LESSON 2 – ETHICO MORAL RESPONSIBILITIES OF NURSES
 Anything that is a natural problem or defect can be fixed
10 MORAL PRINCIPLES
 There are Ten (10) Moral Principles of Health Ethics
 As a health care professional, specifically as a nurse, we
always consider these 10 Moral Principles in our
profession
 These are the following:
1. Golden Rule
2. The principle of Totality
3. Epikia
4. One who acts through as agent is herself
responsible
5. No one is obliged to betray herself
6. The end does not justify the means
7. Defects of nature maybe corrected
8. If one is willing to cooperate in the act, no justice
is done to him
9. A little more or a little less does not change the
substance of an act.
10. No one is held to impossible
GOLDEN RULE
 Do not do onto others what you don't want others to do
onto to you.
 Example:
 If you would like your patient to treat you with
respect, then you should make sure to treat them
with respect too.
THE PRINCIPLE OF TOTALITY
 The whole is greater than its parts.
 Totality
 Directs that the anatomical completeness must
not be scarified without proportional justification.
 Every individual may not dispose of his organ or destroy
their capacity to function except if this is necessary for the
general being of the body.
 Example:
 If your relative or sibling needs a part of your liver
for them to live. There are cases that we need
transplantation or surgical procedures to give a
part of your organ.
 Even though you're going to give a part of your organ (ex.
Liver, kidney, etc.) to your family who needs it, you can
still function well.
EPIKIA
 There is always an exemption to the rule.
 Exception of the principle of totality.
 As the law can be broken to achieve a greater good in a
reasonable manner.
 Example:
 If you have a disturbed patient, you contact the
doctor and the doctor is not around, you can
make an exception to the rule and you may use
restraints so that they can't harm others or their
self.
 See to it that the exception is for the greater good.
ONE WHO ACTS THROUGH AS AGENT
IS HERSELF RESPONSIBLE
 Instrument to the crime
NO ONE IS OBLIGED TO BETRAY HERSELF
 You cannot betray yourself
 We are always responsible for our decisions
THE END DOES NOT JUSTIFY THE MEANS
 A decided result is so-called good or important that any
method (even immorally bad) may be used to achieve it.
DEFECTS OF NATURE MAY BE CORRECTED
 This is true, especially if the baby or child has a cleft-lip
and congenital defect.
IF ONE IS WILLING TO COOPERATE IN THE
ACT, NO JUSTICE IS DONE TO HIM
 Means that if you cooperate at something (may it be bad
or good), no justice shall be done.
A LITTLE MORE OR A LITTLE LESS DOES NOT
CHANGE THE SUBSTANCES OF AN ACT
 There is always a consequence in every act that we do,
may it be bad or may it be good.
 Fairness, justice, and equality must be observed in our
act.
 If you did something (whether big or small), it does not
change the fact that you have done something.
NO ONE IS HELD TO IMPOSSIBLE
 Do not promise impossible things.
 One cannot predicate a moral “ought” or duty except upon
a reasonable expectation that the corresponding duty,
action, and so on can be performed without reaching the
limits of physical or moral impossibility.
ETHICO-MORAL RESPONSIBILITY OF NURSES
 Principle of Totality and Its Integrity
 Integrity focuses on maintaining the basic human
capacity to function well.
 We can apply the following aspects to principle of totality:
1. Surgery
2. Mutilation
3. Sterilization
SURGERY
 A medical or dental specialty that uses operative manual
and instrumental techniques on a person to investigate or
treat a pathological condition such as a disease or injury,
to help improve bodily function, appearance, or to repair
unwanted ruptured areas.
 A surgical procedure, whether it is a minor or major
surgery.
 As nurses, we do assist in surgery.
 Registered Nurse (RN) has ethical and moral
responsibility to represent the patient's interests, show
humility, respect and protect patient autonomy and
preserve patient dignity
 International Council for Nurses, 2013
MUTILATION
 Refers to the procedure that diminishes or destroys the
functional integrity of the human body.
 Examples: Tonsillectomy, Ribs Resection, Sex Transplant,
etc.
 2 Types of Mutilation:
1. Major Mutilation
2. Minor Mutilation
 Major Mutilation
 Refers to the procedure that destroys the
functional integrity of the human body so that it
becomes incapacitated of its natural functions.
 It may also be done by means of surgical
procedures.
 Example: A woman who submits herself for
hysterectomy, a surgery to remove the uterus for
the purpose of avoiding procreation.
 Minor Mutilation
 Refers to the procedure that diminishes but does
not destroy the functional integrity of the human
body.
 Example: Tonsillectomy, Circumcision, Tooth
Extraction, etc.
FUNCTIONAL INTEGRITY
 The degree of completeness necessary for the
performance of functions to the human body.
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 The mutilation does not constitute any destruction of
functional integrity.
 The whole body must function well.
 You must preserve the human body.
3 CONDITIONS ON SURGICAL REMOVAL OF A HEALTHY
ORGAN CAN BE MORALLY ALLOWED:
1. That the preservation or functioning of a particular organ
provokes a serious damage or constitutes a threat to the
whole body.
 Example: If you have a cyst or lump in your
breast, in order to know if it is cancerous, biopsy
must be done.
2. That the damage cannot be avoided or at least notably
diminished, except by the amputation or mutilation in
question and that its efficacy is well assured.
3. That it can reasonably foreseen that the negative effect
will be compensated by the positive effect, exclusion of a
damage to the whole body, mitigation of the pain, etc.

STERILIZATION
 Refers to any technique that renders one sterile or unable
to exercise the power to reproduce during the sexual
intercourse.
 It permits coitus but hinders conception.
 Types of Sterilization:
1. Voluntary or Direct Sterilization
2. Involuntary or Indirect Sterilization
3. Therapeutic Sterilization
4. Contraceptive Sterilization
5. Eugenic and Social Sterilization
6. Punitive Sterilization

VOLUNTARY OR DIRECT STERILIZATION

 Person wills and request that the procedure be done on
himself or herself.
 Either as an end or as a means.
 Example: The willful act of submitting to vasectomy or
ligation.

INVOLUNTARY OR INDIRECT STERILIZATION

 It is done by the order of a public authority or a state.
 Not willfully employed as an end or as a means.
 Example: Surgical removal of ovaries because it is
affected by cancer cells.

THERAPEUTIC STERILIZATION
 The removal or a portion of a reproductive organ to save
one's life or to promote bodily integrity.
 Example: Biopsy shows that it is cancerous and to save
your life, therapeutic sterilization will be performed.

CONTRACEPTIVE STERILIZATION
 Intentional prevention of conception through sterilization.
 Example: Serious illness, genetic abnormality, severe
financial burden, childbearing puts one's health in danger

EUGENIC AND SOCIAL STERILIZATION

 Are performed to hinder the conception and undesirable
and physically and mentally unfit offspring.
 Performed especially if the patient is mentally
incapacitated.

PUNITIVE STERILIZATION
 Is a form of penalty or punishment usually ascribed to sex
related crimes particularly rape.

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