o One has made a decision

BIOETHICS o One has the capacity to

justify one’s choice
PROF. RONA ALCERA o One does not justify one’s
ETHICAL PRINCIPLES choice but does not so in
reasonable manner
Conflict is inveitable. Ethical principles  Disclosure
provide the framework/tools which may  Comprehension
facilitate individuals and society to resolve
 Voluntariness
conflict in a fair, just, and moral manner.
2. Right to informed decision
AUTONOMY - the right to participate in 3. Right to informed choice
and decide on a course of action without 4. Right to refuse treatment
undue influence o Right to die
o Freedom of choice
Self Determination: which is the freedom
to act independently. Individual actions LIMITATIONS OF PATIENT’S RIGHTS
are directed toward goals that are
 2 Methods of Obtaining Informed
exclusively one’s own.
Consent
 “Autos”- self, “Nomos”= rule o Written Consent
 Right to self determination o Verbal Consent
 Treat each individual as an  In emergency cases the types of
autonomous subject. patient need not require informed
 Individuals have right to make consent.
treatment decisions o Comatose obtunded
 Must have the capacity to make patient
decisions independently: o Blind or illiterate patients
o Developmental o Underaged Patients
considerations o Language Barriers
o Health related challenge.
RIGHTS OF PATIENTS
THE MORAL ISSUE OF PATIENT’S RIGHT
1. Right to considerate and respectful
PATIENT’S RIGHT care.
2. The patient has the right to obtain
- The moral and inviolable power
from his physician complete
vested in him as a person to do,
current information concerning his
hold or demand something on his
diagnosis, treatment, and
own.
prognosis in terms that the patient
TYPES OF PATIENT’S RIGHT can be reasonable expected to
understand.
1. Right to informed consent
3. The patient has the right to receive
Four Major Elements of Informed from his physician information
Consent necessary to give informed
 Competence
 consent prior to the start of any  Respecting the “self” of others
procedure and/or treatment.
4. The patient has the right to refuse
treatment to the extent permitted VERACITY
by law and to be informed of the
 Obligation to tell the truth and not
medical consequences of his
to lie deceive others
action.
 Often a source of ethical
5. Right to every consideration of his
challenges arising from differences
privacy concerning his medical
in personal beliefs and unique
care program.
cultural features
6. The patient has the right to expect
 The duty to tell the truth; Truth-
all communications and records to
his care should be treated as BENEFICENCE NONMALEFICENCE
confidential. Do Good Do NOT cause
7. The patient has the right to expect harm
that, within its capacity, the Act in a way that PREVENT harm
hospital must provide a reasonable benefits patients
response to his her request for Centerpiece of REMOVE harm
services. caring
Closely related to More binding than
8. Right to obtain info regarding any
nonmaleficence beneficence
relationship of his hospital to other
What is good? Because you’re
health care and educational
going beyond just
institutions in so far as his care is trying to do good
concerned. to that pt, you’re
9. The patient has the right to be trying to prevent
advised if the hospital proposes to harm.
engage in or perform human telling, honesty.
experimentation affecting his/her
care of treatment. Right to refuse BENEFICENCE & NONMALEFICENCE
to participate in such research
projects.  The principle and obligation of
10. The patient has the right to expect doing good and avoiding harm
reasonable.  This principle counsels a provider
11. The patient has the right to to relate to clients in a way that
examine and receive an will always be in the best interest
explanation of the hospital bill, of the client, rather than the
regardless of source of payment. provider
12. Patient has the right to know the
hospital rules and regulations FIDELITY
apply to his/her conduct as a  Strict observance of promises or
patient. duties
 This principle, as well as other
PRIVACY/ CONFIDENTIALITY
principles, should be honored by
 Respecting privileged knowledge both provider.
  Duty to be faithful to  Some actions can be morally
commitments justified even though consequence
 Make a promise, follow through: may be a mixture of good and evil.
o Includes implicit and  Must meet 4 Criteria:
explicit promises o The action itself is morally
o Implicit- promises that are good or neutral.
implied, not verbally o The agent intends the good
communicated effect and not the evil (the
o Explicit- promises that are evil may be foreseen but
explicitly communicated. not intended)
o The good is not achieved by
JUSTICE the evil
 The principle that deals with o There is favorable balance
fairness, equity and equality and of good over evil.
provides for an individual to claim
that to which they are entitled. PRINCIPLE OF LEGITIMATE COOPERATION
o Comparative Justice:  Principle of Common Good and
making a decision based on Subsidiarity.
criteria and outcomes. Ie:
How to determine who PRINCIPLES OF BIOETHICS
qualifies for one available
kidney. 55 year old male
Principle of Stewardship
with three children versus a
 Stewardship requires us to
13 year old girl.
appreciate the two great gifts that
o Non-comparative Justice:
a wise and loving God has given:
ie: a method of distributing
the Earth, with all its natural
needed kidneys using a
resources and our own human
lottery system.
nature, with its biological,
o Treat alike cases alike
psychological, social, and spiritual
o Distributive justice: refers
capacities.
to distribution of benefits
 This principle is grounded in the
and burdens
presupposition that God has
o Equally disbursed according
absolute Dominion over creation,
to:
and that in so far as human beings
 Need
are made in God’s image and
 Effort
likeness (Imago Del), we have
 Societal Contibution
been given a limited Dominion
 Merit
over creation and are responsible
 Legal Entitlement
for its care.
OTHER RELEVANT ETHICAL PRINCIPLES

DOUBLE EFFECT
Principle of Totality and Integrity procedures, and technology that
 These principles dictates that the offer a reasonable hope of benefit
well-being of the whole person and which can be obtained
must be taken into account in without excessive pain, expense or
deciding about therapeutic burden.
intervention or use of technology.  “Extraordinary Means” means to
 Therapeutic procedures that are all medicines treatments,
likely to cause harm or undesirable procedures and technology that
side effects can be justified only by do not offer a reasonable hope of
a proportionate benefit to the benefit or cannot be obtained or
patient used without excessive pain,
 The Principle of Totality expense or burden.
o An individual may not
Principle of Personalized Sexuality
dispose of his organs or
 Takes not of a humanized
destroy their capacity to
sexuality, one that represents the
function, except to the
fulfillment of physical and sensual
extent that this is necessary
need but also evidenced with love
for the general well-being
and sacramental mystery.
of the whole body.
o Destroying an organ or
interfering with its capacity
to function prevents the
organ from achieving its
natural purpose.
 Integrity refers to each individuals
duty to “preserve a view of the
whole human person in which the
values of the intellect, will,
conscience and fraternity are pre-
eminent”
 Totality refers to the duty to
preserve intact the physical
component of the integrated
bodily and spiritual nature of the
human life, whereby every part of
the human body “exists for the
sake of the whole as the imperfect
for the sake of the perfect”.

Principle of Ordinary and Extraordinary

Means
 “Ordinary means” are all
medicines, treatments,