1ST SEMESTER – FINALS REVIEWER
HEALTH CARE ETHICS (BIOETHICS)
TRANS BY: MARK GREGORY M. ADDATU
ETHICS DEFINITION
“The study of standards of right and wrong; that
part of science and philosophy dealing with moral
conduct, duty and judgement.”
ETHICS ARE:
• Study of right and wrong
• From Ethos, meaning cultural customs on
habit
• System of moral principles and values
• Principles of conduct that help govern
human behaviors, determine which acts
are right and which are wrong, and are
behavior of individuals and groups.
• Means of regulating and setting limits on
behavior.
Ethics in nursing research can be defined as the
act of moral principles which the research to
ensure the rights and welfare of individuals,
groups, or community under study.
Need of Ethical Guidelines
• For the Protection of Rights of Human under
study
• Ethical Conduct need to be Mandatory in
all discipline of research.
• Always Ethical Consideration have been
given adequate importance
HISTORICAL BACKGROUND
Nazi Germany Experimentation
• Charges brought against 23 German
physicians in the Nuremberg War Crime.
Trials for their medical experiments
included:
1. Freezing Experiments
2. Malaria Experiments
3. High altitude of Experiments
• Led to the development of Nuremberg
Code
Jewish Chronic Disease
• Studies were conducted at the Jewish
Chronic Disease Hospital in New York City
to develop information on the nature of the
human transplant rejection process.
Chronically ill patients who did not have
cancer were injected with live human
cancer cells.
• The physicians did not inform the patients
as to what they were doing. The physicians’
rationalization for their actions was as
follows:
i. They did not wat to scare the
patients.
ii. They thought the cells would be
rejected.
Historical Standards of Ethics CIHR (2001)
• Nuremberg code (1947)
• Principles to satisfy moral, ethical,
and legal concepts in human
experimentation, with voluntary
consent being essential.
• Universal Declaration of Human Rights
(1948)
• A recognition of and pledge to
basic human rights for the
international community; human
rights are protected by law.
• Declaration of Geneva (1948)
• A physician’s oath to devote life to
the service of humanity.
• Declarations of Helsinki (1964, 1975, 2000)
• Ethical Principles for Medical
Research Involving Human Subjects
(research procedures, risk
assessment duties, issues of
informed consent)
Belmont Report
• National Commission for the Protection of
Human Subjects
Three principles became pillar of ethics
standards:
1. Beneficence
• Respect persons’ decisions and
protect from harm.
• Maximize possible benefits and
minimize possible harms.
2. Respect for human dignity
• Autonomy of individuals
• Persons with diminished autonomy are
entitled to protection.
3. Justice
• Benefits and risks of research must be
distributed fairly.
Code of Ethics
• Professional Ethics
• Medical Ethics
• Nursing Ethics
• International Council of Nurses Code
• Other Ethical responsibilities toward
state licensing laws
• Statuary Laws
• Common Law
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 1ST SEMESTER – FINALS REVIEWER
HEALTH CARE ETHICS (BIOETHICS)
TRANS BY: MARK GREGORY M. ADDATU

• Law of Privacy Nuremberg Code

• Protection Act about Fundamental right Background:
of every Citizen • The requirement that animals be used in
research and testing to protect humans
Nurses’ Codes for Practice & Research was formalized in the Nuremberg Code
American Nurses Association (1995) – Ethical and subsequent national and international
Guidelines in the Conduct, Dissemination, & laws, codes, and declarations.
Implementation of Nursing Research
• Animal experimentation continued with
Nurse researcher must:
Galen in the first century but modern
- Respect autonomous research
animal use in research and testing dates to
participants’ capacity to consent to
Claude Bernard in 19th Century France.
participate… without negative
• The notion that testing chemicals on
consequences.
animals could be predictive of human
- Prevent or minimize harm & promote good
responses and therefore should be legally
to all participants.
mandated dates back to the 1930s, when
- Respect personhood or diversity of
the sulfa drugs were being introduced for
participants.
infections.
- Ensure burdens and benefits of research
• Sulfa drugs were some of the first drugs that
are equitably distributed amongst
were shown to be effective against certain
participants.
bacterial infections, but they were difficult
- Protect privacy of participants to maximum
to dissolve in solution. This was a problem,
degree.
as children usually require a liquid version of
- Ensure ethical integrity of research process.
a medication because they will not
- Report suspected, alleged, or known
swallow pills. In 1937, one sulfa drug was
scientific misconduct.
dissolved in ethylene glycol and
Canadian Nurses’ Codes for Practice and subsequently administered to children and
Research adults.
Nursing Values & Research, Safe, Competent, &
Ethical research & Practice
- Health & wellbeing The Nuremberg Code Came out of a trial in
- Choice post-war Germany in December of 1946
- Dignity • Nuremberg code was drafted as a set
- Confidentiality of standards for judging physicians and
- Justice scientists who had conducted
- Accountability biomedical experiments on
- Quality research environment concentration camp prisoners. This
code became the prototype of many
Importance of Ethics in Nursing Research
later codes intended to assure that
- Protect the vulnerable group & other study
research involving human subjects
participants from harmful effects of the
would be carried out in an ethical
experimental interventions.
manner.
- Participants are safeguard from
• The first tried 24 Nazis, including
exploitation researchers.
Hermann Göring and Rudolf Hess, at
- Establish risk – benefit ratio for the study
the International Military Tribunal for
subjects.
crimes against humanity.
- Ensure the fullest respect, dignity, privacy,
• This first trial lasted eight months with
disclose of information & fair treatment for
ultimately seven of the 24 defendants
study or reject participation in study & to
being executed.
have access to informed or written consent
• Some were sentenced in absentia,
for participation in research.
some were acquitted, some
Ethical Principle in nursing Research committed suicide or could not be tried
• Principle of Beneficence for medical reasons, and others were
• Principle of Respect of human dignity incarcerated.
• Principle of Justice

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HEALTH CARE ETHICS (BIOETHICS)
TRANS BY: MARK GREGORY M. ADDATU
• Second trial referred to as the “Doctors’
Trial” or the “Medical Case.” Four
judges presided over the eight-month
case, hearing 85 witnesses, and viewing
1,471 documents and 11,538 pages of
transcript.
• Twenty out of 23 defendants were
physicians. All had been singled out as
being responsible for the execution of
humans they deemed “unworthy of
life” and for experiments conducted on
concentra2on camp prisoners.
• The Nuremberg Military Tribunal’s
decision in the case of the United States
v Karl Brandt et al.
• A ten-point statement delimiting
permissible medical experimentation
on human subjects.
• Humane experimentation is justified
only if its results benefit society and it is
carried out in accord with basic
principles that “satisfy moral, ethical,
and legal concepts.”
• Permissible Medical Experiments.” Trials
of War Criminals before the Nuremberg
Military Tribunals under Control Council
Law No. 10. Nuremberg October 1946 –
April 1949, Washington. U.S.
Government Printing Office.
Principles of Nuremberg Code
1. The experiment should be such as to yield
fruitful results for the good of society,
unprocurable by other methods or means
of study, and not random and unnecessary
in nature.
2. The experiment should be so designed and
based on the results of animal
experimentation and a knowledge of the
natural history of the disease or other
problem under study that the anticipated
results will justify the performance of the
experiment.
3. The experiment should be so conducted as
to avoid all unnecessary physical and
mental suffering and injury.
4. No experiment should be conducted
where there is an a priori reason to believe
that death or disabling injury will occur;
except, perhaps, in those experiments
where the experimental physicians also
serve as subjects.
5. The degree of risk to be taken should never
exceed that determined by the
humanitarian importance of the problem
to be solved by the experiment.
6. Proper preparations should be made and
adequate facilities provided to protect the
experimental subject against even remote
possibilities of injury disability or death.
7. The experiment should be conducted only
by scientifically qualified persons. The
highest degree of skill and care should be
required through all stages of the
experiment of those who conduct or
engage in the experiment.
8. During the course of the experiment the
human subject should be at liberty to bring
the experiment to an end if he has reached
the physical or mental state where
continuation of the experiment seems to
him to be impossible.
9. During the course of the experiment the
scientist in charge must be prepared to
terminate the experiment at any stage, if
he has probable cause to believe, in the
exercise of the good faith, superior skill and
careful judgement required by him that a
continuation of the experiment is likely to
result in injury, disability, or death to the
experimental subject.
DECLARATION OF HELSINKI
Adopted by the 18th WMA General Assembly,
Helsinki, Finland, June 1964 and amended by the:
• 29th WMA General Assembly, Tokyo,
Japan, October 1975
• 35th WMA General Assembly, Venice, Italy,
October 1983
• 41st WMA General Assembly, Hong Kong,
September 1989
• 48th WMA General Assembly, Somerset
West, Republic of South Africa, October
1996
• 52nd WMA General Assembly, Edinburgh,
Scotland, October 2000
• 53rd WMA General Assembly, Washington
DC, USA, October 2002 (Note of
Clarification added)
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HEALTH CARE ETHICS (BIOETHICS)
TRANS BY: MARK GREGORY M. ADDATU
• 55th WMA General Assembly, Tokyo,
Japan, October 2004 (Note of Clarification
added)
• 59th WMA General Assembly, Seoul,
Republic of Korea, October 2
• 64TH WMA General Assembly, Fortaleza,
Brazil, October 2013
❖ Came to supersede the Nuremberg Code
as the normative ethical guidance for
medical researchers.
❖ The Declaration of Helsinki represents an
improvement over the Nuremberg Code in
the sense that it balances the concerns of
individuals against the benefits to the
society.
❖ Developed by World Medical Association
(WMA),
❖ Statement of ethical principles for medical
research involving human subjects,
including research on identifiable human
material and data
Note: Both the Nuremberg Code and the
Declaration of Helsinki indicate that animal-based
research should be conducted before human
experimentation, the former more unequivocally
than the latter.
General Principle
1. “The health of my patient will be my first
consideration,” and the International Code
of Medical Ethics declares that, “A
physician shall act in the patient’s best
interest when providing medical care.”
2. It is the duty of the physician to promote
and safeguard the health, well-being and
rights of patients, including those who are
involved in medical research. The
physician’s knowledge and conscience
are dedicated to the fulfilment of this duty.
3. Medical progress is based on research that
ultimately must include studies involving
human subjects.
4. The primary purpose of medical research
involving human subjects is to understand
the causes, development and effects of
diseases and improve preventive,
diagnostic and therapeutic interventions
(methods, procedures and treatments).
Even the best proven interventions must be
evaluated continually through research for
their safety, effectiveness, efficiency,
accessibility and quality.
5. Medical research is subject to ethical
standards that promote and ensure
respect for all human subjects and protect
their health and rights.
6. While the primary purpose of medical
research is to generate new knowledge,
this goal can never take precedence over
the rights and interests of individual
research subjects.
7. It is the duty of physicians who are involved
in medical research to protect the life,
health, dignity, integrity, right to self-
determination, privacy, and confidentiality
of personal information of research
subjects. The responsibility for the
protection of research subjects must
always rest with the physician or other
health care professionals and never with
the research subjects, even though they
have given consent.
8. Physicians must consider the ethical, legal
and regulatory norms and standards for
research involving human subjects in their
own countries as well as applicable
international norms and standards. No
national or international ethical, legal or
regulatory requirement should reduce or
eliminate any of the protections for
research subjects set forth in this
Declaration.
9. Medical research should be conducted in
a manner that minimizes possible harm to
the environment.
10. Medical research involving human subjects
must be conducted only by individuals with
the appropriate ethics and scientific
education, training and qualifications.
Research on patients or healthy volunteers
requires the supervision of a competent
and appropriately qualified physician or
other health care professional.
11. Groups that are underrepresented in
medical research should be provided
appropriate access to participation in
research.
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12. Physicians who combine medical research
with medical care should involve their
patients in research only to the extent that
this is justified by its potential preventive,
diagnostic or therapeutic value and if the
physician has good reason to believe that
participation in the research study will not
adversely affect the health of the patients
who serve as research subjects.
13. Appropriate compensation and treatment
for subjects who are harmed as a result of
participating in research must be ensured.
Risks, Burdens and Benefits
1. In medical practice and in medical
research, most interventions involve risks
and burdens.
2. Medical research involving human subjects
may only be conducted if the importance
of the objective outweighs the risks and
burdens to the research subjects.
3. All medical research involving human
subjects must be preceded by careful
assessment of predictable risks and
burdens to the individuals and groups
involved in the research in comparison with
foreseeable benefits to them and to other
individuals or groups affected by the
condition under investigation.
4. All medical research involving human
subjects must be preceded by careful
assessment of predictable risks and
burdens to the individuals and groups
involved in the research in comparison with
foreseeable benefits to them and to other
individuals or groups affected by the
condition under investigation.
5. Physicians may not be involved in a
research study involving human subjects
unless they are confident that the risks have
been adequately assessed and can be
satisfactorily managed.
When the risks are found to outweigh the
potential benefits or when there is conclusive
proof of definitive outcomes, physicians must
assess whether to continue, modify or
immediately stop the study.
Vulnerable Groups and Individuals
• Some groups and individuals are
particularly vulnerable and may have an
increased likelihood of being wronged or of
incurring additional harm.
• All vulnerable groups and individuals should
receive specifically considered protection.
• Medical research with a vulnerable group
is only justified if the research is responsive
to the health needs or priorities of this group
and the research cannot be carried out in
a non- vulnerable group. In addition, this
group should stand to benefit from the
knowledge, practices or interventions that
result from the research.
Scientific Requirements and Research Protocols
• Medical research involving human subjects
must conform to generally accepted
scientific principles, be based on a
thorough knowledge of the scientific
literature, other relevant sources of
information, and adequate laboratory
and, as appropriate, animal
experimentation. The welfare of animals
used for research must be respected.
• The design and performance of each
research study involving human subjects
must be clearly described and justified in a
research protocol.
• The protocol should contain a statement of
the ethical considerations involved and
should indicate how the principles in this
Declaration have been addressed. The
protocol should include information
regarding funding, sponsors, institutional
affiliations, potential conflicts of interest,
incentives for subjects and information
regarding provisions for treating and/or
compensating subjects who are harmed as
a consequence of participation in the
research study.
In clinical trials, the protocol must also describe
appropriate arrangements for post-trial
provisions.
Research Ethics Committees
• This committee must be transparent in
its functioning, must be independent of
the researcher, the sponsor and any
other undue influence and must be
duly qualified. It must take into
consideration the laws and regulations
of the country or countries in which the
research is to be performed as well as
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applicable international norms and
standards, but these must not be
allowed to reduce or eliminate any of
the protections for research subjects set
forth in this Declaration.
• The committee must have the right to
monitor ongoing studies. The
researcher must provide monitoring
information to the committee,
especially information about any
serious adverse events. No amendment
to the protocol may be made without
consideration and approval by the
committee. After the end of the study,
the researchers must submit a final
report to the committee containing a
summary of the study’s findings and
conclusions.
Privacy and Confidentiality
➢ Every precaution must be taken to protect
the privacy of research subjects and the
confidentiality of their personal information.
Informed Consent
➢ Participation by individuals capable of
giving informed consent as subjects in
medical research must be voluntary.
➢ In medical research involving human
subjects capable of giving informed
consent, each potential subject must be
adequately informed of the aims, methods,
sources of funding, any possible conflicts of
interest, institutional affiliations of the
researcher, the anticipated benefits and
potential risks of the study and the
discomfort it may entail, post-study
provisions and any other relevant aspects
of the study. The potential subject must be
informed of the right to refuse to
participate in the study or to withdraw
consent to participate at any time without
reprisal Special attention should be given to
the specific information needs of individual
potential subjects as well as to the methods
used to deliver the information.
➢ When seeking informed consent for
participation in a research study the
physician must be particularly cautious if
the potential subject is in a dependent
relationship with the physician or may
consent under duress. In such situations the
informed consent must be sought by an
appropriately qualified individual who is
completely independent of this
relationship.
➢ For a potential research subject who is
incapable of giving informed consent, the
physician must seek informed consent from
the legally authorized representative. These
individuals must not be included in a
research study that has no likelihood of
benefit for them unless it is intended to
promote the health of the group
represented by the potential subject, the
research cannot instead be performed
with persons capable of providing
informed consent, and the research entails
only minimal risk and minimal burden.
➢ When a potential research subject who is
deemed incapable of giving informed
consent is able to give assent to decisions
about participation in research, the
physician must seek that assent in addition
to the consent of the legally authorized
representative. The potential subject’s
dissent should be respected.
➢ Research involving subjects who are
physically or mentally incapable of giving
consent, for example, unconscious
patients, may be done only if the physical
or mental condition that prevents giving
informed consent is a necessary
characteristic of the research group. In
such circumstances the physician must
seek informed consent from the legally
authorized representative. If no such
representative is available and if the
research cannot be delayed, the study
may proceed without informed consent
provided that the specific reasons for
involving subjects with a condition that
renders them unable to give informed
consent have been stated in the research
protocol and the study has been approved
by a research ethics committee.
➢ The physician must fully inform the patient
which aspects of their care are related to
the research. The refusal of a patient to
participate in a study or the patient’s
decision to withdraw from the study must
never adversely affect the patient-
physician relationship.
➢ For medical research using identifiable
human material or data, such as research
on material or data contained in biobanks
or similar repositories, physicians must seek
informed consent for its collection, storage
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and/or reuse. There may be exceptional
situations where consent would be
impossible or impracticable to obtain for
such research.
Use of Placebo
The benefits, risks, burdens and effectiveness of a
new intervention must be tested against those of
the best proven intervention(s), except in the
following circumstances:
a) Where no proven intervention exists, the
use of placebo, or no intervention, is
acceptable; or
b) Where for compelling and scientifically
sound methodological reasons the use of
any intervention less effective than the best
proven one, the use of placebo, or no
intervention is necessary to determine the
efficacy or safety of an intervention.
c) and the patients who receive any
intervention less effective than the best
proven one, placebo, or no intervention will
not be subject to additional risks of serious
or irreversible harm as a result of not
receiving the best proven intervention.
Post-Trial Provisions
➢ In advance of a clinical trial, sponsors,
researchers and host country governments
should make provisions for post-trial access
for all participants who still need an
intervention identified as beneficial in the
trial. This information must also be disclosed
to participants during the informed consent
process.
Research Registration and Publication and
Dissemination of Results
➢ Every research study involving human
subjects must be registered in a publicly
accessible database before recruitment of
the first subject.
➢ Researchers, authors, sponsors, editors and
publishers all have ethical obligations with
regard to the publication and
dissemination of the results of research.
Researchers have a duty to make publicly
available the results of their research on
human subjects and are accountable for
the completeness and accuracy of their
reports. All parties should adhere to
accepted guidelines for ethical reporting.
Negative and inconclusive as well as
positive results must be published or
otherwise made publicly available. Sources
of funding, institutional affiliations and
conflicts of interest must be declared in the
publication. Reports of research not in
accordance with the principles of this
Declaration should not be accepted for
publication.
Unproven Interventions in Clinical Practice
➢ In the treatment of an individual patient,
where proven interventions do not exist or
other known interventions have been
ineffective, the physician, after seeking
expert advice, with informed consent from
the patient or a legally authorized
representative, may use an unproven
intervention if in the physician’s judgement
it offers hope of saving life, re-establishing
health or alleviating suffering. This
intervention should subsequently be made
the object of research, designed to
evaluate its safety and efficacy. In all
cases, new information must be recorded
and, where appropriate, made publicly
available.
CONTINIUNG EDUCATION OF ETHICO-MORAL
Advocacy
• Is acting in behalf of others.
Case Advocacy
• aimed at specific patients. it is a tradition in
the profession and upholds ongoing
professional values (Cary, 1992; Gadow
and Schroeder, 1995; Nelson, 1988; Kohnke,
1982; Winslow, 1984; Marks, 1985).
• Nurses are used to speaking up for specific
patients and their families to obtain the
services they need and find solutions to
issues unique to the case.
• Modern case advocate roles place a
strong emphasis on client autonomy. They
place a high value on educating and
assisting clients so they may decide what is
in their best interests and act accordingly
(Kohnke, 1982)
• The skills and goals of case advocacy
frequently place an emphasis on better
coping mechanisms, negotiation, and
facilitating access to already-existing
resources in order to address health issues
without requiring significant systemic.
"class advocacy" aimed at changing legislation
and social situations.
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• focuses on altering the system of opportunities
itself to advance the interests of bigger groups,
organizations, or communities rather than
primarily on the client's opportunity choices.
• The advocate serves as a catalyst to change
current laws, institutional systems, policies, or
resource distribution patterns in ways that
could potentially help many people.
• This type of advocacy can be carried out in
ways that directly question the system or it can
be carried out covertly and indirectly
(Needleman and Needleman, 1974
Nursing Advocacy
• build on of upholding human dignity,
patient equity and freedom from suffering.
• The American Nurses Association (ANA)
defines Nursing practice as "the protection,
promotion, and optimization of health and
abilities, prevention of illness and injury,
alleviation of suffering through the
diagnosis and treatment of human
response, and advocacy in the care of
individuals, families, communities, and
populations." The ANA also discusses the
significance of advocacy in its Code of
Ethics, specifically in Provision 3:
• "The nurse promotes, advocates for, and
protects the rights and welfare of the
patient, family, and the public."
• Nursing advocacy is built on the principles
of upholding human dignity, patient equity,
and freedom from suffering.
BASIS OF NURSING ADVOCACY
1. Preserving Human Dignity
- Patients, as well as their relatives, are
frequently frightened and perplexed in
medical settings. A composed,
knowledgeable nurse can guide
patients through a complex system and
facilitate communication with their
doctors. Sometimes nurses will also
explain testing and procedures to the
patient. In addition to abiding by
privacy regulations, they should be
mindful of how culture and ethnicity
may influence a patient's experience.
Generally speaking, nurses are in a
unique position that enables them to
combine all facets of patient care,
ensuring that issues are addressed,
standards are upheld, and successful
results continue to be the aim.
2. Patient Equality
- The healthcare industry is continually
evolving, both in terms of structure and
use of new technology. Regulations
governing the provision of care and
health services are changing as a result
of these changes. In contrast, the ANA
Code of Ethics mandates that nurses
remain above the fray and represent
patients "with compassion and respect
for the inherent dignity, worth, and
uniqueness of every individual,
unrestricted by considerations of social
or economic status, personal attributes,
or nature of health problems.
3. Freedom from Suffering
- Nursing is a job that people choose
because they want to help others. A
big part of this is the fundamental value
of aiding in the prevention or
management of suffering. This is one of
the most critical components of patient
care and can be accomplished on a
physical, emotional, or psychological
level. As defenders of their well-being,
nurses ought to be accessible to
patients and their families.
LOBBYING IN NURSING
Transfer of information, the art of persuasion, the
contact and relationship building to push a policy
maker for policies that benefit the nursing
profession, communicating nurses' views on local,
state, or national policy issues to the elected
officials in a timely and effective manner, leads to
a favorable change in the quality practice of
profession.
Ethical Conduct of Lobbying:
"the deliberate attempt to influence legislation
through various forms of advocacy directed at
policymakers on behalf of another person,
organizations, or group" Health care lobbyists are
employed by: Insurance groups, Drug companies,
Specialty organizations, Public health groups,
Others who have a stake in health care legislation
What ethical dilemmas does lobbying present?
Ethical dilemmas related to lobbying tend to arise
when various behaviors by lobbyists and
lawmakers undermine the fairness and
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transparency of that process and do not
contribute to the common good.
Note: Lobbying Always involves advocacy but
advocacy does not necessarily involve lobbying.
LOBBYING
• "Means the deliberate attempt to influence
political decisions through various forms of
advocacy directed at policymakers on behalf
of another person, organization or group.
LOBBYIST
• Influences and advocates certain views to
lawmakers in the hope of influencing at local,
state or federal level.
• Able to stand for the concerns of nurses who
do not have the opportunity or access to
represent them personally to the government.
Code of ethics:
• Systematic guides for developing ethical
behavior.
• Answers normative questions of what
beliefs and values should be normally
accepted.
• RA No. 9173
• An act providing for more responsive
nursing profession, repealing for the
purpose Republic Act No. 7164,
otherwise known as "The Philippine
Nursing Act of 1991" and for other
purposes.
International Code of Ethics:
• Adopted by ICN ( International Council of
Nurses ) in 1953.
• It’s a statement of ethical values,
responsibilities and professional
accountabilities of nurses and nursing
students that defines and guides ethical
nursing practice within the different roles
they assume.
• It’s a framework for ethical nursing practice
and decision making to meet professional
standards by regulatory bodies.
Principal elements of Code of Ethics by ICN
• This provides framework for ethical conduct
Adopted in 1953 by ICN and Revised in
2012.
1. Nurse and Patients or other people
requiring care or services.
2. Nurse and the profession
3. Nurse and practice
4. Nurse and Global Health
Nurse and People
• The nurses’ primary professional responsibility
is to people requiring nursing care.
• In providing care, the nurse promotes an
environment in which the human rights,
values, customs and spiritual beliefs of the
individual, family and community are
respected.
• The nurse ensures that the individual
receives accurate information in a culturally
appropriate manner on which to base
consent for care and related treatment.
• The nurse holds in confidence personal
information and uses judgment in sharing
this information. The nurse shares with society
the responsibility for initiating and supporting
action to meet the health and social needs
of the public, in particular those of
vulnerable populations.
• The nurse advocates for equity and social
justice in resource allocation, access to
health care and other social and economic
services.
• The nurse demonstrates professional values
such as respectfulness, responsiveness,
compassion, trustworthiness and integrity.
Nurses & PROFESSION
• The nurse assumes the major role in
determining and implementing
acceptable standards of clinical nursing
practice, management, research, and
education.
• The nurse is active in developing a core of
research-based professional knowledge
that supports evidence-based practice.
The nurse is active in developing and
sustaining a core of professional values.
• The nurse, acting through the professional
organization, participates in creating a
positive practice environment and
maintaining safe, equitable social and
economic working conditions in nursing.
• The nurse practices to sustain and protect
the natural environment and is aware of its
consequences on health.
• The nurse contributes to an ethical
organizational environment and
challenges unethical practices and setting.
Nurses & PRACTICE
• Nurses carry personal responsibility and
accountability for nursing practice, and for
• Maintaining competence by continual
learning
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 1ST SEMESTER – FINALS REVIEWER
HEALTH CARE ETHICS (BIOETHICS)
TRANS BY: MARK GREGORY M. ADDATU
Nurses & CO-WORKERS
• The nurse takes appropriate action to
safeguard individuals, families and
communities when their health is
endangered by a co-worker or any other
person.
• The nurse sustains a collaborative and
respectful relationship with co-workers in
nursing and other fields.
• The nurse takes appropriate action to
safeguard individuals, families and
communities when their health is
endangered by a co-worker or any other
person.
CODE OF ETHICS FOR FILIPINO NURSES
Article II. Registered Nurses & People
Sec 4. Ethical Principles
• Values, customs, and spiritual
beliefs held by individuals shall be
represented.
• Individual freedom to make rational
and unconstrained decisions shall
be respected.
• Personal information acquired in
the process of giving nursing care
shall be held in strict confidence.
Ethical Principles
Section 5
• Consider the individuality and
totality of patients when they
administer care
• Respect the spiritual beliefs and
practices of patients regarding diet
and treatment
• Uphold the rights of individuals
• Take into consideration the culture
and values of patients in providing
nursing care. However, in the event
of conflicts, their welfare and safety
must take precedence
Article III: Registered Nurses & Practice Sec. 6
Ethical Principles
• Human life is inviolable.
• Quality and excellence in the care of pts
are goals of nursing practice.
• Accurate documentation of actions and
outcomes delivered care is the hallmark of
nursing accountability
Section 7
• Know the definition and scope of
nursing practice which are in the
provisions of R. A. No. 9173, known
as the “ Philippine Nursing Act 2002
= Board Res. No. 425, Series of 2003,
the “Rules and Regulations
Implementing the Philippine Nursing
Act of 2002 =, (the IRR)
• Be aware of their duties and
responsibilities in the practice of
their profession as defined in the “
Philippine Nursing Act 2002 = and
the IRR Acquire and develop the
necessary competence in
knowledge, skills, and, attitudes to
effectively render appropriate
nursing services through varied
learning situations
Section 8
• Registered Nurses are the advocates
of the patients: they shall take
appropriate steps to safeguard their
rights and privileges.
Section 9
a. Respect the “Patients’ Bill of Rights” = in
the delivery of nursing care
b. Provide the patients or their families with
all pertinent information except those
which may be deemed harmful to their
well-being.
c. Uphold the patients’ rights when
conflict arises regarding management
of their care.
Section 10
• Registered Nurses are aware that
their actions have professional,
ethical, moral, and legal dimensions.
They strive to perform their work in the
best interest of all concerned.
Section 11
• Perform their professional duties in
conformity with existing laws, rules
and regulations. measures, and
generally accepted principles of
moral conduct and proper decorum.
Not allow themselves to be used in
advertisements that should demean
the image of the profession (i.e.
indecent exposure, violation of dress
code, seductive behavior, etc.)
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 1ST SEMESTER – FINALS REVIEWER
HEALTH CARE ETHICS (BIOETHICS)
TRANS BY: MARK GREGORY M. ADDATU

• Decline any gift, favor or hospitality general welfare of nurses through

which might be interpreted as appropriate legislation is a practice
capitalizing on patients. and visionary mission.
• Not demand and receive any
Article VIII: Administrative Penalties, Repealing
commission, fee or emolument for
Clause, and Effectivity
recommending or referring a patient
Section 18
to a physician, a co-nurse or another
• The Certificate of Registration of
health care worker; not to pay any
Registered Nurse shall either be
commission, fee or other
revoked or suspended for violation of
compensations to the one referring or
any provisions of this Code pursuant
recommending a patient to them for
to Sec. 23 (f), Art. IV of R. A. No. 9173
nursing care
and Sec. 23 (f), Rule III of Board Res.
Article IV: Registered Nurses & CO-WORKERS No. 425, Series of 2003, the IR
Section 12
• RN is in solidarity with other members
of the healthcare team in working for
the pt’s best interest.
• RN maintains collegial and
collaborative working relationships
with colleagues and other health
care providers.

Article V: Registered Nurses , Society & Environment

Section 14
• Preservation of life, respect for human
rights, and promotion of a healthy
environment shall be a commitment
of an RN.
• Establishment of linkages with the
public in promoting local, national,
and international efforts to meet the
health and social needs of the
people as contributing members of
society is a noble concern of an RN.

Article V: Registered Nurses , Society & Environment

Section 16
• Maintenance of loyalty to the nursing
profession & preservation of its
integrity is a deal.

Compliance with the by-laws of the

accredited professional organization
(PNA) and other professional
organizations of which the Registered
Nurse is a member is a lofty duty
Commitment to continual learning
and active participation in the
development and growth of the
profession are commendable
obligations.

• Contribution to the improvement of

the socio-economic conditions and

11