THEORIES AND PRINCIPLE OF
By addressing the ethical obligations and
HEALTH CARE ETHICS
A. Ethical Theories
1. Deontology
 From Greek deon = obligation, duty
 Is the normative ethical theory that the
morality of an action should be based
on whether that action itself is right or
wrong under a series of rules, rather than
based on the consequence of the action
 It is sometimes described as duty,
obligation or rule- base ethics
 Action is more important than the
consequence
2. Teleology
 Teleogical from Greek telos, “end”;
logos “science”
 Theory of morality that derives duty or
moral obligation from what is good or
desirable as an end to be achieved
 Is an account of a given thing’s purpose
3. Utilitarianism
 Is a theory in normative ethics, or the
ethics that define the morality of actions,
as proposed by Jeremy Bentham and
John Stuart Mill
 The greatest happiness principle state
that a moral action is one that
maximizes utility, or happiness, for the
greatest number of people
B. Virtues Ethics
1. Virtues Ethics in Nursing
Virtues
Refer to specific traits
Become apparent through one’s behaviour
and are obviously linked to ethical principles
The ability to respond to ethical dilemmas
then become hinged upon one’s character
Four obligations, six virtues
duties of nurses, the code of Ethics for
Nurses helps you answer the question
FOUR PRIMARY OBLIGATIONS TO
FULFILL THE CONTRACT BETWEEN
NURSIN AND PUBLIC
“respecting the patient’s privacy and
protecting confidentiality"
“communicating honestly about all aspect of
the patient’s diagnosis, treatment and
prognosis”
“conducting and ethically valid process of
informed consent”
“advocating for the patient’s expressed
interest of best interests”
SIX VIRTUES APPLY TO NURSING
Professional competence
Honesty & integrity
Caring & compassion
Fairness & justice
Respect & self-respect
Courage
FOUR PRIMARY PROFESSIONAL
OBLIGATIONS – INFLUENCED BY THE
SIX VIRTUES
1. Protecting privacy and confidentiality
2. communicating honestly
3. conducting and ethically valid informed-
consent process
4. advocating for the patient’s best interest
CRITERIA FOR INFORMED CONSENT
Capacity (to understand and decide)
Voluntariness (in deciding)
Disclosure (of information)
Recommendation (of a plan)
 Understanding (of plan, risks, and
recommendation)
Decision (in favour of plan)
Authorization (of chosen plan)
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- personal beliefs, cultural and spiritual values
CORE VALUES OF A
PROFESSIONAL NURSE
TOP 5 NURSE CORE
1. Compassion – encompasses empathy, caring
and the promotion of each patient’s dignity
2. Trustworthiness – nurses are among the most
trusted group of people, making trustworthiness
one of the most essential nursing value and vital
to your integrity and ethical behaviour
3. Humility – when it comes to wealth of
medical knowledge and skills that allow you to
facilitate healing and alleviate suffering through
diagnosis and treatment, but humility should
also be your companion
4. Accountability – professional nursing values
wouldn’t be complete w/ accountability
5. Curiosity – nursing knowledge encompasses
all the theories, philosophies, research and
practice wisdom of the nursing profession. You
should never stop learning.
ETHICAL PRINCIPLES
1. Autonomy
Term used to describe a person’s or
government’s ability to make decisions, or
speaks and act on their own behalf, without
interference from another party
Although it is used in many different
context, autonomy is most often an
important element of political, philosophical
and medical conversation
PATIENT’S RIGHT AND
RESPONSIBILITIES
As a patient you have the rights to:
Receive care that is respectful of your
An explanation in terms that you can
understand and to have any questions
answered concerning your symptoms,
diagnosis, prognosis and treatment
Appropriate assessment & management of
your symptoms, including pain
Know the contents of your medical records
through interpretation by the provider
Know your health care team
Develop a collaborative plan to prevent your
medical problem from recurring
Choose or change your provider
Refuse to be examined or treated and to be
informed to the consequence of such
decision
Be assured of the confidential treatment of
disclosures of records and to approve or
refuse by law or is necessary to safeguard
you or the university community
Be informed & provide consent to
participate in research conducted at Health
Services
Participate in the consideration of ethical
issues that may arise in the provision of your
care
Provide feedback on the services you
receive
As a patient you have the responsibility to:
Provide health services with information
about your current symptoms/including pain
and medications
Provide health services with information
about your medical and mental health
history
Ask questions if you do not understand the
directions or treatment being given by a
provider
 Keep appointment or notify health services
within a reasonable time frame if you neeed
to cancel
Be respectful of others and other’s property
while at health services
Limit the use of mobile devices while at
health services
Informed Consent – permission granted in the
knowledge of the possible consequence,
typically that which is given by a patient to a
doctor for treatment with full knowledge of the
possible risks and benefit
COMPONENTS
You must have the capacity (or ability) to
make decisions
The medical provider must disclose
information on the treatment, test or
procedure in question, including the
expected benefits and risks, and the
likelihood (or probability) that the benefits
and risks will occur
You must comprehend the relevant
information
You must voluntarily grant consent, without
coercion or threat
DISCLOSURE OF INFORMATION
The condition/disorder/disease that the
patient is having/suffering from
Necessity for further testing
Natural course of the condition &
possible complications
Consequences of non-treatment
Treatment options available
Potential risks and benefits of treatment
options
Duration & approximate cost of
treatment
Expected outcome
Follow-up required
1. LEGALLY AUTHORIZED
REPRESENTATIVE/PROXY CONSENT
Is an individual who, under laws, has the
ability to act on behalf of another person
(such as a minor study participant). The
LAR may be a parent, grandparent,
caregiver who has been invited to
participate in research
2. PRIVACY
Is a state when a person is free from
public interference
3. CONFIDENTIALITY
The state of keeping or being
secret/private
Refers to a state when it is intended or
expected from someone to keep the
information secret
4. VERACITY
Is defined as being honest and killing
the truth
It is the basis of the trust relationship
establish between a patient and health
care provider
5. FIDELITY
Refers to one’s loyalty to a worthy
cause, telling truth, keeping actual and
implicit promises and not presenting
fiction as truth
6. JUSTICE
Refers to everyone having an equal
opportunity
 This principle seeks eliminate
discrimination in biological studies and
healthcare
7. BENEFICENCE
Is an ethical principle that address the
idea that a nurse’s action should
promote good
Refers to the action that promote the
well-being of others
8. NON-MALEFICENCE
Means non-harming or inflicting the
least harm possible to reach a beneficial
outcome
OTHER RELEVANT ETHICAL PRINCIPLES
1. THE PRINCIPLES OF DOUBLE EFFECT
It says that if doing something morally
good has a morally bad side-effect it’s
ethically OK to do it providing the bad
side-effect wasn’t intended. This is true
even if you foresaw that the bad effect
would probably happen
Example: abortions when the mother life
is in danger
GUIDLELINES FOR DETERMINING WHEN
IT IS ETHICALLY PERMISSABLE
Requirements:
1. What you perform must be good or indifferent
2. Intention of the agent – Beneficial
effect/harmful effect
3. The beneficial effect must be equal/better &
greater that the harmful effect, if not the
principle of double effect is illegitimate
4. Order of time
2. PRINCIPLE OF LEGITIMATE
COOPERATION
The cooperation is not immediate
The degree of cooperation & the degree
of scandal are taken into account
3. PRINCIPLE OF ORGAN DONATION
A person can dispose his body parts and
to destine it, that are still useful,
morally, irreproachable, noble and
among them to desire to laid the sick
and suffering
It should not change the personality of
the person
4. PRINCIPLE OF COMMON GOOD AND
SUBSIDIARY
Common Good – refers to either what is
shared and beneficial for all or most
members of a given community
Principle of Subsidiary – states that only
those decisions and tasks that cannot be
effectively decided upon or performed
by a supported or subsidized lower level
authority ought to be relegated to a more
central or higher authority
5. PRINCIPLE OF TOTALITY AND
INTEGRITY
The principle of totality states all that
decisions in medical ethics must
prioritize the good of the entire person,
including physical, psychological &
spiritual factors
All of the organs and other parts of the
body exist for the sake of the whole
person. Because the purpose of the part
is to serve the whole, only action that
damages a part of the body or prevent it
from fulfilling its purpose violates the
natural order and is morally wrong
6. PRINCIPLE OF ORDINARY AND
EXTRAORDINARY MEANS
Ordinary Means – reasonable hope of
benefit/success; not overly burdensome;
does not present an excessive risk and
are financially manageable
Elements:
 Reasonable/proportionate hope of
benefit/success
 Common diligence
 Proportionate
 Not unreasonably demanding
Extraordinary Means – no reasonable
hope of benefit/success; overly
burdensome; excessive risk and are not
financially manageable
No obligation to use it/morally optional
Elements:
 Certain impossibility
 Great effort
 Pain
 Exquisite and extraordinary
expensive
 Severe dread or revulsion
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SEXUALITY AND HUMAN
REPRODUCTION
Human Sexuality – is the way people experience
and express themselves sexually
SEVERAL OF SEXUAL ORIENTATION
THAT ARE COMMONLY DESCRIBED
Moral Evaluation
a) Heterosexual (Straight) – are
romantically and physically attracted to
members of the opposite sex
b) Gay/Lesbian – people whose enduring
physical romantic, and or emotional
attraction to people of the same gender
c) Bisexual, Bi – person who has the
capacity to form enduring physical,
romantic and emotional attractions to
those of same gender or to those of
another gender
d) Pansexual – person who has the capacity
to form enduring physical, romantic or
emotional attraction to any person
regardless of gender identity
e) Queer – people whose sexual orientation
is not exclusively heterosexual
f) Asexual – people who do not experience
sexual attraction
g) Allosexual – people who do experience
sexual attraction and are not asexual
h) Aromantic – people who do not
experience romantic attraction
i) Closeted – people who is not open about
their sexual orientation or gender
identity
j) Androsexual/androphilic – being
primarily, aesthetically and/or
romantically attracted to masculinity
k) Bicurious – people who are exploring
whether or not they are attracted to
people of the same gender as well as
people of another group
l) Demiromantic – people who do not
experience romantic attraction until a
strong emotional or sexual connection is
formed with a partner
m) Gynesexual/Gynephilic – being
primarily, aesthetically and or
romantically attracted to femininity
n) Polyamorous – describes people who
have consensual relationships that
involve multiple partners
We evaluate, or judge, sexual acts to be
morally obligatory, morally permissible,
morally supererogatory, or morally wrong
One’s person agreeing to have sexual
relations with another person when the
 former has no sexual desire of his/her own
but does want to please the latter might be
an act of supererogation
And rape and incest are commonly thought
to be morally wrong

Non Moral Evaluation

Nonmorally “good” sex – is sexual activity

that provides please to the participant or is
physically or emotionally satisfying
Nonmorally “bad” sex – is unexciting,
tedious, boring, unenjoyable, or even
unpleasant