NCM 103 HEALTH CARE ETHICS
ETHICS There are no universal or absolute moral
principles.
A practical and normative science based on reason
Standards of right and wrong are always
which studies human acts and provides norms for
relative to a particular culture or society.
their goodness or badness.
Deals with morality, moral rectitude or the rightness SITUATION ETHICS
and wrongness of human acts.
SIX PROPOSITIONS
Does not subscribe to, nor will it rely on, so-called
Only one things is intrinsically good, namely
“Divine Revelation” for the final answers or
love, nothing else.
resolutions of certain moral issues.
The ultimate norm of Christian decisions is love,
THREE ETHICAL POSTULATES nothing else.
Love and justice are the same, for justice is love
1. HUMAN FREEDOM
distributed.
2. IMMORTALITY OF THE SOUL
Only the end justifies the means, nothing else.
3. GOD
Decisions ought to be made situationally, not
TELEOLOGICAL ETHICS
prescriptively.
Teleological from Greek telos, “end”; logos,
PRAGMATISM
“science”
The true and valid form of knowledge is one
Theory of morality that derives duty or moral
which is practical, workable, beneficial and
obligation from what is good or desirable as an
useful.
end to be achieved.
UTILITARIANISM
DEONTOLOGICAL ETHICS
Is a theory in normative ethics, or the ethics
From Greek deon, “obligation”; “duty”
that define the morality of actions, as
It is the normative ethical theory that the
proposed by Jeremy Bentham and John Stuart
morality of an action should be based on
Mill.
whether that action itself is right or wrong
The greatest happiness states that a moral
under a series of rules, rather than based on
action is one that maximizes utility, or
the consequences of the action.
happiness, for the greatest number of people.
It is sometimes described as duty-, obligation-
or rule-based ethics. KANT’S ETHICS
Action is more important than the
Immanuel Kant
consequences.
For one to act morally if and only if one does
ETHICAL RELATIVISM whatever is obliged to do.
Performed or done from a sense of duty or
obligation.
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NCM 103 HEALTH CARE ETHICS
Physician who performs his/her job out of John Rawl
mere desire to do so VS physician who “Everyone is fair to everyone else in the
recognizes the duty to care. hypothetical community, living ‘under the veil
Act done in accord with duty and act done of ignorance’, the so-called original positon.”
from a sense of duty. Theory of Justice
The essence of morality is to be found in the “Every individual is inviolable”
motive from which an act is done – regardless The greater good to be shared by all
of the consequences it will produce. members should not be used to justify the
One must judge his action according to the loss of freedom of others.
concept of universalizability by means of the An erroneous theory is tolerable in the
categorical imperative. absence of a good one.
Categorical imperative – mandates an action Principles of Justice
without any conditions whatsoever, and Equal access to the basic human rights and
without regard to the consequences that such liberties
an action may yield. Fair equality of opportunity and the equal
No one should be treated as only a means but distribution of socio-economic inequities
always an end. Justice in Human Relations
Fairness in our dealings with others
ROSS’ ETHICS
Fidelity
William David Ross Respect for Persons
Actual Duty VS Prima Facie Duty Beneficence
Rely on our moral institutions Natural Duties
Learn and discern the facts in the case. Duty of justice
Consider the possible consequences of our Duty of helping others in need or in
actions. jeopardy
Reflects on our prima facie duties. Duty not to harm of injure others
Decide on the best course of action under Duty to keep our promises
the circumstances.
NATURAL LAW ETHICS
Duty of Fidelity
Duty of Reparation St. Thomas Aquinas
Duty of Gratitude Thomistic Ethics
Duty of Justice The source of moral law is reason itself – Do
Duty of Beneficence Good, Avoid Evil.
Duty of Self-Improvement Voice of Right Reason or Voice of
Duty of Non-Maleficence Conscience
What is good?
RAWL’S THEORY OF JUSTICE
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NCM 103 HEALTH CARE ETHICS
That which is suitable to or proper for Principle of Totality
human nature. The individual has the right to cut off,
Three Natural Inclinations mutilate, or remove any detective or
o Self – preservation worn-out non-functioning part of his
o Just Dealing with Others body; to dispose of his organs or to
o Propagation of our Species destroy their capacity to function only
Three Determinants of Moral Action in so far as the general well-being of
The Object the whole body requires it.
The Circumstances Principle of Stewardship
o Who? Principle of Inviolability of Life
o What? Principle of Sexuality and Procreation
o Where? Procreation and nurturing of children
o By What Means? Expression of loving union and
o Why? companionship
o How? VIRTUES ETHICS
o When?
VIRTUES
The End of the Agent
Refer to specific traits
The Double Effect Principle
Become apparent through one’s behavior and
A situation in which a good effect and an
are obviously linked to ethical principles.
evil effect will result from good cause.
The ability to respond to ethical dilemmas then
Four Conditions
becomes hinged upon one’s character.
o The action directly intended must be
For example, a nurse might conclude that all
good in itself or at least morally
terminally ill patients are naturally depressed…
indifferent.
However, no matter how difficult, the nurse’s
o The good effect must follow from the
ethical duty is to advocate for patients. This
action at least as immediately as the
requires the virtues of integrity, respect, caring
evil effect; or the evil effect may follow
and courage.
from the good effect.
EXAMPLES
o The foreseen evil effect may not be
A favorite neighbor of yours is admitted to
intended or approved, but merely
your unit with a life-threatening condition.
permitted to occur.
When a mutual friend asks about his status.
o There must be proportionate and
What should you say?
sufficient reason for allowing the evil
An older patient admits that she’s agreed to
effect to occur while performing the
have a surgery in a few hours because her
action.
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NCM 103 HEALTH CARE ETHICS
daughter wants her to have it, not because she through diagnosis and treatment, but humility
want it. What should you do? should also be your companion.
4. ACCOUNTABILITY
FOUR PRIMARY OBLIGATIONS BETWEEN NURSE AND
Professional nursing values wouldn’t be
THE PUBLIC
complete without accountability. Thomson
1. Respecting the patient’s privacy and protecting stresses the importance of taking ownership
confidentiality. over your practice, including every mistake,
2. Communicating honestly about all aspects of the error in judgment or failure to communicate.
patient’s diagnosis, treatment and prognosis.
3. Conducting an ethically valid process of informed 5. CURIOSITY
consent. Nursing knowledge encompasses all the
4. Advocating for the patient’s expressed interests theories, philosophies, and research and
or best interests. practice wisdom of the nursing profession. You
SIX VIRTUES IN NURSING should never stop learning.
1. Professional competence ETHICAL PRINCIPLES
2. Honesty and integrity 1) AUTONOMY
3. Caring and compassion Is a term used to describe a person’s or
4. Fairness and justice government’s ability to make decisions, or speak
5. Respect and self-respect and act on their own behalf, without interference
6. Courage from another party.
CORE VALUES OF A PROFESSIONAL NURSE Although it is used in many different contexts,
autonomy is most often an important element of
1. COMPASSION
political, philosophical and medical conversations.
Compassion encompasses empathy, caring and
the promotion of each patient’s dignity. INFORMED CONSENT
2. TRUSTWORTHINESS Permission granted in the knowledge of the
Nurses are among the most trusted groups of possible consequences, typically that which is
people, making trustworthiness one of the given by a patient to a doctor for treatment
most essential nursing values and vital to your with full knowledge of the possible risks and
integrity and ethical behavior. benefits.
3. HUMILITY Four Components of Informed Consent
Nursing is one of the most rewarding, fulfilling Capacity (or ability) to make the decision
career paths. With it comes a wealth of Full disclosure
medical knowledge and skills that allow you to Comprehension on relevant information
facilitate healing and alleviate suffering Voluntary
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NCM 103 HEALTH CARE ETHICS
Legally Authorized Representative/Proxy 8) NON-MALEFICENCE
Consent Means non-harming or inflicting the least harm
Is an individual who, under law, has the possible to reach a beneficial outcome.
ability to act on behalf of another person
(such as a minor study participant). The
LAR may be a parent, grandparent,
caregiver who has the legal authority to
grant consent on behalf of another who
has been invited to participate in research.
2) PRIVACY
Is a state when a person is free from public
interference.
3) CONFIDENTIALITY
The state of keeping or being kept secret or
private.
Refers to a state when it is intended or expected
from someone to keep the information secret.
4) VERACITY
Is defined as being honest and telling the truth.
It is the basis of the trust relationship establish
between a patient and a health care provider.
5) FIDELITY
Refers to one’s loyalty to a worthy cause, telling
the truth, keeping actual and implicit promises
and not presenting fiction as truth.
6) JUSTICE
Refers to everyone having an equal opportunity.
This principles seeks eliminate discrimination in
biological studies and healthcare.
7) BENEFICENCE
Is an ethical principle that addresses the idea that
a nurse’s actions should promote good.
Refers to the actions that promote the wellbeing
of others.
