Professional Documents
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BNP - Monthly Notes
BNP - Monthly Notes
MORALS
“MOS” – custom
REFERS TO HUMAN CONDUCT ITSELF-APPLICATION OF ETHICS.
FUNDAMENTAL STANDARDS OF R/W THAT AN INDIVIDUAL LEARNS AND INTERNALIZES -
USUALLY DURING EARLY STAGES OF CHILDHOOD DEVT - REFLECTS WHAT IS DONE IN A
SITUATION
Morality
- measure of relation between the human act performed & its norm according to the dictates
of right reason, human nature & ultimately, God’s Eternal Law
A. Relation
Both ethics & morality deal with human act & conduct.
Ethics studies about morality
Morality gives ethics a perspective of what to study about – that is the rectitude of whether
an act is good or bad
Morality provides ethics with a quality that determines and distinguishes right conduct from
wrong conduct
B. Distinction
Ethics pertains to the knowledge of what to study about – that is the goodness or evil of a
human act; Morality pertains to the application of this knowledge in the performance of
human act
Ethics provides learning about the morality of a human conduct; Morality provides ways in
practicing what is learned.
Ethics is the ‘word’; Morality is the ‘flesh’
Ethics indicates the ‘theory’; Morality indicates the ‘practice’
HUMAN ACT
An act that proceeds from the deliberate free will of man
Elements:
1. Knowledge – act is done in the light of the agent’s knowing faculty
2. Freedom – act is performed in accordance with & not against the will
ACT OF MAN
An act that does not proceed from the deliberate free will of man
Elements
1. (-) knowledge – agent not aware/conscious of what he is doing
2. (-) freedom – not a free act
3. (-) voluntariness – no decision of the will to make the agent intend & willfully do
such an act.
The Circumstances – conditions in which the act is done affecting its morality
Different Circumstances
Circumstance of Person
Circumstance of Quantity or Quality of the Act
Circumstance of Place
Circumstance of Means or Instrument
Circumstance of Manner
Circumstance of Time
Circumstance of the Motive of the Agent
ETHICS DETERMINE:
Confidentiality of Records
Right to Privacy
Right to Information
Competent Consent to Treatment
Right to Refuse Treatment
Termination of Treatment
Quality of Service provided for disabled or terminal patients
BIOETHICS
Scientific Advances
“Doctor w/o ethics is only a technician, but with ethics, he is properly called a physician”
Functions:
Other functions:
In the absence of Institutional Review Board (IRB) it can review research protocols on its
ethical aspects
It can also serve as advocates for legislative development on health and contributes its share
to public debate on health care issues.
Committee Composition
Must have a well-balanced representation from medical, nursing & administrative staffs.
Representatives from pastoral care, social work & other areas involved in patient care
A lawyer can be an effective committee member as long as he is careful not to put legal
concern above ethical concerns.
A liaison from the administration should be an active member of the committee
* A committee that does not have the full support of the administration is doomed to fail
The “Code of Ethics for Nurses” BON Resolution 220 series 2004- provides guidance for
carrying out nursing responsibilities consistent with the ethical obligations of the profession
What is a Patient?
The patient is the most important person in the hospital
The patient is not an interruption of our work- he is the purpose of it. He gives meaning and
nobility to our profession
The patient is not an outsider of our day to day operations. He is our concern
The patient is a person, not a statistic
He has feelings, emotion, wants, aspirations and dreams
It is our business to satisfy him
Above all, he is an instrument of our ultimate salvation
Values and Value Clarification
Ethical problems results from changes in society, advances in technology and the nurse’s
conflicting loyalties and obligations
Nurse’s ethical decisions will be influenced by their moral theories and principles, levels of
cognitive development and personal and professional values
The goal of ethical reasoning is to reach a mutual, peaceful agreement that is in the best
interests of the patient.
Salvation History
1. Creation of man 5. Fulfillment of the Promise
2. Fall of Man 6. Establishment of the Church
3. Promise of a Savior 7. Heavenly Kingdom
4. Preparation for the Coming
They must protect, defend, enhance and enable the person’s worth.
They must aim for the maximum and integrated satisfaction of every person’s needs, as an
individual and members of his community.
Every human being has an inner worth and inherent dignity. These he possesses not because of
what he has or what he does but because of what he is: a human person
As a human person, he must be respected regardless of the nature of his health problem, social
status, competence, past actions
Decisions about health must aim at the maximum integrated satisfaction of his needs: biological,
psychological, social and spiritual
Certain actions may never be done because performing them would constitute a violation
against the person’s dignity
Human rights- needs and values as it relates to other human beings
3 Basic Laws
Eternal law- “ the divine will or command that directs all actions & movements in the universe. It
commands that the natural order of things be preserved & forbids that it be disturbed”.
Natural law- commands that nature must be respected in its integrity & it prohibits the
destruction of such nature – nature of human being
Positive law- dictated by the authority of the church or state
NATURAL LAW
Properties of Natural Law
1. Universal 3. Recognizable
2. Obligatory 4. Unchangeable
Contents :
1. Fundamental Principles of Action
2. General Moral Principles of Relationship
3. Application of General Principles of Morality to specific situations in Life and Society
Ethical Theories
Teleological- -telos- “end” ; “goal”
- consequentialism- action is judged as good or bad in relation to the consequence, outcome or
end that is derived from it
Utilitarianism
> Concerned with the consequences or end product of our actions. An action is right if it
brings increased happiness or benefit for those concerned; an action is wrong if it decreases
people’s happiness or benefit
Advantages:
- easy to use
- can justify many decisions based on the happiness principle
Disadvantages:
- average happiness of all or total happiness for few
- harm can be done to the minority
- what constitutes happiness? Who determines what is good?
- end justifies the means
Deontology
duty”- “duty oriented”
- rationalist view that the rightness or wrongness of an act depends upon the
nature of the act rather than the consequences that occur as a result of it
Nurses code of ethics- importance of fulfilling duties that are inherently owed to
patients
Advantages
- provides clear guidelines for judging the rightness and wrongness of an act
- recognizes the dignity and autonomy of individuals and allows all people equal consideration
Disadvantages
- problem with disregard for consequences
- all ethical precepts are viewed as equally important
- exceptionless and rigid
The nurse is duty bound to act under moral rules that establish the right or wrong :
a. duty to honor a patient’s autonomy
b. duty to promote good and well-being
c. duty to be just and fair
d. duty to do no harm
e. duty to tell the truth
f. duty to keep promises and confidentiality
Virtue Ethics
An approach that deemphasizes rules, consequences and particular acts and places the
focus on the kind of person who is acting.
Virtues – admirable character traits, perfection of character
Vices – opposite
Moral Virtues :
are admirable character traits; generally desirable dispositions, which contribute, among other
things, to social harmony
enable us to act in accordance with reason
enable us to feel appropriately and have the right intention
CONSCIENCE
CON – with ; SCIENCE – knowledge
An act of judgment
Determines whether an act is good or bad
Types of Conscience
Correct
◦ judgment of an act as good when it is truly good and an act as evil when it is truly evil.
Erroneous
◦ Judgment of an act as good when it is evil and an act as evil when it is good.
◦ Inculpable – one who has an erroneous conscience through no fault of his own & w/o
any knowledge about being in error
◦ Culpable – one who has an erroneous conscience through his own fault and neglect.
Certain
◦ An assured & firm judgment of an act w/o any fear of being in error
Doubtful or Dubious
◦ No sure judgment of whether an act is good or bad.
Lax
◦ Perceives even morally grave evils as allowable; makes excuses of evil acts though
seriously evil by rationalizing & justifying them.
Scrupulous
◦ Perceives evil in an act when there is none
Pharisaical
judgmental towards other
Callous
Worst type ; no sensitivity to sin
Formation of Conscience
A formed & informed conscience is that which knows how to make a proper judgment on an act
as truly good to be done or truly evil to be avoided in its three moral determinants: act itself, motive of
the agent & circumstances surrounding the act
A. Informed themselves as fully as practically possible about the facts and the ethical norms
B. Form a morally certain judgment of conscience on the basis of this information
C. Act according to this well formed conscience
D. Accept responsibility for their actions
2. Among possible actions that might seem to be means of fulfilling that commitment, exclude
any that are contradictory to it ( intrinsically evil)
3. Also consider how one’s own motives and other circumstances may contribute to or nullify
the effectiveness of these other possible actions as means to fulfill one’s fundamental commitment
4. Among the possible means not excluded or nullified, select one by which one is most likely
to fulfill that commitment and act on it
DIMENSIONS OF STEWARDSHIP
Personal: Life and Health
Social: Stewardship of Resources; the Preferential Love for the Poor.
Ecological: Stewardship of Creation
Biomedical: Research and Experimentation on Human Beings.
b. The basic capacities that define human personhood are never sacrificed unless this is
necessary to preserve life
Cadaver donors
- brain death
- Informed consent (donor, next of kin)
- Proper care at death
STERILIZATION
A medical or surgical intervention which causes a patient, incapacity of generation
Therapeutic- inevitably required for the survival and health of a person- sexual organs-
integrating parts which must yield to the good of the whole.
◦ licit if:
- sickness is grave, certainly diagnosed and definitive that it offsets the evils of
sterilization
- it is necessary because it is the only possible effective remedy
- exclusively curative- intention is important