LPN 240 - BIOETHICS

Prof. Jan-Michael T. Moscoso, RN, USRN, CMTFaculty-in-Charge

Bioethics Is a living study of the conduct of

human life It is a relatively new discipline The term was originally coined in

America by Van Reusselaer Potter, a cancer researcher

Its essence is derived from morality principles and ethics

The basis for our moral conduct primarily comes from our origin. This includes:

family and traditions customs, beliefs, practices society and environment time, season or epoch we live in

- Ethics came from the Greek – Ethos (characteristic way of acting) and from the Latin – Mos, morrs (way of acting)

- It is a generic term for various ways of understanding and examining the moral life of a person (Beauchamp and Childress, 1994)

Approaches to Ethics:1. Normative – actions are based on standards of society and acts are judged by standards of what is accepted as right or good.2. Descriptive – what people believe and how they act are phenomenologically described3. Analytic – people analyze the concepts and methods of ethics in the light of what they observe, believe and practice

Ethics – studies of human acts or conduct from a moral perspective as to whether they are good or they are bad.

Customs – are acts approved by a group or society.

Etiquette – social observance required by good breeding.

Parts of Ethics:

1. General Ethics – deals with the basic principles which are the morality of human acts.

2. Social Ethics – tackles the basic principles in the life of man as a member of the society.

Objectives of Ethics:

1.To make clear to us why one act is better than another.2.To live an orderly social life.3.To appraise and criticize intelligently the moral conduct and ethical system4.To seek the true value of life

Development of Bioethics

There are five waves of development in the field of bioethics, each belonging to a certain time and with a certain theme. This presentation leans heavily on Judeo-Christian tradition, although there are, of course, many other belief systems to be considered.

Wave no. Significant figues Bioethical principles and epoch

I Creation JusticeHammurabbi JusticeMoses Justice

II Hippocrates PaternalismIII New Testament: Jesus

ChristAutonomy

IV Media, Research, Economics, Pluralism

Compassion and Veracity

V Poverty, super-rich, migrants

Sharing and allocation of resources

Justice- In the Bible, the principle of justice was the main conduct of life. When Adam and Eve succumbed to pride by disobeying God’s command, man began to feel the pang of pain in life. Justice was defined. If you disobey, you deserve a corresponding action. What is shown here is that we get what we merit. Justice, then demands that we give what is due and we get what we merit for our conduct in life

- This principle of justice was also emphasized in the Hammurabbi.

During their fights for land and resources, whoever won the battle will get all the oxen, women, children and belongings of the losing party. If you win, you get all; if you lose, you have nothing.

- Another significant event that defined this principle was when Moses came down from the mountain of Yahweh. He brought back two tablets containing the Ten Commandments. Those who lived by these commandments enjoyed prosperity and peaceful living. Those who did not, suffered all sorts of malediction.

• Justice is giving everyone his due. If you are good, you get rewarded, if you are bad, you get punished.

• In contemporary times, the principle of justice applies to everyone. In court trials, those who are guilty are punished, those who have not committed crimes are set free

• In healthcare however, the principle of justice implies that we give each one his/her due. If an individual needs care, he/she has the right to be cared for because care is his/her due. No one therefore has the right to refuse health care to someone who is in need. This is emphasized in times of emergency regardless of the individual’s capacity to pay. As health care professionals, our first duty is to save lives.

• The client / patient has the right to receive care

• The health care professional has the obligation to give that person the needed care

• The principle of justice also applies to the working condition of nurses. In health care, appeals to justice or fairness rule out certain profitable practices, such as the exploitation of nurses through unpaid overtime, and overcharging the gov’t for services w/c are not done. There is a need to know what is fair and just but there is also a corresponding obligation to render quality service.

Paternalism

Hippocrates set the stage for paternalism. We see this concretely in family physicians who are often seen as the supreme health authority of the family’s health. The physician’s orders are often obeyed at all cost because of the paternalistic philosophy. The physician’s orders are often obeyed at all cost, no questions asked.

Paternalism is good if this takes a parental model of benevolent intervention, one that likens the state to a protective parent caring for one incompetent minor. However, paternalistic acts typically involve force or coercion, deception, lying, manipulation, non disclosure of information. A paternalistic action necessarily places a limit on autonomous choice.

Autonomy

With the New Testament, the principle of Autonomy was born. Jesus Christ showed through His teachings the primacy of man’s freedom to make choices and decisions. He never forced any of his disciples to follow His ways but He always prefaced with… “If you wish to become one of my disciples, then come and follow me…”

The word autonomy comes from the Greek word ‘autos’ meaning self and the word ‘nomos’ meaning rule, governance, or law.

With autonomy, patients now have the choice and freedom to seek other opinions to validate or enhance what the physician advised them to do. Autonomy has given us the freedom to grow and develop towards maturity and responsibility.

Compassion and Veracity

This was made possible through the widespread development of media avenues: print, visual and audio. Immediate dissemination of information moves the world to empathy, thus compassion is practiced.

For communication to be credible, it must contain three elements:1.Logia – substantial views of world truth2.Pathos – which means an element of empathy, ability to put oneself in a true situation3.Ethos – which means morally correct and true to the event.These 3 elements comprises the principle of veracity.

Sharing and allocation of resources

The increasing number of Filipinos living below the poverty line, and the existence of a very small percentage living in the super rich income bracket, evokes this practice. It is lamentable to see individuals die because of inability to buy needed medicine. On the other hand, we see the rich waste money on vices and unnecessary leisure activities.

I’ve seen five individuals fight over the use of only one available pacemaker. With such scarce resources and with so many individuals needing help, what guidelines should we follow to answer everyone’s needs?- Gov’t policies need to give importance to the poor: more should be shared with them so that they can live decent lives.

Get a ½ sheet crosswise and answer the following:Give examples that show:1.How the principle of justice applies to the nursing profession.2.How the principle of veracity is practiced in nursing care.3.How do Filipino migrant overseas workers illustrate the principle of sharing and allocation of resources?