Maxim of medical ethics is Primum non
6. According to free market exchange nocere which means , “ above all, do
Significance: unite diverse principles, rules no harm to anyone.”
and judgments.  Oath: “ I will use treatment to help the
sick according to my ability and
Approaches or Theories of Justice judgment, but I will never use it to
1. UTILITARIAN injure or harm them.”
 What is due is determined by the
utility consequences: greatest good for PRINCIPLE OF NON-MALEFICENCE
the greatest number regardless of the AND BENEFICENCE ( Beauchamp
value for the particular person
involved.
& Childress ,1994)
NON-MALEFICENCE
2. EGALITARIAN  One ought not inflict evil or harm
 What is due is what is fair, equal  Avoiding any intent or cause that will
distribution of benefits and burdens, lead to death.
equal opportunity. Maximizes the
minimum situation. Who are equal is BENEFICENCE
difficult to define.  One ought to prevent evil or harm
 One ought to remove evil or harm
 One ought to do or promote good
Examples of Non-Maleficence
1. Do not kill.
Do not cause pain or suffering  What can we do as health providers?
3. Do not cause offense to others.
4. Do not incapacitate others.  ORDINARY MEASURES: NECESSITIES
5. Do not deprive others of the goods of OF LIFE USALLY FOOD, NORMAL
life. RESPIRATION, ELIMINATION PROCESS.
 Examples: IVF, NGT feedings, catheters
 To safeguard health care workers , . These are ordinary measures and
hospitals follow a standard of due care. maybe sustained until death.
The standard of due care specifies that * Chemotherapy and hemodialysis ?
with emergency or urgent cases
attempting to save lives after a major 3.KILLING VS. LETTING GO
accident justifies the risks created by  Assisted suicide- administering help to
such emergency measures. hasten death.
 Is this a form of killing?
GUIDELINES FOR FOLLOWING THE  Letting go- allowing a client to die by
MAIN ISSUES: not administering any hastening
1. WITHHOLDING VS. WITHDRAWING element.
TREATMENTS: Ex. When treatments are withdrawn
 Withdrawn- stopped because these measures no longer offer
 Withheld- not started any benefit to the client, allowing client to
 What feelings do you have regarding die with dignity.
the issue of withholding vs. Hospice care
withdrawing treatment?
 Both withholding and withdrawing 3. DNR order( DO NOT RESUSCITATE)
treatment are bioethical issues which  is indicated when the case is far
can be acted or justified by the ff: beyond reversibility and death is
conditions: certain. Ex. Not administering any CPR
1. When the case is irreversible and any in the event of cardiac arrest.
form of treatment will not benefit the
client.  We should not feel guilty that we have
2. When death is imminent or when patient done our part as long as we have
is already dead. rendered our best nursing care. The
> When such condition will not principle of beneficence and non –
benefit the client, treatment is not maleficence should be our guides in
obligatory. Respect the clients call for the care of clients.
dignity of death.
4. BENEFICENCE
ORDINARY VS. EXTRAORDINARY  Act of goodness , kindness, an action
MEASURES done for the good & benefit of others.
 2.Extraordinary measures entails the It comes from the Latin words “bene”
use of aggressive modalities vis-a-vis meaning good, and “fiche” meaning to
the financial capabilities of the family. act or do.
Ex. Client hooked to respirators, giving
3rd generation antibiotics. Done to  Benevolence- refers to character trait
ease the guilt feelings of the family. or virtue of inclined to do good and act
for the benefit of others.
 Artificially prolong the life of the client.
4.A. Ideal beneficence
 Loading client with more burden and  It is a benevolent act, means going out
fatigue. of one’s way to do good to others.
 Example: A nurse was riding on a bus.  Ex. Lifesaver to rescue someone who is
Suddenly one of the passengers drowning.
fainted because of hypoglycemia and  Cheering up someone who is
fatigue. depressed.
What are the Benevolent acts of the
nurse? INFORMED CONSENT
 Known as enlightened consent.
4.B. Obligatory beneficence  Prior to any interventions, clients must
 Mandatory act to do good, give aid to have full information of what the
those who are in need. procedure is all about, objectives, need
 Ex. Emergency cases, no one should be , and advantages. Including the
denied urgent care. alternative measures as well as
 To offer a glass of water when outcomes of the procedure are made
someone is thirsty. clear to the client ( Beauchamp &
Childress, 1994).
EXAMPLES OF DEMONSTRATING
THE 5 RULES OF BENEFICENCE  CONSENT FORMS are legal documents
 RULE 1. Protect and defend the rights serve as:
of others.  Prima facie ( first hand), evident in the
court cases.
 Ex. Explaining to the client who will  CONSENT must be obtained in
undergo surgery that he/she the right observance of the ff: elements:
to know about the surgery, what 1. Threshold ( preconditions)
benefits and vs. risks the latter will 2. Competence ( to understand)
bring. 3. Voluntariness( in deciding)

 RULE 2. Prevent harm from occurring  COMPETENCE covers the domain of

to others. being mentally, emotionally and
 Ex. Raising the side rails of the bed. physiologically well and sane.
1. Observe PPE
2. Tutoring a failing student  The person is sound and free to decide
and make choices because he or she is
 RULE 3. Remove conditions that will competent and understands what is
cause harm to others. going on. Client should be competent
and understand the ff:
 Ex. When caring for clients who are not 1. Information elements
mentally sound ,hazardous materials 2. Disclosure ( material information)
should be safely kept away. 3. Recommendation(Plan)
 Avoiding talking about topics that will 4. Understanding( of the information and
provoke patients to violent. plan)

 RULE 4. Help persons with disabilities  Disclosure of information- topic is

about surgical intervention, disclosure
 Ex. Are guiding and holding the hands involves information about the body
of a deaf while crossing the street. part involved, procedure to be done,
 Reading a newspaper or book to effects , cost of the procedure,
someone who has defective eyesight. outcome of the intervention.
Ex. visual aids
 RULE 5.
 Rescue persons in danger.
 Informed consent shall be obtained by  All points have been discussed and
the health professional ( SURGEON) , clarified.
who performs the surgery
 The signature of the person is affixed.
 NURSE- witness to see to it that This shows that the consent given is an
elements of the informed consent are informed and enlightened one.
executed by the Surgeon.
ISSUES/CASES OF BIOETHICAL
 RECOMMENDATION entails two way
discussion on the advantages &
CONCERNS
 PLASTIC SURGERY- is a branch of
disadvantages of the procedure and
science of surgery that focus on
making clients feel that the plan is for
reconstruction or repair of deformity,
their utmost benefit.
defector bodily injury , improves the
 Alternatives plans should be offered so appearance or function of the parts of
that clients are really given the best the body.
opportunity to choose what they
believe to be the best.  May entails use of bones, cartilage,
skin being taken from outer parts or
 INFORMED CONSENT carries two main applying artificial substitutes.
functions:
1. PROTECTIVE- to safeguard against  The legal and moral dimensions of
tension of integrity. surgical intervention maybe anchored
2. PARTICIPATIVE- to be involved in the on the principles of totality, autonomy
health care decision making. with consent and double effect.

 If the client ask questions to validate CONDITIONS INORDER FOR THE

what he/she thinks and if these PLASTIC SURGERY TO BECOME
questions are satisfactorily answered, LEGAL & MORAL:
the understanding of the disclosure
 Both the surgeon and client must have
and the recommendation of the plan is
good intention.
evident.
1. Consent elements
 Surgeon must respect client's
2.Decision( IN FAVOR OF THE PLAN)
autonomy and obtain letters consent.
3. Authorization ( of the chosen plan)
4. Signature( execution of the consent
 The intent or motives must be
through signature)
reasonably higher than or
proportionate to extraordinary means
allowed.
 CONSENT OBTAINED FROM THE
CLIENT STARTS WHEN:
 The functional integrity of the human
 Once there is already a decision.
body must not be lessened unless a
sacrifice of any part through surgery is
 Chosen plan is clear and client freely
an extreme necessity to preserve
gives consent by voluntary signing the
health and life.
consent form.

 No more hesitation or vagueness of

what the procedure or intervention is
all about.
EUTHANASIA  Abortion without medical necessity to
 Comes from the Greek words “ eu “ warrant, is legally punishable, even
which means good and “thannatus” , with the consent of the woman or her
which means death. or a good death. husband.
 It implies mercy killing.
 It applies to a practice of hastening
death or causing the death of a person REASONS FOR THE PHENOMENON OF
suffering from incurable disease. ABORTION
 An act of mercy  If the fetus is allowed to develop and
 Painless killing to end one's life as a come to term, p regnant woman
matter of right. herself will die.
 Allowing someone to die in easy death,
without using medical science  Pregnancy will surely produce severely
impaired child.
Three Key Concepts of EUTHANASIA:
1. MERCY KILLING -  Pregnancy is an outcome of rape.
 is the involuntary or uintentional
termination of the life of patient by  Pregnant woman is unmarried, and
someone. there will be the social stigma of
 It does not require his/her permission illegitimacy.
or request.
 Having a child will be an unbearable
2. MERCY DEATH- financial burden.
 means someone takes direct action to
terminate a patients life upon his/her PROS AND CONS : Their MORAL
request. Dimensions
 It is an assisted suicide.  The Abortion issues involves 2
opposing divergent positions:
3.ALL OWING SOMEONE TO DIE-
 implies withdrawal of treatment and  1. PRO- LIFE- is anti abortion. It
acceptance of the fact that the client's resolves that abortion is illegal and
illness has reached a point where and immoral based among ff: grounds:
when no cure is possible.
 The client should be allowed to die a  Human life begins at conception
natural death in comfort, peace,
dignity.  Sanctity or value of life: the unborn
child has all the rights as a human
ABORTION person.
 refers to premature expulsion of fetus
prior to normal birth.  Dangers in pregnancy are relatively
safe due to the advances of medical
 Either spontaneous and induced science.
termination.
 Economic reasons are irrelevant and
 A physician or a nurse are criminally unacceptable.
liable for causing an abortion,
however, if the abortion is done to
save the life of the mother, there is no
criminal liability, this is known as
THERAPEUTIC ABORTION.
UNIVERSAL PRINCIPLES OF The Health Care Profession
BIOMEDICAL ETHICS  Is a complex, organized occupation
1. AUTONOMY – self- determination, preceded by a training program.
freedom to choose and implement one’s
decision, free from deceit or constraint.  It is a calling which members profess to
have acquired knowledge, training,
2. VERACITY – the client and the health experience to guide, ,advise, serve
care provider are bound to tell the truth. others in their specialized field.

BENEVOLENT DECEPTION- practitioner  May refer to watchful keeping of

intends to withhold information according condition of being and sick.
to his judgment when such revelation
would do more harm to an emotionally What is a PROFESSION?
unstable or depressed person.  is a complex., organized occupation
preceded by a long training program.
3. BENEFICENCE- promotes doing acts of
kindness and mercy that benefit the client.  It is a calling in which its members
profess to have acquired special
4. NON-MALEFICENCE- stated as knowledge, by training, or by
admonition in the negative forms to remind experience, so they may guide, advise
nurses to do no harm. or serve others in their specialized
field.
5. JUSTICE- right demand to be treated
justly, fairly and equally.
The Health Care Provider
The Calling of the Health Provider  A professional duly authorized to
CALLING engage in, granted by applicable laws
 signifies occupation, profession or over health care services.
trade.
 imply a response of a human person to  Who are the Health Care Providers?
need, demand to share her talents,
The Nurse: A Mother Surrogate
 expertise, knowledge and skills.  Derive from the Latin verb” nutrire”
which means to feed, nourish and
 It may further denote a VOCATION. suckle.
 - includes calling of the health care
provider to enter into a contract with  It implies that the basic function of a
society in the area of health as their nurse is same with that of a mother,
profession . acts as a surrogate to the patient who
 What are examples? has emotional needs.
 It denotes a vocation, which may
determine what state in life a person  The patient needs motherly
wants to be. encouragement covery, reassurance,
 This vocation includes the calling of the sympathy, understanding, anxiety,
health care provider to enter into a fear, distress.
contract with society.( Taking care of
the sick, aged, disabled, is indeed a
NOBLE PROFESSION).
The Nurse as a PROFESSIONAL The Client
 One who is bound by values, standards  Is a person or group for whom a
other than his organization , setting doctor, nurse etc. person or service
one's rules, seeking to promote acts.
standard of excellence.  Is referred to the patient or any person
 Professional Nurse- one who finished afflicted with infirmity or diaability.
and acquired or gained high level of
specialized skills and knowledge PATIENT'S RIGHTS AND DUTIES
through academic study. 1. RIGHT
 means justice, ethical correctness.
CHARACTERISTICS OF NURSING ( abstract definition)
PROFESSION  power, privilige, inherent to one's
ATTRIBUTES: person.( concrete)
1.EXPERTISE
 competence or special knowledge and 2. DUTY
skills in particular field.  refers to what a person ought to do all
 APPLICATION/ IMPLICATION to Nsg times cause it is legally or morally
profession ? right.

3. AHA (1992)
2. AUTONOMY
 promulgates and adopts Patient Bill of
 self governing, self regulating,
Rights.
independence.
 APPLICATION/ IMPLICATION to Nsg
profession ? PATIENT'S BILL OF RIGHTS
1. The patient has the right to a considerate
3. ACCOUNTABILITY and respectful care.
 responsibility, liability, and
answerability for carrying out one's 2. The patient has the right to & encourage
obligation or duty. to obtain from physicians and other direct
 APPLICATION/ IMPLICATION to Nsg care givers relevant, current, and
profession ? understandable information and diagnosis,
tx and prognosis.
4. AUTHORITY
 permission, legitimacyon power, 3. The patient has the right to make
expertise. decisions about the plan patient care prior
 A form of permission for a profession to and during the course of the treatment
to exist and for its members to and to refuse a recommend treatment of
legitimately practice. plan of care to the extend permitted by law
 APPLICATION/ IMPLICATION to Nsg and hospital policy.
profession ?
4. The patient has the right to have an
advance directives concerning treatment.
5. UNITY
 oneness, union of parts forming a
5. The patient has the right to every
complex whole.
consideration of privacy.
 APPLICATION/ IMPLICATION to Nsg
profession ?
6. Patient has the right to expect that all
communications and records pertaining to
his/her care will be treated as confidential
by the hospital.
7. The patient has the right to review the 6. The patient has the basic right to have
records pertaining to his/her medical care, adequate health care.
to have information explained or
interpreted. PATIENT'S DUTIES AND
8. The patient has the right to expect that,
RESPONSIBILITIES
 The first and foremost requirement
within its capacity and policies, hospital will
from a patient is her /her whole-
make reasonable responses to the request
hearted cooperation and active
of the patient for appropriate care.
participation in the course of
treatment.
9. The patient has the right to ask and be
 Burkhardt and Nathaniel (2002)
informed of the existence of business
suggest some of these responsibilities
relationship among hospitals, educational
that the client should follow.
institutions that may influence patient's tx.
1. To provide honest information about
10. The patient has the right to consent or
past illness, hospitalizations, medications
decline to participate to proposed research
and related to health status.
studies or human experimentation affecting
care and tx.
2. To take initiative in requesting addtl.
info. ,clarification about his/her health
11. The patient has the right to expect
status or treatment when he /she does not
reasonable continuity of care when
fully understand info. and instructions.
approached and to be informed by the
physician and other care givers of available
3. To ensure the the hospital has a copy of
and realistic patient care options when
client's directives.
hospital care is no longer appropriate.
4. To inform his/her physician , nurses if
12. The patient has the right to be informed
he /she anticipates problems in the
of hospital policies and practices that relate
prescribed treatment.
to patient care, tx and responsibilities.
5. To be aware of hospital's obligation to be
SUPPLEMENTARY PATIENT'S BILL reasonably efficient in providing care.
OF RIGHTS
1. The patient has the right to receive 6. To make reasonable accommodations to
information from physician to discuss the the needs of the hospital, other clients,
benefits, risks and treatment. medical staff and hospital employees.

2. The patient has the right to make 7. To provide necessary info. for health care
decisions regarding health care that is insurance coverage, claims and to work
recommended by his/her physician. with hospital to make payment
arrangements orderly and easy.
3. The patient has the right to courtesy,
respect, dignity, responsiveness and timely 8. To recognize and discern the impact of
attention to his needs. his/her lifestyle on his/her personal health.

4. The patient has the right to

confidentiality.

5. The patient has the right to continuity of

health care.
HEALTH CARE PROVIDER-CLIENT 3. CONTRACTUAL
RELATIONSHIP  an agreement entered into and
executed by and between the
 RELATIONSHIP- signifies a state or
professional and client, stipulating the
condition that exist between people or
extent of their respective responsibility
groups that deal with one another.
in a joint effort to meet a need.
 It implies a connection that bind
 APPLICATION: It is doable and when
parties for common objective.
level of knowledge of the problem area
between professional and client are
 Clients- are involved with decision -
more or less equal, otherwise the
making affecting health.
relationship is not appropriate and the
clients needs cannot be meet.
 Physician, nurses, allied professionals,
clients, families
4. AFFINITY
 -- example of collaborative or  relation anchored on trust between
teamwork professional and the client.

 The latter trust the former due to

TYPES: Professional and Client connection or confidence arising from
Relationship ( ROWAN & friendship, expertise, family relation or
ZINAICH) membership in religious
1. AGENCY RELATIONSHIP
 professional does not make decisions,  APPLICATION- Relationship is
client does. appropriate and applicable when the
needs of the client are met without
 Professional work as the agent of the encroaching upon his/her freedom.
client.
5. FIDUCIARY
 APPLICATION: Analyze, consider,  a person holding the character of a
decide best alternative , & educated trustee. The trustee is the professional
about the problem. who is held in trust for the welfare of
the client.
 Agency should upholds clients value of  APPLICATION: In health care
self determination or autonomy. ( physician, nurses, etc. ) are the
trustees in whose highest standard of
2. PATERNALISM knowledge and expertise are set, and
 similar to father-child relationship. in whom the welfare and health of
human life are entrusted. They are
 The professional as a caring parent, unconditionally. legally and morally
client as a child. obligated with utmost diligence.

 APPLICATION: Assumes responsibility Summary:

to analyze, consider and decide the The 5 tasks described are as follows:
solution to the problem of the client so 1. The need or problem must be analyzed ;
is only called to implement decisions. 2. Consider alternatives to respond to the
need;
 Under this set-up, client's self 3. Decide on the best option;
determination and freedom are 4. Education of the client must be done so
curtailed to a great extent. that there is an informed consent and
5. Final decision must be implemented.
Quiz: Essay 3. SERVICE -ORIENTED
From among the models of professional-  quality of being helpful, useful, and
client relationship, which is considered as generous to others.
the most appropriate and commendable
relationship? Why ?  Implies a vaded attitude of education
to one's work, not mindful of
Qualities/ Characteristics of renumeration paid, time spent,
Effective Health Care Providers schedule given.
 QUALITY- dynamic state associated
 Obligation to be of service of the sick,
with people, services, processes,
welfare, and incidentally for money
environment that meets or exceeds
just enough for them to survive and
expectations.
live a quality of life.
 As applied to health professionals,
qualities are professionals proficiencies
that conform clients expectations, 4. SIMPLICITY
measured through clients satisfaction,  quality of being sincere, true, or
treat them with dignity, respect and straightforward.
courtesy.
 It implies absence of show or
 QUALITIES- desirable personal
pretention.
attributes or traits.
 They must have live a quality life first
 In other words, for human person, like
before they can understand the clients
a nurse to be simple, he must live with
perspectives.
integrity, and not with split
 “Nemo dat non habet”- nobody gets
personality. He must must act
what he does not have.
according to what he is not. He must
possess only what he needs so that
others may not be deprived and suffer.
PERSONAL QUALITIES/
5. SENSE OF PERSONAL
CHARACTERISTICS
RESPONSIBILITY & ACCOUNTABILITY
1. SELF-RESPECT
 the ability to respond to a problem or
 proper regard for the dignity of one's
need which or decision making, &
characteror position, with appreciation
accountability to answer for any
or recognition of its obligation or
consequence.
worthy conduct.
 Implies total commitment, social duty,
 As a person ,he must possess :
which require unfailing service to the
1. strong sense of self-worth
needy.
2. Sense of pride
6.RISK TAKING
 quality of being courageous, strong,
2. SELF- TRANSCEDENCE
open and vulnerable.
 quality of going beyond one's own self;
it is self- giving, selfless love.
 Implies leaving one's comfort zone and
going his courageous zone. Nurses
 It implies capacity, readiness and
have to make a stand in favor of
willingness to sacrifice their comfort
client's well being.
zone for the well-being of their client/
patient.
7. PATIENCE
 quality of being willing to put up
waiting, pain or anything that annoys ,
trouble or hurts.

 It implies calmness and self control.

 Caring of the sick is a demading job,

because it involves protection,
preservation and extension of human
life.

 It demands enduring attention and

empathy commited health providers.

PRACTICAL EXERCISES
ISSUE: Why do I want to be a nurse?

Directions:
1. Divide the class into 3 groups. ( RLE
Grouping)
2. Include in the discussion: the motive, the
problems encountered, expectations,
anxieties and or insecurities.
GROUP REPORT

-SYCHING<3
QUIZZES

I.
MATCH COLUMN A WITH COLUMN B ( GOOD AND BAD HABITS)

1. REACTIVE - Blames everybody,do not take responsibility

2. BEGIN WITH NO END IN MIND- Concerned of here and now
3. PUT THINGS FIRST LAST - Manana Habit
4. THIN WIN-LOSE - Does not accept defeat
5. SEEK FIRST TO TALK - Evident of superiority complex
6. DO NOT COOPERATE - Do not believe in teamwork
7. WEAR YOUR SELF OUT - Do not want to learn and improve

1.The following are caring actions to show respect for person EXCEPT:
MAKES DECISIONS FOR THE CLIENT

2.To be with others; to have unity of interest, responsibility or goal refers to :

PRINCIPLE OF SOLIDARITY

3.The following are examples of Non-maleficence EXCEPT:

DO NOT CAPACITATE OTHERS
Do not deprive others of the goods of life
Do not kill
Do not cause client's pain and suffering

4.Means to work together, to unite in producing a result, desire, intend, or

wish in a common thing.
PRINCIPLE OF COOPERATION

5.Refers to moral excellence.

VIRTUE

6. Virtue commonly associated with care and diligence.

PRUDENCE

7. The following actions shows FIDELITY EXCEPT:

SHOWING EMPATHY
Maintains confidential
Being trustworthy
Keeping one's promises
8. Refers to uprightness in character and action.
INTEGRITY

9. Ethical principle in which the nurse take charge in representing and

protecting client's interest.
PRINCIPLE OF STEWARDSHIP

10.Refers to agreement of thought and reality, event  and consistency of

thought.
TRUTH

11.Refers to just compensation for transactional problems such as breach of

contract and practice based on civil law.
RECTIFICATORY JUSTICE

12.Refers to fair, equitable, appropriate distribution of responsibilities; share of

rights and roles
DISTRIBUTIVE JUSTICE

13.One ought to remove evil. This is known as:

BENEFICENCE

14.A nurse is bound to practice her profession within the scope of nursing
practice. Nursing law is :
RA 9173

15.Humility acts with a gentle spirit. The following terms describes humility
EXCEPT:
POSSESSION
SUBMISSION, COURTESY, DOCILITY

16.Receives to  wrongful act or omission that denies people benefits to which
they have the right to
INJUSTICE

17. MATCH COLUMN A WITH COLUMN B ( GOOD HABITS)

1. PROACTIVE - Active in advance and make things happen

2. BEGIN WITH END IN MIND- Defines his vision and mission
3. PUT THINGS FIRST - One prioritizes and manages time
4. THIN WIN-WIN - Belief that everybody can succeed
5. SEEK FIRST TO UNDERSTAND - Listen to others genuinely
6. SYNERGIZE - Harmonizer
7. SHARPEN THE SAW - Rejuvenate, unleash and relax