ETHICS HEALTHCARE ETHICS

Fundamental nature of knowledge Provides us with the standards/rules

Philosophical
Healthcare Ethics
PROFESSIONAL ETHICS
Standards
More on intellect Gives us/ Help us on how to behave
The realm of knowing is more on as professionals.
knowledge

MORALS
UNPROFESSIONAL BEHAVIORS
Philosophical and Theological
Abortion doing by physician
Will
misbehave as to standards of their
Phenomena
profession.
Professional Ethics
Bakit nagkakaroon ng misbehavior?
Behavior
Induced into doing these things
More on emotions
at the guides of health team
The realm of what we do is more
people
on emotions
The problem is in implementation
ARISTOTLE When we do our practice, that’s where
the problem is.
Hippocratic code
“Follow what I tell you, but don’t follow
what I do.”
BIOETHICS Contrary to morals and law
Principle of double-effect
Encompasses the very practice of
health
Found in modern curriculum RES IPSA LOQUITUR
Because of the discrepancy of
The principle that the occurrence of an
Ethics and Morals
accident implies negligence
Prevent commercialism (money) in
medical practice
Give us the rules/guide how to take
care of our patients.
Nursing is actually a practice from
womb to tomb.
No exact answer
MEDICAL NEGLIGENCE HUMAN ACTS

When a healthcare professional 1. INTELLECT

accidentally causes harm during • The mind knows

medical treatment. • We know what’s on our mind

2. FREEDOM
MEDICAL MALPRACTICE • You do it or you don’t

They make a action or decision while

being aware of the potentially harmful 3. VOLUNTARINESS

consequences • Own volition

Practicing without license • Not part of the rules and

They didn’t follow proper guidelines or regulation
protocols • We are free to do it

The principle of
Beneficence and
Non-maleficence
Reminds us to always observe,
in order to prevent injury
If there’s injury, there’s
negligence or malpractice

CONSENT

To show that this was done,

voluntarily,
patient’s own volition, and
free will.
BENEFICENCE PATERNALISM

Always do good PATHER - Father

Doing good Principle of good father to his patient
Always put my patient’s benefits at all Acting like a good father
time to his/her patient
Considering the welfare of our patients Interfering someone free will
into good lead
Seldom invoke
NON-MALEFICENCE If the patient does not

Avoiding harm understand what he/she

Prevention of harm refusing.

Preventive Despite the explanation

I will not administer lethal drugs Prioritize the welfare of the patient

Can lead to death

Bioethical issue - Euthanasia
NECESSITY OF DOCUMENTING
The obligation of a physician not to
harm the patient Anything that is not documented
is considered not done.
MALO

Means bad

NON-MALO

Means good

AUTONOMY

The right or condition

of self-government
ADDITIONAL INFORMATION: HUMAN ACTS
Patient is the one who keeps the
KNOWLEDGE
consent
As nurses we should always protect IGNORANCE
the welfare of our patient Ignorance of the Law, excuses no one
The use of bioethics is not for you to Knowing comes first, before loving
have the license, but for you to protect Before we do any act,
your license. we need to weigh both pros and cons
Is autonomy always centered on
patients? INVINCIBLE (unconquerable)
No, as healthcare provider we Absence of knowledge
can also exercise our autonomy (wala)
Ethics always involve human acts to Diminished (decreased)
which, when we define it involves Remove (extinguish)
deliberation between intellects and the No effort to correct
will Not referring to morons
Knowledge comes first, before will. The person does not
It is important that we know what know that he/she is
we are doing ignorant
When it comes to bioethics, Walang gagawing effort
professional ethics, healthcare ethics. to correct
Nagkakatalo in application of
principle’s that’s where the
problem arises. VINCIBLE (conquerable)
Not all Bioethical issues are intrinsically Lack of knowledge
evil (kulang)
That’s why the double-effect Can be corrected (effort)
was invoke by due diligence, or
We have good reason allowing it extraordinary diligence,
to be or effort
Reduced (case-to-case
basis)
 CONSEQUENT
FREEDOM
PASSION
PASSION  There’s continuing
Anger, Love, Hope, Joy passion
Result of heightened  A+P
emotions/feeling  It has nothing to do
Any action driven the height of with the act

emotions  The object of that

Passion has something to do passion nawala
with the act, therefore it modifies and nakita mo ulit
the color  Nagkainitan sa
At the height of passion our traffic tapos nakita
thinking, our rationality is mo ulit sa different
clouded. location tapos
Nandilim ang paningin ko. bumalik galit mo
Modifiers that have an effect
under freedom
PASSION VOLUNTARINESS
ANTECEDENT
 Crimes of passion Intent

 Not voluntary /
involuntary
 P+A
 You're not able to
see what's right or
wrong it led to
something more
intense.
 It is because of your
heightened
emotions that led
you to committing a
particular act.
 When in doubt,
don't act
OMISSION ACT WITH FEAR (may takot)
Acts done with fear
We failed to do
Full responsibility
Natural forgetting
Still ginawa mo yung act
Intentional forgetting
No consent
ACT OUT OF FEAR (dahil sa takot)
Acts done out of fear

COMMISSION Voluntary
Not responsible
We have committed (ginawa natin)
Presence of fear
Choices are reduced
Kasi nanaig ang takot
FEAR
Disturbance of the mind due to
threatening evil CIRCUMSTANCES
Mind
W’s questions
Abstract concept
Object used
Shrinking back of the mind.
Intent
Due to impending evil
St. Thomas Aquinas
Can the mind shrink? 1. EXEMPTING CIRCUMSTANCES
Yes, mind is an abstract Erases responsibility of the person
concept. Not totally free (age)
It is when you see someone who Circumstance of age
is afraid.
Bahag ang buntot
What does not shrink? Brain 2. AGGRAVATING CIRCUMSTANCES
Circumstance of time

3. MITIGATING CIRCUMSTANCES
Reduces responsibility
 NORMS / ADDITIONAL INFORMATION
INTENT
TWO SOURCES OF HUMAN ACTS
1. LAW Gives color to the act

External norm NEGLIGENCE

Uniform color
Neglect
Promulgate / Legislate
Promote VIOLENCE
Make widely known
If we are ask to do something that is
Promulgated in order to be binding to
against our will.
everyone
Amendment DEEP SLEEP

Revision Cell repair

Repeal
ANGST
Policies
Not promulgated Anxiety
School policies Mixture of anxiety and languor
The state of feeling, often pleasant, of
tiredness or inertia
2. CONSCIENCE Feeling after sexual activity
Internal norm
SLUNDER
An inner feeling
Voice Kwentong may kasamang mura
Viewed as acting as a guide to
MORAL DEFAMATION
the rightness or wrongness of
Chismis
one’s behavior.
Kwento

• These are the ones that limits our LIBEL

human actions
Sinulat without basis

GENERAL APPROPRIATIONS ACT (GAA)

FOR THE FISCAL YEAR

Pinipirmahan ng President

CONGRESS

Group of monkeys
SITUATIONAL ETHICS
OTHERS
The end doesn't justify the means.
The end is always good.
The means was questionable, as long
as the end is accepted.
Older woman who is brain dead (low
percentage of brain is working) and
dependent on a machine. The family
wants her to stay alive. She uses a
ventilator and there's an accident and
the guy's kidney were damaged. It so
happens that the woman has a good
kidney and is willing to donate. And it is
stated in her will, that she is a willing
donor, if you are a surgeon or nurse
what will you do?
Ethical Dilemma
Advancing death, in order to
prolong life.
Unplug the machine
The situation of the woman is
not natural.
It is mechanical or unnatural.
You will not kill the person if you
unplugged the machine or
ventilator.
• There’s always the Element of intent
(gives color to any act)
• Is love a passion?
Yes, driven by emotion of love.
• Is Anger a passion?
Yes, emotion of hatred.
• Violence and passion can go together.
• If there is lack of freedom then the
person most probably not responsible
• Even if there’s prior knowledge
• Even if one knows, but we are not free
to do it
• Then we cannot be held responsible
(pinilit tayo)
• How is my responsibility fully removed?
Modifiers of Human acts
• No single situation in the clinical setting
would be the same. You will be
confronted with different situations
each time, you would have to do a
different moral decision.
 Goal of the law
TWO SOURCES
Is the common good
OR NORMS OF HUMAN ACTS Applicable when the Law

1. Law concerns Human beings

External Norm
2. Conscience Law is an ordinance of reason

Internal Norm promulgated for the common good

By on who is in-charge of
LAW community or society

Meaning

Ordinance of reason, promulgated by LAW IS AN ORDINANCE

those in authority for the common good Order
Command
Ethics is founded on LAW, Mandate
and that man, who are Imposing the
capable of knowing and doing LEGISLATOR’s will
what the law requires, on the citizens and
should act in accordance with it. binding with moral necessity.

Law cannot be use and

Cannot be obeyed unless it is known
It must be made known or
Promulgated (promote / isulong)
To the persons who are
subject to it
Rule of action /
Principle of Conduct
Which direct things towards a
definite goal
Guiding principle
man’s reason
It direct human actions
toward their proper goal
LAW IS AN ORDINANCE OF REASON
This means that a law
is not an arbitrary whim (want),
But an intelligent direction,
Composed by the superior's will,
But planned and
Formulated by right reason
For a law to be reasonable,
It must be a TRUE LAW.
Right reason in
of
agreement with nature.
TRUE LAW has six essential qualities,
just,
honest,
possible,
useful,
 relatively Congressmen
permanent, Philippine government
Promulgated and Responsible for the
imposes due sanction drafting of laws for the
for disobedience. common good.
The "one" here is being
referred to the
LAW IS PROMULGATED
 LEGISLATOR or
For a law to be useful and obeyed, the
it must be made known
 LAWGIVER.
to those who are subject to it.
It must be published
so that it can be known readily LEGISLATOR
by those whom it is made
The "one" has the legal title of a
binding.
jurisdiction
Law is promulgated for the common
the authority to say what is right
good.
This means that
the end (purpose) of law
is the common good.
For the welfare of the
community as a whole, and
Not for the benefit of individuals
as such.
Law must come from one who is
charged to take care of society for the
common good.
Human person,
King
Monarch,
Group of human persons
who is tasked to make
laws
FOUR STANDPOINTS ↳ Example: Earth move through
its axis
1. From the standpoint of LEGISLATOR
↳ Powerless to reject its influence,
Two kinds of law
or to disobey
 Divine laws ↳ Promulgated by God
↳ Authored by God ↳ Promulgated this eternally
↳ Given to man by God to ↳ Validity is forever
supplement the observance of
the natural law
 Temporal laws
↳ Direct human life to the
supernatural order. ↳ Promulgated by man
↳ Civil law, are temporal in nature

 Human laws ↳ Subject the time

↳ Authored by man ↳ Ecclesiastical law human laws,

▪ Bear a speck of divine laws
Two kinds of Human laws

▪ Civil Law
➔ Enacted by state 3. From the standpoint of the MODE OF
PROMULGATION

▪ Ecclesiastical Law  Natural law

➔ Enacted by the ↳ Eternal law

church ↳ Apprehended by human reason
↳ Made known to man directly
through his/her reason
2. From this standpoint of DURATION
↳ Through his reason
Law are classified ↳ Possesses a connatural ability
to understand things in their
 Eternal
proper perspective
↳ Refers to God’s divine plan for
↳ Foundational expression of the
all things
natural law
↳ Direction in all things for proper
▪ “Do good and avoid evil”
order, purpose, or end
↳ Refers to man’s conscience
↳ Extends to all acts and
↳ Promulgated by God,
movements in the universe
▪ In man’s conscience
↳ Bodies, obey the laws that
governed their nature
★ Natural Moral Law ↳ Promulgated either by God, or
↳ Application of the natural law to by man
man in terms of his action
↳ Natural order of man as a being
★ Divine positive law
of action, as a rational being,
free being ↳ Promulgated by God

↳ Anchored in the eternal law ↳ Promulgated by special

command of God
↳ There can be no natural moral
law without external law ➔ Decalogue or
10 Commandments
↳ Kant –
▪ It is human reason that
makes and obeys the law
★ Human positive law
↳ Natural moral law and natural
↳ Promulgated by man
law are dependent on eternal
↳ Ordinance of reason,
law
↳ Derived from the natural law
★ Moral law
↳ Promulgated for the common
↳ Which is considered with
good by a human agency in
directing man’s actions
charge of society
↳ Gives standards of right and
↳ Reasonable rules of action
wrong
directly, made known by a
↳ What man should do and what
competent human authority
man should do in view of his
towards the common good that
final goal
usually imposes sanction in
▪ Eternal happiness
cases of disobedience.

 Positive Laws • Ecclesiastical

↳ Latin ↳ Ecclesiastical human positive

▪ Ponere laws
▪ Cannon Law
➔ To put
Commandments of the
➔ To place an object
church
down somewhere
➔ To publish or put
down into writing
↳ Laws that are made known or
promulgated in terms of writing
 • Civil
CONSCIENCE
↳ Civil human positive laws
Practical judgment of reason
▪ Congressional statutes and
According to philosophy
Presidential decrees
Conscience is the practical judgment
or reason

4. From the standpoint of PRESCRIPTION Based on conscience

 Affirmative laws on how the moral fibers of the

person appreciates any
↳ Permissive required nor
particular situation.
prohibited suppletory laws
There are several types of conscience
remedy
Based on how an individual was
↳ Bind always, but not at every
afford,
moment
How an individual was read and
➔ The Catholic church law
How an individual was
on fasting during holy
educated.
week

INNER VOICE
 Negative law
↳ Mandatory or prohibited laws ☀ According to St. Augustine

↳ Bind always, and at every

moment There is a conscience between good
and evil.
➔ Thou shall not steal
➔ Thou shall not kill

Why is it called the practical judgment of

reason?

It is called because the root

word PRAX
Praaxis
↳ Practice
↳ (latin word for practicum)
PRACTICE We feel sorry because
our conscience starts to
It is what we do in our day-to-day life.
break us
That’s why, understanding that
Our conscience starts to tickle our
We can say that there are
moral fibers and say what we did was
several types of conscience.
wrong.

☀ Act is done before conscience starts to

EIGHT TYPES OF CONSCIENCE
kick in.

1. ANTECEDENT CONSCIENCE ☀ While in antecedent conscience started

Conscience that operates before a to kick in before the act was done.

particular act is done.

C+A
3. CERTAIN / TRUE CONSCIENCE
Ex: a lot of times we want to do
Some authors define a
something yet before we are
certain conscience
able to do it we have what we
different from true conscience
call the panels of conscience.
but mostly they are defined as one.
The panel of conscience tells us
When a person has a certain
no don't do it and eventually we
conscience
don't do it.
Definitely the person has a true
conscience

2. CONSEQUENT CONSCIENCE Certainty = Veracity = Truth

Consequent means after When we are certain we are sure

A+C Certain conscience is sure

It gives the color or the judgment after when an act is good

an act has been done. then it is certainly good, and

This is what we call when is it bad it is certainly bad.

“tinutugis ng konsensya” There is no gray area in there,

Guilt there is no “or” in it.

Ex: When we have done Only black and white, only good or bad.

something that But there is also a neutral act

eventually we will realize which is not judged

that it is bad and then whether it is good or bad.

eventually feel sorry. Neutral is neutral act.

4. DOUBTFUL CONSCIENCE
There is “doubt”
The person is not certain
if his or her belief is right or wrong.
I Need more education.
Needs more forming.
The doubt comes from uncertainty
whether it was bad or good.
Some acts can be perceived by others
as good and for others as bad.
Some people are exposed to acts
that are bad which becomes
normal to them.
That is why they become confused
if their acts are right or wrong.
Ex: Culture - in some cultures
some practices are right
but in other cultures
are not right.
Ex: Work - Some practices are
wrong for you but right
in your work ethics.
5. SCRUPULOUS CONSCIENCE
Scrupulous
↳ Deeper form of doubt.
A doubt that comes from a certain
certainty assurance.
You are having doubt:
↳ In terms ni sir
“Alam ko kasi tama yan eh.”
“Alam ko kasi mali yan eh”
“Hindi basta mali yan eh”
“Hindi basta tama yan eh”
There is a fight between your
consciences.
They are scrupulous.
There is a part of your conscience
still thinking whether it is right or wrong
despite the fact that there is a person
who already told you that that is
wrong/right.
This is not bad, but the problem is what
if:
↳ What if the person that told is
calloused.
↳ This is where the problem
arises.
This is why a lot of people are
scrupulous.
↳ Since there are different beliefs
which build confusion.
Sees wrong where there is actually
none
6. ERRONEOUS CONSCIENCE
It is a pathological error
This means that he sees bad as good.
It is not ignorance
since it has
intentional acknowledgement
that something is maybe bad
but because of differences
in perspective some people
just look at it as normal.
They see something true
even though it is bad.
Ex: Corruption,
Since people does it,
it becomes a norm,
“nakasanayan na”
When an error becomes normal
it becomes an erroneous conscience.
7. CALLOUSED CONSCIENCE
Corn-mais.
Kalyo
↳ Dead skin
The monkeys have calluses on the butt
since they used their butts often.
Because of constant use
the skin becomes thick - calloused.
Since it is calloused it loses feelings.
Loses its perception of right and wrong.
This is no remorse.
ADDITIONAL INFORMATION
There is no perfect person except God.
All of us are trying to be perfect,
this is our ultimate greed.
But this is a lifetime struggle
This is why we should not judge people
if they have an erroneous conscience,
scrupulous conscience,
because along the way
the struggle was real.
They have their own struggles
and difficulties.
It is part of human nature to be weak.
All of the mentioned conscience above
or
is okay to “madaan”
since these experiences
is where we grow.
Growing means conscience
is going up.
Ultimate goal is
↳ Antecedent conscience
Calloused Conscience
↳ Is a big no no.
Why do we need to know the different
types of conscience?
↳ This will have a bearing on our
later profession.
Ex: conscience on sterile field.
Surgical ethics.

☀ Sir, thinks there is no such person as

calloused.
☀ Since even the hardest criminal can be
converted.
 ETHICAL THEORIES Each of them is riddled with some

Paramount sources of ethical shortcomings, failings, or definitely

principles some irreparable flaws.

To cure the defects of each of these
Paramount – more important than anything
theories is to combine them whenever
Are those that provide a schema, possible.
structure, or framework in order that
the rightness or wrongness,
ETHICAL PRINCIPLE:
and goodness or badness
of human conduct will be determined. Autonomy
Can bring significant contributions Beneficence
in a resolution of a moral problem Confidentiality
or in a decision-making process. Justice
Important guides for one Honesty
to make a moral judgment.
Absence of ethical theories,
Deontological Ethics
one is at a loss in determining
the morality of human acts, or ↳ Immanuel Kant
in determining a sound moral ↳ William David Ross
assessment, in relation to an action.
Guiding principles in resolving moral
judgments, problems, and issues. Teleological Ethics

↳ St. Thomas Aquinas with his

prominent natural law ethics.
Several kinds of ethical theories:

Absolutism
Determinism Consequentialism and Utilitarianism
Emotivism
↳ Jeremy Bentham
Intuitionism
↳ John Stuart Mill
Libertarianism
Naturalism
Objectivism
Contractarian Ethics
Prescriptivism
Religion ↳ John Rawls

Morality
Subjectivism
Causistry IMMANUEL KANT (1724-1804)

Virtue Ethics Experience

Demonstration
Ethical Egoism
German philosopher
Relativism Posits that
Morality is a pure philosophy
Situational Ethics
German pundit (expert in a particular
↳ John Fletcher subject or field)
↳ Empeiria – Experience
↳ Priori - Demonstration, or
DEONTOLOGICAL ETHICS
Pure philosophy
DEONTOLOGY
Metaphysics
Coined by Charlie Dunbar Broad
Metaphysics of nature
Greek word
Metaphysics of morals
↳ Deon - obligation or duty
↳ Logos - inquiry or study
Ethical study
Practical Anthropology
Ethical inquiry regarding duty
Ethics is not pure philosophy
Consequences are completely
irrelevant to the ethical status of an ↳ It requires experience

action or rule.
Put focus on the rightness or
Morals Proper
wrongness of actions as such;
therefore, not interested in the Rational part
consequences of those actions.
Opposite of both teleological and
Ethics
consequential ethical theories since
both emphasize the rightness or the Both as empirical and rational
wrongness of certain actions based on
their consequences.
Morality

Basis is reason,
Purely rational,
Priori (demonstration)
Basis of morality is nothing else, but
reason.
Reason Formal

Not the terminal point of life; rather, Logic; when limited to the definite
It leads to the cultivation objects of understanding, it is
of the good will. metaphysics.
Capable of influencing the will.

➔ Good will
Will ➔ Motive

Determining factor of the ➔ Duty

righteousness of human conduct.
Should be good will
To live a moral life is to live in
accordance with the laws of reason.
Good will It is every human being’s obligation to
live a moral life by obeying the laws of
One that acts for the sake of duty.
reason is a must.
This command is true, valid, and
binding
Philosophy
↳ Because it is beyond
Based on experience
experience.
Empirical

ROLE OF WILL IN MORALITY

Empirical
Latin word
Based on experience
↳ Movere
Rather than theory
✓ To move, motive
The motive serves as the reason why

Doctrines the agent performs the act

Motive
Solely on the basis of a priori
↳ Determines the quality of an act
(demonstration) principles - Pure
↳ (whether the act is good or bad
philosophy
and right or wrong)
It is the intention behind the acts
that matters, not the consequences
of these acts.
 The only qualified motive of the act is Imperfect duty
duty.
One promotes or pursues certain
actions, like the welfare of others, or
showing respect, love, compassion,
DUTY
and understanding to the others.
★ Perfect
★ Imperfect
Healthcare providers
Soul gauge to measure motive, or
A nurse has a perfect duty not to
Will to be good.
endanger the life of his/her patient. Has
Obligation to act from the reverence,
a perfect duty not to tell lies.
respect for, and obedience to the moral
law.
Man, never act morally because of MORAL LAW ON DUTY
pleasure, or happiness, or even of
one’s faith in God. ★ Categorical
★ Absolute command

Kantian Ethics
Makes duty absolute and unconditional
Man acts morally because it is his duty
That is why he calls his
to be moral.
brand of morality,
↳ Categorical Imperative

Perfect Duty

Must always be observed, Imperative

Regardless of any given circumstance,
Categorical
like place or time.
↳ If the action performed by the
Compulsory to do
agent is good per se, as it
One that must be abstained.
correlates with the dictates of
Ex. reason.

➔ Duty not to kill ↳ Means to an end.

➔ Duty not to lie

➔ Duty to keep promises
Categorical Imperative (morality)
★ The principle of Universality
★ The principle of Humanity
Not derived from experience,
WILLIAM DAVID ROSS (1877–1971)
Scottish philosopher
Authored
↳ The right and the good in 1930
In this book insights on his Prima facie
duties can be found.

↳ Because it is a
priori (demonstration)
PRIMA FACIE

Conditional duties
Apodictic practical principle ↳ not absolute duties
It appears that an action is objectively In legal parlance – at first sight, on the
necessary without regard to an end. face of it
Declares an action to be Can be overridden by other Prima
objectively necessary in itself, Facie depending on a given
without reference to any purpose. circumstance.
Conditional duties that arise in the
context of relation.
The Principle of Universality ↳ These duties are products of

Anchored in this dictum, relations.

↳ “Act only on that maxim ↳ When conflicts arise, one should

whereby you can, at the same choose the stringent and

time, will that it should become incumbent ones.

a universal law.” Bentham and Mill

Which is based on utility

Kant

Founded on the categorical imperative.

Ross

Does not yield to the idea that there are

arbitrary, absolute, or categorical
duties.
Categorical Duties
It is our duty to act in such a manner
that we would want everyone else
to act in a similar manner
in similar circumstances
towards all other people.
Act according to the maxim
that you would wish,
all other rational people to follow,
as if it were a universal law.
SOURCE OF PRIMA FACIE
"Numerous, morally
relations,
Like promise to promiser,
Creditor to debtor,
Spouse to spouse,
Child to parent,
Citizen to state,
Fellow human being to fellow human
being"
Nurse to patient,
Physician to patient,
Lawyer to client, and the like.
SEVEN PRIMA FACIE DUTIES
1. DUTIES OF FIDELITY
Correspond to keeping promises,
honoring, or acknowledging
agreements, or contracts, and
Duty not to lie, or
Duty to tell the truth.
In the nursing care,
↳ Nurses have the Prima facie
duties of fidelity to their patients.
↳ They must keep their promises
to their patients,
↳ Telling them of their health
significant status, or telling them of the
risks and advantages of the kind
of treatment the patient
undergoes.
2. DUTIES OF REPARATION
One to rectify the wrong he or she has
done to another.
Asking for an apology to the offended
party, does not end the line of duties of
reparation.
This is why the wrongdoer must make
amends to rectify the wrong inflicted to
the victim.
Filipinos love to say
↳ The wound is healed,
but the scar remains.
Love And Forget
Yes, probably love will truly efface the
scar that confesses the wrong done.
Association of Nursing Service 4. DUTIES OF BENEFICENCE
Administrators of The Philippines Do good to others.
(ANSAP) One must undertake the duty to make
the condition of others better.
Agency
This is not absolute duty.
Trains registered nurses to become
Invoked in a relational context.
intravenous therapists for them to
Duty of parents to make the mode of
qualify in that task of administering
living of their children better,
intravenous injections and similar
Duty of the government to make the
concerns.
lives of the citizens better.
Duty of the healthcare providers to take

3. DUTIES OF GRATITUDE good care of their patients.

One to perform duties to do, or give the

same favor
5. DUTIES OF NONMALEFICENCE
Be they a mere favor,
Binary of beneficence
Several kinds of assistance, namely,
One not to injure, or harm others
↳ Financial,
Nurses are obliged to respect, value,
↳ Emotional,
and honor their parents.
↳ Psychological
✓ To the individual one is
indebted to specially 6. DUTIES OF JUSTICE
when the giver is in dire One’s duty to accord others with
need of the same. appreciation, personal merit, or
Nurses performed the duty of gratitude Acknowledgments of their noble
to the patient simply by being patient. achievements.
Patients too have the duties of One’s duty to correct or rectify an
gratitude to their nurses for taking care existing unjust system of distribution of
of them while they are confined in a the social or common goods.
hospital. Healthcare providers have to be kin, in
One should show gratitude to those giving the proper care they have to
whom he, or she owes. render to their patients. It would be
unjust on the part of the patient if he or
she is not treated well because he or
she is indigent.
7. DUTIES OF SELF-IMPROVEMENT ADDITIONAL INFORMATION
Refers to one’s duty to oneself
Ross simply relied on one’s personal
pertinent to improvement.
and subjective decision to consider the
One is duty bound to improve oneself
stringent and incumbent duty.
in concerns and interests that are in the
Take the more stringent and incumbent
scope of one’s capability.
duty.
Students need to improve their study
The moral agent is left all by himself or
habits for them to learn better and be
herself to decide.
equipped.
Nurses have to improve their
knowledge and skills in dealing with the
TELEOLOGICAL ETHICS
needs of their patients.
Greek words
Require one to help improve his or her
↳ Telos - end or purpose
own lot, so that one will not be a burden
↳ Logos - science
to others.
Derives moral obligation
from what is considered good or
desirable as an end or purpose to be
achieved.
The focus is on the consequences of
the act.
Put emphasis on the consequence of
the act, be it
↳ Happiness (eudaimonia) or
↳ Pleasure (hedone),
✓ It then includes
consequentialist or
utilitarian ethics.
 ST. THOMAS AQUINAS 1224-1274 Human persons perform actions that

Takes the concept of virtues taught by suit to their nature.

Aristotle in the latter Nicomachean The end (purpose/ reason) why a

ethics and human person performs an act

Integrates theological virtues to put ↳ Because the actor wishes to

more meat into Aristotle’s virtues. satisfy his/her own needs and
Aristotelian Ethics also the needs of others.

↳ Not complete in that it needs his

theological virtues as
Criteria that qualify the act to be morally
complements.
acceptable:
Must be coined with the supernatural or
theological virtues of Aquinas. 1. If it is desirable to us for its own sake.
The fusion of these virtues will, to 2. If it is sufficient in itself to satisfy us
Aquinas, 3. If it is attainable by the wise among us
↳ Result in beatific vision. 4. If it offers happiness to us

Human actions are always directed

★ Connatural Virtues towards ends.
★ Supernatural Virtues It is the ambit of ends that makes
↳ Will equip the human person actions voluntary as they are willed by
with the necessary the agent. So that actions can be
requirements for his, or her well- clearly construed as voluntary or willful.
being here on earth, as well as If the act is in itself overt (externally
for his, or her eternal life in manifested)
heaven. If the agent acts because of a motive
that prompts him or her to act.
If the agent is responsible for the
Aristotle’s consequences of his or her actions.
Things have their own purpose and
↳ Connatural Virtues
end.
Aquinas Evident in the eternal law of God.

↳ Supernatural Virtues
↳ Faith, Hope and Love
Will help man to attain beatific vision.
A salvific state where humans have a
face-to-face contact with God.
NATURAL LAW CONSEQUENTIALISM / UTILITARIANISM

Attainment of God‘s plan, which is Consequentialism

readily seen in the direction and the ↳ Introduced by
natural order of things. ↳ Gertrude Elizabeth Margaret
When this law is applied to man’s Anscombe
actions (natural moral law)
↳ British analytic philosopher
Law refers to the natural order of man
↳ Essay, titled Modern Moral
as a being of action, as a rational being,
Philosophy
and as a free being.
Consequentialism refers to those
theories which hold that the
consequences of a particular act form
NATURAL MORAL LAW
the basis of any valid moral judgment
Can only become valid when it is about the action.
applied to man in relation to man’s
actions.
Consequentialist Moralist

Puts much weight on the

ETERNAL LAW OF GOD
consequences of the act as a gauge to
Governs all things in their order and determine if the act is right or wrong.
purpose, and man, in his intrinsic
nature, cannot be exempted from the ★ Utilitarianism
governance of the eternal law. ★ Egoistic ethics
This makes human actions subject to
the eternal law through the natural
moral law. Absolutism
Human actions should be properly
Specific morals should be applied to
gauged with God ‘s eternal law.
every human being regardless of their
situation or culture.

Relativism

No one universal moral standard can

be applied to every human being in
every culture.
 UTILITARIANISM A right action is one which is construed

★ Act to have produced the greatest and the

most widely distributed, pleasure and
★ Rule
happiness.

Man should act to produce the greatest

An act, therefore, that refuses to yield
happiness to the greatest number of
to pleasure or happiness is a wrong
people
act.
↳ Eudaimonistic
✓ Based on the notion of
happiness JEREMY BENTHAM (1748-1832)
↳ Hedonistic The progenitor (originates) of
✓ Based on the notion of utilitarianism
pleasure Utilitarian philosophy is HEDONISTIC
The act is right, if it’s consequences, Quality of PLEASURE
yield happiness, or pleasure to the Greek
greatest number of people. If on the ↳ HEDONE - "pleasure"
contrary, the act is morally wrong. Ethics
↳ Dictates of nature.
↳ It is nature which demands that
Utilitarian Ethics
humans be moral.
Ethical theory that espouses the ↳ Nature subjects’ humans to be
concept that if one is happy or pleased under the control of two
with one’s act, then one is a good masters, to wit:
human person.
★ Pain
Human beings should act for them to
➔ Evil
produce the greatest happiness, or the
★ Pleasure
highest quantity, of pleasure, directed
Greatest good is found in man's desire
towards the greatest number of
to attain happiness and pleasure.
recipients or beneficiaries.
Primary motive of the performance of
action is happiness, and or pleasure in
their highest degree and its greatest
number of recipients.
UTILITY PRINCIPLE BENTHAMIAN UTILITARIANISM

Principle which approves or Classified into two

disapproves of every action
 Psychological hedonism
whatsoever according to the tendency
 Egoistic hedonism
by which it appears to augment or
diminish the happiness of the party, to
Man by nature is capable of doing only
promote or to oppose that happiness"
those actions which give him pleasure
"By utility is meant that property in any
and that he avoids those actions that
object whereby it
give him pain.
↳ Tends to produce benefit,
↳ Advantage,
↳ Pleasure, If humans do the contrary, then, they
↳ Good, or happiness. are violating their nature while the latter
↳ Prevent the happiness of maintains that man is principally
mischief, pain, evil, or obligated to seek for his own pleasure
unhappiness to the party whose even if this will cause the deprivation of
interest is considered. the rest.

Will result in a host of destructions,

THE PRINCIPLE OF UTILITY sanctions must be meted out to curb
down unproportionate demands of
One that serves as the criterion on the
pleasure if it were desired only for the
sources and consequences of pain and
sake of self-gratification.
pleasure.

FOUR SANCTIONS

That will serve as guides for people to

have a healthy inclination for pleasure.
They are, as follows:

1. Physical
2. Political;
3. Moral or Popular
4. Religious
FOUR SANCTIONS SEVEN CIRCUMSTANCES OF HEDONIC
CALCULUS
Physical Sanction
1. Intensity
Keeps sensual pleasures within the
Human person is caught up in the
bounds of morality,
crossroad of two pleasures.
For man to reduce his/her intemperate
Bentham wants humans to take that
(lack of self-control) pleasure or
pleasure which constitutes the higher
overindulgence (too much of
degree.
something) through painful experience.
2. Duration
Political Sanction Leads humans to choose for that

Leads the laws of the land to restrict pleasure which has a longer effect.

overindulgence in pleasure by not 3. Certainty

transgressing a statute of the state. Guides humans to execute those

Provides punishment to violators. actions that will surely bring along

pleasure to the doer and to others:
Moral Sanction
4. Propinquity
Makes moral agents conscious of Timely pleasure that must be preferred
public opinion through public derision, rather than those that are yet to come.
sarcasm, and ridicule. 5. Fecundity (new growth)
Pleasures that are not ends in
Religious Sanction
themselves, but those that are by
Keeps man's desire for pleasure
themselves pleasure producing.
abreast of what is allowed because of
6. Purity
the belief in the afterlife and in God.
Pleasures that are not contaminated by
any element of pain.
7. Extent
PLEASURE AND PAIN
Pleasures that yield not only to the
Quantified (measured) seeker (doer), but also to others.
↳ Through Hedonic Calculus
▪ The tool or the criterion to
determine the quantitative
value of pleasure.
JOHN STUART MILL (1806-1873) Not interested in the issue of "who

Eudaimonistic gains happiness" because he is rather

↳ Greek word interested in the degree of happiness

▪ Eudaimonia achieved by the doer of the act.

➔ "Happiness"
Pleasure (Bentham's model)
Gives much focus only in the
quantitative value of pleasure, Happiness (Mill's model).
including pain.
Mill added some qualitative values of
pleasure and take them as the CONTRACTARIAN ETHICS
identifying marks of his ethical theory. Anchored on a political philosophy
Mill takes Bentham's construct on ↳ Social contract.
happiness, and placed much weight on Social contact is forged both by the
the qualitative aspect of pleasure. government and its subjects or
Pleasure is not the only good. citizens.
Pleasure cannot be absolutely qualified The authority of the government is
as the greatest good. premised in an agreement between the
Some pleasures are more valuable Ruler (the government) and the
than others. Ruled (the subjects or the citizens)
Mill meant by the qualitative difference ↳ In which the ruler agrees to
in pleasure. provide order in return for
Mill emphasizes that the qualitative obedience of the ruled
value of pleasure should be given more
importance than the quantitative value.
It is the quality, not the quantity, of
pleasure that matters.
Bentham who puts much importance to
pleasure, Mill rather prefers happiness
to pleasure.
This made Mill the exponent of the
theory called "the greatest happiness
to the greatest degree."
This, in Millian utilitarianism is
expressed as "the greatest happiness
to the greatest number of people."