NCM108_N Health Care Ethics ➢ It is wrong to accept bribe money because it is

dishonesty
Good Ethics, Good Caregiving ➢ Therefore, Rogelio will not accept bribe money,
even if it means less comfort for his family.
Ethics & Bioethics
The study of norms and human acts as guided by Major Ethical Theories:
human reason.
Egoism
Making an Ethical Judgement ➢ Self-interest of the performer of the act
determines the goodness of the act
➢ Self-love

Utilitarian Theory / Utilitarianism

➢ Human act is ethically right if:
➢ It minimizes pain and suffering
➢ It maximizes pleasure
➢ It seeks happiness for as many people as possible

Theory of Deontology
➢ Human acts as ethically right and wrong in so far
as they conform or not to a legitimate duty or
Making an Ethical Judgement responsibility or to the law laid down by legitimate
➢ The human act is ethically good when the act authority.
itself, the intention, and all circumstances ➢ Comparison with utilitarianism:
surrounding it are all good ➢ Pediatric ward staffing
➢ The human act that is good in itself becomes ➢ Utilitarianism: which of the young patients
ethically bad when the intention or even one of the should receive care and attention first?
circumstances is lacking goodness. ➢ Deontologism: feeling of bounded by contract,
➢ The human act that is indifferent in itself (that is, duty, and responsibility to deliver care ➔ how
it is neither good nor bad) becomes ethically good to deliver care and attention fairly and equally to all
when both the intention and all the circumstances the young patients.
are good. When either the intention or even one of ➢ Categorical imperative
the circumstances lacks in goodness, the act
becomes ethically bad. Ethical Relativism (or Subjectivism)
➢ When the human act is in itself intrinsically bad, ➢ What may be considered as ethically right by one
nothing can make it ethically good, not even when individual, by one group, or one society, may not
both the intention and all the circumstances under necessarily so when considered by another
which the act is done are good. individual, by another group, or by another society.
➢ The standard of right and wrong is relative to
Good vs Bad people, to time, and to place.
Reason tells Rudy, a family man of six children, to ➢ There is no absolute standards of right and
seek the wellbeing and comfort of his family. wrong, nor are there intrinsically unethical or
➢ To accept bribe money means more comfort for immoral human acts.
the family
➢ Therefore, Rudy accepts bribe money in his Theory of Proportionalism
function as a public servant ➢ Abstract ➔ absolute moral norms
➢ Concrete ➔ absolute ethical norms may change
Rogelio will not do wrong in his capacity as a under any circumstance
public servant. ➢ Natural Law: Do good, Avoid evil, Do no harm
➢ Concrete Norms: Do not kill, Do not lie, Do not rather than their consequences, guided by rules or
fornicate, etc. ➔ exceptions duties.
➢ Commensuration ➔ if the good results from the ➢ Ethical relativism holds that moral standards are
act is greater than the harm to be caused, the act is not absolute but vary according to culture, society,
ethical, even if the act is in violation of the norm. or individual preference; what is considered right or
wrong depends on the context.
Situation Ethics (Situationalism) ➢ Proportionalism evaluates the morality of an
➢ There is in ethics no absolute rules that bind at all action by weighing its positive and negative
times and in all places because a situation can consequences, seeking a balance where the good
present an exception to the law or to the norm. outweighs the bad.
➢ It is the nature of the situation that determines ➢ Situationalism posits that ethical decisions should
whether an act is good or bad. be made based on the specific context and
➢ If the situation serves love, the act becomes good. circumstances of each situation, rather than
➢ Love Ethics following universal moral rules.
➢ Natural law theory asserts that there are universal
The Natural Law Theory moral principles inherent in human
➢ Not man-made nor has it been laid on man by nature and reason, which can be discovered through
man himself. rational reflection and are fundamental to human
➢ The law is the work of the Creator, placed in the well-being.
nature of the world, man included, so that there is
order and harmony in creation.
➢ The nature of man is body-spirit. The Patient’s Right to Autonomy
➢ The standard of right and wrong in human
behavior originates from the nature of man. ▪ It is of no one’s health or life that is at stake
➢ Good and evil are objective and universal but the individual’s, the responsibility for one’s
health lies in no one but the individual’s.
Summary ▪ Individual’s responsibility = individual’s right
➢ Ethics involves the study of norms governing ▪ Provided:
human actions, guided by reason and focused on ▪ The individual is competent to make decisions /
determining what is right or wrong in human participate freely
behavior. ▪ The right to self-determination
➢ Ethical judgments are based on evaluating the ▪ In the pursue of recovery or wellness, the
moral object (what is done), the intention (why it is individual is placed at a disadvantage.
done), and the circumstances (context) surrounding
the act. The Patient’s Right to Truth
➢ Ethics differentiates between good and bad ▪ In the past, telling the patients the truth about
actions, where good actions align with moral values their medical condition was not a serious
and contribute to well-being, while bad actions concern.
detract from it. ▪ Doctor-knows-best attitude
➢ Egoism is the ethical principle that emphasizes ▪ Patient’s full confidence
acting in one's own self-interest as the primary ▪ Inability of the healthcare provider to explain in
motivation and justification for behavior. less-than-technical language the nature of the illness
➢ Utilitarianism judges the ethical value of actions ▪ A good measure of quality of care
based on their outcomes, specifically aiming to ▪ A good measure of the sensitivity of the
maximize overall happiness or well-being for the healthcare provider
greatest number of people. ▪ Necessary so that a patient can exercise right
➢ Deontologism focuses on the inherent rightness to informed consent
or wrongness of actions themselves,
The Patient’s Right to Informed Consent Why?
▪ The capacity of the of the patient to accept or ▪ Is right to life a human right? Why?
refuse treatment. ▪ Is right to life a legal right? Why?
▪ Requires: ▪ Nurses and other healthcare providers are held
▪ Diagnosis responsible for respecting and according right to the
▪ Prognosis patient so that the patient is able to decide for
▪ Risks him/herself in matters relating to health for the very
▪ Benefits reason that health primarily lies in the individual.
▪ Treatment
▪ Alternatives
▪ The patient has a right to a clear explanation
of all proposed or panned procedures,
including the professional profile of the
personnel involved in the delivery or
performance of treatment procedures
▪ Extends to the surrogate decision maker
The Nurse’s Duty to be Truthful
The Use of Placebos
The Patient’s Right to Confidentiality
▪ Inert medication or preparation that is given to a
▪ Nurse – patient = relationship that requires
patient for its psychological effect.
mutual respect, trust, honesty, and
▪ To satisfy the patient
confidentiality.
▪ It is not ethically justifiable when it is a lie.
▪ Personal information
▪ May be used only under the following
▪ Assures the patient that the information
conditions:
revealed will not be further disseminated to
▪ When the patient positively responds to its use
persons having no responsible concern about
▪ When other options/alternatives are risky or
the patient’s health condition.
ineffective
▪ Respect the patient’s trust!!!
Free from:
▪ Manipulation
▪ Intimidation
▪ Condescension

The Nurse’s Duty to be Truthful

Withholding Information from the Patient
▪ Justifiable when:
▪ There is no good reason to think that telling the
truth or disclosing information would do harm to the
patient, as when the truth drives the despondent
Duties & Responsibilities of Nurses patient to suicide
▪ A right is something that is due to someone. ▪ The patient, due to religious or sociocultural
▪ That something may be by reason of the nature of reasons, prefers not to be told the truth.
that someone. ▪ What would you do if the patient asked you what is
▪ Does an unborn fetus have the right to life? his/her diagnosis?
▪ What would you do if you committed medication The Nurse’s Duty to be Trustworthy
error? The Right of the Public to Safety
▪ What would you do if you witnessed a medical ▪ When there is:
error or mistake by a colleague? ▪ Legal proceeding/inquiry
▪ Administrative proceedings
The Nurse’s Duty to Provide Correct Information ▪ Civil cases
▪ Deal with patients not only honestly, but ▪ Criminal cases
intelligently. ▪ Controversies involving
▪ A clear, complete, and accurate evaluation of the hospitals/healthcare provider
medical treatment/surgical procedure to be
administered/performed, including:
▪ Probable outcome
▪ Financial costs
▪ Side effects / after-effects
▪ Impact on patient’s lifestyle
▪ All other pertinent information

The Nurse’s Duty to be Trustworthy

▪ Precautions on access to patient’s information
▪ All information gathered from patients should be
considered confidential and privileged.
▪ Consent of the patient / surrogate

The Nurse’s Duty to be Trustworthy

The Right of the Public to Safety
▪ When an individual is placed in serious danger, the
nurse and other healthcare professionals are bound Summary
to protect such individual from serious threat or ➢ Patients have the right to make their own
harm, even to the extent of disclosing confidential healthcare decisions based on their values and
information. beliefs, free from coercion.
▪ Homicidal intentions ➢ Patients are entitled to accurate and complete
▪ Physical abuse information about their health, treatment options,
and prognosis, allowing them to make informed
The Nurse’s Duty to be Trustworthy choices.
The Right of the Public to Safety ➢ Before any medical procedure or treatment,
▪ When there is concern for public welfare patients must be given all necessary information to
▪ Epidemics make an informed decision, including risks, benefits,
▪ Pandemics and alternatives.
▪ Spread of other communicable diseases ➢ Patients' personal and medical information must
be kept private, and only shared with those directly
involved in their care or as legally required.
➢ Nurses are ethically obligated to provide honest
and accurate information to patients, contributing to
their ability to make informed decisions.
➢ Nurses must ensure that patients receive all
relevant information regarding their care, including
the nature of their condition, treatment options, and
potential outcomes.
➢ Nurses must build and maintain trust by
consistently acting in the best interests of their
patients and adhering to ethical principles.
➢ The public has the right to expect that healthcare
providers will act in a manner that ensures their
safety, including the proper conduct of medical
procedures and the prevention of harm.