ETHICS & BIOETHICS
ETHICS
• is a practical and normative science, based on
reason, which studies human acts and provide norms
for their goodness or badness
• likewise known as moral philosophy, moral rectitude
or the rightness and wrongness of human acts
ETHICS
a. PRACTICAL SCIENCE
• ethics deals with a systematized body of knowledge
that can be used, practiced and applied to human
action
• considers the usefulness, practicality and application
of human knowledge, which is simply interested in
truth for its own sake, without any bearing on action
and experience
b. NORMATIVE SCIENCE
• ethics establishes norms or standards for the
direction and regulation of human actions
ETHICS
• How can one determine whether one is acting
rightly or wrongly? Is there a norm of good and
evil? (Ethics attempts to resolve these questions.)
• Investigates the facts, analyzes them and draws
from them practical applications to particular
actions.
• Does not subscribe to, nor will it rely on, so
called “divine revelation” for the final answers
or resolutions of certain moral issues.
ETHICS
• DIVINE REVELATION: refers allegedly to
certain knowledge revealed by God to humans,
knowledge which we cannot fully understand,
but which we have to accept as true because
God said so and because we know that God
can neither deceive us nor be deceived by us
• RELIGIONIST: contends that there can be no
morality without God
• ETHICIAN: maintains that morality remains
possible even without God
Types of ETHICS
1. GENERAL ETHICS
• Diverse ethical formulations of general and
universal concepts and principles which
serve as the foundation of morality
• Raises the problem of moral norms and
attempts to formulate and defend a system
of fundamental ethical perceptions that
settle which acts are and which are evil
• Also known as normative ethical inquiry
Types of ETHICS
1. APPLIED ETHICS
• Specifies the particular situations in life in
which they are valid and legitimate
• Also known as special ethics
• PROFESSIONAL ETHICS: deals with
certain moral precepts or rules by which
persons behave and act in the exercise
of their calling or profession
• BIOETHICS
BIOETHICS
• Comes from the Greek word “bios” = ethics of life
• Ethics of medical care
• Investigates practices and developments in the life
sciences and/or biomedical fields
• Study of ethical issues and values not only in
medicine and biology but also in the behavioral
sciences
• Primary and major predicaments are from life,
health, and death resulting from modern biological
technology
EVOLUTIONARY PHASES OF BIOETHICAL STUDIES
1. Medical Ethics
• Oldest phase of bioethical exploration which is a
formulation of ethical norms for the conduct of
health care professionals in the treatment of patients
• Example: Hippocratic Oath (named after
Hippocrates)
Hippocratic Oath
• Physician’s all-out concern for the patient to be kept
from harm and injustice
• The physician should not prescribe a fatal drug to
anyone even if asked to do so nor suggest that fatal
drugs to be taken
• Rules out the practice of abortion and sexual
relations between doctors and patients, be may
male or females, rich or poor, free or slaves
• Moral significance of confidentiality or medical
secrecy
2. Research Ethics/Biomedical Research
• Second phase in the development of bioethical study
• Refers to the use of humans as experimental
specimens (e.g. prisoners, poor patients, children and
fetuses)
3. Public policy
• Third stage in the development of bioethical inquiry
• Accentuates the participatory aspect of decision-
making in a democratic set-up with regard to the
formulation of public policies for the benefit of all
• Refers to people’s efforts or involvement in
formulating public guidelines for both clinical cases
and biomedical research
• Done through surveys, meetings, conferences,
convocations
DOMINANT THEMES IN BIOETHICAL INQUIRY
1. Principle of Beneficence
• Practice of doing acts of goodness, kindness and
charity
• “Do not harm and produce good” or “Do good and
do no harm”
• Healthcare professionals should take care not to
compound or aggravate the ill patient’s condition by
causing further injury
• Example: If a fetus is detected to be deformed or
defective, would you be doing it more good than
harm by aborting it?
2. Principle of Autonomy
• Marks the significance of individual autonomy which
mandates a strong sense of personal responsibility
for one’s own life
• Every person is autonomous, in which case one should
choose what one wishes to be and should take
responsibility for that choice
• Right to self-determination giving emphasis to the
moral right of an individual to determine what is
good for himself/herself
• Example: Unique burden of women in pregnancy
and childbearing
3. Principle of Justice
• Rendering of what is due or merited
• Example: awarded a BS Medical Technology
degree
oAwarding the degree is just because it is
due to the individual; receiving the degree
is just because the individual merits or
deserves it
3. Principle of Justice
a. COMPARATIVE JUSTICE
• an individual or group receives is
determined by balancing the competing
claims of other individuals or groups
• Kidney transplant to dying renal failure
patient or to patient who has just been
diagnosed?
3. Principle of Justice
b. NONCOMPARATIVE JUSTICE
• distribution of medical goods is determined
by a certain standard rather than buy the
needs or claims of individuals
• “First come, first served”
• But suppose a 10-year old is more likely
to benefit a medical procedure than a
90-year old. Should the latter be
served first, since the patient arrived
first?
TELEOLOGICAL & DEONTOLOGICAL ETHICS
TELEOLOGICAL
• stresses the end-result, goal or consequence
of an act; also called consequential ethics
DEONTOLOGICAL
• stresses duty as the norm of moral actions;
also known as duty ethics
ETHICAL SCHOOLS OF THOUGHT
1. Ethical Relativism
• Also known as moral relativism
• No universal or absolute moral principles
• Standards of right and wrong are always relative to
a particular culture or society
• Example: Jehovah’s Witnesses refused blood
transfusions
2. Situation Ethics
• By Joseph Fletcher (an American Protestant medical
doctor)
• Legalism: prescribes certain general laws or norms
Antinomianism: frees the Christian from the
obligations of the moral law
Situationism: moral norm depends upon a given
situation, but whatever situation may be, one must
always act in the name of Jesus Christ
3. Pragmatism
• By Charles Peirce and William James
• More of the theory of knowledge, truth and
meaning than of morality
• Holds that the true and valid form of knowledge is
one which is practical, workable, beneficial and
useful
• Example: determine which contraceptive method is
the most effective
4. Utilitarianism
• By Jeremy Bentham and John Stuart Mill
• The righteous and wrongness of actions is
determined by the goodness and badness of their
consequences
• Principle of utility: “Actions are good insofar as
they tend to promote happiness, bad as they
produce unhappiness”
• Examples:
i. Children aging ten years old and below are
not allowed to visit patients
ii. Visiting hours are from 7:00am to 9:00pm
5. Kant’s Ethics
• By Immanuel Kant
• Maintains that one acts morally of and only if one
does whatever one is obliged to do
• A doctor who performs his/her job out of the mere
desire to do so is not acting morally. It is only when
he/she recognizes the duty to cure a patient that
he/she is genuinely a moral person
6. Ross’s Ethics
• By William David Ross
• There are some exceptions for every rule
• 7 types of prima facie duties:
1. Duty of fidelity
• Faithful to our duties and obligations (loyalty)
2. Duty of reparation
• “Kung nakagawa ka ng masama, gumawa ka ng
mabuti.”
3. Duty of gratitude
• Appreciate and recognize the services others
have done for us
6. Ross’s Ethics
4. Duty of justice
• Proper distribution of social benefits and burdens
5. Duty of beneficence
• Contribute whatever small way we can to others
6. Duty of self-improvement
• Improve and develop ourselves with respect to
virtue, intelligence and happiness
7. Duty of nonmaleficence
• Not injuring others
• “Ang masakit sa iyo ay huwag mong gawin sa
kapwa mo.”
7. Rawl’s Theory of Justice
• By John Rawls
• The greater good to be shared by all members should
not be used to justify the loss of freedom of others
• Individual rights are not subject to political bargaining
or compromise
i. “Walang palakasan.”
ii. “Pagbibigayan ang kailangan. Walang
lamangan.”
• Example: land grabbing and killings perpetuated by
the powerful and influential against the peace-loving
citizens in the Cordilleras
8. Natural Law Ethics
• After St. Thomas Aquinas (Thomistic/Scholastic ethics)
• “Do good. Avoid evil” through the voice of right
reason or conscience
• 3 determinant of moral actions:
i. Object
• Either a thing (money) or action (surgical
operation)
ii. Circumstances
• Conditions which are superadded to the nature
of moral act
8. Natural Law Ethics
iii. End product
• Affects the goodness or badness of an action or
decision in a number of important ways
• A good act with a bad motive makes the moral
action bad
• Example:
a. to inject a lethal drug into a terminally ill
patient
b. human experimentation
c. allow babies suffering from serious birth
deformities to die (wrong)
d. abortion and use of contraception (wrong)
PATIENT’S RIGHTS
• refers to the moral and inviolable power vested in
him/her as a person to do, hold or demand
something as his own
1. Right to informed consent
• Right to receive all necessary information concerning
diagnosis and treatment
• Refers to knowledge and information about the consent
to a particular for of medical treatment
1. Right to informed consent
• Major elements:
1. COMPETENCE
o Patient’s capacity for decision making
o One can choose between alternatives
o One can justify one’s choice
o One does not only justify one’s choice but does so in a
reasonable manner
2. DISCLOSURE
o Content of what a patient is told or informed about
during the consent negotiation
3. COMPREHENSION
o Whether the information given has been understood
4. VOLUNTARINESS
o Means that consent must be voluntary
1. Right to informed consent
• Types of patients that requires informed consent:
a. Comatose patients
b. Blind or illiterate patients
c. Underaged patients or those who are
unable to understand the circumstances
d. Language-barrier patients
NOTE: Parents, immediate relatives, guardians or
next of kin should be informed.
2. Right to informed decision
• Information and understanding are necessary for
genuine deliberation
2. Right to informed choice
• Refers to the necessary information a patient
should know about a medical treatment or
experiment
Other rights:
4. Right to considerate and respectful care
5. Right to obtain from his physician complete
current information concerning diagnosis,
treatment and prognosis
6. Right to refusal of treatment
7. Right to confidentiality of results
8. Right to expect reasonable continuity of care
9. Right to examine and receive explanation of the
hospital bill
10. Right to know the hospital rules and regulations
“ The diversity of moral theories is an explicit
acknowledgement of the complexities of life, and
of the grey areas in the moral realm. We should
therefore take the competition, or even conflict,
among the ethical schools of thought not only as
challenges for further reflection and discernment,
but also as grounds for further refinement and
improvement, thus honing the critical mind to
continue searching for new horizons of human
meanings and values.
Further, in dealing with moral issues, it is better
to have certain moral principles by which to act
and make moral decisions, than to do so rather
than on mere impulse, inclination and self-interest.
Admittedly, in situations in which a high premium
is placed on our moral decisions, as is often the
case in medical-moral matters, being able to
explain, support and justify our decisions is of
paramount importance. At the end of the day,
choosing what particular theory over another is a
matter of individual preference yet, after all,
WE ARE ALL RESPONSIBLE FOR OUR OWN ACTION.”
DOUMO
ARIGATOU
GOZAIMASU!
