Bioethical Principles

BIOETHICAL PRINCIPLES

What is a Principle?

Is that from which something proceeds in any manner, whatsoever.

Example: the principle of smoke is fire or a cigarette butt. It is fire or cigarette butt from which smoke proceeds.

A moral principle

refers to a fundamental rule of moral law containing certain truth from which knowledge of a definite moral action for performance proceeds along with the provision of solution to specific moral problems or issues.

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The Principle of Indirect Voluntary Act

Sometimes, in the performance of human act which is of course a willed act as freely determined by the will, an evil effect sprouts which is not directly willed

That is why, oftentimes, remarks like: “sorry I did not truly mean it,” or “sorry, it was not really intended” are at once addressed by the one who performs the act, with an evil effect which he does not directly intend, to the other who suffers from the said effect.

Is there a moral culpability in an act that is directly willed but whose evil effect is not directly willed by the agent? When does the evil effect that is not directly meant become imputable to the agent?

A directly willed act whose evil effect is not directly willed holds the agent responsible provided that the principle of indirect voluntary act is employed whose conditions are fulfilled.

The Three Conditions

The evil effect must be foreseen or foreseeable in the performance of the act at least in a general way.

There must be freedom to choose not to do the act which is the cause of the evil effect.

Refraining from doing an act which is the cause of the evil effect holds the agent morally bound.


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Case Example:

Jane, a staff nurse does the act of injecting an injectable antipyretic substance into the buttock of a febrile four-year old boy to normalize his temperature. Nevertheless, the injection happens to hit the sciatic nerve of the little boy resulting to paralysis.

Analysis:

Hitting the sciatic nerve is always foreseen in the administration of injection into the pediatric patients considering the tenderness of their buttocks. Thus the first condition is met.

As Jane sees the evil effect, he is, of course, free not to pursue the act of injecting along that particular course where the sciatic nerve is foreseeably hit. She can attempt on a specific site at the buttocks where the intramuscular injection takes place as safe as it should be. Hence, the second condition is present.

Foreseeing the evil effect and being free to take the safer course, Jane is morally bound to refrain from doing that which is the cause of the said effect. Thus, the third condition is fulfilled.

This goes to show that Jane is liable for the evil effect that is not directly willed of his act that is directly willed.



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The Principle of Justice

Justice – rendering of what is one’s due

Principle of Justice – refers to moral principle by which certain actions are determined and deemed as just or unjust, as due or undue.

Basically, what is deserved by reason of right constitutes what is due.

What is a Right?

o Is a moral power of performing, of possessing, or of requiring something which is due.

o Right is inseparable from duty

What is Duty?

is defined as a moral obligation incumbent upon a person of doing or omitting (avoiding) something.

The exercise of duty, in its truest sense, sustains and ensures protection of right so that what is due- which is again a matter of justice – may be rendered



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Main Duties and Obligations of Health Care Practitioners Preservation of life

and health Protection of Bodily

integrity from harm Respect for human

dignity

Problems Relevant to the Principle of Justice

o Justice can be manifested in the equitable distribution of health care resources and goods because of equality of rights

Distributive Justice

pertains to a fair scheme of distributing society’s benefits and burdens to its members.

The Utilitarian Alternatives

These represent maximizing strategies to achieve the greatest amount of good or minimizing strategies to reduce the amount of potential harm.

The medical success principle

gives priority to those for whom treatment has the highest probability of medical success

The principle of immediate usefulness gives priority to the candidate who

is of greatest immediate service to the larger group under the circumstances

The principle of conservation

gives priority to those candidates who require proportionally smaller amount of resources and therefore more lives will be saved

The parental role principle

gives priority to those who have the largest responsibility to dependents

The principle of general social value

gives priority to those believed to have the greatest general social worth thus leading to the good of society

The Egalitarian Alternatives

these represent maintaining or restoring the equality of the person in need

The principle of saving no one

gives priority to no one because not all can be saved.

The principle of medical neediness

gives priority to the candidates with the most pressing medical needs

The principle of general neediness

gives priority to the most helpless or generally neediest in an attempt to bring them as nearly as possible to the level of well-being equal to that enjoyed by others. The poorest candidate would receive the available resource

The principle of first come, first served basis

gives priority to those who arrive first.

The principle of random selection

gives priority to those selected by chance or random. The candidate chosen in a lottery receives the resource.

Situations that demand whose claim has to be chosen among others show conflict of rights in which paying attention to one would mean violation of the other. This is the so-called collision of rights. In case of such a collision, one has to be reckoned greater to prevail over the other as the lesser, and the lesser ceases to be a right, at least at that point.

CONDITIONS FOR THE GREATER RIGHT

Three conditions that determine which is greater to prevail over the other in the collision of rights. Any one of which renders the right greater:

(That right) belongs to the more universal order.

(It) is concerned with the graver matter. (It) is founded upon the stronger title or

claim.

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Bioethical Principles