Bioethics Midterm

• Who was considered as the father of the natural law theory?

• Whose greatest work was the Summa theologiae

St. Thomas Aquinas

• Founded by the Persian Mani

• A form of religious dualism focused on principles of good and evil

• Influenced by of Zoroastrian, Babylonian folklore, Buddhist ethics, and some small Christian elements

Manichaeism

• Issues regarding God and the process of creation

• The moral return of humans to God

• Christ as a guide with sacramental practices as ways to return to God

  • Second part focuses on the virtue of life

Summa Theologiae

Type of virtue;

• Where habit allows individuals to adopt and are directed by reason

Acquired

Type of virtue;

• Where the moral virtues that God provides to shape and guide moral development

Infused

What are the theological virtues?

• Charity

• Hope

• Faith

What are the cardinal virtues? PJFT

• Prudence

• Justice

• Fortitude

• Temperance

Defined as the right use of reason to guide moral actions.

Prudence

Defined as giving what is due to each person.

Justice

Type of justice;

• That is trade between people

Cumulative Justice

Type of justice;

• That is relations between community and individual

Distributive Justice

Defined as the good of the individual (actions consistent with reason).

Fortitude

Defined as a curb of natural passions

Temperance

What are the four types of Law;

• Human Law

• Eternal Law

• Natural Law

• Divine Law

Type of law;

• The rational basis for order among creation according to God

Eternal Law

Type of law;

• The human participation in eternal law; the degree to which order actually exists

Natural Law

Type of law;

• When natural law is drawn up to the form of civic law to guide society

Human Law

Type of law;

• The rule and measure of all virtue

Divine Law

Natural Law Summary;

• The natural law is given by God

• It is naturally authoritative over all human beings; and

• It is naturally knowable by all human beings

• The good is prior to the right, that

• Right action is action that responds nondefectively to the good

• There are a variety of ways in which action can be defective with respect to the good,

• Some of these ways can be captured and formulated as general rules

“Within the discipline of nursing, no matter how speculative the injury, the end is ________.”

Practice

Whom was this cited from?

• The decision and ability to apply principles within a particular situation is the art of practice

Whelton, 2002

What are the conscious powers capable of development?

• Power of willing

• Intellect

• Emotive capacity

Become more proficient with frequent use

Intellect

• Can be actualized through many habits

• More important habits of the will = justice and charity

Power of Willing

• Feelings culminating in sensory desires

• Goal to develop reasonable self-control

• Affective reaction to difficulties and threats

• Goal is to develop fortitude

Emotive Capacity

What are the standards used to evaluate Natural law?

• Strengths

• Weaknesses

• Applicability

• Simplicity

• Empirical content

What are the strengths of natural law?

• Offers certainty and provides security to a society

• Suggest that all of humanity shares a common purpose and origin

• States there are real reasons to live a moral life

• Is a complete way of life, dealing with character, motive and action

• It gives a day-to-day and lifelong system

• Clearly calls certain acts intrinsically wrong

What are the weaknesses of natural law?

• Assume that humans everywhere share a moral sense of what is right and wrong

• Suggest that humans share basically the same nature, any deviation from that nature is unnatural.

• Criticized for being rigid, inflexible, and legalistic

• Incompatible with

  • Atheism

  • Agnosticism

• One cannot have a theory of divine providence without a divine being

Simplicity of structure

Understandable

Simplicity of application

Usefulness

Key purposes of Human Existence; POWER

• Preservation of life

• Ordering society for the benefit of its members

• Worshipping the creator

• Education

• Reproduction of the species

Assume law is a dictate of reason, for the common good, made by the one who has authority over the community, and is promulgated (made known).

Empirical Content

Are habits of character that predispose persons to meet their moral obligations; that is, to do what is right.

Virtues

Are habits of character that predispose a person to do a particular job or task well.

Excellence

• Authored The Right and the Good (1930)

• An introduction to Intuitionism as a Model of Ethics

Sir William David Ross

The basic truths of ethics by a special power

Intuition

What are the prima facie (conditional duties we know);

• Gratitude

• Fidelity

• Reparations

• Non-injury

• Self-improvement

• Generosity

• Justice

• Also called conditional duty

• Is a characteristic which an act has, in virtue of being of a certain kind of being an act which would be a duty proper

• Is more an account of materials from which we must make a selection that it is an account of our actual obligations

Prima facie duty

Is our obligatory responsibility, no matter the nature of the occasion

Duty Proper

What to do whenever a person has to make a moral decision in a situation in which more than one prima facie duty applies?

Study the situation as fully as I can until I form the considered opinion than in the circumstances one of them is more incumbent than any other.

Is an occupation requiring advanced, specialized and systematic study and training in the knowledge of health care designed to provide services to society in that particular field.

Health Care Profession

Is person who has acquired an advanced, specialized and systematic training and experience in the knowledge of health care.

Health Care Practitioner

Is any recipient of medical attention, care of treatment.

Client

The word patient was originally meant as __________. This English noun comes from the Latin word patiens

One who suffers

• Is a patient who is not hospitalized for 24 hours or more but who visits a hospital, clinic, or associated facility for diagnosis or treatment.

• Ambulatory care

Outpatient

Admitted to the hospital and stays overnight or for an indeterminate time, usually several days or weeks.

Inpatient

Is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families, or communities.

Health Care Provider

Is a health worker who specializes in the planning and delivery of a patient’s peri-operative care, including during anesthethic, surgical and recovery stages.

Surgical Practitioners

What are the outlined core set of competencies for health care providers according to the World Health Organization?

• The ability to adopt a client-centered approach

• Communicating skills associated with collaborating with patients, families, carer, and other services

Factors for Standard of Care

• Physical Endurance

• Attention to Detail

• Problem Solving Skills

• Emotional stability

• Respect

• Flexibility

• Interpersonal skills

• Empathy

• Quick Response

Requires that health provider use the ordinary and reasonable skill that would be commonly used by other reputable practitioners when caring for individuals.

Standard of Care

Basic Ethical Principles

• Human life comes from God

• We have the responsibility to protect and defend it

• We have the obligation to see appropriate medical care to ensure its proper functioning

A single part may be sacrificed if the loss is necessary for the good of the whole person.

Totality

Who stated that all of the organs and other parts of the body exist for the sake of the whole person?

Thomas Aquinas

An action with both good and bad results.

Double Effect

What are the four conditions of double effect?

• Actions must be morally good or neutral itself

• Bad result cannot be the means for achieving the good results

• Motivation for carrying out the action must be solely to achieve the good results.

• The good result must be at least as significant as the bad

Developed in the Catholic moral tradition as a way of helping individuals discern how to properly avoid, limit or distance themselves from evil in order to avoid a worse evil or to achieve an important good.

Cooperation

This principle invites us to consider how we relate to each other in community.

Solidarity

Agreement to respect another’s right to self-determine a course of action; support of independent decision making.

Respect for person - Autonomy

• Derived from the work of John Rawls

• This principle refers to an equal and fair distribution of resources, based on analysis of benefits and burdens of decision.

Justice

• Inalienable right of life

• God has ultimate power on human life

• According to Catholic Moral Theology, the “taking of life” may be justified in cases of self-defense and “just war”

• However, direct killing of an innocent person on one’s own authority is always wrong.

Inviolability of Life

• Avoidance of harm

• Core of medical oath and nursing ethics

• Extends to making sure you are doing no harm in the beneficent act of using technology to extend life or using experimental treatment that have not been well tested.

Non-Maleficence

Compassion; taking positive action to help others; desire to do good; core principle of our patient advocacy.

Beneficence

Embraces virtue as “learned, not innate”.

Natural Law

What are the key precepts of natural law?

• Good should be promoted and carried out

• Evil must be identified and avoided

Assumptions consistent with that is known in nature and society.

Empirical Content

Sections that reflect Aquinas’ ethical principles;

• Wholeness of character

• Influence of the environment on moral virtues

• Influence of the environment on ethical obligations

ANA code under Prudence, Justice, and Fortitutde;

• Acting on questionable practice

• Addressing impaired practice

ANA code under temperance;

• Conflict of interest for nurses

• Professional boundaries

Significant Points of Ross’ Model;

• These duties are not all-inclusive

• They are not in prearranged harmony

• There duties may contract each other

Who does Ross agrees with that defining ethical predicates in term of natural predicates commits the naturalistic fallacy?

G.E. Moore

Reasons why Ross, reject utilitarianism;

• Single criterion

• Violates common sense

Why does Ross? Reject Kant?

Common sense

Means working well with all kinds of people

Interpersonal Skills

Defined as thinking outside the box and being able to figure out what to do after traditional methods.

Problem Solving Skills