LESSON 1: HEALTH CARE ETHICS

Ethics KEY CONCEPTS:

- A theoretical science of good and bad or Moral Values

right and wrong actions
- standards or principles that individuals and
Morality societies hold as important in determining
what is right or wrong
- the application of the theories of ethics
Moral Judgments
Biology
- evaluations or decisions about the moral
- study of living things and their vital
status of an action or behavior
processes that deals with all the
physicochemical aspects of life Moral Responsibility

Bioethics - idea that individuals are accountable for

their actions and can be praised or blamed
- the systematic study of the human conduct
based on their moral choices.
in the areas of the life sciences and
healthcare Moral Theories

Healthcare Ethics - philosophical theories provide frameworks

for evaluating the morality of actions
- the ethics that unravel the right and
wrongs of different areas of healthcare ETHICS MORALITY
practice in the light of philosophical THEORY OF RIGHT PRACTICE OF
analysis ACTION AND GREATER RIGHTNESS AND
GOOD WRONGNESS OF
Professional Ethics
HUMAN ACTION
- Professional Ethics the process of defining
what is meant by good or bad within the
BIOETHICS
narrower confines of a particular practice,
and the skills, and knowledge which are Greek word: BIOS – life
associated with it
ETHICS OF LIFE - ETHICS OF MEDICAL CARE
ETHICS
- a more recent discipline, an outgrowth of
- The study of social morality and philosophy focusing on man as the center
philosophical reflection on its norms and of reality and human life; it is a philosophy
practices (basic human behaviors that are of life
specifically and inherently human) - very comprehensive and treats human life
and society
ETIOLOGY:
SCOPE OF BIOETHICS
Greek: ethika - having to do with character ethos
- behavior or custom that is permanent Latin: mos Initial stage: Bioethics was concerned with
or moris - moral, morality medical practice
A practical and normative science based on reason Later stage: It has expanded to include social
which studies human acts and provide norms for issues related to health, animal welfare and
its goodness and badness environmental concerns.
Importance/ Significance of Bioethics • Thinking being

• The health care procedures done by health HUMAN PERSON

professionals and their corresponding right
- To become a human person, one must
conduct in the practice of health care:
become a human being first
• Preventive
- having physical, spiritual, emotional,
• Curative
intellectual attributes.
• Rehabilitative
- Thomas Aquinas: having physical, spiritual
• The possession of health or wholeness of substance because he has a soul and is
health seekers or patients is entrusted to created by Superior being with divine
health professionals. Medical practice is an purpose.
integrally technical and ethical profession.
• The world of health profession and life can SELF AWARENESS
only be possibly practiced and lived by - person having clear perception of oneself
recognizing the ethical dimension in them including his/her thoughts, emotions,
through which they can regulate human intensity, actions
actions and relations.
• Bioethics deserves careful recognition SELF-DETERMINATION
especially by those who have not been - capacity to make choices and decisions
well-versed in complexities of medical or based on own preferences, monitor, and
health care professions. regulate actions; goal oriented; self-
Rationale in the study of Bioethics directed

EXTERNALITY
• Address perennial ethical problems, issues
and dilemmas confronting health and - capacity to reach out and interact with
pastoral workers: others and the world
• Address legal problems in health care with
DIGNITY
ethical concerns.
• Address legal problems in health care with - innate right to be valued and respected
ethical concerns
ACT OF MAN
LESSON 2: THE HUMAN PERSON
- acts not deliberately done nor voluntary;
they are performed without the free will of
the agent in deliberately not done freely
involuntarily

HUMAN ACT

- Human acts are those acts of rationality of

man
Characteristics of Human Being: - Free and conscious acts of a human being
proper to man alone, emanating from
• The human body deliberate and free will.
• Feeling being - Actions done Consciously and freely
• Potential being - “An act which proceeds from the
• Communicating being deliberate free will of man.” Paul J. Glenn
ELEMENTS OF HUMAN ACTS

• Knowledge Key Philosopher: Immanuel Kant

• Freedom
- (1724–1804) Kant argued that moral
• Voluntariness
actions must be guided by reason and
NORMS OF HUMAN ACTS should be performed out of a sense of duty.
- Kant’s Categorical Imperative: actions are
Law
morally right if they can be universalized—
- St. Thomas defines law: An ordinance of meaning that the moral rule behind the
reason, promulgated for the common action should be applicable to everyone
good by one who has charge of society without contradiction.

Conscience Teleological Ethics: Consequence-Based Ethics

- the practical judgment of reason upon an - Core Idea: from the Greek word "telos"
individual act as good to be performed or meaning "end" or "goal,"
as evil to be avoided - is an ethical theory that assesses the
morality of actions based on their
LESSON 3: ETHICAL THOUGHTS
outcomes or consequences.
THEORIES AND PRINCIPLE OF HEALTH ETHICS is
Key Philosopher: Jeremy Bentham&John Stuart
classified into two majors:
Mill
• Deontological Ethics
- Utilitarianism Jeremy Bentham (1748–
• Teleological Ethics
1832) and John Stuart Mill (1806–1873) are
Deontological Ethics: Duty-Based Ethics associated with utilitarianism, a form of
teleological ethics that evaluates actions
- Core Idea: derived from the Greek word
based on their ability to maximize overall
"deon" meaning "duty,"
happiness or well-being.
- is an ethical theory that emphasizes the
- The morally right action is the one that
morality of actions based on adherence to
produces "the greatest happiness for the
rules or duties, rather than the
greatest number."
consequences of the actions.
Key Features of Teleological Ethics
Key Features of Deontological Ethics
Consequentialism: Actions are judged by their
Moral Absolutism: Certain actions (e.g., murder,
outcomes or results. The ends justify the means.
lying) are always wrong, no matter the context or
consequences. Maximization of Good: The morally correct choice
is the one that produces the most favorable
Respect for Autonomy: Individuals have moral
consequences for the largest number of people.
worth and should not be treated merely as means
to an end, but as ends in themselves. Relativism: Teleological ethics is more flexible, as
actions that might be wrong in one context could
Duty Over Consequences: The rightness of an
be morally right in another, depending on the
action is determined by whether it conforms to a
results.
moral duty, not by its outcomes.
Key Differences Between Deontological and Pleasure and Pain Actions
Teleological Ethics
- are morally right if they produce the
greatest amount of pleasure and the least
amount of pain for the greatest number of
people.

Quantitative focus

- All pleasures and pains are fundamentally

the same, so they can be measured and
compared.

UTILITARIANISM Short-term pleasure

- It is rooted in the idea that an action or - Hedonic utilitarianism may place

practice is right if it leads to the greatest significant value on immediate pleasure,
possible balance of good consequences in even if long-term well-being is
the world as whole. compromised.

THE PRINCIPLE OF UTILITY: Maximize the good Eudaimonistic Utilitarianism

Hedonism - influenced by the Aristotelian idea of

eudaimonia-"flourishing" or "well-being."
- the ethical theory that pleasure (in the It shifts the focus from pleasure to the
sense of the satisfaction of desires) is the quality of life and human flourishing.
highest good and proper aim of human life.
John Stuart Mill
Eudaimonism
- Happiness is pleasure, but with strict
- A moral philosophy that defines right priority given to those pleasures produced
action as that which leads to the "wel- by the exercise of the higher human
being" of the individual, thus holding "wel- faculties as opposed to those from the
being" as having essential value lower faculties.
Hedonic Utilitarianism KEY PRINCIPLES
- is based on the idea that the ultimate good Happiness as flourishing
is pleasure or the absence of pain.
- the ultimate good as human flourishing,
Jeremy Bentham which includes both higher intellectual
- According to him, the happiness of many is pleasures and a sense of living a
a crucial factor at all times. Jeremy meaningful, purposeful life
Bentham's theory of utilitarianism holds Qualitative focus
that pleasure and pain are linked to
people's actions. - distinguishes between higher and lower
pleasures.

KEY PRINCIPLES
Long-term well-being KEY CONCEPTS VIRTUE ETHICS

- actions that contribute to sustainable, VIRTUE

long-term fulfillment rather than
- a trait of character manifested in habitual
immediate gratification.
action that it is good for the person to
possess
- it is a set of character trait, that once
develop will lead to predictably good
behavior. It is a mid point between two
extremes.

Eudaimonia (Flourishing)

- is the ultimate goal of human life in virtue

LESSON 4: VIRTUE ETHICS ethics. It refers to living well, flourishing, or
achieving the good life.
VIRTUE ETHICS
- Virtues are essential to achieving
- an approach that focuses on the character eudaimonia. A person who embodies
with the assumption that a person with virtues in their actions is more likely to live
good virtue will tend to behave in ways a flourishing life.
that are consistent to their character
The Doctrine of the Mean
ARISTOTLE “If we can just focus on being a good
- Aristotle proposed the Doctrine of the
people the right actions will follow effortlessly.”
Mean, which states that virtues are a
Historical Background balance between two extremes, or vices.
Virtue is found in the "mean" or moderate
Virtue ethics has its roots in Ancient Greek
position between excess and deficiency.
philosophy, particularly in the works of Plato and
• Courage is the mean between recklessness
Aristotle. While Plato discussed virtues in works
(excess) and cowardice (deficiency).
like The Republic, it is Aristotle’s Nicomachean
• Generosity is the mean between
Ethics that forms the foundation of classical virtue
prodigality (excess) and stinginess
ethics.
(deficiency).
ARISTOTLE • Honesty is the mean between brutal
- argued that ethics is about achieving honesty (excess) and deceit (deficiency).
eudaimonia, often translated as Phronesis (Practical Wisdom)
"flourishing" or "the good life." For
Aristotle, living well means cultivating - Phronesis, or practical wisdom, is the
virtues— excellent character traits that intellectual virtue that allows a person to
enable a person to live in accordance with make sound moral decisions. It involves
reason. the ability to discern the right course of
action in any given situation.
- Virtue ethics does not provide strict rules for
action. Instead, it emphasizes the
development of good judgment (phronesis) so
that individuals can navigate complex moral
situations wisely.
VIRTUE ETHICS IN NURSING

- concerned with the character of individual

nurses and seeks ways to enable nurses to
Personal Values
develop character appropriate for actions
that enhance well-being - values internalized from the society or
culture in which one’s lives.
THE FOCAL VIRTUES
Professional Values
COMPASSION
- values acquired during socialization into
- ability to imagine oneself in the situation of nursing from codes of ethics, nursing
another person experiences, teachers, and peers
DISCERNMENT CORE VALUES OF NURSING
- sensitive insights involving acute judgment Human Dignity
and understanding resulting in a decisive
- Is a respect for the inherent worth and
action
uniqueness of individuals and populations
TRUSTWORTHINESS
Integrity
- a confident belief in the moral character of
- refers to adherence to moral norms that is
another person
sustained overtime
INTEGRITY Autonomy
- soundness, reliability, wholeness, and an - the right to self-determination. Considered
integration of moral character to be an important criterion in judging
CONSCIENTIOUSNESS professional status

- feeling of moral responsibility to work Altruism

carefully and to be fair to others - is a concern for the welfare and wellbeing of
others
“Virtue is an important trait of a good nurse”-
Florence Nightingale Social justice

It is further reflected in the Florence Nightingale - acting in accordance with fair treatment
Pledge which implies virtue of character as nurses regardless of economic status, race,
promise purity, faith, loyalty, devotion, ethnicity, age, citizenship, disability or sexual
trustworthiness, and temperance. orientation

Aristotle believed that virtue can be practiced and OTHER VALUES OF NURSING
learned, so we can learn through practice. Safe & competent
VALUES - employing safety and competence for the
- One’s set of personal beliefs and attitudes welfare of the patient.
about the truth, beauty and worth of any Health & well –being
thought, object or behavior. They are
- strive to maintain health practices both mind
action oriented and gives direction and
and body; so that he/she can promote health
meaning to one's life'
and well-being as well.
Choice JUSTICE (DUTY OF FAIRNESS)

- recognize choices and makes value-based - The duty to ensure fair distribution of
decision making benefits and burdens, and to prevent or
rectify injustice.
Dignity
GRATITUDE (DUTY TO REPAY BENEFICENCE)
- a person who values the self as well as
respect for the rights of others as human - The duty to show gratitude for benefits or
being. favors received and to reciprocate them
when possible
Confidentiality
BENEFICENCE (DUTY TO PROMOTE GOOD)
- a deontological virtue; which places a duty
on one individual to another; it is about - The duty to promote the well-being of
keeping information secret and private. others, to help them when possible, and to
improve their situation.
Social Justice
NON-MALEFICENCE (DUTY TO AVOID HARM)
- respecting the equal worth of all citizens,
the equal right to meet the needs and - The duty to avoid harming others, whether
eliminating unjustified inequalities through action or negligence

PRIMA FACIE DUTIES SELF-IMPROVEMENT (DUTY TO IMPROVE

ONESELF)
- DEFINITION ethical obligations that are
binding at first glance (prima facie) but - The duty to work on one’s own moral,
may not be the final duty in a given intellectual, and physical improvement
situation, depending on other competing
VERACITY (DUTY OF TRUTHFULNESS)
duties.
- The duty to tell the truth, closely related to
W.D ROSS ROSS
fidelity, but more specifically focused on
Adapts the latin phrase “prima facie” (“at first honesty in communication
glance”) to capture the idea that these are duties
RESPECT FOR FREEDOM (DUTY TO RESPECT
that always have some moral weight, but that no
OTHERS' AUTONOMY)
prima facie duty always has priority over the
others. - The duty to respect the freedom and
autonomy of others, allowing them to
TYPES OF PRIMA FACIE DUTIES
make their own decisions
FIDELITY (DUTY OF PROMISE KEEPING AND
CONTRACTARIAN ETHICS JOHN RAWL’S THEORY
HONESTY)
OF JUSTICE
- The duty to keep promises, fulfill contracts,
CONTRACTARIAN ETHICS OVERVIEW
and be truthful.
Contractarianism
REPARATION (DUTY OF MAKING AMENDS)
- is based on the idea that moral and
- The duty to make up for harm that you
political principles should be the result of
have caused others, whether intentionally
an agreement, or contract, among rational
or accidentally.
individuals.
Thomas Hobbes: people agree to form a social JUSTICE AS FAIRNESS: AN EGALITARIAN
contract to escape the chaos of the state of nature. APPROACH

John Locke: the social contract protects life, liberty, By placing people behind the veil of ignorance, he
and property ensures that society’s rules will not be biased
toward the interests of the privileged.
JOHN RAWLS’ THEORY OF JUSTICE AS FAIRNESS
Rawls vs. Utilitarianism
- John Rawls introduced the idea of justice
as fairness to describe a system of justice Utilitarianism
that is impartial and fair to all individuals.
- focuses on maximizing overall happiness or
- A just society is one where institutions and
utility, even if that means some individuals
policies are arranged to ensure fairness for
suffer for the benefit of others.
everyone, especially the least advantaged
members of society. Rawlsian justice

A THE ORIGINAL POSITION AND THE VEIL OF - in contrast, prioritizes fairness and
IGNORANCE protects individuals from being treated
merely as means to an end.
original position

- a hypothetical scenario where individuals

come together to agree on the principles
that will govern their society.

veil of ignorance

- they do not know their own social status,

wealth, talents, gender, race, or other
personal characteristics.

Purpose of the Veil of Ignorance: The veil ensures

that individuals are impartial because they do not
know how the rules will affect them personally.

B THE TWO PRINCIPLES OF JUSTICE

EQUAL BASIC LIBERTIES Each person has an equal

right to the most extensive set of basic liberties
that are compatible with the same liberties for
others.

THE DIFFERENCE PRINCIPLE: Social and economic

inequalities are permitted only if they benefit the
least advantaged members of society.