Ethical Consideration in

Leadership and Management

Group V
Reyes, Mark Jacob
Reyes, Arvin
Reyes, Stephanie
Rondero, Jairus
Rosal, Ma. Daniela

BSN 2A
Table of Contents
Ethical Consideration in Leadership and Management

A. Moral Decision making

1. Principle of Moral Discernment
2. Principle of Well-Formed Conscience
3. Strategies of Moral Decision Making Process Ethical Dilemma

B. Meaning and service value of Medical Care

1. Allocation of health Resources
2. Issues Involving Access to Care

Ethical Issues Related to Technology in the Delivery of Health Care

A. Data Protection and Security

1. Data Privacy Act 2012
(RA 10173 Series of 2012)
B. Benefits and Challenges of Technology

C. Current Technology: Issues and Dilemma

 Ethical Consideration in Leadership and
Management

A. Moral Decision making

1. Principle of Moral Discernment
What is Discernment?

❏ Refers to the ability to recognize the moral good, distinguish a moral right
from wrong, and must have the standard with measure or compare the
good thing and bad thing
❏ Moral Discernment defines the moral convictions that determine one's
behavior and ultimately one's life.

4 Principles of Moral Discernment/Judgement

1. Principle of Formal Cooperation
2. Principle of Material Cooperation
3. Principle of Lesser Evil
4. Principle of Double effects
Principle of Formal Cooperation

❏ Usually is distinguished from the full involvement of two or more people in

the same wrongful action.
❏ It occurs when someone intentionally helps another carry out a sinful act.
❏ Cooperation is distinguished from leading others into sin –which is what is
meant by sandal in its strict, theological sense.
❏ Cooperator refers, not to someone who instigates another's wrongdoing,
but to someone involved in wrongdoing initiated by another.
Example: (Suppose that a nurse is caring for a terminally ill patient, and she
knows that the patient plans to commit suicide.)
The patient has obtained a pain medication that he can use to commit
suicide by overdose. The nurse might cooperate formally with the suicide of that
patient by deciding to omit a scheduled visit to the patients room, so that the
overdose will not be detected until the patient is dead.
Principle of Material Cooperation

❏ When a person's actions unintentionally help another person do something

wrong.
❏ It is sometimes morally acceptable and sometimes not, depending on how
closely related it is to evil.

Example:
A nurse who works in an abortion operating room, even if she does not
agree with what the doctor is doing, is too closely related to the evil to be
permitted to continue in her job.
Principle of Lesser Evil

❏ The principle that when faced with selecting from two immortal options, the
one which is lease immortal should be chosen.

Example:
When your professor asks you what your classmate deserving grade is and
the professor lets you pick if 3.0 or 5.0, even tho you know those are both low
grades you will pick 3.0 because it is the lesser evil and your classmate will not
fail the subject.
Principle of Double Effects

❏ If doing something morally good has a morally bad side-effect, it's ethically
OK to do it providing the bad side-effect wasn’wasn't intended. That is true
even if you foresaw that the bad effect would probably happen.

Example: In cases when saving the life of a pregnant woman causes the death
of her unborn child
Performing an abortion when continuing the pregnancy would risk killing
the mother.
 Ethical Consideration in Leadership and
Management

A. Moral Decision making

2. Principle of Well-Formed Conscience
What is a Well-formed Conscience?

❏ “Conscience is a Judgement of practical reason that helps us to recognize

and seek what is good and to reject what is evil” (Catechism of the Catholic
Church, no.1778, 1796)

Principle of Well-formed Conscience

To attain the true goals of human life by responsible actions, in every free
decision involving an ethical question, people are morally obliged to do the
following:
● Informed themselves as fully as practically possible about the facts and
ethical norms.
● Form a morally certain Judgement of conscience on the basis of this
information
● Act according to this Well-formed Conscience.
Principle of Well-formed Conscience cont…

● Also consider how one's own motives and other circumstances may
contribute to or nullify the effectiveness of these other possible actions
as means to fuldill ones 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.

Conscience Formation

❏ Making moral decisions demand mature responsibility

❏ A fully mature and responsible conscience should be free, correct, clear, and
certain
❏ Discerning what is right and what is wrong
❏ We must follow our decision only after we have done our best to search for
the truth regarding the issues facing us.
Qualities of Conscience

Personal Freedom
● Free - Able to choose.
● Unfree - Impeded by some obstacles such as fear and anger

Objective Value
● Correct - subjective conforms to the objective moral values
● Objective - norms of morality erroneous lack of conformity to the objective
norms of morality.
● Culpable - one is in error and therefore responsible.
● Inculpable - has erred in good faith.
Qualities of Conscience cont…

Moral Attitude
● Lax - careless in its effort to seek the truth
● Strict - follow to the letter
● Scrupulous - tends to judge sin to be present when there is none
● Pharisaical - judgemental towards other
● Clear
● Callous - no sensitivity to pain
Ethical Consideration in Leadership and
Management

A. Moral Decision making

3. Strategies of Moral Decision Making
Process Ethical Dilemma
WHAT ARE NURSING ETHICS?
● Ethics are defined as the moral principles that determine how a
person or group of people will act or behave in specific situations.

● Strong ethics are vital to nursing, as moral dilemmas can

frequently arise while attending to patients.
Principles of Nursing Ethics

● Ethical principles are general by nature because they’re intended to

serve as a framework that people use to weigh the facts of a
situation that presents a moral or an ethical dilemma.

● The Oncology Nursing Society describes the principles of nursing

ethics that serve as guideposts for ethical decision-making in
healthcare settings.
Principles of Nursing Ethics
NONMALEFICENCE

Nurses have an obligation not to inflict harm and not to allow others to inflict harm. They must also promote
good actions on behalf of their patients.

BENEFICENCE
Nurses have a strong duty to act in ways that benefit individuals, communities, and society. Beneficence is
rooted in the innate love we feel for humanity and the drive to demonstrate that love through our actions.

AUTONOMY
Autonomy is the ability to explain one’s needs and make fully informed decisions about one’s health. Illness
may threaten a patient’s autonomy. However, nurses are obligated to honor a patient’s autonomous actions.

JUSTICE
Nurses are responsible for ensuring that healthcare benefits and burdens are distributed fairly throughout
the population. The uneven distribution of healthcare resources is related to societal inequalities and
personal prejudices
Following the Nursing Code of Ethics

The American Nurses Association’s nursing code of ethics

serves as a guide for nurses to practice with competence and
integrity. People’s own set of ethics and morals influence their
actions and decision-making, as well as how they perceive the
consequences of those actions. ANA’s nursing code of ethics
also ensures that nurses abide by all regulations and policies
that apply to their profession and their employment.
 Provision 1-3:
1. COMPASSION Nurses recognize the dignity, worth, and
uniqueness of all people. They understand that the right to
healthcare applies to everyone, and they respect at all times their
patients, co-workers, and everyone else they interact with.

2. COMMITMENT Nurses’ primary commitment is to their patients.

They have a duty to recognize and address potential conflicts of
interest that may jeopardize their commitment to their patients.

3. ADVOCACY Nurses promote and protect patients’ rights, health,

and safety by understanding privacy guidelines, consent, and the
need for full disclosure and honesty when dealing with patients.
Misconduct or other threats to patients’ well-being must be reported
in a timely manner.
 Provision 4-6:
4. RESPONSIBILITY Nurses are accountable for the care they provide
their patients. They must ensure that their care aligns with
professional guidelines, ethical concerns, and patients’ rights.

5. SELF-REGARD Their responsibility to promote health and safety

extends beyond the workplace to their homes and other settings.
They have a duty to improve and adapt to maintain competence and
grow in their profession.

6. SAFETY Nurses have a duty to maintain a safe work environment

that promotes quality care to all patients. Institutions are responsible
for outlining safety standards and enforcing ethical obligations of
care to ensure optimal patient outcomes.
Provision 7-9:
7. HEALTHCARE ADVANCEMENT Nurses are charged with
advancing the profession through research, development of
professional standards, and creation of nursing and health policy.

8. HUMAN RIGHTS In collaboration with other healthcare

professionals, nurses protect human rights, foster health diplomacy,
and address healthcare inequities.

9. SOCIAL JUSTICE Social justice principles must be integrated into

a nurse’s practice and advocacy for equitable healthcare policies. By
taking part in organizations and committees that acknowledge and
address ethics issues, nurses strengthen their voices in calling for
social justice.
How to Deal With Ethical Dilemmas in Nursing
Even the most extensive code of ethics can’t
account for all the potential dilemmas that nurses
may encounter in their work. That’s the reason that
one of the duties stated in the nursing code of ethics
is to seek the advice and counsel of others whenever
a nurse is uncertain about a medical decisions ethical
aspects.
Problem-Solving Process to make Ethical
Decision-Making Easier:
D E F I N E T H E P R O B L E M : Clearly define the ethical dilemma and
the circumstances behind it.

C O L L E C T I N F O R M A T I O N : Review published information,

professional position papers, codes of ethics, and information about the
ethical dilemma.

A N A L Y Z E I N F O R M A T I O N : Organize and assess the collected

information
Problem-Solving Process to make Ethical
Decision-Making Easier:
I D E N T I F Y S O L U T I O N S : Explore the problem and seek out all possible
solutions and alternatives to resolve the dilemma.

C H O O S E A S I N G L E S O L U T I O N : Select the best possible solution.

Keep in mind that the best solution might not be the most desirable, but it may
follow the most ethical path.

P E R F O R M S O L U T I O N : Follow through on the chosen solution.

E V A L U A T E R E S U L T S : Review the outcome of the situation, how it

aligns with the original desired outcome and the overall effectiveness of
resolving the dilemma.
EXAMPLE:
Scenario: Nurse Nicole works on a busy pediatric ward
and loves her job. Recently, the mother of one of her
patients sent her a friend request on social media and
posted a comment on Nurse Nicole public wall asking
about a patient who was in the room next to her son's.
The post said, "Hey Nicole! How is Nhiel ? We haven't
seen him since Toto was discharged."
Scenario: Nurse Nicole works on a busy pediatric ward and
loves her job. Recently, the mother of one of her patients sent
her a friend request on social media and posted a comment on
Nurse Nicole public wall asking about a patient who was in the
room next to her son's. The post said, "Hey Nicole! How is Nhiel
? We haven't seen him since Toto was discharged."

EXAMPLE: Ethical Dilemma: Our world is filled with technology at

our fingertips. When used correctly, there is nothing wrong with using
technology such as social media platforms. For nurses, it is essential
to understand where the line between personal and professional
relationships or acquaintances lies and to be careful not to blur or
cross those lines.
 Ethical Consideration in Leadership and
Management

B. Meaning and service value of Medical Care

1. Allocation of health Resources
ALLOCATION OF HEALTH RESOURCES

- In economics, resource allocation is the assignment of available resources to

various uses. In the context of an entire economy, resources can be allocated
by various means, such as markets, or planning.

Macro Allocation
- Macro Allocation is usually the province of Congress, state legislatures,
insurance companies, private foundations, and health organizations as society
aims to determine how much should be expended and what kinds of goods
and services will be made available.

Micro Allocation
- Micro-allocation is the more personal determination of who will receive scarce
resources, such as intensive-care beds, advanced technology, or organ
transplants.
 Two-Tier System and Decent Minimum

1) Everyone will be guaranteed

2) Based on the ability to pay

Oregon Rationing System

- Rationing- allow each person to have only a fixed amount of (a particular
commodity).
- Started in 1983 Citizens Health Care Parliament: (1) Society Must Decide
(2) Quality of Life in Allocating Health Care Resources

❖ The 1988 Legislature acted on these initiatives, making Oregon the first
jurisdiction to explicitly decide on a rationing system for health care in the
United States.
The most disturbing of our rationing methods has to do with the fact that cultural and
social barriers still bar for many of our citizens to receive healthcare:

➔ Controls placed on access by pricing

➔ Differing and arbitrary payment methods
➔ Variations in practice patterns
➔ Insufficient emphases on practice patterns
➔ Language and Cultural barriers
➔ Insufficient numbers of minority health professionals
➔ Lack of information about available health services
➔ Social class membership as deterrent
➔ Limited organ supply for transplantation
 Triage
This process of allocating scarce resources has been commonly
practiced and justified in the crises of war or disaster.

In medicine:
Category 1 - Immediate
Category 2 - Urgent
Category 3 - Non urgent
Ethical Consideration in Leadership and
Management

B. Meaning and service value of Medical Care

2. Issues Involving Access to Care
Introduction

The Consumers are patients with complex needs. With increased

awareness of health care, health care facilities and Consumer Protection Act,
patients are getting aware about their rights. Nurses also have now the
expanded role. Issues which seem not feasible, and ideal, may become practice
with the change of time. These issues are base for the future trends in care.

Meaning of Legal Issue

❏ Law is standard or rules of conduct established & enforced by government.

❏ Legal issues in nursing are those in which a person lead to face legal
problems in which nurse face problem when not meeting proper patient
care.
MedicoLegal
Medico Legalissues
Issues
1. Duty to seek medical care for the patient
1. Duty to seek medical care for the patient.
2. Confidentiality
3. Permission to treat
4. Informed consent
5. Negligence
6. Malpractice
7. Invasion of privacy
8. Report it/ tort it
Medico LegalIssues
Management Issues
- It is a considerable challenge to meet the needs of the organization, the
1. Duty to seek medical care for the patient
needs of patients, and the needs of the nurse employees.

1. Turnover
2. Funding
3. Workload
4. Issues regarding malpractice in nursing
5. Issues related to staffing
6. Ethics
7. Issue in curriculum development in nursing
Medico Legal
Employment Issues
Issues

1. Duty to seek medical care for the patient

1. Issues related to nursing shortage
2. Issues in nurse migration
3. The Right to work and the right to practice
4. Exploitation and Discrimination
5. Sexual Harassment at the workplace
6. Unsatisfactory work performance and termination of employment
7. Diploma vs. Degree in nursing for registration to practice nursing
 Ethical Issues Related to Technology in the
Delivery of Health Care

A. Data Protection and Security

1. Data Privacy Act 2012 (RA 10173 Series of 2012)
 AN ACT OF PROTECTING INDIVIDUAL PERSONAL
INFORMATION IN TERMS OF INFORMATION AND
COMMUNICATION SYSTEMS IN THE GOVERNMENT
AND THE PRIVATE SECTOR, CREATING FOR THIS
PURPOSE A NATIONAL PRIVACY COMMISSION, AND
FOR OTHER PURPOSES

R.A NO. 10173

Data Privacy Act of 2012

Processing personal information can create problems for
individuals

- Loss of trust
- Loss of self-determination
- Loss of autonomy
- Loss of liberty
- Exclusion
- Physical harm
- Discrimination
- Stigmatization
- Power imbalance
What does the Law Says?
- The law upholds the right to privacy by protecting individual
personal information. The National Privacy Commission
protects individual personal information by regulating the
processing of personal information.

- THE SCOPE OF DPA 2012

- SEC. 4 Applies to the processing of all types of personal

information, in the country and even abroad, subject to certain
qualifications.
Personal Information
Any information whether recorded in a material form or not,
from which the identity of an individual is apparent or can be
reasonably and directly ascertained by the entity holding the
information or when put together with other information would
directly and certainly identify an individual

Section 12
Conditions under which processing
Personal Information is allowed…
SENSITIVE PERSONAL INFORMATION

- race, ethnic Health, Unique

- origin, education, identifiers
- marital genetic or issued by
- status, age, sexual life of government
- color, and a person agencies
- religious, peculiar to
- Philosophica an individual
- Political affiliations;
Processing

Any operation of any set of operations performed upon personal

data including, but not limited to, the collection, recording,
organization, storage, updating or modification, retrieval,
consultation, use, consolidation, blocking, erasure PROPERTY or
destruction of data.
Personal Information Controler

A natural or juridical person, or any

other body who controls the
processing of personal data, or Any natural or juridical person or
instructs another to process personal any other body to whom a personal
data on its behalf. Information controller may outsource
or instruct the processing of personal
It excludes: data pertaining to a data subject.
A natural person who processes
personal data in connection with his
or her personal, family, or household
affairs
OBLIGATIONS of PICs
- The PIC should collect personal information for specified and
legitimate purposes determined and declared before, or as soon
as reasonably practicable after collection

- The PIC should collect and process personal information

adequately and not excessively.

- The PIC should process personal information fairly and lawfully,

and in accordance with the rights of a data subject.
OBLIGATIONS of PICs
- The PIC should process accurate, relevant and up to date personal
information.

- The PIC should retain personal information only for as long as

necessary for the fulfillment of the purposes for which the data was
obtained. The information should be kept in a form which permits
identification of data subjects for no longer than is necessary.

- The PIC must implement reasonable and appropriate organizational,

physical and technical measures intended for the protection of
personal information.
DATA SUBJECT
- Right to be Informed
- Right to Access
An individual whose - Right to Object
personal, sensitive - Right to Rectification
personal or privileged - Right to Erasure or
information is
processed. Blocking
- Right to Damages
- Right to Data
Portability
- Right to File A
Complaint
Data Privacy Principle
Transparency

Legitimate Purpose

Proportionally
Transparency

A data subject must be aware of the nature, purpose, and extent

of the processing of his or her personal data, including the risks
and safeguards involved, the identity of personal information
controller, his or her rights as a data subject, and how these can
be exercised. Any information and communication relating to the
processing of personal data should be easy to access and
understand, using clear and plain language.
Legitimate Purpose
The processing of information shall be compatible with a declared and
specified purpose, which must not be contrary to law, morals, or public
policy

CONSENT OF THE DATA SUBJECT Refers to any freely given, specific,

informed indication of will, whereby the data subject agrees to the
collection and processing of personal information about and/or relating to
him or her. Consent shall be evidenced by written, electronic or recorded
means. It may also be given on behalf of the data subject by an agent
specifically authorized by the data subject to do so.
Proportionally

The processing of information shall be adequate, relevant,

suitable, necessary, and not excessive in relation to a declared
and specified purpose. Personal data shall be processed only if
the purpose of the processing could not reasonably be fulfilled by
other means.
 Ethical Issues Related to Technology in the
Delivery of Health Care

B. Benefits and Challenges of Technology

Benefits

- Technology Promoted Better Healthcare

Through Telemedicine / Telehealth…

Telehealth is the distribution of health-related services and information via

electronic information and telecommunication technologies. It allows
long-distance patient and clinician contact, care, advice, reminders,
education, intervention, monitoring, and remote admissions.
Improved Patient Education

Not too long ago, patient education relied primarily on written materials
about disease processes, medication, medical management, and self-care
instruction guidelines. Today, the Internet and mobile technology have made
health information available to patients anywhere.

Digital technology thus far is pervading and influencing nursing

practices.
Additional benefits, include facilitating communication between health care
providers; improving medication safety, tracking, and reporting; and
promoting quality of care through optimized access to and adherence to
guidelines.
Easy access to patient medical records.

Advantages of Electronic Health Records

EHRs and the ability to exchange health information electronically can

help you provide higher quality and safer care for patients while
creating tangible enhancements for your organization. EHRs help
providers better manage care for patients and provide better health
care.
Additional benefits, include facilitating communication between health
care providers; improving medication safety, tracking, and reporting;
and promoting quality of care through optimized access to and
adherence to guidelines.

Easy access to patient medical records.

Advantages of Electronic Health Records

EHRs and the ability to exchange health information electronically can help
you provide higher quality and safer care for patients while creating
tangible enhancements for your organization. EHRs help providers better
manage care for patients and provide better health care.
 Challenges in Technology

1. Inadequate Staffing
2. Mandatory Overtime
3. Inefficiencies and Errors in Data Sharing
4. Privacy Issues & Technology in Healthcare
Organizations
 Ethical Issues Related to Technology in the
Delivery of Health Care

C. Current Technology: Issues and Dilemma

 Technology rapidly advanced in various areas such as medicine,
healthcare, and welfare, provide many benefits to the number of
people to achieve them, and increased focus on the potential of new
technology to meet society’s future needs.

The impact of technology is not limited to patients. Technology

has also changed the day-to-day experience of working in health
care. An example of this is how electronic medical records have
changed physician interactions and relationships with patients.
Substandard Medical Devices And Medical Equipment

The list of medical technology hazards also includes the use by

hospitals and other medical professional providers of consumer-grade
medical devices, including:
· Finger pulse oximeters
· Blood pressure cuffs
· Glucose monitors

ECRI warns that these and other healthcare equipment may be

substandard, compared to medical-grade, as most consumer-grade
medical devices are not subject to stringent FDA guidelines. When used
by medical providers, they may be unreliable, which could lead to a
potentially fatal misdiagnosis or delayed diagnosis
Substandard Medical Devices And Medical Equipment

The use of artificial intelligence can also lead to a misdiagnosis, ECRI

warns. AI systems are dependent on data input to “learn,” and if the data
used is suspect or incomplete, dependence on these hi-tech systems can
lead to substandard care or medical errors, including treatment plans based
on medical imaging results, for example

The unique relationship between doctors and patients requires trust built by
the ethical care of patients and family. Technology in health care can
continue to move fast and break things, including breaking the trust
between patients, family, and staff.

An ethical issue affects quality of care, and it may impact patient safety.
Substandard Medical Devices And Medical Equipment

Medical technology, used correctly, potentially offers life-saving

benefits. But when used incorrectly or without proper caution, it can
unnecessarily and catastrophically injure the very people it is designed
to help.

When physicians’ practices are mediated by technology, or eliminates

the need of human, by replacing the human operator with an artificial
intelligence remote operator, therefore, ethical dilemmas may arise
between instrumentalism and caring relationships
Substandard Medical Devices And Medical Equipment

Technological development challenge…

- Nurse no longer uses some skills because they have become
unnecessary due to technology
- Nurse has had to upgrade some skills to incorporate technological
changes
- Nurse is able to use just a few of the skills she acquired in training
- Nurse feels he/she needs to acquire more skills to be effective it takes
too much time
Emerging ethical dilemmas in
Science and Technology
Emerging ethical dilemmas in Science and Technology

New ethical problems regarding the use of science and technology are
always arising. When is it right to use science and technology to apply to
real-life scenarios and when does it impede human rights?
Neurotechnology and privacy

Neurotechnology is nothing new, but new advances

allowing the use of technology to gradually change behavior
or thought patterns poses severe questions about privacy and
may contradict cultural or religious beliefs.
Ethical Considerations

● What level of control should individual patients have over the use of
their private health information that becomes part of public health
databases?
● How can healthcare providers ensure equitable access to expensive
technologies that not only treat illnesses but also promise to promote
longevity and enhance patients’ quality of life?
● What policies could help avoid “genetic discrimination” when medical
test results reveal conditions or genetic susceptibilities to specific
diseases that weren’t the subject of the original tests?
● What effect will AI-based medical care have on the relationship
between patients and their doctors and other healthcare providers?
 Using technology in health care may have a great benefits but there is
always a disadvantage. It is the obligation of a nurse to act for the benefit
of patients by supporting patient's right, prevent harm and remove
conditions that could cause harm.

Ethical decisions in technology should not be taken lightly. If we believe

that technology can help to solve the world’s problems, addressing the
ethics involved is the only way to us get there.
THANK YOU!
THANK YOU!
-Group