BIOETHICS: ETHICAL PRINCIPLES

This aims to provide specific guideline for determining when it is morally permissible to perform an action:

- In the pursuit of good end

- in knowledge that the action will bring bad results

THE PRINCIPLE OF DOUBLE EFFECT

GOOD ACTION in ITSELF has to effects:

- Intended and not reasonably attainable good effect

- Unintended yet foreseen evil effect

The object of the act must not be intrinsically contradictory to fundamental moral commitment to God and neighbor (including the self). It must be a morally good action or must not be evil.

GOOD ACTION in ITSELF

The agents primary intention must be to achieve the beneficial effects and avoid harmful effects as far as possible (it must also only be indirectly intended).

DIRECT INTENTION

The good outcome must not be a direct result of the harmful effect. It should be achieved independently of the bad effect. Or, in other words, the foreseen beneficial must not be achieved by the means of foreseen harmful effects

GOOD EFFECT (NOT ACHIEVED BY BAD MEANS)

The foreseen beneficial must be equal to or greater than the foreseen harmful effects. A careful balance between good and bad outcomes is required.

PROPORTIONALITY

The beneficial effect must follow from the action at least as immediately as the harmful effect.

IMMEDIATE GOOD EFFECT

There are significant disagreement of his principles that states:

- "In cases where a contemplated action has both good effects and bad effects, the action is permissible only if its not wrong in itself and it does not require one directly intended the evil result."

- because its applications are morally complex in which it cannot achieve a particular desired good result without also bringing about some clearer evil.

THOMAS AQUINAS (11225-1274)

FOUR CONDITIONS OF THE PRINCIPLE OF DOUBLE EFFECT:

- First, that the action contemplated be in itself either morally good or morally indifferent.

- Second, that the bad result not be directly intended.

- Third, that the good result not be a direct casual result of the bad result.

- Fourth, that the good result be "proportionate to" the bad result.

- in the ethical sense as the participation of one agent in the activity of another agent to produce a particular effect or share in a joint activity.

- This becomes ethically problematic when the action of the primary agent is morally wrong.

Cooperation

criteria for legitmate cooperation:

Moral object of your action is good

You act with good intentions

Evil is only tolerated as side effect

Cooperation is material (not formal)

Cooperation is remote, not proximate

Action does not cause scandal

the specific action chosen; the "what" of the act that determines if it is good or bad.

moral object

is the reason why you choose to act.

intention

______ does not imply condoning evil

cooperation

refers to moral acceptability, not the legal meaning of conforming to a set of standards and requirments to be acceptable

legitimate

is the one who starts the bad action and really intends to do harm.

wrongdoer

is someone who is involved in the situation, but their intention is not to cause harm. Their main goal is good, but they may still be connected to the wrong act.

cooperator

- This happens when a nurse knowingly and intentionally supports an immoral or harmful act.

Formal Cooperation

- direct intention

- when a person willingly and directly approves of and intends to participate in another's immoral act as a means to that act

explicit

claims not to intend, but still does essential tasks that make the act possible

implicit

The nurse doesn't intend the evil act but indirectly contributes to it.

Material Cooperation

2 types of Material Cooperation

- mediate

- immediate

(indirect/incidental)

- cooperator's involvement is only accidental to the wrongdoing

mediate

(direct/essential).

- cooperator's involvement is necessary for the evil to continue

immediate

Refers to how "close" or "distant" the nurse's actions are from the immoral act.

Proximate vs. Remote Cooperation

- Direct contribution → more morally wrong.

- Your action is closely connected to the evil act.

Proximate

- Indirect or distant contribution → less responsibility.

- Your action is distant or indirect from the evil act.

Remote

the good effect of your action must be equal to or greater than the possible bad effect; the good gained should outweigh the evil tolerated.

proportionate good

leading or influencing others to sin or to do something wrong, either by your words, actions, or example.

scandal

- Means working for the good of all

- Respecting the rights and responsibilities of every person

- Not just about individual benefit, but well-being of the whole community

Common Good

- "Common Good is the sum total of social conditions which allow people, either as groups or individuals, to reach their fulfillment more fully and easily." (Vatican II)

- It is about the progress and dignity of persons

Church Teaching

Why "Common Good" is important?

- Promotes justice and fairness

- Ensures no one is left behind, especially the poor and vulnerable

- Builds a peaceful, united, and caring society

- Decisions should be made and responsibilities carried out at the most immediate (or lowest) level capable of addressing them.

- Higher levels of authority intervene only when smaller units cannot handle the problem.

Subsidiarity

- It involves valuing and respecting patients' priorities and self. determination.

- Nurses become ________ or teachers to patients who may not have the expertise or experience in the disease process, but who understand the consequences of their ilness.

Stewardship in nursing

- Nurse leaders must prioritize self-development to fulfill stewardship in health care.

Personal Stewardship (Stewardship of Self)

- is essential to nurture future transformational nurse leaders.

Succession planning

- According to Dutta, Lawson, and Marcinko (2012), ________ can be defined as the responsibility to work not only towards organizational goals but also to consider the wider impact of these goals on society and the environment. It involves the wise use of resources, long-term planning, and the promotion of human development and social stability.

Social Stewardship (Stewardship of Society)

- means acting as a steward, or, caretaker, of the environment. Stewards can be government bodies, community groups, corporations, or individuals.

- To protect the resilience of crucial ecological processes, including those of flora, fauna, and atmosphere.

Ecological or environmental stewardship

refers to the responsible management of the environment and natural resources.

Environmental stewardship

Preventing damage to ecosystems through conservation.

Protection

Repairing ecosystems that are degraded or destroyed

Restoration

- play an important role in environmental stewardship. People can help the environment by reusing, recycling, and making ethical consumer decisions.

Everyday choices

play a crucial role in promoting environmental stewardship through collective action.

Communities

can mobilize resources and knowledge to address specific environmental issues.

Local groups

fosters a sense of ownership and responsibility towards local ecosystems.

Community engagement

- It's the practice of using and disposing of biomedical materials with the utmost care to protect public health and the environment.

- It involves handling everything from body secretions and waste to medical equipment and deceased patients.

Biomedical Stewardship

The goal is to prevent the spread of infection, minimize environmental impact, and ensure the safe handling of all biomedical materials.

Biomedical Stewardship

- This includes items like used bandages, syringes, and gloves.

- They should be placed in designated biohazard bags (often red or yellow) to prevent exposure.

Contaminated Waste

Needles, scalpels, and other sharp objects must be placed in a puncture-proof container (a "sharps" box) to prevent accidental needle-stick injuries.

Sharps Disposal

During pandemics, like the COVID-19 pandemic, specific protocols must be followed to safely handle the bodies of infected patients.

Infection Control

Amputated body parts or deceased patients require a death certificate and must be handled and buried according to government-approved protocols.

Documentation