BIOETHICS .1

is the branch of philosophy that studies principles of right and wrong behavior

Ethics

It deals with what people ought to do in terms of fairness, justice, duty, and moral responsibility in personal, social, and professional life.

Ethics

understanding and examining what is “right” and what is “wrong” in biomedical research and practice.

BIOETHICS

A science that deals with the study of morality of human conduct concerning human life in all aspects from the moment of its conception to its natural end.

BIOETHICS

BIOETHICS

Beginning-of-life issues (e.g. abortion, IVF, genetic screening)

End-of-life issues (e.g. euthanasia, palliative care)

Medical decision-making (e.g. informed consent, autonomy)

Biomedical research ethics (e.g. Privacy and confidentiality)

Allocation of scarce medical resources

Emerging technologies (e.g. AI in healthcare, gene editing)

e.g. abortion

Beginning-of-life issues

IVF

Beginning-of-life issues

genetic screening

Beginning-of-life issues

euthanasia

End-of-life issues

, palliative care

End-of-life issues

. informed consent

Medical decision-making

autonomy

Medical decision-making

AI in healthcare

Emerging technologies

gene editing

Emerging technologies

Strongly emphasizes the 4 fold responsibility of the nurse:

1. The universality of nursing practice.

2. The scope of their responsibilities to the people

they serve

3. To their co-workers

4. To society and environment, and to their profession.

5. “promotion of spiritual environment”

In ____, the Code of Ethics promulgated by the PNA was approved by the PRC and was recommended for use.

1989

In 1989, the Code of Ethics promulgated by the ___ was approved by the PRC and was recommended for use.

PNA

In 1989, the Code of Ethics promulgated by the PNA was approved by the ____ and was recommended for use.

PRC

In _____, a new Code of Ethics for Filipino Nurse was adopted

July 14, 2004

and was promulgated by the BON

R.A.9173

-Fully updated under Philippine Nursing Act of 2002

R.A.9173

-Emphasizes not just clinical responsibility, but also advocacy, leadership, research, and public health.

R.A.9173

-More aligned with international nursing standards,

while still grounded in Filipino values and culture.

R.A.9173

provide part of the decision- making foundation when ethics are in play because these theories represent the viewpoints from which individuals seek guidance as they make decisions.

Ethical theories

-In order to understand ethical decision making, it is important for students to realize that not everyone makes decisions in the same way, using the same information, employing the same decision rules.

Ethical theories

- states that people should adhere to their obligations and duties when engaged in decision making when ethics are in play

1. Deontological

-The term deontology‘ is derived from the Greek word ‘deon” which means

duty

and ‘logos” which means

discourse

will always keep his promises to a friend and will follow the law.

1. Deontological

-is a theory that says decisions should be based on whether an action is morally right with no regard for the result

1. Deontological

-a person will follow his or her obligations to another individual or society because upholding one’s duty is what is considered ethically correct.

1. Deontological

-The RIGHT is said to have “priority” over the GOOD

1. Deontological

-The Golden Rule

1. Deontological

Example

Suppose a nurse is assigned to care for a patient with COVID. Could she reasonably refuse to care for the patient on the ground that the patient’s condition may threaten her health?

1. Deontological

Example

As practitioners of the healing art, nurses are to take care of the sick even if patients have conditions that threaten their personal health. Nurses, however, must observe the necessary precautions to protect their health.

Do what is right, because it is your duty—even if the outcome is difficult or unpopular.

1. Deontological

are based on an assumption that a decision behind certain conduct has to be based on an assessment of a respective outcome.

The name itself “teleology” has originated from a Greek name “telos” which means

an end

an action itself cannot be good or bad; however, an outcome or an impact of this action upon involved parties can be either positive or negative

2. Teleology

Example

A nurse decides to break hospital policy by allowing a child to visit a dying parent in the ICU.

2. Teleology

The action violates the rule—but if the outcome is emotional closure and peace for the family, a teleological view would see it as morally justifiable.

2. Teleology

An action is morally right if it leads to a good or desirable outcome. It is wrong if it leads to harm or negative results

2. Teleology

-the choice that yields the greatest benefit to the most people is the one that is ethically correct.

3. Utilitarianism

(The greatest good for the greatest number of people)

3. Utilitarianism

"Man is under two great masters,

pain and pleasure”

"Man is under two great masters, pain and pleasure”

-Jeremy Bentham

The great good that we should seek is happiness

Hedonistic perspective

Ethical Implications: Actions are judged based on their ability to increase overall happiness or pleasure for oneself and others.

Hedonistic perspective

suggests that ethical principles should be applied rigorously and consistently to maximize moral goodness

Maximalism

-A lifestyle or moral impulse aligned with maximizing pleasures, but only acceptable if it improves overall well-being

Maximalism

- a person performs the acts that benefit the most people, regardless of personal feelings or societal constraints such as laws.

1. Act utilitarianism

According to this theory truth telling will be deemed as good if that truth produce greater good for the greatest number of people in a particular situation

1. Act utilitarianism

. If it doesn‘t produce greater good for the greatest number of people then the action of truth telling will be referred to as bad action.

1. Act utilitarianism

- benefit the most people but through the fairest and most just means available.

2. Rule utilitarianism

-it values justice and includes beneficence at the same time

2. Rule utilitarianism

-action will be called good or morally right if and only if it is done according to that rule which seeks to produce the greatest number of good over evil for the greatest number of people.

2. Rule utilitarianism

, rules like truth- telling are followed because they generally lead to the greatest good

2. Rule utilitarianism

. Even if telling the truth seems harmful in a specific case, the rule is upheld for its overall long-term benefits.

2. Rule utilitarianism

Example : If helping 10 people brings more happiness than helping 10____favors helping the 10 — even if it's not "fair.

, act utilitarianism

Example: A rule like "Do not steal" benefits society overall,

even if breaking it once might seem to help someone

RULE utilitarianism:

-Focuses on following rules consistently that — when followed by everyone — lead to the greatest happiness in society.

RULE utilitarianism:

-are useful, desirable behaviours that help define workplace culture

VALUES

FUNDAMENTAL BELIEFS & PRINCIPLES

VALUES

are measures of excellene of goodness and maybe more important to individuals due to their personal nature.

VIRTUES

Both are important in the workplace and need to be embraced and operationalized in order to meet both individual and organizational needs.

VALUES & VIRTUES

-Making a decision in light of those favored virtues

Virtue Ethics

-Emphasizes the virtuous character of individuals who make the choices

Virtue Ethics

-deals with questions such as “what sort of person must I be? ” and “what makes an individual a good or virtuous person?” Rather than, “What is right or good to do?”

Virtue Ethics

nursing is concerned with the character of individual nurses and seeks ways to enable nurses to develop character traits appropriate for actions that enhance well-being.

Virtue Ethics

-We do, We learn, We reflect

Virtue Ethics

"the will that each receive her due."

JUSTICE

-Is really about right relationships.

JUSTICE

-Nurses have to build relationships of trust and cooperation with patients, family and other health care providers.

JUSTICE

-How much do I give this patient, or to that one?

JUSTICE

-Nurses must have a sense of proportion and of equitable distribution of medical resources, including personal attention.

JUSTICE

-Is one who knows what to do in a particular situation by applying general rules and knowing why the general rule won't

work in this case.

PRUDENCE

-Enables a nurse to know when to be firm and when to be flexible, when to encourage and when to comfort, when to

accede to a patient request and when not to.

PRUDENCE

-its the habit of making morally sound decisions especially when situations are complex-a person doesn’t act impulsively.

PRUDENCE

•A persons principle or standards of behavior; one’s judgement of what is important in life.

Values/ Value Ethics

*Are a key component of a healthy workplace culture because they clarify how your organization and its staff should behave.

Values/ Value Ethics

is a character trait or moral excellence that inclines a person to do good habitually

virtue

a deeply held belief about what is important or desirable.

value

Nurses are able to act for themselves according to the level of their capacity. Independent & interdependent Nursing Interventions

❖Professional Nurse Autonomy

Does allow for health care providers to educate the patient;

but does not allow the health care provider to make the decision for the patient

❖Patient Autonomy

Patients Right

1. Right to Appropriate Medical Care and Humane Treatment.

2. Right to Informed Consent

3. Right to Privacy and Confidentiality

4. Right to Information.

5. The Right to Choose Health Care Provider and Facility.

6. Right to Self-Determination.

7. Right to Religious Belief

8. Right to Medical Records.

9. Right to Leave.

10.Right to Refuse Participation In Medical Research.

11. Right to Correspondence and to Receive Visitors.

12. Right to Express Grievances.

13. Right to be Informed of His Rights and Obligations as a Patient.

Filipino Patient’s Bill of Rights

1.The patient has the right to considerate and respectful care irrespective of socio- economic status.

2.The patient has the right to obtain from his physician complete current information concerning his diagnosis, treatment and prognosis in terms the patient can reasonably be expected to understand.

3.The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and/or treatment.

4.The patient has the right to refuse treatment/life – giving measures, to the extent permitted by law, and to be informed of the medical consequences of his action.

5. The patient has the right to every consideration of his privacy concerninghis own medical care program.

6. The patient has the right to expect that all communications and records pertaining to his care should be treated as confidential.

7. The patient has the right to review the records pertaining to his/her medical care and to have the information explained or interpreted as necessary except when restricted by law.

8. The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services.

9. The patient has the right to be advised if the hospital proposes to engage in or perform human experimentation affecting his care or treatment.

10. The patient has the right to expect reasonable continuity of care; he has the right to know in advance what appointment times the physicians are available and where.

11. The patient has the right to examine and receive an explanation of his bill regardless of source of payment.

12. The patient has the right to know what hospital rules and regulation apply to his conduct as a patient.

Information Necessary for Informed Consent:

Specific Procedure or Treatment:

Medically Significant Risks:

Probable Duration of Incapacitation

Alternatives for Care or Treatment:

Identification of Responsible Personnel:

Patients should receive clear and detailed information about the procedure or treatment that is proposed, including what it involves and why it is recommended.

*Specific Procedure or Treatment

Patients have the right to be informed about the risks associated with the procedure or treatment.

Medically Significant Risks:

should be significant enough to influence their decision-making process.

Medically Significant Risks:

If the procedure or treatment is likely to affect the patient's ability to function normally for a period of time, this should be communicated to them.

Probable Duration of Incapacitation:

: If there are other medically significant alternatives available (such as different treatment options or approaches), patients have the right to know about them.

*Existence of Alternatives:

If patients ask for information about alternative treatments, healthcare providers should provide them with relevant details to facilitate informed decision-making.

Patient's Request for Information

*Patients have the right to know the names of the healthcare professionals who will be involved in their care, especially those responsible for performing procedures or treatments

Identification of Responsible Personnel:

the principles of informed consent are adjusted due to the urgent nature of the situation where immediate medical intervention is required to preserve life or prevent serious harm

EMERGENCY PROCEDURES

: In emergencies, healthcare providers may proceed with necessary treatment based on

Implied Consent:

This assumes that a reasonable person would agree to lifesaving or essential treatment under the circumstances

Implied Consent:

Despite the urgency, healthcare providers should communicate with the patient or their surrogate decision-maker whenever possible

Communication

They should provide information about the situation, the proposed treatment or procedures, and any foreseeable risks that can be reasonably explained in the limited time available.

Communication

: Providers should consider any known preferences or previously expressed wishes of the patient regarding emergency care, if this information is available and relevant to the situation.

Patient Preferences:

It's crucial to document the emergency circumstances, the actions taken, and any communication with the patient or family members.

Documentation