Theories and

Principles of Health
Ethics
Lecturer:
Vincent Z. Solidum, MAN, RN

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 Objectives

 To gain an understanding of the concept of ethics.

 Introduction to contrasting theoretical ethical approaches.
 Introduction to the application and scope of BIOETHICS.
 Introduction to key bioethical principles.
 To gain a basic understanding of the relationship between
ethics and law inhealthcare.
 Gain an understanding of how ethics relates to
professional practice.

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 “Ethics is the enterprise of disciplined
reflection on the moral intuitions and
moral choices that people make”
(Veatch, 1989, p1).

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Why Study Ethics?

Because health care is changing, you need tools

for making necessary and difficult decisions.

It will help you better understand patients, fellow

professionals, and the system in general.

It will assist you in building and maintaining your

career.

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 What isEthics?

 Ethics is the concept of interpreting morality.

 How should we behave?
 What choices should we make about how we live our
lives?
 What do we consider acceptable in our society?

BUT!!!

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What Factors Affect HowWe Find
Answers?

 Religions
 Intuitive Feelings
 Cultural Norms
 Laws and Policies
 Professional Codes of Conduct
 Coercion

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 Consider…

 Should termination of pregnancybe

morally permissible?
 You will have strong feelings over whether this is
ethically acceptable.
 A ‘gut feeling’ based on many influences.
 Through a critically evaluative approach you can move
beyond this to provide a reasoned argument and
rationale for rejecting an alternative position through
the study of ethics.
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 Consequentialism (Teleology)

 Consequentialism (Teleology) looks at whether

an action is ethically right or wrong by the
consequencesit produces.
 If we are faced with two courses of action, then
we should choose the one with the best overall
consequences.
 Stealing…….

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Consequentialism-Utilitarianism

 Utilitarianism is a consequentialist approachwhich

looks at humanhappiness.
 The action that leads to the greatest amount of
human happiness is the preferredaction.
 Consider resource allocation-
Should we give one person a very expensive treatment
or fund treatment for twenty other people?
Should we open one more ICU (Intensive Care Unit) bed
or two HDU (High Dependency Unit) beds?
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 Deontology

 Deontology- Holds that certain things are right or

wrong regardless of the consequences.
 Eg- Telling the truth may cause happiness or upset but
is considered the right thing to do.
 Often deontological principles are absolute rights and
fundamental principles
 Key principle is that you cannot justify the breach of a
fundamental or absolute principal just by the
consequences.

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 Virtue Ethics

 Virtue Ethics considers the moral character of the

person performing the act.
 This approach is not concerned with the consequence
or whether the act is carried out in accordance with
moral duties.
 What matters is whether the person carrying out the
act does so in accordance with qualities that are
considered to be virtuous, in other words good moral
intentions.

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 Task

 Identify thebasic consequentialist and deontological

approaches to the following scenario;

 Atwelve year old requires a bone marrow transplant

for any chance of survival but the only compatible
match is a thirty year old male who is in prison for
violent offences and refuses to donate his bone
marrow.

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 Bioethics

 Bioethics is the investigation of ethical issues that arise in

life sciences by applying moral philosophy principles.
Bioethics covers;
 Medicine
 Healthcare
 Genetics
 Biology
 Research
 Pharmacology

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 Bioethics

 Bioethics is a form of applied ethics.Contemporary

issues include;
 Abortion
 Euthanasia
 Cloning
 Stem Cell Research
 Xenotransplantation
 Genetic Engineering for ‘designerbabies’

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 Autonomy

 Autonomy and patient self-determination are

upheld when the nurse accepts the client as a
unique person who has the innate right to have
their own opinions, perspectives, values and
beliefs.
 Nurses encourage patients to make their own
decision without any judgments or coercion from
the nurse.
 The patient has the right to reject or accept all
treatments.
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Patient’s Rights/Bill of Rights

 Patient rights are those basic rules of conduct

between patients and medical caregivers as well
as the institutions and people that support them.
 Please refer to your NEOLMS for the copy of the
Bill of Rights

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 Informed Consent

Informed consent is a process of communication

between you and your health care provider that
often leads to agreement or permission for care,
treatment, or services. Every patient has the right
to get information and ask questions before
procedures and treatments. If adult patients are
mentally able to make their own decisions,
medical care cannot begin unless they give
informed consent.
This information can include:

The name of your condition

The name of the procedure or treatment that the
health care provider recommends
Risks and benefits of the treatment or procedure
Risks and benefits of other options, including not
getting the treatment or procedure
Why do I have to sign a consent
form?

The main purpose of the informed consent

process is to protect the patient.
 Proxy Consent

Proxy consent is the process by which people

with the legal right to consent to medical
treatment for themselves or for a minor delegate
that right to another person.

HIV Case…
 Confidentiality

Clinician's obligation not to disclose confidential

information about a patient
 Privacy

Patient privacy encompasses a number of

aspects, including personal space (physical
privacy), personal data (informational privacy),
personal choices including cultural and religious
affiliations (decisional privacy), and personal
relationships with family members and other
intimates (associational privacy).
 Veracity

Health care provider and patient must tell the

truth - carries over into documentation and
medical record keeping

Completely truthful with patients; nurses must

not withhold the whole truth from clients even
when it may lead to patient distress.

A patient who withholds information, or provides

untrue information, places self at risk - and
makes the health care provider job difficult
 Beneficence

 This is the principle that means healthcare

professionals must do good for their patients.
 What has to be considered is what is good for that
patient and not what is good for the healthcare
professional.
 In short it is the principle of acting to achieve a
greater good than harm.

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 Non-maleficence

 The principal of ‘doing no harm’.

“Doing no harm”, as stated in the historical
Hippocratic Oath. Harm can be intentional or
unintentional.

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 Fidelity

is keeping one's promises. The nurse must be

faithful and true to their professional promises
and responsibilities by providing high quality,
safe care in a competent manner.
 Justice

 is fairness. Nurses must be fair when they

distribute care, for example, among the patients
in the group of patients that they are taking care
of.
 Care must be fairly, justly, and equitably
distributed among a group of patients.

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 Relationship Between Lawand
Bioethics

 The study of bioethics affects how healthcare evolves

and is delivered.
 Healthcare, medicine and research are regulated by
law. Consider the consequences of research without
ethics in the second world war.
 Often the outcome of medical advancement can be
unknown.
 It is essential to recognise that law and bioethics are
not always a reflection of each other.

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 Law and Bioethics

 Simply because something is illegal doesnot

always mean it is morally wrong.
 Consider the arguments for euthanasia.
 Likewise, because something is legaldoes not
mean that it is morally right.
 Consider the opposition arguments to abortion
and cosmetic surgery
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Ethics and Professional Practice

 Why are ethics part of professional practice?

 Professional codes of conduct exist as a result of the
ethical and legal duties and responsibilities expected
of practitioners.
 Through ethically reasoned argument we establish
what is considered right and a positive obligation, or
whatis considered wrong and prohibited.
 Provides a moral standard that patients and staff can
expect from us.

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The End….

Thank you
Questions

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 References

 Beauchamp.T. and Childress.J. Principles of Biomedical

Ethics. 2009. 6th Edition. Oxford: Oxford University
Press.
 Harris.J. (Ed). 2001. Bioethics. Oxford: Oxford
University Press.
 Mason.J. and Laurie.G. 2013. 13th Edition. Law and
Medical Ethics. Oxford: OxfordUniversity Press.
 Pattinson.S. 2011.12th Edition. Medical Law andEthics.
London: Sweet and Maxwell.
 Veatch.R. 1989. Medical Ethics. New York: Jonesand
Bartlett.
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