CARE AT THE

BEGINNING OF LIFE
Topics to discuss
NATURAL
PREVENTION OF
REPRODUCTION
REPRODUCTION

1 3

ASSISTED
REPRODUCTION

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1 Natural reproduction
Let’s start with the first set of slides
“
The female ovaries expel the mature
egg towards the Fallopian tubes
every 28 days. The male’s testes
produce the sperms which are
expelled at ejaculation. With the
conjugal act the sperms are
deposited in the vaginal canal. The
sperm travel up the uterus into the
uterus into the Fallopian tubes and
there fertilize the egg. The fertilize
egg (mean the embryo) travels down
to the uterus where it is implanted,
develops, grow (embryo, fetus) after
9 months the baby is born.

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PRINCIPLES: The principles involved and promoted in
the reproductive issue are:

▫ Inviolability of Life
▫ Stewardship
▫ Double Effect
▫ Nonmaleficence
▫ Beneficence
▫ Respect for Person

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INVIOLABILITY OF
LIFE
▫ All human from the moment of
conception (fertilization) and
through all subsequent stages is
sacred. Thus, all have the duty to
affirm, respect, love and defend it.
Violation of this principle occurs
like in: abortion, in vitro-fertilization
and stem cell research.

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STEWARDSHIP
Man must take care, cultivate,
creatures within the creature’s
innate nature and teleology and
within man’s knowledge and
understanding. Violations arises
in: surgical sterility, substitution
of reproduction, use of
hormones, intra-uterine devices
(IUD) donation of sperm or egg
genetic manipulation.
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DOUBLE EFFECT
▫ A foreseen evil effect may be
allowed if the foreseen intended
good effect is greater than and
does not result from the evil effect.
This is applied into maternal-fetal
conflict, removal of diseased organ
like in ectopic pregnancy,
anencephalic infants.

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NONMALEFICENCE
Do no and risk no harm. This is
applied into: sterilization,
hormones psychological harm
psychological and financial effect
of new technologies.

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BENEFICENCE
▫ Do good and provide a benefit.
This applies when removing
diseased organs, facilitating
pregnancy, educating on
responsible parenthood.

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RESPECT FOR PERSON
1) Not to be denatured/destroyed.
Issues/ and violation arises in:
artificial methods of reproduction
(like: IVF and AID or AIH), cloning.
2) To be an end and not a means to an
end. This happens in contraception,
commodification of sperm/egg,
uterus dysfunction, and embryonic
manipulation.

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2 Assisted reproduction
Now, we go to the second topic
ASSISTED REPRODUCTION

In-vitro fertilization
and embryonic
transfer

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1. (IVF-ET)
In IVF-ET the gametes are
separately harvested, in
number of eggs are fertilized in
‘Petri Dish’ some zygotes are
implanted into the mother, and
unwanted embryo may be
removed.

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In-vitro fertilization and embryonic transfer
(IVF-ET)
a) Inviolability of Life (some unwanted zygote are allowed to die)
b) Stewardship (the procedure is artificial and it substitutes the conjugal act)
(the baby may develop the ‘genealogical bewilderment syndrome’,
also, if sperm is from a donor, the unknown biological lineage may lead
c) Nonmaleficence
to incest or inherited diseases. Mothers are psychologically harm by
series of unsuccessful attempt)
(if private funds are used the prohibitive cost limits availability to the
d) Justice
rich. If public funds are used, more essential needs are abandoned)
(the human body, the uterus, sperm egg becomes commodities
trafficked, transferred or sold; the baby is not a gift but a product of
e) Respect for Person other’s will to be disposed of as desired (the unused embryo; ‘take
home’ baby in term of wasted babies are often not shared with
parents)
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2. CLONING
is the reproduction of a genetic
copy of another human being either
through ‘splitting’ of the embryo’s
cell or through somatic cell nuclear
transfer. The latter, involved the
removal of the nucleus from the
unfertilized female egg and its
replacement by the nucleus of a
cell taken from donor.
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Cloning
a) Inviolability of Life (embryo are destroyed in the therapeutic cloning)
b) Stewardship (the process is artificial)

(the psychological and physical risks to mother and child. In addition

c) Nonmaleficence
the concept of the ‘family’ is perhaps destroyed)

(denatured and destroyed by stockbreeding with no uniqueness as

d) Respect for Person individuality; parents were reduced to a mere providers of human
‘materials’, like, sperm, egg and uterus)

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3. HUMAN EMBROYNIC
stem cells
(Human ES cells) it is the
production of human embryos/the
use of surplus embryos from IVF or
aborted embryos or frozen
embryos.

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Human Embryonic stem cells
The isolation of the inner cell mass (ICM) which is cultured and sub
a) Nonmaleficence cultured to form colonies then cell lines must be done early in the
embryonic life and destroyed the embryo.
This intentional killing is morally illicit. Thought the end may be
b) Double Effect praiseworthy as in a regenerative medicine, it cannot justify the
means.
To use commercially available or supplied ES cells obtained from them
c) Respect for person
and Nonmaleficence is proximate material cooperation with scandal in the act of embryo
destruction

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3
Prevention of
reproduction
For the last Topic, make sure you have take aways.
PREVENTION OF REPRODUCTION

CONTRACEPTION ABORTION

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Contraception
(drugs and devices that inhibit fertilized ovum
transport to and implantation in the uterus or its
1 Inviolability of life development are abortifacient.

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2. ABORTION
B. INDIRECT ABORTION
A. DIRECT ABORTION is a process of terminating
pregnancy directly in which
OR INDUCED
the moral object of the
it a kind of abortion with action is the therapy of the
the intentional of mother and the death of the
immediate purpose of fetus is a side effect that is
ending or destroying the inevitably unavoidable
fetus at any stage of after effect.
its conception.

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Abortion
Injection with concentration
saline
It burns their skin off them while
were still alive the babies
breathe it in and swallow it,
frying their insides.
this is characterized by using a
suction tube to remove the
fetus and placenta
Dilation and Evacuation
Dilation
Hysterectomy
(abortion by caesarian surgery)
(is a method by suctioning of
the lining of the uterus through
the use of a thin and flexible
tube inserted through the
opening of the cervix)
Vacuum aspiration
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Thank You!
Any questions?
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 CARE
AT THE
PROMOTION
OF LIFE:
ORGAN
TRANSPLANTA
TION
AND
DONATION
 ADVANCE IN SURGERY AND INTRODUCTION OF
NEW DRUGS HAVE LED TO THE STEADY GROWTH
OF ORGAN TRANSPLANTATION AND DONATION
 LACK OF ORGAN RESOURCE
LED TO ABUSES SUCH AS :

• ROBBING
• MAIMING
• KILLING OF DONORS
• COMMERCIALIZATION OF ORGANS
BY HEALTH CARE GIVERS
• MIDDLE MEN OR INSTITUTIONS
• COERCION EXPLOITATION OF
DISADVANTAGED DONORS OR
NEEDY RECIPIENTS
TINATAYANG NASA MAHIGIT 20 NA ANG MGA TAONG NAWAWALA NA
HANGGANG SA NGAYON AY WALA PANG MALINAW NA PALIWANAG
KUNG NASAAN NA ANG MGA ITO. NITO LAMANG NAKARAANG TAON,
BATA RAW ANG PINUPUNTIRYA NG MGA "PUTING VAN." PERO
NGAYON AY MUKHANG WALA NA SILANG PINIPILING EDAD, BATA KA
MAN O MATANDA NA, PAYAT MAN O MATABA, BASTA KAYA KANG
ILAGAY SA VAN AY KUKUNIN KA NILA. MAY ILAN DIN NA
TERMINOLOG
IES
TO
CONSIDER
 ORGAN
DONATION
GIVING OF
TISSUE/ORGAN/BO
DY BY A PERSON
TO ANOTHER
PERSON OR TO AN
INSTITUTION
 DONOR
THE GIVER WHO
MAY BE A
CADAVER (WITH AN
ASSUMPTIVE
DOCUMENT BY
THE DONOR WHEN
STILL ALIVE OR BY
PROXY) OR A
LIVING PERSON
(EITHER BY
 VENDOR

PERSON WHO
EXCHANGE THEIR
ORGAN FOR
MONEY
 RECIPIENT

THE RECEIVER OF
THE ORGAN GIVEN
BY THE DONOR OR
INSTITUTION; A
RECIPIENT WHO
PAY THE ORGAN IS
A BUYER
 ORGAN
TRANSPLANTATIO
N
THE TRANSFER OR
THE PLANTING
ACROSS OF
ORGAN FROM
DONOR/VENDOR
TO
RECIPIENT/BUYER
 XENOTRANSPLAN
TATION

PLANTING OF AN
ORGAN FROM
ANIMAL ORGAN TO
HUMAN BEINGS.
 ALLOTRANSPLAN
TATION

THE
TRANSPLANTATION
OF THE ORGAN
FROM ONE BODY
TO ANOTHER
BODY OF THE
SAME SPECIES.
HARM
AND

RISK
1.ACCURATE DEFINITION
OF DEATH MUST BE
FOLLOWED AND
OBSERVED
2. THE DYING CANNOT BE
KILLED
 3. THE
ORGAN TO
BE
REMOVED
MUST NOT
BE A
NECESSAR
Y
CONDITION
FOR LIFE
OR FOR
4. AN PART
OF THE
BODY
THAT CAN
EASILY BE
REGENER
ATED CAN
BE GIVEN
SUCH AS
BLOOD,
 5. A
SECOND
KIDNEY
OR A
PORTION
OF THE
LIVER
THESE
ARE NOT
NECESSA
RY FOR
THE
 • THE DONOR SHOULD BE AWARE
ABOUT THE PRE-DURING AND POST
HEALTH SCHEME OF THE
OPERATION.
1. PROPER
SCREENING
 2.
STANDARD
OF
HEALTH
CARE
3. REIMBURSEMENT OF MEDICAL
EXPENSES
 4. DISABILITY AND LIVELIHOOD LOST
(BURIAL EXPENSES OF THE CADAVER)
5. PREVENTION OF
6. PREVENTION IN COMMUNITY
ACCEPTANCE
• THE INTRINSIC WORTH AND DIGNITY
OF THE DONOR MUST BE RESPECTED.
THE FOLLOWING MUST OBSERVED:
1. FREE AND INFORMED CONSENT
MUST BE GIVEN
2. INFORMATION GIVEN SHOULD
INCLUDE PROCESS OF MATCHING,
THE CHANCE OF SUCCESS OF THE
TRANSPLANT AND PERMISSION TO
REFUSE
3. FINANCIAL NEED AND
IGNORANCE MAKE TE
 • IN CASE OF CADAVER,
CONSIDERATION MUST BE
OBSERVED:
1. CONSENT FOR THE DONATION
MUST BE GIVEN OR OBTAINED
SPECIALLY PERSON THAT MET AN
ACCIDENT
 ORGAN
RECIPIENT
 -IN CASE OF
SERIOUS
ILLNESS MAN
HAS THE RIGHT
AND THE
OBLIGATION TO
TAKE
NECESSARY
MEASURES TO
PROMOTE LIFE
AND HEALTH.
-TO THE
EXTENT THAT
IF IT IS
SOME BIOETHICAL
CONSIDERATION
ARE REQUIRED
FOR IT TO BE
MORALLY AND
BIOETHALLY
ACCEPTED:
*RESPECT FOR
AUTONOMY MUST
BE ALLOW THE
RECIPIENT TO
CHOOSE HOW TO
GET AN ORGAN. IT
REQUIRES:
*THERE MUST BE JUSTICE IN
ALLOCATION.
 THE FOLLOWING MUST
BE CONSIDER:
1. THE CRITERION FOR
JUDGING EQUALITY IS
BASED ON THE CHANCE
OF SUCCESS.
2. THE ABILITY TO PAY
THE COSTS OF THE
TRANSPLANT AND THE
EXPENSIVE ANTI-
REJECTION MEDICATION
DETERMINES SUCCESS
AND ACCESS
3. GIVEN THE CASE
THAT BOTH ARE
 WHAT THE NURSE
CAN DO, THEY MUST
CONTRIBUTE ON THE
COMMUNAL
DIALOGUE AND
PUBLIC EDUCATION
MUST BE GIVEN
COMMODITIES TO
SELF LOVE
COMMERCIALIZATION
TO CHARITY
 POTENTIAL DONORS MUST BE
PROTECTED AGAINST HARM, THUS
BECOME AN ADVOCATE OF THE
DONORS
EDUCATING DONORS THAT SELLING
ORGAN IS NOT ENCOURAGE
 NURSE SHOULD ADDRESS THE
UNDERLYING POVERTY, IGNORANCE
AND VULNERABILITY OF PEOPLE THAT
SELLS THEIR ORGANS; ORGANS
‘SHOULD NOT BE FOR SALE’
CARE AT
THE END
OF LIFE
EUTHANASIA AND PHYSICIAN ASSISTED
SUICIDE
 One’s values regarding life and death
are reflected in how one dealt with the
dying. If one cannot bear to see
suffering, then one resorts to an
“advance” death, such in euthanasia,
suicide, or physician assisted suicide.

- CARE AT THE END OF LIFE

If one sees life as the highest value with
death as a form of human defeat, or if
one is overly influenced by available new
technology and biological idolatry then
one does everything to prolong life
beyond one’s one time and this is known
as dysthanasia.

- CARE AT THE END OF LIFE

On the other hand, if one sees death as
the culmination of a good life, to be
valued only until its natural end, one
looks for a good death this is
orthothanasia.

- CARE AT THE END OF LIFE

MOMENT OF DEATH
Inevitable and critical moment when organism ceases to function
as specified, unified, homeostatic system and becomes
disorganized into a mere collection of heterogeneous chemical
substance. To know that body is disorganized we must at least
become sure of three things:
MOMENT OF DEATH

• The body does not now exhibit specific human behavior.

• The body does not function humanly in the future.
• The body has no more radical capacity for human functions due
to its lost of basic structure required for human unity.
 MOMENT OF DEATH
The third reason is necessary due to the fact that
medical experience had shown that persons who are
in coma nevertheless have sometimes recovered full
human consciousness. Such resuscitation is
possible, however, after true human death some
cells or even organs of the human body for a time by
artificial respirator, continue to exhibit some life
functions but these functions are not those of
human organism but simply a residual life at level of
organization similar to a plant or animal.
Thus, the essential point of determining human death is not to decide whether any
life is present, but whether human life in the most radical sense of a unified
human person is still present.

• life force of cell is no longer united to the matter with which it was at any
times united.
• religious orientation, the separation of the body and the soul (medically,
it is understood as, body’s lack of sensation and self-movement.
• the lose of touch irrevocably with a person who previously was able to
communicate and to share our human community of thought, of love, of
freedom and or creativity.
1. Human organism is irreversibly
dysfunctional and dead

2. Less conclusive, absence of breathing and

heartbeat

-SIGNS OF DEATH
 SIGNS OF DEATH
Now, the signs are not a guaranteed bases and signs
of death due to some technological advancement that
is perfected to aid the lungs and heart to functions
artificially as in resuscitation.
an artificial sustained heart and lung activity is not a
proof that human life still remains. That is why as long
as this heart and lung is sustained by mechanical
device that runs it artificially the traditional bases of
death is impossible to verify.
 SIGNS OF DEATH
Aside from the new technology used, another reason is the
possible organ transplant of heart and kidney. It is said to
be that the success of transplanting of heart will likely to
be very successful if the organs to harvested from a body
through which blood is circulating. Hence, surgeons, kept
the body alive in the respirator.

So then, how is it possible to be sure that the donor is in

fact dead?
 1. cardiovascular clinical signs (this is used when the person is not attach to
respirator. Thus, reliance on technology must be moderated rather than
encourage)

2. the new clinical sign must be ascertained by the well-trained professionals

(basis must be properly observed. That is for no less than 24 hours when it
uses the EEG or electroencephalogram as it is done in the USA: Harvard
Criteria for Brain Death of 1968, this is used to person who is under a
hypothermia and drug-induced coma. But today, short intervals is now allowed
within 6 hours, and the EEG is being replaced by an Angiogram it is an
apparatus to test the blood flow in the cerebellum of the patient)

-SIGNS OF A DEAD PERSON

Angiogram Electroencephalogram
 TYPES OF DEATH
1. Euthanasia means an action/omission
which of itself or by intention causes death,
in order that suffering may be eliminated. It
procures/imposes death before one’s time.

Types of Euthanasia:
•Voluntary and involuntary (patient’s initiative)
•Active and passive (healthcare provider’s initiative)
 Human life must be promoted because we are as
stewards of it. Filipinos have seen that disabled newborn
as “good luck” and caring a sick person is a privilege. In
solidarity, one can’t abandoned, replaced, worst of all, kill
another person. May it be in the name of economy,
practicality, compassion or autonomy. procuring death is a
perversion of a diseased society made worse if done by a
family or healthcare provider.

-EUTHANASIA
 TYPES OF DEATH

2. Dysthanasia is the delaying or postponing death beyond its

natural time by all means available
 Dysthanasia is popular for the following reasons:

• Doctor’s training (reasons: treating is more comfortable than not treating,

doctor’s felt guilty to abstain, death of patient is seen as a failure of
management).
• Technologic imperative (reasons: advances and success pushes the doctor to
use everything, that is, malignant over-diagnosis and over-treatment. It is also
biology rather then personhood is the object of medical attention).
• Ignorance (reasons: proxy’s are unaware of the distinction between killing and
letting die; lack of information with regard on prognosis pain high quality of end
of life care, the best place to die).
 Dysthanasia is popular for the following reasons:

• Hospital culture (reasons: rights of patients are considered as preference

rather than directives).
• Fear (reasons: doctor’s worry about on the accusation of legal liability and
malpractice if everything were not done).
• Philippine culture (to add in the Filipino hospital context) (reasons: the Filipino
non-confrontational attitude makes all concern hesitate to hear ‘badnews’,
instead the ‘status quo’ is the main focus).
 Living should not be a penalty to be
prolonged at all cost. To cause suffering
unnecessarily in unworthy of trust and
respect the healthcare provider has.

PRIORITY OF USING THE LAST MOMENT OF LIFE

MUST BE GIVEN TO FINISH ONE’S OWN
RESPONSIBILITIES TO OTHERS.