NCM 108 BIOETHICS- FINALS
is preserving moral courage and
ETHICAL CONSIDERATION IN
LEADERSHIP AND MANAGEMENT
- like Florence Nightingale you must
be a role model
 The nurse leadership ethical behavior
can promote the care quality by
affecting the nurses’ performance and
bringing up several positive
consequences for the organiz

 ation (BARKHODARI-SHARIFABAD
et al., 2018)
o e.g minsan sa performance
binibase for example if
masipag ka map’promote ka
ganun.
 By creating an ethical climate, ethical
leadership leads to positive and
effective outcomes, professional
progress and development.; (El-Gazar
and Zoromba,2021)
 Intensity of moral distress forms the
ethical climate that affect ethical
decision making and influencing moral
courage and ethical behavior, specially,
ethical work climate was significant
and properly correlated to moral
courage and organizational citizenship
behavior and negativity with moral
(Abdeen and Atia, a.d. MA & NM,
2020)
 Perceived ethical climate takes place in
moral courage
 There was a significant positive
correlation between nurses’ ethical
climates and their moral courage.
(Taraz et al, 2019)
 Moral sensitivity and ethical decision-
making are identified as co-existent
dinvr moral sensitivity with ethical
decision making (Chen et al., 2021)
 An important aspect of decision making
preventing moral distress association
with controversial practice situations.
(Dolan 2017)
A. MORAL DECISION MAKING
- consequences ng bawat decision na
gagawin natin is una dapat iniisip
- ethical decision-making confidence
develop clinical practice.
THE PHASES OF COMPETENCY
1. Knowledge development-moral
sensitivity
2. Knowledge Application
3. Creating an ethical environment
4. Promoting social justice within the
health care system
1. PRINCIPLE OF MORAL
DISCERNMENT
2. PRINCIPLE OF WELL-
FORMED CONSCIENCE
3. STRATEGIES OR MORAL
DECISION-MAKING
PROCESS
4. ETHICAL DILEMMA
18 INDICATORS
IDENTIFIED IN THE
DEVELOPMENT OF ETHICAL
DECISION-MAKING CONFIDENCE
(BIRKHOLZ ET AL., 2022)
1. Recognize a genuine ethical dilemma in
practice
2. Make a sound ethical decision
3. Explain ethical decisions using correct
ethical terminology and language.
4. Provide a clear statement of the
personal values that guide your ethical
decision-making and practice.
5. Articulate legal guidelines related to
complex ethical issues in patient care.
(I.E., Assisted suicide, informed
consent, research involving minors)
6. Articulate difference between ethical
dilemmas, moral distress, issues related
to interprofessional collaboration and
communication, difficult patients, etc.
7. Articulate the definition of moral
distress in your practice
8. Identify ethical issues in complex
patient care (i.e. Identify scenarios
requiring ethical decision making
and/or ethical consult team guidance.
9. Apply ethical decision-making models
or structured processes to complex
clinical problems
10. Participate in/and or guide medication
related to complex clinical problems
involving ethical dilemmas or moral
distress
11.Recognize and manage moral distress
in self and others
12. Role model collaborative problem
solving in complex clinical problems
involving ethical dilemmas or moral
distress
13. Engage in preventive ethics initiative
to address the ethical environment in
your practice area.
14. Mentor others to develop ethical
practice behaviors
15. Address barriers to ethical practice
through systems changes
16. Use preventive ethics to decrease unit
level moral distress
17. Engage in health policy initiative
supporting social justice
18. Provide leadership at the unit,
organizational, local, state and federal
level for policy change initiative to
address social justice issues in health
care.
THE PROCESS OF MAKING MORAL
DECISIONS
 COMMITMENT
 CONSCIOUSNESS
 COMPETENCY
GOOD DECISION ARE BOTH
ETHICAL AND EFFECTIVE:
 ETHICAL DECISION
 EFFECTIVE DECISION
B. PRINCIPLE OF MORAL
DISCERNMENT
 TO MAKE A CONSCIENTIOUS
ETHICAL DECISION ONE MUST
DO THE FOLLOWING
- Among possible actions that might
seem to be means of fulfilling that
commitment, exclude any that are
contradictory to it (or those that are
intrinsically evil)
- 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.
- Among the possible means not
excluded or nullified, select one by
which one is most likely to fulfill
that commitment and act on it.
- 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.
 - Among the possible means not certitude. (TOPIC:
excluded or nullified, select one by FREEDOM, LAW AND
which one is most likely to fulfill CONSCIENCE- OPUS DEI,
that commitment and act on it. n.d.)
- OBJECTIVE VALUE
- MORAL ATTITUDE
C. PRINCIPLE OF WELL- - DEGREE OF CERTITUDE
FORMED CONSCIENCE
CONSCIENCE FORMATION
 TO ATTAIN TRUE GOALS OF
HUMAN LIFE BY RESPONSIBLE  OBJECTIVE VALUE
ACTIONS, IN EVERY FREE o CORRECT
DECISION INVOLVING AN o OBJECTIVE
ETHICAL QUESTIONS, PEOPLE o ERRONEOUS
ARE MORALLY OBLIGED TO DO o CULPABLE
THE FOLLOWING o INCULPABLE
- Informed themselves as fully as
 MORAL ATTITUDE
practically possible about the facts
o LAX
and the ethical norms.
o STRICT
- act according to this well-formed
o SCUPULOUS
conscience.
- accept responsibility for their action. o PHARISAICAL
 CONSCIENCE FORMATION o CLEAR
- LATIN, CONSCIENTA, AND o CALLOUS
FRENCH CONCIENSE  DEGREE OF CERTITUDE
- Define as the internal sense of what o PERPLEXED
is right or wrong, and one’s ability o DOUBTFUL
to choose between, as well as act o PROBABLE
upon, what one perceives to be the o CERTAIN
right thing to do.
o KEY POINTS ON
CONSCIENCE FORMATION ETHICAL ISSUES IN NURSING
o making moral decision LEADERSHIP AND MANAGEMENT
demand mature responsibility
 ATTRIBUTE OF ETHICAL
o Quality of conscience
COMPETENCE OF NURSING
o conscience can be described
LEADERS WERE IDENTIFIED
in terms of objective value, UNDER THREE () MAIN
moral attitude and degree of CATERGORIES (Barkhordari-
certitude. (TOPIC: Sharidibad et al., 2018)
FREEDOM, LAW AND o ETHICAL INTERACTION
CONSCIENCE- OPUS DEI,
o ETHICAL BEHAVIOR
n.d.)
o EXALTED MANNERS
o conscience can be described
in terms of objective value, 3 MAIN OBSTACLES WERE
moral attitude and degree of IDENTIFIED:
1. ETHICAL PROBLEMS  SHORTAGE OF HEALHCARE
2. CULTURAL PROBLEMS WORKERS
3. MANAGERIAL PROBLEMS  LIMITED ACCESS TO
HEALTHCARE FACILITIES
 HIGH OUT OF POCKET
ETHICAL PROBLEMS EXPENSES FOR
1. Conflicts in practical situation HOSPITALIZATION
2. Lack of Appreciation
3. Disregard of problems and disregard of
problems consisted of matters that the TOPIC
nurse managers considered wrong but ETHICAL ISSUES RELATED TO
somehow accepted as existing in the TECHNOLOGY IN THE
organization culture, or at least there DELIVERY OF HEALTH CARE
was nothing active going on the correct
them
4. A. Experienced Inadequacy A. DATA PROTECTION AND
a. Patient related problem in the SECURITY
category of experience inadequacy 1. DATA PRIVACY ACT 2012
were prioritization of patient care, (RA 10173 SERIES OF 2012)
limited power circumstances B. BENEFITS AND CHALLENGES
b. Related to staff, experienced OF TECHNOLOGY
inadequacy related was reported by C. CURRENT TECHNOLOGY:
NM’s as fatigue on the part of staff ISSUES AND DILEMMA
B. Meaning and service value of
medical care
A. DATA PROTECTION AND
1. Allocation of resources SECURITY
- ACCORDING TO TEISBERG et al
DATA PROTECTION
(2022), VALUE ALIGNS CARE
WITH HOW PATIENTS - is the act of protecting information,
EXPERIENCE THEIR HEALTH both sensitive and personal sensitive
BY FOCUSING ON THE to unauthorized and use.
OUTCOMES THAT MATTER
PROTECTION: ADVANTAGES
MOST TO PATIENT.
 CAPABILITY - it allows employees to safely share
 COMFORT shared logical and physical address
 CALM spaces.

C.ISSUES ON ACCESS TO SECURITY: 3 MAIN ATTRIBUTE

HEALTH CARE - availability
 "BAHALA NA" MENTALITY - integrity
- confidentiality
SECURITY EXTERNAL THREAT DEFENSE
SYSTEM
- EXTERNAL DANGER
o INDIRECT - firewalls
o DIRECT - antivirus software
INDIRECT THREATS - deleting users no longer authorized
o TROJAN to use systems
o WORM
o COMPUTER VIRUS
IMPLICATIONS TO PRACTICE
DIRECT DANGER
o TARGETED ATTACT BY A - HEALTH CARE SERVICES
HACKER o rely heavily on the open
exchange of information
PROTECTION
among all participants.
- is a strategy used within systems to o whether the costumers, the
handle hazards and ensure proper health care professionals, or
operation. the health institution
- provides a framework for controlling
access to data, process, programs DATA PRIVACY ACT (NATIONAL
and other resources. PRIVACY COMMISSION, 2021)

SECURITY  REPUBLIC ACT NO. 10173

 DATA PRIVACY ACT OF 2012
- employed to deal with threats from (DPA)
outside the systems in order to keep 1. PROTECT THE PRIVACY OF
the system running effectively. INDIVIDUALS WHILE
- provides a technique for protecting ENSURING FREE FLOW OF
both user and system resources from INFORMATION TO
unauthorized external entities in PROMOTE INNOVATION
terms of functionality. AND GROWTH.
POLICY 2. REGULATES THE
COLLECTION, RECORDING,
- primary distinction between security ORGANIZATION, STORAGE,
and protection. UPDATING, OR
SECURITY POLICY MODIFICATION,
RETRIEVAL,
- implemented by the system CONSULTATION, USE,
administrator, determines whether or CONSOLIDATION,
not a person may use a system. BLOCKING, ERASURES OR
PREVENTIVE PRECAUTION DESTRUCTION OF
PERSONAL DATA
- establishing permissions 3. ENSURES THAT THE
- encryption keys PHILIPPINES COMPLIES
- electronic signatures WITH INTERNATIONAL
- data vaults STANDARDS SET FOR DATA
 PROTECTION THROUGH
NATIONAL PRIVACY
COMMISSION
NPC
- is the country’s privacy watchdog
- an independent body mandated to
administer and implement the DPA
- monitor and ensure compliance of
the country with international
standards set for data protection.
WHO ARE COVERED BY THE DPA?
- APPLIES TO THE PROCESSING OF ALL
TYPES OF PERSONAL INFORMATION
AND TO ANY NATURAL OR JURIDICAL
PESON INVOLVED IN PERSONAL
INFORMATION PROCESSING,
INCLUDING PERSONAL INFORMATION
CONTROLLERS AND PROCESSORS
WHO, WHILE NOT LOCATED OR
ESTABLISHED IN THE PHILIPPINES, USE
EQUIPMENT LOCATED IN THE
PHILIPPINES, OR THOSE WHO
MAINTAIN AN OFFICE, BRANCH OR
AGENCY IN THE PHILIPPINES SUBJECT
TO THE IMMEDIATELY FOLLOWING
PARAGRAPH: PROVIDED, THAT THE
REQUIREMENT OF SECTION 45 ARE
COMPLIDE WITH.
DOES THE HOSPITAL OR HEALTH
CARE SETTING NEED A DATA
PRIVACY OFFICER?
- APPOINTING DPO IS A LEGAL
REQUIREMENT FOR PERSONAL
INFORMATION CONTROLLERS
(PICS) AND PERSONAL
INFORMATION PROCESSORS
(PIPs) UNDER THE DATA
PRIVACY ACT OF 2012
- HEALTH CARE INDUSTRY:
PICs or PIPs
o HOSPITAL INCLUDING
PRIMARY CARE
FACILITIES, MULTI-
SPECIALTY CLINICS,
CUSTODIAL CARE
FACILITIES, DIAGNOSTIC
OR THERAPEUTIC
FACILITIES, SPECIALIZED
OUT-PATIENT FACILITIES
AND OTHER
ORGANIZATIONAL
PROCESSING GENETIC
DATA
WHAT IS A PRIVACY NOTICE?
- is a statement made to a data subject
that describes how the organization
collect, uses, retains and discloses
personal information
WHAT ISA PRIVACY IMPACT
ASSESSMENT (PIA)?
- a process undertaken and used to
evaluate and manage impacts on
privacy of a particular program,
project, process, measure, system or
technology product of a pic or pip
WHAT IS THE CONSENT OF DATA
SUBJECT?
1. description of the personal data to be
entered into the system
2. purposes for which data will be
processed
3. basis for processing, especially
when it is not based on consent
4. scope and method of the personal
data processing
5. recipients to whom data may be
disclosed
 6. methods used for automated access
by the recipient and the extent to
which such access is authorized
7. identify and contact details of the pic
or its representative
8. existence of the rights of the data
subject
what do I need to keep in mind when
storing client’s information?
how my personal data may be disposed
of?
- In secure manner
- DPA PWEDE RIN
RELEVANT ISSUES AND
CONCERNS OF DATA PRIVACY TO
COVID 19 RESPONSES
1. what are the guidelines when
conducting contact tracing?
- release by the DOH, April 17, 2020
memorandum no.20200189.
2. can I share information about covid
19 patients?
3. can I publicly disclose the identities
of covid 19 patient?
B. BENFITS AND CHALLENGES
OF TECHNOLOGY
BENEFITS OF TECHNOLOGY
ACCOORDING TO ROSS 2019
1. IMPROVED CARE
COORDINATION
2. IMROVED POPULATION HEALTH
MANAGEMENT
3. IMPROVED PATIENT EDUCATION
CHALLENGES OF TECHNOLOGY
ACCORDING TO ZARIF 2022
1. HEALTH CARE ORGANIZATION
2. HEALTHCARE PROVIDERS
3. PATIENTS
C. CURRENT TECHNOLOGY
ISSUES AND DILEMMA
1. PRIVACY AND SECURITY
2. SOCIOTECHNICAL HEALTH
A. APPLICATION SOFTWARE
B. MATERIAL DEVICES AND
SUPPLY CHAINS
C. INFRASTRUCTURE
D. INDIVIDUAL HEALTH
RELATED PRACTICES
E. INTERPERSONAL POLICIES
F. ORGANIZATIONAL POLICIES
Code of ethics
- read
1. Code of Ethics For nurses
ICN - lahat may code ethics na sinusundan
- guide for our daily everyday nursing
practice
Responsibility:
 Promote health (health teachings)
 Prevent illness
 Restore health
 Alleviate suffering (support)
Respect for human right & cultural type
- di porque di kapareho. Kapag yung mga
yon pasyente, libre lahat automatic. Refer
DSWD
 - kung ano tinanong, yun lang isasagot
Right to life and choice - dignity. Di - dont use medical term
porque maganda bihis, magalang ka. Same.
• Hold confidence, personal info and use
Social standing. Give respect to that
judgment in sharing info
person.
- Di basta basta shini-share
• Society
Nursing care: Restpectful and
comsideration of age, color, disability and Nurse share to society the responsibiloty
illness. for initiation action to meet social health of
public
- nandidiri (×)
- within vulnerable group
- wear gloves (✅️) for protection
- responsibility
- kahit ano pang klaseng social status
• Advocate equity and social justice,
- sexual orientation = respect
allocation
- nationality
- di dapat nag aaksaya ng suplly
- politic
• Access to healthcarw and economic
services
Nurses render health services to - di pwedeng tumanggi ng patient
individual - based on doctor's order.
- explain situation, refer
- pag 10 dumating, explain sa lahat ng
- nasa pasyente if gusto nila o hindi
relative kasi yung culture. So, explain to
indiv and fam. • Demonstrate values
- respectfullness, responsiveness (sagot &
sunod), integrity
4 elements:
1. Nurses and people
2. Nurses and Practice
- primary responsibility to people requiring
nursing care - ...and maintaining compitence by
continual learning
• Providing care
- training, seminar, nagbabasa-basa
- promote and respect lahat ng paniniwala.
- IV
- give health teaching kahit di gagawin
- give judgment (accept and deligating
- ex. Lochia, postpartum beliefs
activity)
• Recieve accurate and sufficient
- must know how to assess to give right
information in culturally appropriate
care (BP, facial grimace)
manner
- base on consent for care and treatment.
- this reflects well on profession and - ex. may request for lab test, saan area
enhace competence magre-request? (CBC = Lab to Medtech)
- conduct: anong ugali sa bahay, yun ka sa - Refer, request, makisuyo sa aid
work (×)
- lahat ng co-worker kahit janitor - must
- pag professional ka na, confident ka respect
dapat
- use of technology; scientific advances :
Nurses as nurse takes action to safe guard
compatible to right of people
individual, fam and community, and when
- dapat alam ni nurse paano gamitin health is endangered by co-worker or any
other profession
- pag may nag-complain, idaan sa process
3. Nurses and the Profession
di dapat maniwala agad
- major role in implementing acceptable
- Appropriate action to support, guide co
standard
worker to advance ethical conduct
- perform nursing procedure within
- Purpose of the code must be understood
standard, management, research or
education
- pag teacher ka, di ka pwedeng mag work Those are the element of the code
sa hospital as nurse ; kung ano profession,
yun ang pathway
Nurses and Nursing students - lahat yan,
- practice nursing care : pag walang order,
you have to stidy standard and lahat ng
wag magbigay. Kung alam mong need,
element ng code, you have to study,
must refer. (TSB)
reflect, know ano ba yung standard, gaano
- Active in developing and sustaining core kahalaga yung standard, think how to
values and acting through the professional apply ethics during nursing domain
organization (PNA) Philippine Nurses (practice, research), discuss experiences,
Association. ethical dilemma
- contribute an ethical organizational
environment an challenges in ethical
Element of the code
setting
(Code 1)
- practitioners and managers (care provide
4. Nurses and Co-worker
care by human right, sensitive sa values
- to co-worker and lahat ng and beliefs)
makakasalamuha, what appropriate
- educators and researchers (sa curicculum,
behavior?
equity, justice, human rights)
- sustain a collaborative
- national nurses association (yung position
statement and guifeline that support ethical
standard. Involve nurse and ethic
committee. Advocate safe and healthy
environment)
Code 2
- practitioners and managers (standard care
and work setring that promotes quality
care: evalutation, continuing education,
renewing of license. 3 years mostly.)
- educators and researchers
- national nurses association
Code 3 (pare-pareho hanggang 4)- support
conduct, utilization of research and health
= educator and research
- education and management
- to advance nursing profession
- collaborate
- create strategy for conflict management
- Must understand role of other worker
Code of ethics for filipino nurses
-BON - BOARD OF NURSING
- board exam
- OR cases, major and minor during duty,
deliver, assist, cord dressing
- BOARD OF NURSING - has the power
na bawiin, pwedeng di ka mag take ng
exam. With coordination with Philippine
Nursing act of 2002
- *basahin preamble
- freedom to make decision, respect
individual freedom
- dapat alam yung PNA of 2002, Board
Resolution No. 45 series of 2003, and
Rules of regulation implementing the PH
act of 2002 or IRR.
- dapat aware of duty and practice in
profession (see PNA of 2002)
- knowledge, skills, attitude
*Modification of practice shall consider as
the principle of nursing practice
- if there is unlawful practice dapat may
authority, be legally responsible to to be
effective
- Sec A ethical principle: guideline: RN
must respect bill of rights in the delivery of
nursing care. (Right to refuse but
responsibility to explain)
- Does not allow themselves to be use in
advertisement
- Decline any gift or favor which might be
interpreted as capitalizing on the patient
- Avoid abuse of previledge, relationship -
access allowed to property
- palagi iniisip best interest ng patient
- collaborate, maintain professional role
and identity
- honor and safe guard the reputation and
dignity of nursing and other profession
- respect right of co-worker
*Participate actively in growth and
development of the profession
* Implementation of labor work and work
standard