Introduction to Bioethics

Definition of Ethics

 Ethics is deduced from the Greek word ethos, meaning “customs" or “behaviors".
 Behavior is more attributed to human behavior and is therefore inherent to human beings.
 The term ethos has an equivalent meaning in Latin word moris which means “morals".
 Ethics is not to be understood as specific to nation but rather as inherent human

Definition of Ethics

Ethics is a mental-set, disposition or values.

Ethics is defined as:

 As a science, it deals with the morality (rightness or wrongness) of the human act.
Two Sets of Action that we
Judge:
Involuntary Actions/ (blinking of the eye, gurgling of your stomach) those are not subjected to
your ethical scrutiny those involuntary actions are called Acts of Man.

Voluntarily Action when the person acts voluntarily then that is the subject of

Ethical Scrutiny it is considered as Human Act, that can be determined whether it is right or it is
wrong
 As a discipline, it is meant for the exercise of a human conduct, both ethical and unethical.
 As a philosophical study, it guides the intellect in discerning concrete human conduct.
 Now in our subject healthcare ethics this was first termed as Bioethics, because it encompasses
all life science with all procedure that concerns human beings or living things.
 Ethics, when combined with the prefix bio, becomes Bioethics, a discipline that covers all life
sciences
 Bioethics is started mainly on medicine
 Ethics in medicine is not something new. Indeed because both medicine and ethics aim at the
overall well-being of persons, they are intrinsically connected. Though medicine concentrated
more on the physiological and psychological well-being of the patient, it did not abstract from,
or ignore the social and creative aspect of the patient. Good physiological function usually made
it possible for a person to pursue the other goods of life which lead to human fulfilment.

Bioethics as Applied Ethics

 It is an ethics of medical care, but not the same as medical ethics.

Note: When we say medical ethics it’s the type of wherein you are more concerned about the
practice of the medical profession likewise when we say nursing ethics is more concerned on
the ethical practice or legal aspect of nursing itself.
 Bioethics investigates practices and developments in the life sciences and biomedical fields it
involves ethical considerations when it comes to research.
  All pertinent fields of study must be pooled together in an attempt to settle certain moral
dilemmas in bioethics there will be always a mixture of different practices to resolve ethical
dilemmas.

Importance of Bioethics

 It is necessary for the conduct of appropriate and judicious healthcare procedure

 It is necessary in providing humanistic care to clients
 It is necessary to grasp the ethical dimension of medical procedures.
 It is necessary to practice bioethis because of authority given by the population.

Ethical Schools of thought (Part A)

Ethical Relativism

 This ethical doctrine claims there are no universal or absolute moral principles.
 Standard of right and wrong are always relative to a particular culture or society.
 Sometimes, morality is based on someone’s moral opinion of a certain matter.

Strength of ethical relativism:

 To the moral relativist, one would be considered too ambitious in claiming that one knows
absolute and objective ethical principles that are true.

Criticism and objection:

 Ethical relativism contradicts common beliefs and ordinary experiences in several ways.
 It removes the essence of one’s duty in determining whether an act is right or wrong.
 Ethical relativism is a contradiction in itself.

Situation Ethics

 Moral norms depend upon a given situation, but whatever situation maybe, one must act in the
name of Christian love.
 Three type of love exist:
- eros, philia and agape.
- Eros refers to your romantic love (girlfriend, boyfriend, or crush)
- Philia brotherly love it also involve platonic love (to your friends)
- Agape unconditional love, loving as Christ has loved us.
 Six propositions:
- Only love is intrinsically good
- Ultimate norm of Christian decision is love
- Love and are the same justice is love distributed
- Love wills the neighbor’s good whether we like him or not.
- Only the end justifies the means.
- Decision ought to be made situationally, not prescriptively.
  Situation ethics makes moral decision flexible and adaptable to varying situations.
 Agapeic love serves to check selfish motive as sell as uncaring health personnel, no filial or erotic
considerations.
 Contextualism may encourage ethical relativism. This may be used to justify the ends to which a
medical procedure is perfoprmed.

Pragmatism

 Attributed to Charles Peirce and Wiliam James, American philosophers.

 The most valid form of knowledge is one which is practical, workable, beneficial.
 If an idea can be operationalized in the most practical and beneficial way, it is true.
 Truth is a part of experience that can provide workable guides to practical behavior.
 Pragmatism took on many forms:
- experimentalism and instrumentalism.
 For one to learn, one must reconstruct human experiences and relate them to one’s own.
 Difficulties of Pragmatism:
- Pragmatism is materialistic.
- Pragmatism is too individualistic.

Utilitarianism

 Proponents of this school of thought are Jeremy Bentham and John Stuart Mill.
 Rightness and wrongness of ethical actions is determined by the goodness or badness of their
consequences.
 The principle of utility is the only one principle worth noting
 “Actions are good insofar as they tend to promote happiness, bad as they produce unhappiness.
 No action seems to be intrinsically right or intrinsically wrong.
 We ought to choose the action that produces the most benefits at the least cost of pain or
unhappiness.
 The principle of greatest happiness: the greatest amount of happiness for the greatest number
of people.
 The more people that will benefit form a better moral decision, the better.

Ethical Schools of Thought (Part B)

Kan’t Ethics

 Established by Immanuel Kant, a German thinker.

 First appeared in his work, “Groundwork of the Metaphysic of Morals.”
 Kantian ethics focuses on duty of obligation (deontologism/intuitionism).
- Morality is exclusively within the human personality
- Morality is a matter of intent, motive and will.
 Kant maintains that one acts morally if and only one does whatever one is obliged to do.
 Act done in accord with duty and act done from a sense of duty; non-moral acts are those who
do not have a moral sense.
  Categorical imperative implies that an action be done irrespective of the results.
 Act only on the maximum which you can at the same time, will to become a universal law.
- Golden Rule: “Let’s take it in the positive that you want others, if you want other do unto
you, you must do it unto them” it is the characteristic of Kantian ethics.
 Humans should be treated as an end and not as a mean
 Formula of Autonomy
 Kingdom of Ends
 Two types of duties exist:
perfect and imperfect.
 The concept of autonomous will.
 Difficulties include:
- Conflicting duties
- Categories imperatives fail to establish duties
- Conflict with the concept of human beings.

Ross’ Ethics

 Established by William David Ross, an Aristotelain philosopher.

 Rightness of action is not determined by its consequences
 Ross viewed deontology as rigid and insensitive in some cases.
 Moreover, deontological precepts sometimes conflict each other.
 Ross believe in moral rules, however he postulated that it should not be absolute or inflexible.
 Moral rules serve only as guidelines
 Absolute rules are often insensitive to the consequences of an act.
 Rightness and goodness are the only moral properties.
 Nonmoral properties need to be ascertained (why/what)
 The concept of actual duty and prima facie duty.
 Act in accordance with the stronger, more stringent or more severe prima facie duty.
 Act in accordance with the prima facie duty which has a greater balance of rightness over
wrongness.
 Only one is a prima facie duty
 Ross’ ethics relies more on moral intuitions.

Seven Types of Prima Facie Duties

Duty of Fidelity
¤ Being faithful to our duties, obligation, vows or pledges.
¤ Being loyal to a worthy cause

Duty of Reparation
¤ The duty of making amend for injuries that we have inflicted over others.
¤ Asking for forgiveness is insufficient.
¤ “Kung nakagawa ng masama, gumawa ka naman ng
mabuti.”
 Duty of Gratitude
¤ Appreciating and recognizing the services other have done for us.

Duty of Justice
¤ We can enjoy the social benefits with others, but we should also equally share with them the
burdens of social living.
Example: the human rights.

Duty of Beneficence
¤ The duty to do what is good.
¤ This type of duty enjoins us not only to bring about what is good for others but also to help
them better their conditions with respect to duty to virtue, intelligence or comfort.

Duty of Self-Improvement
¤ This the duty to do what is good to one’s self.
¤ We are encouraged to improve ourselves in order to be serve others

Duty of Nonmaleficence
¤ The duty of not causing harm/injury to others.
¤ We ought to avoid inflicting evil, injury or harm upon others as we would avoid doing so to
ourselves.
¤ Culpable negligence is an infraction of this duty.
¤ “Ang masakit sa iyo ay huwag mong gawin sa kapwa mo.”

Rawl’s Theory of Justice

 Postulated by John Rawls, a Harvard philosopher.

 Synthesized the deontological and utilitarian views.
 Justice is fairness in terms of the “original position.”
 If principles that would support inequalities in their society are introduced, the outcome would
be that, the people in their original position would take advantage of it.
 Every individual is inviolable.
 The greater good to be shared by all members should not be justify the loss of freedom of
others.
 Or, the larger sum of advantages which is supposedly to be enjoyed by the many should no
outweigh the inconveniences to be imposed on a few.

 Equal access to the basic human rights and liberties.

¤ Right to vote and eligibility to public office, freedom of speech and peaceful assembly,
liberty of conscience, freedom of thought , right of ownership and freedom from arbitrary
arrest.
  Fair equality of opportunity and the equal distribution of socio-economic inequalities.
¤ A just society is one in which inequalities must be demonstrated to be legitimate.

St. Thomas Aquinas’ Ethics

 Also known as natural law ethics/Thomistic ethics/Christian ethics.

 According to St. Thomas, the source of the moral law is reason itself.
 Human good is that which is suitable to or proper for the human nature.
 The good is built into human nature and it is that to which we are directed by our natural
inclinations as both physical and rational creatures.
 Humans have three natural inclinations:
¤ Self-preservation
¤ Just dealings with others.
¤ Propagation of our species.
 Natural moral law is founded on human nature itself (unchangeable).

FUNDAMENTAL CONCEPTS IN BIOETHICS

The Human Act

 Human act is a conscious and free exercise of one’s faculties, therefore, conscious and free.
 Act of man is an act beyond the control of one’s will.
 Morality or ethics is more concerned with human acts rather than acts of man.
 Constituents of Human Act:
¤ Knowledge – resides in the intellect and is the mindfulness of what the moral agent is doing.
¤ Freedom – quality of the freewill by which one is able to choose between one or more
alternatives.
¤ Voluntariness – quality of the human act whereby any commission or omission of an act is a
result of the knowledge which an agent has of the end.

Sources/Determinant of Morality

 The Object of the Act

¤ The very substance of the act
¤ “What was performed by the agent?”
 Motive of the Agent
¤ Purpose for which a human agent does the act.
¤ “What specifically does the agent want?”

 The Circumstances
¤ What – the intended object of the act.
¤ Why – personal intention of the agent
¤ By what means – tools or procedures used
¤ How – modes of doing the act
 ¤ When – the time the act was performed.
¤ Where – the spatial setting where the act is done.
¤ Who – the person who does/receive

Standards/Norm of Morality

 Natural Law and Conscience

 “An ordinance of reason promulgated by a duly constituted authority for the common good of
the society.”
 Law is necessary to regulate acts of the freewill.
 Kinds of Law
¤ Natural Law/Divine Law/Human Positive Law
 Natural Law
¤ A system of law that is purportedly determined by nature, and thus universal.
¤ The pattern of behavior of animals, plants, or minerals follow such actions or movements in
accordance with the will of the Divine Mind.
¤ “Our universe is composed of an infinite variety of beautifully arranged things. Indeed nature
shows a constant order which is the result of a universal plan and of immutable laws.” (Panizo,
1964)
 Conscience
¤ The practical judgment that determines that an act is good, therefore to be done, and evil,
therefore to be avoided.
¤ Considered as subjective because it is borne out of the mental process of man.
 Man has to follow his conscience.
 Follow the law
 Follow one’s cultural beliefs
 Follow one’s feelings
 Follow one’s religious beliefs.

Principles of Well-Formed Conscience

 Inform themselves as fully as possible about the facts of the case and about the attendant
ethical norms.
 Form a morally certain judgment of conscience on the basis of this information.
 Act according to this well formed-judgment
 Be responsible for the actions performed.
 “To follow one’s conscience is properly to follow one’s well-formed conscience.”

The Concept of Freedom

 The will is the human faculty whose function is to desire.

 The object of freewill is that which is good, either in itself or as compared to other alternative
good.
 Man alone is capable of morality because of his rational knowledge and freewill.
 Responsibility is an inherent outcome of an act done with freedom.