BIOETHICS appropriate referral can be made for post
procedure care.
Why do we need to study bioethics?
- Medical policies and patient rights
legislation are ever-changing (e.g. uniform,
license, no drinking and smoking)
- Health care systems function differently
than before
- Clinical practice now involves decision-
making about many new issues
Difference between ETHICS and MORAL
• ETHICS
- Ethics is the discipline about moral or
philosophy on moral.
- Ethics is a philosophical discipline about
problems that deals with the art of the living.
- Ethics is not merely obeying the law.
Though in many instances, laws are
statements of considered ethical positions
and most of the time, obeying the law is an
element of ethical behavior.
- “I will live like this because I know it is right”
• MORAL
- Moral is a system of norms or rules, written
or not, about human behavior.
- It is not a like with religious norms.
Religious norms are more absolute, without
conditions and inevitable than moral ones.
When religious norm is broken, a man felt
he committed a mistake against his dignity
- Moral= human dignity
- “How should I live, what’s beneficial to all,
right or wrong”
- Universal Principle
ETHICAL ISSUES
• Abortion
- It is the deliberate termination of human
pregnancy, most often performed during the
first 28 weeks of life
- Spontaneous Abortion- inevitable
- Induced Abortion- sinadya
- Health Care Providers may need to explore
their own feelings or beliefs about abortion
before assisting in these procedures. They
must also be aware of client’s feelings prior
to performing such procedure so that
• Euthanasia
- It is a practice of intentionally ending a life to
relieve pain and suffering
- A doctor is allowed by law to end a person’s
life by a painless means, if the paint and
their family agree.
- It can be classified as:
○ Voluntary and involuntary- patient
○ Passive and active- inject
- Physician- Assisted Suicide- A doctor
assists a patient to commit suicide if they
request it. Intentionally helping a person
commit suicide by providing drugs for self-
administration, at that person’s voluntary
and competent request.
- REASONS:
1. Utility- economic constraints from the
increasing health costs of the growing
elderly population, mainly the chronically
ill.
2. Hedoism- when quality of life is poor or
life is burdensome and useless then the
person, like a hurt animal can be killed.
3. Autonomy- a request for an elderly
death may be an attempt of the patient
to regain control whether only in
deciding when to die; it is practicing the
“right to die”.
- Dysthanasia- is delaying or postponing
death beyond its natural time by all mean
available. The person is kept alive
artificially.
- Orthonasia- is allowing death at its natural
time. Deliberate or stopping of artificial or
heroic means of maintaining life. Passive
euthanasia.
• Birth Control or Contracepton
- It is a method or device used to prevent
pregnancy
- Natural methods: calendar method,
withdrawal
- Artificial methods: condoms, pills,
implants, Intrauterine device?
• Stem Cell Technology
- It is a rapidly developing field that combines
the efforts of cell biologists, geneticists, and
clinicians and offers hope of effective
 treatment for a variety of malignant and
non-malignant diseases.
- The scientific term for adult stem cells is
somatic stem cells. They are found in
umbilical cord blood, bone marrow, blood,
peripheral blood stem cells, menstrual
blood, skin, teeth and placental tissues
- Embryonic stem cells are taken from
donated human embryos that are not
needed for invitro fertilization these are only
used with the permission of the parents.
The blastocysts grows in the petri dish for
six months, producing a cell line, which
contains millions of stem cells.
- Today the most common medical treatment
using stem cells are transplants to patients
with serious diseases of blood, such as
leukemia or lymphoma
• Homosexuality
- Sexual attraction or the tendency to direct
sexual desire toward another of the same
sex: the quality or state of being
homosexual.
- LGBT rights
- Marriage Rights
- Sex Change
ADOLESCENT ISSUES
VICES
- Any bad habit that provides pleasure to, yet
causes bad effects on the person who
practices it.
- Examples: drug use, excessive alcohol
drinking, shopping, internet use, smoking,
sex, copying, gambling, vandalism
Why do we have to talk about vices
- To learn about the influences that make
people practice these habits that are
considered vices
- To learn about the effects of these activities
to the people who do them
- To prevent people from developing these
habits
- To diminish and gradually eliminate these
habits (for those tho have already
developed them)
DRUG USE
• Injected- opium, heroin or diacetylmorphine or
morphine diacetate or diamorphine
•Inhaled- rugby, methamphetamine hydrochloride
or shabu
• Ingested- methylnediocymethamphetaine or
ecstasy, marijuana
Statistics
- 1972~20,000/ 37million
- 1997~1.7 million/ 69 million
- 1999~ 3.4 million/ 75 million
- 2004~ 6.7 million/ 86 million
- Shabu and marijuana are the illegal drugs
preferred by Filipinos aged 10 to 44 years
- 65% of crimes are committed by suspects
that are drug addicts
How does drug work
• Shabu/meth
- Methamphetamine hydrochloride stimulates
release of excessive dopamine (dopamine
is produced in the nerve cells of the ventral
tegmental area and is concerned with
pleasure regulation in the brain. Upon
entering the nerve cell, meth causes the
stimulates release of dopamine which then
binds to specialized receptors of other
nerve cells creating the typical “rush”
Effects of using drugs
- Drug depence → drug addiction
a. Drug tolerance- person no longer
respond eme need na ng higher dosage
b. Physical dependence- physical need for
a drug accompanied by unpleasant
withdrawal symptoms
c. Psychological dependence- sakit na sya
- Personal and social disorganization
- Serious and sometimes fatal diseases
- Hypersexual behavior
SMOKING
- “suicide in slow motion”
- One in every three Filipino teenagers aged
13 to 15 were already smokers, despite the
existence of Republic Act 9211 or the
Tobacco Regulation Act of 2003. [World
Health Organization, 2007: Global Tobacco
Youth Survey (GYTS)]
 - Those who were raised with both parents
present were less likely to smoke than those
who grew up with a single parent
- Those who have close relationship with
parents were less likely to smoke [Teen
Tobacco Epidemic in Asia, 2004]
Alcohol
- Acts as depressant and slows down the
brain’s activities
- If used in sufficient amounts, it will damage
or even kill biological tissues including
muscle and brain cells
- In 1994, 60% or 5.3 million Filipino youths
were said to be drinking alcoholic
beverages
- About 4.2 million of them are males and 1.1
million are females
- On the average, Filipino youths starts
drinking alcohol at the age of 16 or 17.
However, there are also many cases when
children as young as 12 years old are
already drinking alcoholic beverages.
- About 37 percent of the respondents in the
survey have continued the habit of drinking
alcohol while 33 percent said they only drink
alcoholic beverages on special occasions.
Some 17 percent said they have already
decided to stop the vice of drinking
- Among girls, drinking is more acceptable
than smoking. But is its considered more
appropriate for men than for women to
drink.
- The teenagers said their family, friends, and
the mass media have influenced them to
experiment with drinking alcohol
- The study indicated that those who are
more likely to drink are those:
a. Who are not living with parents (for
example, college students living in
dormitories
b. Whose parents approve drinking
c. Who frequently attending social
gatherings
d. Who enjoy going out to parties, bars and
discos
e. Who do not take part in sport activities
Effects of Alcohol
- Reduced inhibition (lack of self
consciousness)
- Impaired judgements
- Feel more talkative
- And more confident
- Skilled performance (such as driving0
become impaired
- Intellectual functioning, behavioral control,
and judgement become less efficient (As
more alcohol is ingested)
- Coma (extreme intoxication)
- Each of these behavioral effects varies
according to how the adolescent’s body
metabolizes the alcohol, the individual’s
body weight, the amount of alcohol
ingested, and whether previous drinking has
led to tolerance
Influences
• Family
- Family time
• Adolescent development
- Curiosity
- High-stimulation experiences: Appetite for
adventure and predilection for risks
• Friends
- Peer pressure
- PEERsuasion
• Culture
- Media
Why do adolescent take drugs (smoking and
drinking)
- Pleasurable sensations
- Adapt to an ever-changing environment
- Reduce tension and frustration
- Relieve boredom and fatigue
- Escape the harsh realities of the world by
giving inner peace, joy relaxation,
kaleidoscopic sensations, surges of
exhilaration, or prolonged heightened
situation
- Curiosity- intrigued by sensational accounts
of drugs in the media, or even popular
songs
- Social reasons- allows adolescents to feel
more comfortable and enjoy the company of
others
REDUCTION
• the first approach is primary prevention for non-
users.
- Involved here are the Department of
Education, Labour and Employment; The
Commission on Higher Education; and other
government and non-government agencies.
The mass media- both broadcast and print,
also play an important role here
• The secondary approach is secondary prevention
for “experimenters” and casual drug users
- The Department of Health is the lead
agency here, with support from the
Department of Social Work and Community
Developments, the local government units
and the Philippine National Police
• The third approach is tertiary prevention for
addicts and recovering persons
- The Department of Health is also the lead
agency here.
Agencies
- Narcotic Foundation of the Philippines
- Philippine Drug Enforcement Agency
- Narcotics Group of the Philippine National
Police (PNP)
- National Bureau of Investigation (NBI)
Narcotics Division
- Bureau of Customs Drug Interdiction Unit
- National Drug Law Enforcement and
prevention Coordination Centre (DEP
Centre)
- National Anti-Drug Program of Action
- Department of Health(DOH)
- Dangerous drug board
PREVENTION AND CURE
• Therapy- involves the ability to determine the
mental health status of clients and provide them
with the help necessary to improve their coping
abilities
FOUR BASIC CATEGORIES OF THERAPY
1. Individual therapy- the client and the
therapist explore together in private the
feelings, emotions, and attitudes of the
client.
2. Family therapy- therapy which is limited to
the client and his/her parents or may include
family members as well
3. Group therapy- the therapist interacts with
each individual within a small group of
people (normally no more than ten) and
encourages them to interact with one
another.
4. Couple therapy- the working through of
problems between two individuals (who
need not to be related) with a mental-health
worker
Prevention: reducing “the incidence of new cases of
mental disorder in the population by combating
harmful forces which operate in the community and
by strengthening the capacity of people to
withstand stress” (Caplain, 1974 as cited in Adams
and Gullote, 1989)
TOOLS OF PREVENTION
1. Education
- By increasing our knowledge we can
change attitudes and behavior that hurt
ourselves or others
- Example: Public service announcements,
printed materials, etc.
2. Community Organization/ Systems
- It is focused on achieving a more equitable
distribution of power to improve the
standard of living of a group of people within
a community
- Example: Neighborhood associations,
rehabilitation of housing stock
3. Competency Promotion
- It promotes a feeling of being a part of,
rather than apart from, society. It
encourages feelings of worth, care for other,
and belief in oneself
- Example: Art and theater programs,
assertiveness training.
4. Natural care giving
- It recognizes the ability within each of us to
help a fellow human being. It involves
behaviors such as sharing of knowledge,
experiences, companionship, and when
necessary, confrontation
- Examples: coaches, lawyers, friends