NCM 108 (BIOETHICS) – MIDTERM REVIEWER

BIOETHICS AND ITS APPLICATION IN WHY STUDENT HAVE TO UNDERSTAND

VARIOUS HEALTH CARE SITUATIONS HUMAN SEXUALITY?
 To gain insight into their own
A. SEXUALITY AND ITS MORAL sexuality.
EVALUATION  To become comfortable with their
sexuality
1. HUMAN SEXUALITY AND ITS  To be able to understand and accept
MORAL EVALUATION their clients.
 Human Sexuality – is the way ISSUES:
people experience and express  Premarital sex
themselves sexually.  Masturbation
 It involves biological, erotic,  Sexual desires and practices
physical, emotional, social, or  Sexual orientations
spiritual feelings and behaviors.  Heterosexuality
 Homosexuality
HUMAN SEXUALITY  Bisexuality
 It is the fundamental drives behind one’s  Transexuality
feelings, thoughts and behaviour. It
defines the means of biological, SEXUAL EXPRESSION:
reproduction, describes psychological and  Sexual abstinence – abstaining from
sociological representations of self and sexual acts
orients a person’s attraction to  Erotic stimulation – using of visual
others. materials such as magazines and
 Can be good for your mental health. photographs for sexual arousal.
 Human sexuality becomes the language  Fetishism – using objects or
of love and it’s considered as one of the situations for sexual acts
deepest forms of human communications.  Transvestism – individual who
 Human sexuality plays a major role in dresses in the clothes of the opposite
everyone’s life. sex
 Sexuality is an integral part of our  Voyeurism – obtaining sexual arousal
personalities. by looking at another person’s body
 Sadomasochism – sadism (the
WHY STUDY HUMAN SEXUALITY? person inflicting pain) masochism
(the person receiving pain to achieve
 It is a primary source of motivation. sexual satisfaction
 It is about relationships, not just  Exhibitionism – revealing one’s
engaging in sexual act. genitals in public
 It includes:  Bestiality – sexual relations, having
 Feelings of attraction towards sex with animals
others  Pedophiles – sex with children
 Intimacy with others
 Feelings related to body image MARRIAGE
 Personal values  A lifetime contract with a spouse as
ministers.
 A school and source of life.
 An institution of the natural law; not
just a social.
 A sacrament a union of three
partners: MAN, WOMAN AND GOD.
1
 NCM 108 (BIOETHICS) – MIDTERM REVIEWER

WHAT IS THE TRUE MEANING OF means that you only accept, but also
MARRIAGE? admire your differences. Respect can also
- A commonly accepted and encompassing help you listen to each other’s opinions
definition of marriage are the following: and overcoming challenges and
A formal union and social and legal disagreements.
contract between two individuals SUCCESSFUL MARRIAGE IS:
that unites their lives legally, 1. Communicate clearly and often
economically, and emotionally.  Talking with your spouse is one of the
Being married also gives legitimacy best ways to keep your marriage healthy
to sexual relations within the and successful. Be honest about what
marriage. you’re feeling, but be king and
WHAT IS THE PURPOSE OF MARRIAGE? respectful when you communicate.
 Image result for MARRIAGE Part of good communication is being a
 Marriage is the beginning – the beginning good listener and taking the time to
of the family – and is a life-long understand what it is your spouse wants
commitment. It also provides an and needs from you. Keep the lines of
opportunity to grow in selflessness as you communication open by talking often, and
serve your wife and children. Marriage is not just about things like bills and the
more than a physical union; it is also kids. Share your thoughts and feelings.
spiritual emotional union. This union 2. Tell your spouse that you’re thankful
mirrors the one between God and his for having him or her in your life. IT
church. IS GIVING SOMEONE – PARTNER A
THREE IMPORTANT ASPECT OF FEELING OF BEING IMPORTANT.
MARRIAGE  Appreciate each other, your relationship,
1. Commitment: Commitment is more than your family, and your lives together.
just wanting to stay together for a long Show gratitude when you and your
time. It’s the act of choosing your partner partner cooks dinner, helps the kids with
for life and promising to go through all of their homework, or does the grocery
its up and down together. And while shopping. It may help to take a few
there may be plenty of fish in the minutes each evening to tell each other
sea, being married means you are at least one thing you appreciate that
wholeheartedly invested in making the day.
relationship last, casting away any doubts 3. Make time for two of you as a couple.
that this just a temporary excitement.  With work and family responsibilities, it
2. Unconditional Love: While most couples can be easy to lose the romance factor.
start out their relationships being in love, Plan special dates, either to go out or just
sustaining that feeling for each other stay at home. If you have children, send
takes effort, sacrifice, and generosity. them on a play date while you relax, talk,
True love means putting your partner first and enjoy each other’s company.
and giving of yourself without expecting 4. Plan for some personal time.
anything in return. It also helps you to  Alone time is just as important as couple
accept each other’s for who you are, flaw, time. Everyone needs time to recharge,
and all, and to forgive each other when think, and enjoy personal interests. That
you fall short. time is often lost when you’re married,
3. Respect: Expressing love, no matter especially if you have kids. Go out with
what heartfelt, doesn’t mean much if friends, take a class, or do volunteer
married partners don’t respect each work, whatever you find enriching. When
other. Respecting your partner for their you’re back together with your spouse,
qualities, thoughts, and capabilities you’ll appreciate each other even more.
2
 NCM 108 (BIOETHICS) – MIDTERM REVIEWER

5. Understand that it’s OK to disagree  Issues on sex outside the marriage

 You won’t agree on everything, but it’s and homosexuality.
important to be fair and respectful doing  Issues on contraception, its morality
disagreements. Listen to your spouse’s and ethico moral responsibility of
point of view. Try not to get angry and nurses.
don’t let yourself become too frustrated.  Contraception is defined as the voluntary
Walk away and calm down if you need to, prevention of contraception by the
then discuss the problem again when positive use of artificial means, which
you’re both in a better frame of mind. hinders the generative cells from uniting
Compromise on problems so that you during sexual act.
both give a little.  Contraception is an action which normally
6. Build Trust impedes the union of the egg and the
 Marriage therapist and research John sperm before, during or after coitus.
Gottman, PhD, has found that criticism, Human life begins at the moment of
contempt, defensiveness, and conception.
stonewalling are serious threats to a  Respect for human life and abortion is
marriage. The more a couple engage evil.
in these destructive activities, the  The sanctity of human life demand that it
more likely they are to divorce. His must be respected and protected
decades of research and of working with absolutely from the moment of
couples have shown that spouses who conception.
stay together know how to fight without  From the first moment of his/her
being hostile and to take responsibility for existence, a human being already
their actions. They are also more likely to possesses the rights of person, among
respond quickly to each other’s wishes to which is the inviolable right of every
make up after fights and repair their innocent being.
relationship. JUSTIFICATION OF CONTRACEPTION
7. Learn to forgive 1. Parenthood and birth are matters of
 Everyone makes mistakes. Your spouse moral and responsibility and intelligent
may hurt your feelings or do something choice.
that upsets you, and that may make you 2. An individual should be the one to
angry, even furious. But it’s important to determine his/her fertility and should be
deal with your feelings, let them go, and able to control his/her fecundity. One’s
move one. Don’t keep bringing up the procreativity should not be left to fate or
past. the blind forces of nature.
3. One should be able to decide how many
Remember: children one is able to bear and support.
To remain committed to your spouse, your ARTICLE 11, SEC. 12 OF THE 1986
family and the life that you have built CONSTITUTION
together. Support each other emotionally Provides that “The state be recognizes
and in everyday ways. You, your spouse, and that sanctity of life and shall protect and
your relationships may grow and change strengthen the family as a basic
with time, but these ideas can help your autonomous social institution. It shall
marriage stay successful over the years. equally protect the life of the mother
and the life of the unborn from
conception.”

3
 NCM 108 (BIOETHICS) – MIDTERM REVIEWER

MEDICAL ETHICS AND CONTRACEPTION Yet surrogate motherhood is fundamentally

 What ethical issues do doctors or other moral in the sense that it helps infertile
medical professional face when giving on women to have a family. It is the right of
contraceptive advice? every couple to have their own child. Yet
 Their primary concerns should always be some females are infertile or face other
the welfare of the patient concerned. medical problems that make it impossible for
This goes hand in hand with respecting them to have a baby.
the autonomy of the patient, the
nurse/doctor. Must respect the patient’s MORALITY OF ABORTION, RAPE AND
right to make their own decisions, which OTHER PROBLEMS RELATED TO
means the nurse/doctor should provide ESTRUCTION OF LIFE.
the method patient prefers unless there is
medical reason not to do so. I. ABORTION: human life is scared because
conception from the beginning already
THE PRINCIPLE OF INFORMED CONSENT involves the creative action of God. Human
REQUIRES DOCTOR AND THE NURSE TO life is endowed with majesty and dignity
MAKE SURE THAT THE PATIENT IS AWARE which calls for an equally dignified response.
OF AND HAS GENUINELY UNDERSTOOD THE We owe human life respect and reverence.
HAZARDS AND BENEFITS OF VARIOUS
METHODS OF CONTRACEPTION. MORALITY OF ABORTION
 It is the expulsion of a living fetus from
ISSUES ON ARTIFICIAL the mother's womb before it is viable
REPRODUCTION, ITS MORALITY AND
ETHICO-MORAL TYPES OF ABORTION:
RESPONSIBILITY OF NURSES 1. NATURAL - Expulsion through an
accident /spontaneous or miscarriage.
I. ARTIFICIAL INSEMINATION: 2. DIRECT OR INTENTIONAL -
ARTIFICIAL INSEMINATION (AI) is a fertility deliberately terminating the pregnancy.
procedure in which prepared sperm (washed 3. THERAPEUTIC/INDIRECT - medical
sperm) is inserted into a woman's uterus reasons.
directly, to improve the chances of 4. EUGENIC - recommended in cases
conceiving. This procedure involves the use wherein defects are discovered in the
of sperm that is either fresh (from the developing fetus through a procedure -
partner) or frozen (from the partner or a Amniocentesis
donor).
RAPE
II. IN-VITRO FERTILIZATION -  Rape is a detestable, evil action. The
Fertilization within a glass. Catechism offers a clear moral teaching.
 "Rape is the forcible violation of the
III. SURROGATE MOTHERHOOD: means sexual intimacy of another person. It
substitute in place of another. It is a does injury to justice and charity.
biomedical technique whereby a fertilized  Rape deeply wounds the respect,
ovum is implanted into the uterus of another freedom, and physical and moral integrity
woman who will carry the fetus either as a to which every person has a right. It
favor or for a fee. Termed a "womb for hire causes grave damage that can mark the
or woman for rent or uterus for rent". victim for life. It is always an intrinsically
evil act. Graver still is the rape of children
What is the moral implication of committed by parents (incest) or those \
surrogate motherhood? responsible for the education of the
4
 NCM 108 (BIOETHICS) – MIDTERM REVIEWER

children entrusted to them) Note that go on living with an incurable and

rape is "an intrinsically evil act," meaning distressing sickness.
that it is evil at its very root, nothing
justifies it, and it is objectively a mortal THE NEGATIVE ARGUMENT OF
sin. EUTHANASIA
 If a woman is raped, even though she  Euthanasia erodes human dignity because
may fear exposing herself to shame and it means cowardliness in the face of pain
notoriety, she should seek proper medical and suffering. People who have faced the
care as soon as possible. Such care must realities of life with courage die with
be extremely sensitive and dignity.
compassionate.
CLASSIFICATION OF EUTHANASIA
DIGNITY IN DEATH AND DYING
EUTHANASIA AND PROLONGATION OF 1. Suicidal euthanasia: when a person
LIFE subject himself, resorts to lethal means to
interrupt or suppress his life. Done with a
 Euthanasia is defined as the intentional person's consent.
killing of a dependent human being, by 2. Orthothanasia: Passive death. The
act or omission for his or her alleged legal person is left to die by omitting any medical
benefit. The key word is "intentional" if assistance.
death is not intended then it is not an act 3. Voluntary euthanasia: the person
of euthanasia. requests to be killed.
 Derives from a Greek words "EU" which 4. Non voluntary: when the person did not
means good and "THANATOS" which give consent to be killed.
means death. It signifies "Good death". 5. Euthanasia by action: intentionally
A pleasant and gentle death without awful causing the person's death by performing an
suffering. action such as giving him lethal injection.
 Euthanasia may be defined as an action, 6. Euthanasia by omission: not providing
or omission that by its nature or in the food or water until the person dies.
intention causes death for the purpose of 7. Dysthanasia: dysthanasia is the term for
eliminating whatever pain - major reason. futile or useless treatment, which does not
Financial reasons. benefit a terminal patient. It is a process
through which one merely extends the dying
DEATH AND HUMAN DIGNITY process and not life per se.consequently,
 The issue of death has become more patients have a prolonged and slow death,
complicated than it used to be because of frequently accompanied by suffering, pain
ethical conflict. The moral issue of and anguish.
euthanasia revolves around the
preservation of human dignity in death EUTHANASIA AND ASSISTED SUICIDE
even to the individual's last breath.  Debates on public policy about euthanasia
and assisted suicide profoundly affect
THE POSITIVE ARGUMENT OF family relationships, interaction between
EUTHANASIA: doctors and patients and concepts of
 Aims to preserve human dignity until basic ethical behavior.
death. Not only does one have a duty to
preserve life but one also the right to die
with dignity. To die with dignity means
that one should be able to make decision
to die when dying would be better than to
5
 NCM 108 (BIOETHICS) – MIDTERM REVIEWER

EUTHANASIA AND ASSISTED SUICIDE presented in court. These will serve as

LEGAL? evidences.
• Netherlands and Belgium are the only
places in the world where Euthanasia and PURPOSE OF CLIENT RECORD/CHART
assisted suicde is lawfully permitted. Oregon 1. Communication
permits assisted suicide. 2. Legal documentation - anything done
but was never documented by the nurse in
NURSING ROLE AND RESPONSIBILITIES the chart of the patient is considered not
 Sanctity of human life - in religion and done.
ethics the inviolability or sacntity of life is 3. Research
a principle of implied protection regarding 4. Statistics
aspects of sentient life that are said to be 5. Education
holy, sacred or otherwise of such value 6. Audit and Quality Assurance
that they are to be violated. ethical 7. Planning client care
8. Reimbursement – insurance
CONSIDERATIONS OF THE NURSE:
 Establish facts in a situation SOURCES OF RECORDS
 Decide whether the situation involves  Primary source - patient
legal or ethical issues  Secondary source - family member,
 Identify options and consequences documents/files/ records of the patient.
 Choose the best option
 mplement your decision. GUIDING PRINCIPLES FOR
DOCUMENTATION
ETHICAL CONSIDERATIONS 1. Comprehensive and complete record
1. Informed consent must be clear, concise and accurate and
2. Voluntary participation true record of care.
3. Do no harm -beneficence 2. Must be client centered.
4. Confidentiality 3. Must ensure and maintain confidentiality.
5. Only assess relevant components Alert: Avoid tampering or erasures during
6. anonymity- privacy charting or documenting.

GUIDELINES AND PROTOCOLS IN NUREMBERG CODE

DOCUMENTATION AND HEALTH CARE  Aimed to protect human subjects
RECORDS (patients) from enduring the kind of
o Documentation - serves as a permanent cruelty and exploitation the prisoners
record of client information and care. endured at concentration camps.
Must be keep private and confidential.  Voluntary consent is essential. The
o Reporting- takes place when two or results of any experiments must be for
more people (nurses) share information the greater good of society. The voluntary
about client care, either face to face. consent of the human subject must be
o Alert: telephone orders given by doctors absolutely essential.
are only accepted in cases of extreme
emergency and must be countered signed
by the later within 24 hours.
o Subpoena - the physical presence of the
nurse/doctor must appear in court
o Subpoena Duces Tecum - documents/
records/ files of the patient must be

6
 NCM 108 (BIOETHICS) – MIDTERM REVIEWER

DECLARATION OF HELSINKI - 1964 4. Right to confidentiality

 The world medical association has 5. Right to be protected from harm
developed the declaration of Helsinki to
guide physicians and other health team VULNERABLE SUBJECTS
participants in medical research involving Subjects who are:
human subjects (patients). It is the duty  Mentally ill or legally incompetent such as
of the physician/ nurses to promote and unconscious /comatous, fetuses, mentally
safeguard the health of the people. retarded, minor and geriatric that are
incapable of evaluating the risks involved
THE THREE BASIC PRINCIPLES: and cannot be given consent in the or
1. Respect for persons own behalf.
2. Beneficence - to do kindness and mercy
3. Justice WHAT NURSES SHOULD INFORM
CLIENTS ABOUT?
BELMONT REPORT - 1979 C = current medical status and general
Identifies ethical principles for conducting course of illness
research that involve human subjects and R = risks and benefits of proposed
sets guidelines: treatment.
1. That individuals must be treated with A = alternatives to proposed treatment
respect and treated as autonomous - self- P = proposed treatment rationale. Why is
determination. there a need for such treatment.
2. That persons with diminished autonomy
(vulnerable subjects) are entitled to INFORMED CONSENT
protection.  V = Voluntary. No force or duress or
threat. Free will of the patient.
HUMAN SUBJECTS  I= Informed. Explain properly.
 A human subject is "a living individual  C = Competent, has the capacity. The
about whom an investigator (whether team that will do the procedure.
professional or student) conducting  K = Knowledgeable information provided
research”.  S = Signed prior to pre-op or any
procedures.
GUIDELINES WHEN DURING RESEARCH:
1. Employment in settings where research is IN PLANNING A RESEARCH, PROTOCOL
conducted. MUST CONSIDER:
2. Vigilant protection of human subject’s • Autonomy
rights. • Beneficence - patient and risk calculations.
3. Scope of application • Nonmaleficence - to do no harm
4. Supporting accrual of knowledge - body/ • Confidentiality privacy
group of professional medical team. • Justice
5. Informed consent - secured the family.
6. Representation on human rights
committee.

BASIC HUMAN RIGHTS OF A RESEARCH

SUBJECT OR HUMAN SUBIECT
1. Right to informed consent
2. The right to refuse or withdraw from
participation
3. Right to privacy
7