BIOETHICS

GLENN Y. VILLARMIA, RN

Ethics

 a systematic approach to understanding, analyzing, and distinguishing matters of right and

wrong, good and bad

Morality

 beliefs about what is right behavior and what is wrong behavior derived from one’s ethics

 One’s morals are judged to be good or bad through systematic ethical analysis

Bioethics

Specific domain of ethics that is focused on moral issues in the field of health care.

What Makes Human Acts Good or Bad?

3 Determinants of Moral Act

1. Object - is the thing with which the action is essentially concerned. For a morally good act, the
object of it must be good

2. Intention - For a human act to be morally good the agent or doer must have a good intention

3. Circumstances - are such things as the person involved, the time, the place, the occasion

-contribute to increasing or diminishing the moral goodness or evil of human acts.

7 Major Ethical Principles

1. Autonomy - refers to the right to make one's own decisions. But nurses might decide to act in
ways that they believe are for a patient’s “own good”. The deliberate overriding of a patient’s
autonomy in this way is called, Paternalism.

2. Veracity - refers to telling the truth

3. Fidelity - means to be faithful to agreements and promises

4. Beneficence - is an ethical principle that includes doing good and removing harm.

Requires taking actions to benefit others.

5. Nonmaleficence – the injunction to “do no harm”. Often paired with beneficence.
Nonmaleficence involves refraining from action that might harm others.

6. Confidentiality - is at the centre of maintaining trust between patients and health care providers

7. Justice – refers to the fair distribution of benefits and scarce health care resources.

Other Important Ethical Theories

Utilitarianism - based on the approach that the greatest good should be given to the greatest number

Deontology – the basic standards for an action’s being morally right are independent of the good or
evil

Teleology - theory of morality that derives duty or moral obligation from what is good or desirable as
an end to be achieved

Egoism - an ethical theory holding that the good is based on the pursuit of self-interest

Other Important Ethical Theories

Hedonism - the philosophical doctrine that all pleasure is intrinsically good, and nothing but pleasure
is intrinsically good.

Good Samaritan Law - are laws designed to protect health care providers who provide assistance at the
scene of an emergency against claims of malpractice.

Hippocratic Oath - is an oath embodying a code of medical ethics usually taken by those about to begin
medical practice.

Whistle blowing - is the reporting of illegal, unethical and incompetent performance .

Epikia - The principle in ethics that a law can be broken to achieve a greater good

Informed Consent

“Every human being of adult years and sound mind has a right to determine what shall be done with
his own body.” (Justice Benjamin Cardozo, 1914)

Elements of Informed Consent

1. Disclosure of information/Presentation - The patient must have a clear understanding

2. Understanding - physicians must make reasonable efforts to assure comprehension by

explaining things clearly and simply.

3. Voluntariness - patient voluntarily agree to the proposed treatment or procedure, free from
unfair persuasion.
 4. Capacity/Competence - is assessed by evaluating whether the patient understands the
condition, understands available options, and his/her decision is based on a rational
processing of information.

Areas of Potential Liability in Nursing

Tort - is a civil wrong that unfairly causes someone else to suffer loss or harm

Nursing liability is usually involved with tort law. It is important for the nurse to know the differences
between malpractice (an unintentional tort) and intentional torts.

Unintentional Torts

Negligence and Malpractice

Negligence – is misconduct or practice that is below the standard expected of an ordinary, reasonable,
and prudent person.

Malpractice – is “professional negligence,” that is, negligence that occurred while the person was
performing as a professional

Incompetence/Gross Negligence - extreme lack of skills or abilities

4 Elements for a Malpractice to be Proven:

1. Duty - The nurse must have a relationship with the client that involves providing care

2. Breach of duty - There must be a standard of care that is expected in the specific situation but
that the nurse did not observe.

3. Harm or injury - patient must demonstrate some type of harm or injury as a result of the
breach of duty.

4. Damages - If malpractice caused the injury, the nurse is held liable for damages that may be
compensated

Intentional Torts

The defendant executed the act on purpose or with intent.

Assault and Battery

Assault - can be described as an attempt or threat another person unjustifiably.

Battery - is the willful touching of a person that may or may not cause harm.

False Imprisonment
is the “unjustifiable detention of a person without legal warrant to confine the person”

False imprisonment accompanied by forceful restraint or threat of restraint is battery.

Invasion of privacy

The client must be protected from four types of invasion:

1. Use of the client’s name or likeness for profit, without consent.

2. Unreasonable intrusion

3. Public disclosure of private facts.

4. Putting a person in a false light - This type of invasion in- volves publishing information that is
normally considered offensive but which is not true.

Defamation

is communication that is false, or made with a careless disregard for the truth, and results in injury to
the reputation of a person.

1. Libel is defamation by means of print, writing, or pictures.

2. Slander is defamation by the spoken word, stating unprivileged or false words by which a
reputation is damaged.

Doctrines of Liability

Attachment of responsibility to a person for harm or damages caused by another person in either a
negligence lawsuit or criminal prosecution.

Respondeat Superior

“Let the master answer”

Captain of the Ship

“surgeon”

Principle of medical-malpractice law, holding a surgeon liable for the actions of assistants who are
under the surgeon's control

Res Ipsa Loquitur

“Let thing speaks for itself”

Example: Leaving a foreign object inside the patient after surgery

Force Majeure

“Irresistible force”

Example: calamities

Moral Turpitudes

1. Murder – killing of a person (with intention)

2. Homicide – killing of a person (w/o intention)

3. Infanticide - killing of less than 3days old

4. Parricide – killing of father, mother, or child, whether legitimate or illegitimate, or any of his
ascendants, or descendants

5. Abortion – killing before age of viability

6. Robbery – taking any personal property belonging to another by using force

7. Theft – “without force”

3 Persons Criminally Held Liable

1. Principal – “master mind”, by direct or inducement

2. Accomplice – necessary persons to commit the crime (before the

act)

3. Accessory – destroys or hides the evidences

(after the act)

4 Circumstances Affecting Criminal Liability

1. Justifying - a person may not incur criminal liability under

some circumstances

2. Exempting – exempted by law from criminal liability for the crime (e.g.,
insane, 9y.o., accident)

3. Mitigating – reducing the degree of penalty (e.g., voluntary surrender, SC,

done under passion 18y.o & 70 yrs old)

4. Aggravating – increasing the degree of penalty (e.g., use public power, done
under night, stealing during calamity)

Will
  Testator/Testatrix – the maker of the Will

 Testate – a person died with Will

 Intestate – a person died without Will

 Probate – proves the validity of the Will

 Escheat – transfers name of property

2 Types of Will

1. Holographic Will - written, dated, and signed by the hand of the testator
himself, (need not be witnessed)

2. Nuncupative/Authenticated Will – “oral expression” of a person's wishes as to the

disposition of his or her property to be performed or to take

effect after the person's death

Thank you!