• NCM 108

Ethics in Health Care

Gil Benedict C. Llamelo, RN
Bulacan State University –College of Nursing
 Why study Bioethics?
1) Able to do the do’s and don’t’s
2) Legal Dimension
3) Facing issues, dilemmas and problems
4) Challenges of Technology
5) To enrich one’s competence by understanding that patient is a
person and holistic individual
6) To make clear to us why one act is better than the other
7) Enable us to live and have an orderly way of life
Human GROWTH AND DEVELOPMENT
Gil Benedict C. Llamelo,RN
Health Occupations
Bachelor of Science in Nursing
 7 LIFE STAGES
• Infancy: BIRTH TO ONE (1) Year
• Early Childhood: 1-6 years
• Late childhood: 6-12 years
• Adolescence: 12-18 years
• Early Adulthood: 19-40 Years
• Middle Adulthood: 40-65 Years
• Late Adulthood: 65 Years and Older
 Growth and development
• Growth – the measurable physical changes that occur
throughout a person’s life.
examples: height, weight, body shape, dental structure (teeth)

• Development – Refers to the changes in intellectual, mental

and emotional skills that occur over time. Think, maturation.
A health care worker must be aware of the various life stages and of individual needs to provide
quality health care.
 Four main types of growth and development
• 1. Physical – body growth that includes height and weight
changes.
• 2. Mental – intellectual development, problem solving
• 3. emotional – refers to feelings and includes dealing with love,
hate, joy, fear, excitement, and other similar feelings.
• 4. social – refers to interactions and relationships with other
people.
 Erik erikson
• A psychoanalyst who identified eight stages of psychosocial
development. He believes that as people move through eight
stages of development, they must overcome a conflict. If an
individual is not able to resolve that conflict at that appropriate
age, the individual will struggle with that same conflict later in life.
An example is a toddler who is not allowed to learn and become
independent by mastering basic tasks, the toddler may develop a sense of
doubt in his abilities. (autonomy vs. shame and doubt)
See table 8-1 in text for examples of each stage
Infancy – birth to 1 year
 Infancy – birth to 1 year
• Physical development: The most dramatic and rapid changes in
growth and development happen during the first year of life.
• Mental development: infants make their needs known by
crying. They cannot speak yet, but are able to understand some
words by six months old. By one year, they understand many
words and use single words in their vocabulary.
• needs: infants are dependent on others for all their needs. Love
and security are essential for emotional and social growth.
Stimulation is essential for mental growth.
Early childhood 1-6 years
 Early childhood 1-6 years old
• Physical: By age 6, the average weight is 45lbs and the average height is 46
inches. Muscle coordination allows the child to run, climb, and move
freely. Children learn how to write, draw and use a fork and knife. By 2-4
years, most children learn bowel and bladder control.
• Mental: Develops rapidly. Vocabulary grows from using several words at
age one to 1,500-2,500 words by age 6. By age 6 most children want to
learn how to read and write.
• Emotional: “terrible twos”-children become frustrated when they cannot
perform as desired. They can become stubborn.
• Needs: still include food, rest, shelter, love, and security. They must learn
to be responsible and to follow rules. This is accomplished by making
reasonable demands based on the child’s ability.
Late childhood 6-12 years
 Late childhood 6-12 years
• Physical: Also known as preadolescence. Most of the baby teeth
are lost and permanent teeth erupt. During ages 10-12, secondary
sexual characteristics may begin to develop in some children.
• Mental: Rapid because child is in school.
• Emotional: Fears surrounding starting school are brought under
control. By ages 10-12, sexual maturation and body changes can
lead to periods of depression followed by periods of joy.
• Needs: The same as infancy and early childhood but now peer
acceptance is added.
Adolescence 12-18 years
 Adolescence 12-18
• Physical: physical changes ae most dramatic in the early period. Growth
spurts occur that can affect coordination. Puberty occurs where secondary
sexual characteristics and sexual organs mature. Sexual characteristics include
development of pubic hair, facial hair for males, and breasts for females.
• Mental: growth primarily involves increase in knowledge and sharpening of
skills. Conflict occurs when adolescents are treated both as children and
adults, or told to ‘grow up’ while being reminded that they are ‘still children’.
• Emotional: often stormy and in conflict. Trying to establish independence and
identities.
• Social: spending more time with friends than family. Seek security in groups
of people their own age.
• Needs: In addition to basic needs, adolescents need reassurance, support and
understanding. Eating disorders and chemical abuse may occur if adolescents
experience feelings of inadequacy or insecurity.
Early adulthood 19-40 years
 Early adulthood 19-40
• Physical: Usually the most productive life stage. Physical development is
basically complete. This is the prime time for childbearing.
• Mental: formal education continues, young adults may choose to marry
and start families.
• Emotional: may experience stress related to careers, marriage, family.
• Social: development frequently involves moving away from peers to
association with coworkers and mates. Young adults do not necessarily
accept traditional sex roles and adopt nontraditional roles. For example,
males may become nurses or secretaries, females may take administrative
or construction positons.
Middle adulthood 40-65
 Middle adulthood 40-65
• Physical: changes begin to occur. Hair begins to gray and thin,
skin begins to wrinkle, hearing loss starts, vision declines, and
weight gain occurs.
• Mental: mental ability can continue to increase. This is a
period when individuals understand life and have learned to
cope with many of its stresses.
• Emotional: can be a period of contentment or crisis. Emotional
status varies depending on life changes revolving around
children growing up and leaving home, job satisfaction,
financial success, good health.
Late adulthood 65 years and older
 Late adulthood 65 years and older
“elderly”, “senior citizen”, “golden ager” , “retired citizen”
Physical: physical development are on the decline. All body systems are affected. Skin
becomes dry, wrinkled, and thinner. Hair becomes thin and bones become brittle and more
likely to break. Muscle loses tone, nervous system can cause intolerance to temperature
changes.
Mental: mental abilities vary among individuals. While some elderly people continue to
learn, others have mental declines that can affect short-term memory. MANY INDIVIDUALS
CAN CLEARLY REMEMER EVENTS THAT OCCURRED 20 YEARS AGO, BUT DON’T REMEMBER
YESTERDAY’S EVENTS. DISEASES SUCH AS ALZHEIMER’S DISEASE CAN LEAD TO IRREVERSIBLE
LOSS OF MEMORY, INTELLECTUAL FUNCTION, SPEECH, AND DISORIENTATION.
EMOTIONAL: VARIES DEPENDING ON INDIVIDUAL’S ABILITY TO COPE. SOME REMAIN HAPPY
AND ENJOY LIFE, WHILE OTHERS MAY BECOME LONELY, FRUSTRATED, DEPRESSED AND
WITHDRAWN.
NEEDS: IN ADDITION TO THOSE OF ALL OTHER LIFE STAGES, THE ELDERLY NEED A SENSE OF
BELONGING, SELF-ESTEEM, FINANCIAL SECURITY, SOCIAL ACCEPTANCE, AND LOVE.
Principles of Development
• Early foundations are critical
• Development and learning results from interactions of heredity and environment
• Development proceeds in definite and predictable directions
• There are individual differences in development
• Each phase of development has hazards
• Development is aided by stimulations
• Domains of children’s development – physical, social, emotional and cognitive are
closely related
• Development is affected by cultural changes
• There are social expectations for every stage of development
 Issues on Human Development
• 1) Nature and Nurture
• 2) Continuity Vs. Discontinuity
• 3) Passivity vs. Activity
• 4) Early Experience Vs. Later Experience
 Needs and Values
• NEEDS are the things that we always get to survive. We may
not have the same needs but we have one goal in achieving it
everyday, and that is TO LIVE!  But living is not all about
consumption, because we have to LIVE WITH VALUES!
 Values
• Comes from latin word, valere which means to be strong,
worthy
• Freely chosen, enduring beliefs or attitudes about the worth
• Important because they heavily influence decisions and actions
• Heavily influences by:
– Culture, religion, family and peer