 This course deals with human acts, human reason based on human experiences, basic

universal ethical principles that student nurses should know and apply to the time they
become professional.
 This course also discusses the different life and death issues, genetic engineering and
ethics in research using human subjects. Thus, this also emphasizes the rights of the
patients and nurses as well.
 At the end of the course, the student will be able to:
o Identify the basic rights of patients and nurses
o Apply the different ethical principles in the care of patients and in dealing with
others.
o Advocate patient’s rights in the event of dilemma or crises

 Major Examination – 1/3

 Quizzes – 1/3
 Class Standing – 1/3
 Projects, Reports, Assignment
 Attendance (including Behavior)

 Ethics
 Biology
 Bioethics
 Ethical Conduct
 Laws/Legal
 Requirements
 Professional Ethics
 Ethical Conduct Right or Wrong Loss of Professional Reputation
Loss of Professional Affiliations
Punishment as prescribed by law
Legal Requirements Legal or Illegal

Professional Etiquette Proper or Improper Loss of Professional respect and

fellowship

 A philosophical and practical science that deals with the study of morality of human acts
or human conduct.
 The science of human acts with reference to right or wrong.
 The study of human conduct and principles of morality.

 Morality is that quality of human acts where the acts could be good or right, evil, or
wrong.
 An act is good when it is in conformity with the dictates of right reason.
 To Christians, an act is good when it is in agreement with God’s moral law and gospel
values exemplified by Christ.

 To reach its conclusions, ethics/moral philosophy draws upon the following sources:
o A. Human reason as its primary source
o B. Contemporary and historical experiences
▪ (Personal experiences and experiences of others)

 Is a science that deals with the study of the morality of human conduct concerning health
and health care.

 A science that deals with the study of the morality of human conduct concerning human
life in all its aspects.
1. When if ever, is it permissible to take a gift or gratuity from a patient?
2. When is it legitimate to break a patient’s confidence?
3. Is it permissible to lie to a client if it is for his own good?
4. What should I do if I make a medication error that no one else knows about but it appears
harmless to my patient?
5. What if I come upon a practice that is legal but appears to me personally to be unethical?
6. What if I come upon a situation where what I want to do seems ethical, but is illegal?
7. If I begin to have feelings for a patient, can I ethically date him or her?

 Be constantly aware of and learn by heart the essential role ethics plays in the practice.
 Live the knowledge of ethics in the practice of your profession and share it with other
practitioners.
 In case of doubt seek counsel from persons in authority.
 Be brave in adhering to the norm or standard of morality at all times.

 Is an act that proceeds from the deliberate free will of man.

 In ethics, being deliberate means knowledge in the intellect of what one is about, and it
means.

o Means that the act is done in the light of the agent’s knowing faculty. He is aware
and conscious of what he is doing.

o The act is performed in accordance with and not against the will. The power
resides in the will to choose to do or not to do an act.

o The act is done by the agent is intentional. The agent intends it as a product of his
decision which is within the power of his will.
 o The rational faculty that tends towards the truth. It is commonly called mind or
intelligence.

o The rational faculty that tends towards the good as its object

 The performance of human acts in the context of health care practice should carefully
take into considering the value of human life.
 Human life is at stake and the moral implications the said performance may bring about.
 Health care practice is credited to the health care practitioner. It presupposes knowledge
of that which is performed, the freedom of the will and the voluntariness of performing it.
 As long as the three elements are present, the administered health care holds the health
care provider responsible.
 Health Care practice has to be good human act in the sense that is keeping with the
Eternal Law manifested in the order of nature.
 For it to be good, it has to be in conformity with the dictates of the right reason in all the
three determining agents of morality.

✓ Ethical theories provide part of the decision-making foundation for Decision Making
When Ethics Are in Play because these theories represent the viewpoints from which
individuals seek guidance as they make decisions.
Each theories emphasizes different points – a different decision-making style or a decision rule –
such as predicting the outcome and following one’s duties to others in order to reach what the
individual considers an ethically correct decision.
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.
✓ The basic premise of utilitarianism is that an action is moral if it maximizes the
overall social ‘utility’ (or happiness)
✓ A form of consequentialism requires an individual to calculate the right response
to an ethical question by weighing up the positive and the negative consequences
of an action. Whatever produces the most happiness for most people will be the
most ethical solution.
✓ It is important to note that the consequences should be measured in terms of
overall impact, not only in terms of the decision maker. All consequentialist
theories hold that morality depends on the consequences of actions.

✓ The basic premise of deontology, in contrast to consequentialist theorist like

utilitarianism, is that an action is moral if it conforms to certain principles or
duties (irrespective of the consequences). Deontology is derived from, the Greek
work deon, which means duty. The one name that stands out from all others in
terms of this approach is that of Immanuel Kant.
✓ Immanuel Kant (1724-1804) argued that the supreme principle of morality is a
standard of rationality that he dubbed the “Categorical Imperative” (CI). Kant
characterized the CI as an objective, rationally necessary and unconditional
principle that we must always follow despite any natural desired or inclinations
we may have to the contrary.
✓ In layperson’s terms, the Categorical Imperative can be compared and contrasted
with what is often described as the Golden Rule, one that can be found in many
different cultural and religious traditions: do unto others as you would want them
do unto you. It is immediately evident that this type of argument will provide
solutions to ethical problems that are different from utilitarian approach.

✓ The basic premise of virtue ethics is that morality depends on perfecting one’s
character. Different from utilitarianism (consequences) or deontology (duty), the
emphasis is on the virtues of the individual. Based on the ancient contribution of
Aristotle (384 to 322 BC).
✓ Virtue ethics is a broad term for theories that emphasize the role of character and
virtue in moral philosophy rather than either during one’s duty or acting in order
to bring about good consequences. A virtue ethicist is likely to give you this kind
of moral advice: “Act as a virtuous person would act in your situation.”
✓ Most virtue ethics theories take their inspiration from Aristotle who declared that
a virtuous person is someone who has ideal character traits. These traits derive
from natural internal tendencies, but need to be nurtured; however, once
established, they will become stable.
For example:
▪ A virtuous person is someone who is kind across many situations over a lifetime
because that is her character and not because she wants to maximize utility or gain
favors or simply do her duty. Unlike deontological and consequentialist theories,
theories of virtue ethics do not aim primarily to identify universal principles that
can be applied in any moral situation. And virtue ethics theories deal with wider
questions – “How should I live?” and “What is the good life?” and “What are
proper family and social values?”
 THEORIES
WHAT IS IN

MY
BEST
LONG TERM
INTERESTS
?
WHAT WILL BRING THE
GREATEST OVERALL

GOOD
FOR

ALL
STAKEHOLDERS
?
 THEORIES
WHAT IS MY
DUTY
TO
OTHERS
CONSIDERING
 APPROACHES
AM I SHOWING
AM I BEING AN
EXEMPLARY CARE
PERSON OR OTHERS IN MY
?
COMMUNITY
?
Source:

 A concern for justice and fairness

 Shifting process that reacts to change
 Acts are judged on the universal standard of the reasonable person
 Doctrine of Individual Rights and Responsibilities – every person is liable for his or her
own actions.


o A person who brings an action in a court of law
o Nagkaso

o A person against whom an action is brought
o Kinasuhan
 o When a plaintiff files a petition (complaint) with the court, this requires that
he/she present evidence for all essential facts in the case.
o The defendant may file a motion to dismiss and must address the plaintiff’s
allegations.
o Essentially the defendant has three (3) choices:

o The fact-finding phase, this is where parties decide if they should settle or drop
claims and/or defenses.
o The major elements are
▪ Series of questions
▪ Patient records, personnel history
▪ Questioning witnesses

o A case may be tried before a judge only or before a judge and jury.
o During trial, evidence is collected, each sides presents witnesses and placed on
record. After each side has presented its case and cross-examined the witnesses,
each is allowed time for a closing argument.
o The decision will be made, and a verdict will be given.

o The losing party may appeal a trial court decision to a higher court in that
particular jurisdiction; however, only a final judgment may be appealed.
o Review of the arguments and processes of the lower court and the applicable
decision of law rendered.

▪ Involves a neutral third party that both sides have agreed will have the power to decide
the outcomes and render a binding decision.
▪ Involves statements from both sides, documents presented, reviews evidence and
proposes a compromise settlement.
▪ Less time consuming and less expensive than trial and suit proceedings.
✓ In healthcare, it has come to mean a form of personal liberty, where the individual is free
to choose and implement his or her own decisions, free from deceit, duress, constraint or
coercion.
Three basic elements:
1.The ability to decide
▪ without adequate information and intellectual competence,
autonomy seems hollow.
2.The power to act on decisions
3.Respect for individual autonomy of others
 Rules involving Informed Consent which contain the elements of disclosure,
understanding, voluntariness, competence and permission giving.
 Legal exceptions to the rules of Informed Consent have been made in cases of
emergency, incompetence, waiver and when there is implied consent.

1. Binds both the health practitioner and the patient in an association of truth.
2. The patient must tell the truth in order that appropriate care can be provided.
3. The practitioner needs to disclose factual information so that the patient can exercise
autonomy.
4. A nurse must be committed to the truth when faced with situations in which lying seems
a rational solution.

 The term suggests acts of mercy and charity.

 Any action that benefits another.
 All statements of beneficence involved positive action toward preventing, or removing
harm; and promoting the good.

 means non-harming or inflicting the least harm possible to reach a beneficial outcome.
Harm and its effects are considerations and part of the ethical decision-making process.
 In attempting to maintain ethical position in these cases, some practitioners have
explained their actions through the principle of double effect.

1. The course chosen must be good or at least morally neutral

2. The good must not follow as a consequence of the secondary harmful effects
3. The harm must never be intended but merely tolerated
4. The good must outweigh the harm

 is one of the core duties of practice. It requires health care providers to keep a patient's
personal health information private unless consent to release the information is provided
by the patient.
 Patients who share private information have chosen to relinquish some aspects of their
privacy because they have a reasonable expectation that sensitive information shared with
certain people will further their own welfare.
 The sharing of “secret” information with members of the interprofessional care teams or
others involved in the patient’s care is not considered a breach of confidentiality as long
as the information has relevance to their role in the case.In fact, sharing is deemed
essential for arriving at a caring response.
 A reliable general test for which team members should be given certain types of
information is the “need to know” test.
 Is it necessary to perform one’s specific job?
 Does this person need this information to help provide the most caring response?
 Does the sharing among the healthcare team will result to effective care?

1. Facilitate the sharing of sensitive information with the goal of helping the patient.
2. Exclude unauthorized people from such information.
3. Discern need to know information from mere interest when deciding what to share.

 The importance of confidentiality is recognized in both law and professional practice;

however, in certain cases, the most caring response requires breaching the patient’s
confidence.
 Legal to the standard practice that information must be kept, except with the patient’s
consent or at the patient’s request to break it, include the following:
 An emergency in which keeping the information will harm the patient.
 The patient is a danger to, or threatens to harm himself (e.g., suicidal)
 The patient is incompetent or incapacitated, and a third party needs to be a decision
maker for the patient
 Identified third parties are at a serious harm (e.g. STI, child or elder abuse)
 Request for hospitalization of a psychiatrically ill patient
 A serious risk that others may be harmed ( a terror threat)
 A court order

 Justice is fairness. Nurses must be fair when they distribute care, for example, among the
patients in the group of patients that they are taking care of.
 In health care we deal with distributive justice as we struggle with the distribution of
scarce resources.
 The principle of justice states that there should be an element of fairness in all medical
decisions: fairness in decisions that burden and benefit, as well as equal distribution of
scarce resources and new treatments, and for medical practitioners to uphold applicable
laws and legislation when making choices.

 Modern health care is the practice of a team, as no single individual can maintain the
data/ information needed to provide rational care.
 Whatever the assigned role, the practitioner must practice faithfully within the constraints
of the role.

1. It expresses the aims of the group

2. It promotes integrity, dedication and principled behavior
3. It provides guidance as to appropriate conduct
 The scope should be clear and one does not cross the line without willful intention.
 Self-regulation is one key elements of our profession.
 Disparagement and bad-mouthing of other health care providers serves neither our
profession nor our patients.
 Care must be taken to manage the therapeutic relationship so that patient exploitation is
avoided.
 The primary objective of health professions is to render service to humanity. Reward or
financial gain is a subordinate consideration.