PRINCIPLE

S OF
HEALTH
ETHICS
ETHICAL
DILEMMA
 Value conflicts

 No clear consensus as to the “right” thing to do.

 A conflict between moral obligations that are difficult to

reconcile and require moral reasoning.

 When you have to judge what is right or wrong

 Choosing between options

 Deciding whether to do something or do nothing

 Should I or shouldn’t I?

 Weighing up the potential impact of your decisions or

actions

 A dilemma – making a difficult choice

ETHICAL
PRINCIPLES
 Conflict is inevitable.
 Ethical principles provide the framework/
tools which may facilitate individuals and
society to resolve conflict in a fair, just
and moral manner.
PRINCIPLES OF HEALTH
ETHICS
AUTONOMY
BENEFICENCE
NON-MALEFICENCE
JUSTICE
AUTONOMY
 SELF RULE
 PATIENT’S MOST BASIC RIGHT

 THE PATIENT HAS THE CAPACITY TO ACT

INTENTIONALLY, WITH UNDERSTANDING, &
WITHOUT CONTROLLING INFLUENCES THAT
WOULD MITIGATE AGAINST A FREE &
VOLUNTARY ACT
 INORMED CONSENT – OUTCOME OF THIS
PRINCIPLE
EXAMPLE
 Zoro is in a life-threatening case where
a blood transfusion is required to save
his life.
 Zoro, a Jehovah’s witness, have a
belief that it is wrong to accept a blood
transfusion.
 Zoro must be informed.

 The consequences of refusing a blood

transfusion must be made clear.
Desiring to “benefit” the patient,
Dr. Chopper may strongly want to
provide a blood transfusion, believing
it to be a clear “medical benefit”.
 When properly & compassionately
informed, Zoro is then free to choose
whether to accept the blood
transfusion in keeping with a strong
desire to live, or whether to refuse the
blood transfusion in giving a greater
priority to his religious convictions
about the wrongness of blood
transfusions, even to the point of
accepting his death.
BENEFICENCE
 TO DO GOOD
 THIS PRINCIPLE COUNSELS A PROVIDER
TO RELATE TO CLIENTS IN A WAY THAT
WILL ALWAYS BE IN THE BEST INTEREST
OF THE CLIENT, RATHER THAN THE
PROVIDER
 THE HEALTHCARE PROFESSIONAL
SHOULD ACT IN A WAY THAT BENEFITS
THE PATIENT
BENEFICENCE
 BENEFIT – SHOULD BE DEFINED BY THE
PERSON THEMSELVES.
 IT IS NOT WHAT WE THINK THAT IS
IMPORTANT
EXAMPLE
 When the patient is incapacitated by the grave
nature of accident or illness, we presume that the
reasonable person would want to be treated
aggressively, and we rush to provide beneficent
intervention by stemming the bleeding, mending the
broken or suturing the wounded.
NON-
MALEFICENCE
 TO DO NO HARM
 THIS PRINCIPLE REQUIRES HEALTH
PROFESSIONALS TO NOT INTENTIONALLY
CREATE A NEEDLESS HARM OR INJURY TO
THE PATIENT
 IT IS AN ACT OF NEGLIGENCE IF ONE
IMPOSES A CARELESS OR UNREASONABLE
RISK OF HARM UPON A PATIENT
 IT AFFIRMS THE NEED FOR MEDICAL
COMPTETENCE
EXAMPLE
 How to best treat a pregnant woman newly diagnosed with
cancer of the uterus. The usual treatment, removal of the
uterus is considered a life saving treatment. However, this
procedure would result in the death of the fetus.

 What action is morally allowable, or, what is our duty? It is

argued in this case that the woman has the right to self-
defense, and the action of the hysterectomy is aimed at
preserving her life. The unintended consequence (though
undesired) is the death of the fetus.
NON-
MALEFICENCE
1. The action itself must not be
intrinsically wrong, it must be a good or
neutral act.
2. Only the good effect must be intended,
not the bad effect, even though it is
foreseen.
3. The bad effect must not be the means of
the good effect,
4. The good effect must outweigh the evil
that is permitted
JUSTICE
 GIVING TO EACH WHAT IS DUE
 ACTING IN A NON-DISCRIMINATING WAY

 RESPECT FOR PEOPLE’S RIGHTS

 RESPECT FOR THE LAW

 SHOULD BE ABLE TO JUSTIFY YOUR

ACTIONS IN EVERY SITUATION
JUSTICE
 DEMANDS THAT THE HEALTH
PRACTITIONER SHOULD TRY TO BE AS
FAIR AS POSSIBLE WHEN OFFERING
TREATMENT TO PATIENTS &
ALLOCATING SCARCE MEDICAL
RESOURCES
JUSTICE
 The principle that deals with
fairness, equity and equality and
provides for an individual to claim
that to which they are entitled.
 Comparative Justice: Making a
decision based on criteria and
outcomes. ie: How to determine who
qualifies for one available kidney. 55
year old male with three children
versus a 13 old girl.
 Non-comparative Justice: ie: a method
of distributing needed kidneys using a
lottery system.
ETHICAL
RULES
ETHICAL RULES
VERACITY
PRIVACY
CONFIDENTIALITY
FIDELITY
VERACITY
 THE PRINCIPLE OF TRUTH TELLING
 IT IS GROUNDED IN RESPECT FOR
PERSONS & THE CONCEPT OF
AUTONOMY
 INFORMED CONSENT

 VIOLATED BY: LYING, OMISSION,

DELIBERATE CLOAKING OF
INFORMATION
PRIVACY
 A PERSONS RIGHT TO REMAIN PRIVATE
 TO NOT DISCLOSE INFORMATION
CONFIDENTIAL
ITY
 ONLY SHARING PRIVATE INFORMATION
ON A NEED TO KNOW BASIS
FIDELITY
 LOYALTY
 MAINTAINING THE DUTY TO CARE FOR
ALL NO MATTER WHO THEY ARE OR
WHAT THEY MAY HAVE DONE
 STRICT OBSERVANCE OF
PROMISES OR DUTIES.
 THIS PRINCIPLE, AS WELL AS
OTHER PRINCIPLES, SHOULD BE
HONORED BY BOTH PROVIDER
AND CLIENT.
ETHICAL
THEORIES
CONSEQUENTIALISM
DEONTOLOGY
DEONTOLOGY
 DUTY OR PRINCIPLE BASE THEORY
 BASING OUR ACTIONS ON A SET OF
PRINCIPLES OR DUTIES
 AN ACT IS RIGHT IF IT CONFORMS TO AN
OVERRIDING MORAL DUTY
DEONTOLOGY
 the Greek word, “Deon”, meaning duty.
 Considers that some acts are right or
wrong independent of their
consequences.
 Looks to one’s obligation to determine
what is ethical and answers the question:
What should I do and why should I do it?
Deontology: A duty

Example: Zelda, a practitioner, believes she has a

duty to give cardiac clients detailed information on

the pathology involved in their condition even

though the client has indicated that they are not

ready or may be terrified to hear the information

causing the client distress.

CONSEQUENTI
ALISM
 TAKING THE CONSEQUENCES OF OUR
ACTIONS INTO CONSIDERATION
 UTILITARAINISM – TYPE OF
CONSEQUENTIALISM
 ACTIONS OUT TO PRODUCE THE MAXIMAL
BALANCE OF POSITIVE VALUE OVER
DISVALUE
CONSEQUENTI
ALISM
 Teleological
 Greek word “Telos”, meaning end or consequence.
 Actions are determined and justified by the
consequence of the act.
 Consequentialists consider all the consequences of
what they are about to do prior to deciding a right
action.
 What should I do and why should I do it?
Consequentialism: Action

Example: Had Zelda respected the wishes of her

clients, she would have given them only the
information which would have been a benefit to
them and not caused them undue stress. She
would have been motivated by her desire to do
good (beneficence), rather than her sense of duty.
This is a Deontological betrayal.
QUIZ # 2
GET 1 WHOLE YELLOW PAD
ANSWER THE FF:
1. DEFINE AUTONOMY
2. DEFINE BENEFICENCE
3. DEFINE NON-MALEFICENCE
4. DEFINE JUSTICE
QUIZ # 2
 You are on a sinking ship and there is only ONE
lifeboat available. Posted on the side of the lifeboat
is a sign which reads, “Maximum Occupancy” - 8
persons…this boat will sink if over occupied.”
Standing on the deck and waiting on board the
lifeboat are nine adults and one child.

 You must decide who dies. Defend your decision.

CHOOSE!!!
Persons on deck
 You
 A young mother and her infant son
 A 75 year old retired physician
 His 68 year old wife
 A 17 year old, pregnant girl
(this counts as one person)
 A professional athlete (male)
 A member of the clergy
 A middle aged school teacher and
 Her husband, a banker
 CHRISTIAN
ANTHROPO
LOGY
JACKLYN RISIA D. SAN GABRIEL
CHRISTIAN
ANTHROPOLOGY
 ANTHROPOLOGY
 STUDY OF HUMANITY
CHRISTIAN
ANTHROPOLOGY
 STUDY OF HUMANITY FROM A BIBLICAL
PERSPECTIVE
 PRIMARILY FOCUSED ON THE NATURE
OF HUMANITY – HOW THE IMMATERIAL &
MATERIAL ASPECTS OF MAN RELATE TO
EACH OTHER
 AFFIRMS THE CHRISTIAN GOD WHO IS
LOVE, TRUTH & TRIUNE
•Christian Anthropology deals with who we are and how we
relate to God.

•Whether people are inherently good or inherently sinful is

crucial in determining how our relationship with God can be
restored.

•Whether the souls of human beings carry on after death

determines in large part our view of our purpose in this world.
 Christian Anthropology helps us to understand
ourselves from God's perspective.
 When we delve into this subject, we get a clearer
understanding of our fallen nature, and this leads to
a sense of wonder at the love of the Savior who
saw our helpless state and went to the cross to
redeem us.
 When we accept that sacrifice and appropriate it as
our own, our natures are transformed by God who
creates in us a completely new person
It is this new person
who can relate to
Him as we should,
as His adored
children.
SEATWORK # 1
 GET ½ SHEET OF YELLOW PAPER:
 IN RELATION TO OUR TOPIC
TODAY:
 PICK 1 QUOTE THAT DEFINES YOU
AS A CHRISTIAN
 AND IF PERHAPS YOU ARE NOT,
PICK 1 QUOTE THAT DEFINES
CHRISTIANITY IN YOUR OWN
PERSEPECTIVE.
IF
YOU ARE NOT AS CLOSE TO
GOD AS YOU USED TO BE, WHO
MOVED?

THEWORST MOMENT FOR THE

ATHEIST IS WHEN HE IS REALLY
THANKFL, & HAS NOBODY TO
THANK

EVERYEVENING I TURN MY
WORRIES OVER TO GOD. HE’S
THE REAL ATTITUDE OF SIN IN
THE HEART TOWARDS GOD IS
THAT OF BEING WITHOUT GOD

THE GREATEST ACT OF FAITH

TAKES PLACE WHEN A MAN
FINALLY DECIDES THAT HE IS NOT
GOD

I WOULD RATHER WALK WITH

GOD IN THE DARK THAN GO
  LIVEAS THOUGH CHRIST DIED
YESTERDAY, ROSE FROM THE GRAVE
TODAY, IS COMING BACK TOMORROW

A MAN CAN NO MORE DIMINISH

GOD’S GLORY BY REFUSING TO
WORSHIP HIM THAN A LUNATIC CAN
PUT OUT THE SUN BY SCRIBBLING
THE WORD, ‘DARKNESS’ ON THE
WALLS OF HIS CELL

 ANY FOOL CAN COUNT THE SEEDS IN

 GOD CANNOT GIVE US A
HAPPINESS & PEACE APART
FROM HIMSELF, BECAUSE IT IS
NOT THERE. THERE IS NO
SUCH THING.

YOU DO WELL TO BELIEVE IN

GOD. SATAN ALSO BELIEVES &
TREMBLES
 WE
TURN TO GOD FOR HELP WHEN
OUR FOUNDATIONS ARE SHAKING.
ONLY TO LEARN THAT IS GOD
SHAKING THEM.

IBELIEVE IN CHRISTIANITY AS I
BELIEVE THAT THE SUN HAS RISEN,
NOT ONLY BECAUSE I SEE IT, BY
BECAUSE BY IT I SEE EVERYTHING ELSE

A HEATHEN PHILOSOPHER ONCE

ASKED A CHRISTIAN “WHERE IS
 FOR WHEN WE CEASE TO WORSHIP
GOD, WE DO NOT WORSHIP
NOTHING, WE WORSHIP ANYTHING

 THECHRISTIAN IDEAL HAS NOT BEEN

TRIED & FOUND WANTING; IT HAS
BEEN FOUND DIFFICULT & LEFT
UNTRIED

 HOW
IS IT THEY LIVE IN SUCH
HARMONY THE BILLIONS OF STARS –
WHEN MOST MEN CAN BARELY GO A
TO ONE WHO HAS FAITH,
NO EXPLANATION IS
NECESSARY. TO ONE
WITHOUT FAITH, NO
EXPLANATION IS POSSIBLE