MIDTERM BIOETHICS
1ST WEEK
HUMAN SEXUALITY
INTRODUCTION OF HUMAN SEXUALITY
● is the process by which people
experience and express themselves as
sexual beings.
● Sexuality has been a consistent focus of
curiosity, interest, and analysis to
humankind
● Sexuality is determined by anatomy,
physiology, the culture in which a
person Ives, relationships with others,
and developmental experiences
throughout the life cycle
● includes the perception of being male or
female and private thoughts and
fantasies as well as behavior.
● Normal sexual behavior brings pleasure
to oneself and one's partner, involves
stimulation of the primary sex organs
including coitus
● Normal scxuality is devoid of
inappropriate feelings of guilt or anxiety
and it not compulsive
● Recreational VS Relational sex
Masturbation, Various forms of
stimulation sex organs. Getting sexual
gratification in several ways etc.
ANATOMICAL PERSPECTIVE
● Primary sex organs - Reproductive
organ
● Secondary sexual characteristics and
organs
● Nervous system, Endocrine system
PHYSIOLOGICAL PERSPECTIVE
● Action of Neurotransmitter
● Actions of Hormones
● Sexual drive
COGNITIVE PERCEPTION
● How a stimulus or situation is
interpreted determines how the
individual will respond to the stimulus
● Perception includes at least three
components detection, labeling, and
attribution
Detection is defined by an individual's ability to
note the presence of a stimulus or to
discriminate it from other stimuli
Labeling is the descriptor that an individual
uses to categorize the stimulus event.
Attribution is an explanation for the perception
COGNITIVE PERSPECTIVE
Another cognitive factor is evaluation when an
individual evaluates a sexual stimulus as good
or positive, sexual arousal may be enhanced.
On the other hand, when a stimulus is
evaluated negatively, sexuality will be
diminished.
LEARNING PERSPECTIVE
● Learning theory postulates the
environmental factors that shape sexual
behavior
● When sexual activity is pleasurable - it
reinforced
● if sexual activity is restricted, punishable
or full of shame then people may come
to associate sexual stimulation with
feelings of guilt or anxiety
● Observational learning of sexual
behavior.
"Human sexuality is not simply imposed by
instinct or stereotypical conducts, as it happens
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in animals, but it is Influenced both by superior
mental activity and by social, cultural,
educational and normative characteristics of
those places where the subjects grow up and
their personality develops. Consequently, the
analysis of sexual sphere must be based on the
convergence of several lines of development
such as affectivity, emotions and relations BY:
Boccadoro L., Carulli S. Italian Mentors”
SIGMUND FREUD
● Three Essays on the Theory of
Sexuality
● Psychesexual development
● Oral stage, Anal Stage, Phallic Stage,
GenitalStage
● Oedipus complex
● Sexual etiology of neuroses.
● Libido developed in individuals by
changing its object, a process codified
by the concept of sublimation
● Generalization that pleasurable
impulses and activities are originally
sexual.
MICHEL FOUCAULT
● Sexuality are the activities and
sensations determined historically,
regionally and culturally.
● The construction of sexual meanings, is
an instrument by which social
institutions (religion, marketing, the
educational system, psychiatry, etc.)
control and shape human relationship.
SEXUAL ETHICS AND LEGALITY
● Unlike some other sexual activities,
vaginal intercourse has rarely been
made on religious grounds or by law.
● Many of the cultures that had prohibited
sexual intercourse entirely-Shakers,
Roman Catholic Church, Mahayana
Buddhist Monks
- masturbation (auto- erotic
sexuality)
- fornication or live together
- Adultery or Extramarital sex
- Homosexual- Gay, Lesbian
- Commercial sex or Prostitution
- Necrophilia (sex with dead body)
- Child Sex Abuse or Pedophilia
- Bestiality
- Sexual intercourse during
woman’s menstrual period, as
prohibited by Islam and Judaism
- sex between members different
tribes / same cast
- Public decency( exhibitionism
and voyeurism)
BENEFITS IF SEX BEYOND
REPRODUCTION
● Relieve stress
● Boost the immune systems
● Improves CVS Lower P
● Self esteem
● improves intimacy with partner
● Reduce pain + oxytocin
● Risk of prostate cancer
● Strengthens pelvic muscles
● Promotes good sleep
● improves the sense of smell
● improves urinary bladder control
FUNDAMENTALS OF MARRIAGE
● Marriage was divinely established in
Eden and affirmed by Jesus to be a
lifelong union between a man and a
woman in loving companionship.
● The Bible does not support a union
between the same sexes.
MARRIAGE DEFINITIONS:
● And the LORD God said, it is not good
that the man should be alone, I will
make him an help for him. (Gen 2:18
KJV)
● And the LORD God caused a deep
sleep to fall upon Adam, and he slept
and he took one of his ribs, and closed
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 up the flesh instead therec (Gen 2:31
KIV)
● and the rib, which the LORD God had
taken from man, made he a woman, and
brought her unto the man. Den 2:22 V)
● And Adam said, this is now bone of my
bones, and flesh of my flesh shall be
called Woman, brause she was taken of
Man (Gen 2:22 XIV) Therefore anuli a
man leave his father and his mother,
and shall cleave unto his wife and they
shall be one flesh (Ben 2:24 KJV.
MARRIAGE IS A COMMITMENT
● For the Christian a marriage
commitment is to God as well as to the
sonne, and should be entered into only
between partners who share a common
faith,
● What about two Christians from different
denominations?
● Be not unequally yoked together with
unbelievers: for what fellowship hath
righteousness with unrighteousness?
and what communion hath light with
darkness? (200 6:14 KIV)
● Mutual love, honor, respect, and
responsibility are the fabric of this
relationship, which is to reflect the love,
sanctity, closeness, and permanence of
the relationship between Christ and His
church.
MARRIAGE AND DIVORCE
● And said, For this cause shall a man
leave father and mother, and shall
cleave to his wife: and they twain shall
be one flesh? (Mat 19:5 KIVI
● Wherefore they are no more twain, but
one flesh. What therefore God hath
joined together, let not man put asunder.
(Mat 19:5 IUV)
● Regarding divorce, Jesus taught that the
person who divorces a spouse , except
for fornication, and manies another,
commits adultery.
● And I say unto you, Whosoever shall put
away his wife, except it be for
fornication, and shall marry another,
commit adultery)
● Although some family relationships may
fall short of the ideal, mariage partners
who fully commit themselves to each
other in Christ may achieve loving unity
through the guidance of the Spirit and
the nurture of the church.
SEPARATION?
- It is recognized that sometimes
marriage relations deteriorate to the
point where it is better for a husband
and wife to separate. "To the married I
give charge, not I but the Lord, that the
wife should not separate from her
husband (but if she does, let her remain
single or else be reconciled to her
husband) and that the husband should
not divorce his wife" (1 Cor. 7:10, 11,
RSV).
● A separation or divorce which
results from factors such as
physical violence or in which
"unfaithfulness to the marriage
vow" is not involved, does not
give either one the scriptural
right to remarry. unless in the
meantime the other party has
remarried, committed adultery or
formication; or died.
MARRIAGE IS SERVING ONE ANOTHER
● Submitting yourselves one to another in
the Icor of God. (Eph 3:21 KIV)
● Wives, submit yourselves unto your own
husbands, as unto the Lord (Eph 5:22
KIV)
● For the husband is the heed of the wife,
even as Christ is the head of the church:
and he is the savior of the body. (eph
5:23 KV)
● Therefore as the church is subject unto
Christ, so let the wives be to that own
husbands in every thing, [Eph 3:24 KIVI
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 ● Husbands, love your wives, even as
Christ also loved the church, and gave
himself for it: (Eph 5:25 KIVI
● So ought men to love their wives as
their own bodies. He that loveth his wife
loveth himself (ph 5:28KV)
● God blesses the family and intends that
its members shall asüst each other
toward complete maturity.
SEX OUTSIDE MARRIAGE
SEX BEFORE MARRIAGE: IS IT THE SIN?
WHERE IS THE LINE.
CATHOLICS.
● Catholics believe that sex outside of is
not allowed. The purpose of sex is to
PROCREATE (have bables).
● This must be done within marriage so
that children can be brought up in a
loving Christion family.
● Adultery is condemned in the 10
commandments."Thou shall not commit
adultery"
● The catechism teaches that sex outside
marriage is wrong-Catholics should
follow the catechism.
● Sex is a gift from God (sacred) and
should be kept within marriage When a
couple marry they become joined
together as one.
● Pre-marital sex is wrong as the couple
haven't committed themselves Tully to
each other.
● Promiscuity is wrong as it is abusing
your body and St Paul teaches that your
body is a temple of the Holy Spirit
ISSUES ON CONTRACEPTION
● The deliberate use of artificial methods
or other techniques to prevent
pregnancy as a consequence of sexual
intercourse,
● Contraception (birth control) prevents
pregnancy by interfering with the normal
process of ovulation, fertilization, and
implantation There are different kinds of
birth control that act at different points in
the process.
TYPES:
● Hormonal Methods include control
pills. Depo Provera injection and
Norplant
● Barner Methods includes condom,
diaphragm, and conical cap
● Spermicides it contains nonoxynol
● Intrauterine Devices also known as
IUD
● Tubal Sterilization
● Vasectomy
● emergency Contraception
ON MORAL ISSUES.
● Those who say contraception a morally
wrong dose for a variety of
- Contraception is inherently wrong
- Contraception is unnatural
- Contraception is anti-Efe
- Contraception is a form of abortion
- Contraception separates sex from
reproduction
Contraception is unnatural
● The natural consequence of having
sexual intercourse is conceiving a child,
it is wrong to interfere with this.
Therefore, birth control is Intrinsically
wrong
● This argument depends on two other
ideas
- It is wrong to Interfere with the natural
order of the universe
- human beings interfere with the natural
wonder of the universe all the
Contraception is anti-life
● This argument is based on the premise
that life is a good thing.
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 ● of this view argue that contraception is
morally wrong because life is a
fundamental good - It's a good thing CONTRACEPTION
● those who use contraception are ● Voluntary prevention of conception P
engaged in an intentionally Ble" act ● uses artificial means that prevents the
because they intend to prevent a new union of sperm and egg
life coming into being ● Synonymous with
● Family planning
Couraception is a form of abortion
● Manned parenthood
● Some birth contra techniques can ● Responsible parenthood
operate by preventing the implantation ● Birth Control
and development of a fertilized egt.
Those opposed to such methods say
that this amounts to an abortion, and STERILIZATION
that if abortion is wrong thon those
forms of contraception must also be ● Positive use of artificial methods
wrong. ● Cutting off the sexual capacity in a man
● The forms of contraception included in and woman
this thjection are ● Usually done surgically
- some birth control pills
- most modern birth control pills Types : according to willingness
- the "morning-after pill ● Voluntary
- the UID ● maluntary
Contraception separates sex from Types: according to purpose or ends
reproduction
● Therapeutic
● Contraception makes it easier for people ● Contraceptive
to have sex outside marriage. This is ● eugenic
certainly true, since sexual intercourse ● social
without contraception cames a ● Punitive
significant risk of conceiving a child,
which most of those having sex outdo
marriage would regard as a deterrent THERAPEUTIC STERILIZATION
- Removal of part or all of the
reproductive organ
People think separating sex from manisage is
- to save one's life or promote bodily
wrong because
integrity
- it makes immoral behavior less risky
Principle of totality (UNDER NATURAL LAW
- it undermines public morality by making
OF ETHICS)
it rarely that people will have sex outside
marriage
- It weakens the family.
CONTRACEPTIVE STERILIZATION
Justification
WEEK 2
1. Serious illness of either husband of wife 13,
THE MORAL ISSUES OF CONTRACEPTION epileptics, syphilitics and lepers
AND STERILIZATION.

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2. Probability of genetic abnormality Carrier of
defective gere
3. Financial burden
4. Child-bearing puts one's health in danger.
5. Contraception checks the transmission
of recessive disorder or genetically -
linked diseases.
- Genetic testing and chromosomal
analysis.

EUGENIC AND SOCIAL STERILIZATION METHODS OF CONTRACEPTION

● Purpose of hindering the conception of ● Folk methods

undesirable and physically or mentally - Precoiltal /Poscoital Douche
unfit offspring - Prolonged Lactation
● Social engineering - Withdrawal - coitus interruptus, coitus,
● Society free from individuals afflicted reservatus
with social diseases
● Grave mental defects
● Lepers, idios ● Mechanical method
● Imbeciles - condom
● Morons - Diaphragm
● Imane - sponge
● Carners of congenital defective genes

● Chemical methods
PUNITIVE STERILIZATION - vaginal suppositories and tablets
- vaginal jellies, cream,and foams
● Done as punishment for crime or
antisocial behavior
● Catholic theologians defended this
under the double effect principle ● Hormonal methods
● The sterilization is not "direct" since the - Contraceptive pills
primary and intended effect is - injections and implants
punishment and the contraceptive effect
is therefore "indirect" or secondary.
● Abortifacients
- Intrauterine Device
- DES (diethylstilbestrol)
JUTISFACTION OF CONTRACEPTION
- Prostaglandin
1. parenthood and birth are matters of - Anti Pregnancy vaccine
moral and intelligent choice - Low-dose of contraceptive pills
2. An individual should be the one to
determine his/her fertility and should be
able to control his/her fecundity SURGICAL METHODS
3. One should be able to decide how many
children one is able to bear and support ● Tubal ligation
4. Contraceptive technology makes men - vasectomy
and women persin of will and decision, - Hysterectomy
and not inert and powerless bodies ● Natural or behavioral methods
subject to church prescriptions or the - Rhythm or calendar method
divine will. - Temperature method
- Ovulation (Mucus) Method

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 - Sympto thermal method
- Sex relations during menstruation
● Do it yourself
● Homologous IV and ET
APPLICATION OF ETHICAL THEORIES
● Natural law ethics had two division 1. Homologous in vitro embryo transfer
- only rhythm method and abstinence
- Voluntary sterilization as WRONG
● Utilitarianism
- Justily contraception and sterilization for
the greatest happiness and benefits
● Pragmatism
- Contraception and sterilization is
practical, useful, beneficial
-
AID TWO METHODS
MORAL ISSUE OF ARTIFICIAL
INSEMINATION ● Heterologous artificial insemination
● Heterologous IVF and ET
● Depositing a man's semen in the vagina,
cervical canal or uterus, through the use
of instruments to being about
conception without samal intercourse
● How is it done?
- Intravaginal
- Intracervical
- Intrauterine

JUSTIFICATION OF AIH
METHODS OF EXTRACTION
1. husband is impotent
● Masturbation
● Condomestic itercourse 2. Anatomical defects
● Coltus interruptuw
● Anal massage of the prostate gland 3. Oligospermia/ azoospermias -
● Direct puncture of the epididymis characteristized by the absence of in the
semen; severe, oligospermia is defined as the
TWO TYPES OF AI
presence of fewer than 5 million sperm of
1. Homologous insemination. (AIH) ejaculate

- Semen is from the husband 4. Spinal injury

2. Heterologous insemination (AD 5. Vasectomy

- Semen from other person other than 6. Physiological obstruction genital organs of
husband wife

AIH ( HOMOLOGOUS ARTIFICUAL

INSEMINATION
APPLICATION OF ETHICAL THEORIES
- 2 methods

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 ● Natural law ethics/Roman Catholic
- Immortal
- situational ethics
- moral
- our right to overcome childlessness
● UTILITARIANISM
- Moral since it produces more happiness
● Pregnatism
- Moral since it is practical beneficial and
useful and workable
● Immanuel Kant
- principle of autonomy
- It is moral only if the couple is
voluntary and mutually agreed.
IN-VITRO FERTILIZATION
● Ovum and sperm cells combined
outside woman's body
● Cells grown in laboratory and later
implanted into woman's uterus
● In most cases, unused embryos are
destroyed
● Embryos may be frozen for possible
future implantation
SURROGACY
● Surrogacy is a method of reproduction
whereby a woman (referred to as
surrogate) agrees to carry a pregnancy
and give birth as a substitute for the
contracted party/ies. Surrogacy may be
Natural traditional/ Straight) or
Gestational Indian Law
● The word 'surrogate' has its origin in
Latin 'surrogatus, past participle of
Surrogate', meaning a substitute, that is,
a person appointed to act in the place of
another
- Many people favoring pro life are
strongly against the surrogacy method
because they think for a women's body
it is against moral issues and degrading
- However there are those that oppose
the pro le's idea and think that as long
as the situations are suitable and
beneficial towards both sides then it
shall be fine.
- Everyone has different opinions about
surrogate mothering method because
everyone is raised in different ways and
backgrounds, so it is hard to judge
someone's opinion based on what he or
she believes.
METHODS OF SURROGACY
● Traditional surrogacy:
In traditional surrogacy, the surrogate mother
is impregnated naturally or artificially, but the
resulting child is genetically related to the
surrogate mother. A traditional surrogate is the
baby's biological mother since the child
connives to the union of the egg and the
father's sperm.
Gestational surrogacy
- In gestational surrogacy, the pregnancy
results from the transfer of an embryo
created in- vitro fertilization (IVF) ,in a
manner so the resulting child is
genetically unrelated to the surrogate.
Gestational surrogate mothers are also
referred to as gestational carriers.
TYPE OF SURROGACY
● Commercial Surrogacy
- Implicates that the surrogate mother is
rewarded compensation fee for her
involvement. This fee covers not only
medical expenses but also
miscellaneous expenses related to the
pregnancy, travel provisions, but a sun
for her time and unselfish efforts.
● Altruistic Surrogacy
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 - Conceal the Surrogate Mother in
agreeing to become pregnant and
delivering the baby for the intended
Parents without any rewarding financial
compensation. Conversely, in this case,
the Surrogate Mother can still be
compensated for pregnancy- related
expenses.
- Throughout some places in the world,
commercial surrogacy is illegal and
gestational surrogacy is prohibited in
other places.
ORIGIN OF SURROGACY
● The first official legal surrogacy
agreement was enacted in the mid-
1970s in the US with the child who was
referred to as Baby M.
● During that same time frame, surrogacy
made the national and international
beed with the world’s first “test tube “
baby Louise Joy Brown.
● The world’s second and India’s first IVF
( in - vitro fertilization) baby, Kanupriya
alias Durga was born in Kolkata on
October 3, 1978
● In the 1980s, a 37 years old woman was
paid $10,000 for the successful delivery
of a baby boy.
ISSUES RELATED WITH SURROGACY
- Attachment with the Gestational Mother
- involvement with the Gestational Mother
- Identity of the Child
- Compensation
- Surrogate health issues
- Detachment of intended parents
- Social issues
SURROGATE MOTHERHOOD
● Surrogate mother agrees to beer child
for infertile couple
● Contract established
● Couple must pay for medical expenses
of surrogate mother
● The Baby M case
ETHICAL CONSIDERATION WITH
SURROGATE MOTHERHOOD
- is it right for a mother to give up a baby
she has carried for nine months?
- Does or should child have emotional or
physical link to surrogate mother?
- Will relationship between husband and
wife be altered husband's sperm is
implanted into another woman?
- What is sibling relationship toward a
surrogate baby?
- Can a contract between surrogate
mother and couple be enforced?
OTHER ETHICAL DILEMMAS WITH
SURROGATE MOTHERHOOD
- Potential court battle over custody of
child
- Potential embarrassment for surrogate
(some have likened her actions to
prostitution)
- Potential harm to surrogate's own child
when he or she learns she gave one
child away and received money in return
- future emotional distress when child
learns he or she was taken from natural
mother
- Reduces birth to legal arrangement and
the exchange for money to cover
medical expenses
ABORTION
● Abortion is described as the expulsion of
the products of conception before the
embryo or fetus is viable. Any
interruption of human pregnancy prior to
the 28th week of gestation or the
delivery of a fetus weighing less than
500 grams is known as abortion.
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SPONTANEOUS ABORTION(MISCARRIAGE) - Most 1st trimester abortion in North
America and the United Kingdom are
- this is defined as the delivery of a
done in this manner.
nonviable embryo or fetus ( the fetus
cannot survive ) before the 20th week of
pregnancy due to fetal maternal factors.
- Recurrent spontaneous abortion - the
occurrence of three or more consecutive
losses of clinically recognized
pregnancies prior to the 20 week of
gestation( immunological reactions, in
which maternal antibodies mistake the
fetus for foreign tissue, have been
implicated in recurrent , or habitual
spontaneous abortion).
- It is estimated that at least 20% of all HYSTEROTOMY ABORTION
pregnancies end miscarriage
( estimates range from 15% to 75% ).
Most occur in the first two weeks after ● Used for late term abortions in
conception, and in many cases the instances.
mother is not aware of the pregnancy. ● Identical to a Cesarean Section
- Therapeutic Abortion - This procedure delivery used to deliver a live baby in
is performed to preserve the health or the presence of certain pregnancy/fetal
life of the mother. It can be induced for complications, except the objective
medical reasons or an elective decision there is to deliver a dead fetus.
to end the pregnancy (eg prevent the ● The live fetus is first terminated while
birth of a deformed child or a child still in the mother’s womb , such as by
conceived as a result of rape or incest). cutting off the umbilical cord.Once the
- Elective (Induced) Abortion - Defined fetus is dead, the fetus is then physically
as a procedure intended to terminate a lifted out of the mother’s womb and the
suspected or known intrauterine abortion is completed.
pregnancy and to produce a nonviable
fetus at any gestational age, deemed KILLING PEOPLE IS WRONG
necessary by the woman carrying it and
- killing innocent human beings is wrong
performed at her request. - Human life begins at concept ion
METHODS OF CONDUCTING ABORTIONS - the fetus is an innocent human being
- Killing the fetus is wrong
- therefore abortion is always
- A fetus is a person
SUCTION (VACUUM ASPIRATION - A fetus has a unique genetic code
ABORTION - A fetus is a unique individual Causing
pain is wrong
- The cervix is stretched to allow passage
- it is wrong to cause pain and suffering.
of a hollow suction tube with sharp-
edged openings near its tip into the WEEK 3
uterus.
- Powerful suction lerce is the apod DIGNITY OF HEALTH AND DYING
allowing the fetus to be ripped apart
then suctioned out of the uterus into a
collection container

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WHAT IS EUTHANASIA
● Euthanasio comes from the Greek
words: Du (good) and Thanatosis
[death) and it means "Good Death,
"Gentle and Faly Death." This word has
come to be used for "mercy killing
● It is the act or practice of ending a life of
a person either by a lethal injection or
suspension of medical treatment.
● the word "authanasia" was first used in
a medical context by Francis Bacon in
the 17th century, to refer to an easy,
painless, happy death. during which it
was a "physician's responsibility to
alleviate the physical sufferings of the
body
TYPE OF EUTHANASIA
ACTIVE EUTHANASIA
● is when death in brought by an act for
example taking a high dose of drugs-to
and a person's life by the use of drugs,
either by oneself or by the aid of o
physician,
● Panettast When death is brought by an
omission eg: When someone lets the
person die, this can be done by
withdrawing or withholding treatment
- For example switching off a machine
that keeps the person alive
- For example not carrying out a surgery
that will extend the life of the patient for
a short time.
● Voluntary euthanasia is committed
with the willing or autonomous
cooperation of the subject. This means
that the subject is free from direct or
indirect pressure from others.
● Nonvoluntary Euthanasia that occurs
when the patient is unconscious of
unable to make a meaningful choice
between living and dying, and an
appropriate person takes that decision
for him/her
● This is usually called murder, but it is
possible to imagine cases where the
killing would count as a favor for the
patient.
Assisted suicide : This usually refers to cases
where the persons who are going to die need
help to kill themselves and ask for it. -It may be
something as simple as getting drugs for the
person, and putting those drugs within thes
reach.
Pindirect euthan: This means providing
treatments mainly to reduce pain that has a
side effect of shortening the patient's life.- Since
the primary intent wasn't tokitb morally
accepted by the same people.
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Assistence in Suicide
● Assistance in suicide means knowingly
and intentionally providing a person with
the knowledge or means or both
required to commit suicide, including
counseling about lethal doses of drugs,
prescribing such lethal doses or
supplying the drugs
WHEN DOES LIFE BEGIN? WHAT IS THE
MORAL STATUS OF THE DEVELOPING
PRODUCTS OF GESTATION?
● at the time of FERTILIZATION
● IMPLANTATION-6 to 8 days after
● fertilization
● "PRE-EMBRYO"-14 days after
fertilization
● at the appearance of the primitive
streak
Embryo- 3rd- 7th week after fertilization
Age of Viability - variable at 23rd to 28 week
At later term, before birth
● All its genetic coding and all its features
are INDISPUTABLY HUMAN It has the
CAPACITY TO DEVELOP, IT EXISTS,
IS ALIVE and is SELF-DIRECTED It is
NOT the same being as its mother
● The fertilized egg/zygote is not just "a
blob of protoplasm"
● It is a COMPLETE, UNIFIED structure
that contains all the information and
ACTIVE POTENTIAL for self-
development
● The fertilized egg/zygote should be
given FULL MORAL STATUS
Religious Christian Point of View
An elemental experience which all men share,
is a vital reality closely allied to instinct and the
NATURAL LAW, which declares a fundamental
moral truth:LIFE IS SACRED AND
INVIOLABLE
ABORTION
- Expulsion of a NON-VIABLE FETUS
(before the 27th to 28th week of
gestation) From a MORAL
STANDPOINT
- Expulsion of the fetus--- DEATH A
direct act of killing
FORMS OF ABORTION
MEDICAL STANDPOINT
1. Spontaneous abortion
- (ACCIDENTAL or INVOLUNTARY)
Usually within the first few days of
gestation
- due to maternal or ocular pathology
- leading to defective development,
- even death of the embryo.
2. Induced Abortion
- VOLUNTARY ABORTION directly
willed as the principal end may be
presented or packaged as a therapeutic
abortion"
3. Therapeutic Abortion
- aims to caminated a REAL or
PRESUMED RISK for the mother
precipitated by the pregnancy.
THERAPEUTIC ABORTION
● REAL RISKS-medical conditions which
may truly precipitate the death of the
mother if the pregnancy is continued
● SEVERE UNCONTROLLED
HYPERTENSION
● MALIGNANCIES IN THE FEMALE
● GENITAL TRACT
● MENTAL HEALTH PROBLEMS.
● Termination of pregnancy may be
MORALLY JUSTIFIABLE.
● PRESUMED RISKS medical conditiom
which may not necessarily affect the
health of the mother
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 ● PREVENTION OF THE BIRTH OF AN
● ABNORMAL CHILD
● TERMINATION OF PREGNANCY IN
RAPE OR INCEST CASES
● USE AS A METHOD OF BIRTH
CONTROL
● PERMISSIVE LEGISLATURE of
abortion allows these reasons to be
legal in secking abortion rights
MORAL STANDPOINT
1. DIRECT ABORTION-ane in which the direct,
immediate purpose of the procedure is to
destroy the human fetus at any stage after its
conception, or to expel it when it is not yet
viable.
UNETHICAL
VIOLATES THE SANCTITY OF HUMAN LIFE
WHICH BEGINS AT FERTILIZATION.
2. INDIRECT ABORTION-ane in which the
direct, immediatz purpose of the procedure is to
treat the mother; the death of the fetus is an
INCIDENTAL and SECONDARY result that
would have been avoided if possible. (REAL
RISIKS for "therapeutic abortion")
ETHICAL AND JUSTIFIABLE "PRINCIPLE OF
DOUBLE EFFECT"
THE PRINCIPLE OF DOUBLE EFFECT
● For any licit action, there are two
consequential events, ONE GOOD THE
OTHER EVIL. If the good event
PRECEDES the evil one, it is
permissible in conscience to INTEND
the GOOD, and ALLOW the EVIL.
INVIOLABILITY OF HUMAN LIFE
● The concept of inviolability is an
important tie between the ethics of
eligion and the ethics of love, as each
seeks justification for its principles as
based on both parity and mural suncopt,
as well as in anivernality of application.
● In religion and ethics, the inviolability or
sanctity of life is a arnciale of implied
protestion mgaming nands of sention life
that are said to the holy, sacred, in
otherwise of such value that they are not
in be viniated
● The phrase sanesity of Ble relers in the
idea that hurman He is sazred, holy and
precious, argued mainly by the pro-life
side in political and moral hathausas
abortion, contraception, euthanasia,
embryonic stem cell research, and the
right to die
DYSTHANASIA Dysthanasia is a term
generally used when a person is seen to be
kept alive artificially in a condition where,
otherwise, they cannot survive, sometimes for
some sart of ulterior (intentionally
hidden/fututre) motive.
Etymology: means faulty or Imperfect death. it
is the medical process through which the
moment of death is postponed by all means
available, it may be considered as an undue
prolongation of death
ORTHOTHANASIA: A normal or natural
manner of death and dying. Sometimes used to
denote the deliberate stopping of artificial or
heroic means of maintaining life Passive
euthanasia.
etymology: correct dying it is the same as
pasive euthanasia, It allewing a person to die a
dignified and natural death.
WAYS OF THE PERFORMING EUTHANASIA
1. Administration of a lethal does of poison.
2.Overdosage of sedatives, hypnotics or other
pain relieving drugs.
3. Sinjection of air into the blood stream.
4. Application of strong electric currents
13
5. Failure to instituce the necessary
management procedure which is essential to
preserve the life of the patient
6. Failure to perform tracheostomy when there
is marked distress in breathing due to laryngeal
obstruction.
7. Tallure to give transfusion in several
hemonhage
8. Depriving the child of Nutrition
9. Removal of patient from a respirator when
voluntary breathing is not possible.
WHO MAY PERFORM EUTHANASIA
1. The patient himself
Any person who deilberstely puts an end to his
life commits suicide. Suicide is not a crime in
our jurisdiction because a person committing
suicide is a moral wreck and he must be given
an eye of pity or sympathy rather than an eye of
penalty by law. This is also based on a
philosophy that a person has a complete
dominion over his own body.
2, the physician, Which or Without the
knowledge and consent of the patient
● Even if a physician has humanitarian or
merciful motive in putting to death pent
his and humuikkuble in spite of the
pudiere's current
● Art 253, Revised renal Code Olving
assistance to suicide any person who
allast another to commit suicide shall
suffer the pisuty of prian mayor if such
person lends tra assistance to another
to the extent of doine the killing himmelt,
the shall suffer the penally of mini
however, if the suicide not
consummated, the penalty of amesto
mayor in its motum and maximum
perlets be imponed
The above provision contemplates the
following situation
A. If a physician assists a person in the
commision of suicide by giving him
a( lethal dose of position, for example)
upon him the penalty of prison mayor
6years, And 1 day 10 12
yearsimprisonment.
B. if the physicians lends assistance to
another to the extent of doing killing
himself be punished by reclusion
temporal (12 years and 1 day to 20
years.
C. if the sucide with the assistance of the
physician is not consummated, the
penalty of arresto mayor (1 month and 1
day to 6 months) in its medium and
maximum period shall be imposed and,
3. If poison was administered by the
physician to the patient without any
knowledge and consent of the patient.
● then this is murder. Treachery is
inherent to the act of poisoning and
treachery qualifies the killing to murder.
● In other jurisdictions, the modern
attitude is allow physicians to perform
euthanasia in some special cases.
In the case of DR. adams who was charged
the murder by administering a pain-killing drug
to a patient suffering from a painful and
incurable disease, which he was then acquitted
the court held that "If the first purpose of
medicine (the restoration of health could no
longer be achieved, there was much for the
doctor to do, and he was entitled to do all that
was proper and necessary to relieve pain and
suffering even if the mean he took might
incidentally shorten life by hours or perhaps
14
even prolong it. The doctor who decides
whether or not to administer the drug would not
do this job if he were thinking in terms of hours
or even in mounsth. The defense in the present
case was that treatment given by Dr. Adams
was designed to promote comfort, and if it was
the right and proper treatment the fact that it
shortens life did not convict him for murder .
(Rv. Adams, Cm LK 365,20577)
CASE
In a recently Decided case in the matter of
Karen quinian N... Sup.Ct. Mar. 51, 1976),
Karen cuanlan had been in coma for almost a
year and has been heut alive be a respirator.
The father petitioned the court to authorize
discontinuation of the respirator there is no
reasonable "with grace and dignity the court
allowed such removal provide it is with the
conseat of the attending physician and a panel
of hospital staff the court lose on the right of
privacy of the patient or the right of the patient
to make life-sustaining medical decision and
that since the patient was incompetent to
make such decision , it belongs to her father
acting as guardian. the court does not question
the sad's the state undoubted power punish the
taking of human life nut that power does not
encompass individual termination treatment
pursuant in their right of privicy.
WEEK 4
ENDING OF LIFE
- Final stage of life when death is
imminent
- Unpredictable
- Many last minutes, houn, or wecks
- End-of-life core refers of physical,
psychosocial, and spiritual care
provided to patients and their families
- Care addresses issues related to death
and dying.
GOALS OF END-OF-LIFE CARE.
- Prevent or relieve suffering
- Provide comfort and support
- Maintain human dignity
- Respect patient's wishes and desires
- Improve quality of life
- Provide emotional support
SCOPE OF PROBLEM
● Many nurses are not well prepared to
deal with death and dying
● Nonmalignant or chronic conditions,
(such as cardio respiratory disease) are
usually treated with acute care focus
● Nurses are frustrated by giving futile
treatments
● Lack of a palliative care plan may mean
patient is less likely to have a "good
death"
● Palliative care vs. hospice care is not
well understood
PALLIATIVE CARE
- An approach that improves the quality of
life of patients and their families facing
the problems associated with life
threatening illness, through the
prevention and relief of suffering by
means of early identification and
impeccable assessment and treatment
of pain and other problems, physical,
psychosocial, and spiritual-World Health
Organization (2004)
- Affirm life and regard dying as a normal
process
- Neither hasten nor postpone death
- provide relief from pain and other
distressing symptoms
- integrate psychological and spiritual
aspects of care
- Offer a support system to help patients
live as actively as possible up to death
- Use a team approach to address the
needs of patients and their families
15
 - Offer a support system to help the family
cope during the lines and their own
bereavement.
Palliative Care
● Making life as easy as possible for
patients and families living with serious
illness
Hospice care
● hospice care is given when there is life
expectancy of 6 month or less
PAIN MANAGEMENT
Pain assesment
- Determine type of pain
- Nociceptive- responds well to the
opioids (pain from physical damage or
potential damage to the body).
- Neuropathic - responsible to tricyclics,
anticonvulsants ( muscle weakness or
atrophy is often degrenative).
- WILDA
W- Words to assess plan
I - Intensity - choose from several pain
scales
L - location
D- Duration. Is the pain always there?
A- aggravating or alleviating factor.
Treatment Goal
- Achieve optimal patient comfort with
minimal medication adverse effects.
- Non-pharmacologic interventions
- Relaxation techniques
- Dees Breathing
- Meditation
- Guided imagery
- Massage
- Reflexology
- Acupuncture
- prayer
Pharmacologic interventions
- 3 step Analgesic Ladder
Step 1: Non oplates for mild pain (scale 1-31
Step 2: Mild oplates for moderate pain (scale 4-
6)
Step 3: Opold agent drugs for severe pain
(scale 7-10)
MYTHS AND MISCONCEPTION ABOUT
OPIOIDS
- "Anyone who takes opioids for pain
control will become addicted."
Fact: Studies repeatedly show that the
incidence of addiction in people given opioids to
relieve cancer pain is less than 0.1%.
- "If strong opioids are used too soon,
there will be nothing left for ter
Fact: There is no ceiling on the amount of
opioid analgesic that can be given
The dose may be adjusted up or down to ANY
DOSE that effectively relieves the patient's
pain.
- "Clock watching is a sign of addiction."
Fact: Clock watching is a sign that the PLAN is
wrong!
Either the order is for a medication with a
duration. that is too short for the frequency to
be given, or the dose ordered is below the
effective level for that patient.
16

- We must believe what the patient tells
us about their pain."
No, we must only ACCEPT what the patient
tells us about their pain
COMMUNICATION
THE IMPORTANT ROLE OF GOOD
COMMUNICATION
- Clinicians with good communication
skills identify patients' problems more
accurately
- We can't predict patients wishes
- Patients and their family members say
it's important
- Patients are more satisfied with care
and better adjusted psychologically.
COMMUNICATION COMPETENCIES
- Wisten to caters
- Encourage questions from the patients
- Talk with patients in an honed and
straightforward way
- Gives bad news in a positive way
- Prepare info, location, setting
- Find out what they already see
- Ask how much they want to know
- Share the information
- Respond to the parent's emotion
- Negotiate a concrete follow up step
- Give enough information to understand
their illness and treatments
- Tell patients how this illness may affect
their He
- Guide patient and family to helpful
resources
- Lise willing to talk about oyin
- Be sensitive to when patients are ready
to talk about death.
- talk with patients about what their dying
might be like
Preparation For A Discussion About End Of
Life Care
COMMON MISCONCEPTIONS ABOUT
ADDRESSING END STAGE OF CARE
- The discussion will be too depressing
The patient has never thought about the
seriousness of their condition We
stimulate suicidal ideation This
represents abandonment of primary
patient care.
PREPARING DISCUSSION ABOUT END OF
LIFE CARE
- Advance preparations Knowledge of
patient/family and disease Review goals
of discussion Plan timing, location, and
setting As early as possible in course of
business Quiet and private room
Appropriate people present Family,
friends, staft, interpreter.
HOLDING DISCUSSION ABOUT END OF
LIFE CARE
- Elicit patient/family's understanding and
values Use language appropriate to the
patient Align patient and clinician values
Use repetition to show you are listening
Acknowledge emotions, difficulty Use
reflection to show empathy Tolerate
silences.
FINISHING A DISCUSSION ABOUT END OF
LIFE CARE
- Achieve a common understanding Make
recommendations Don't leave
patient/family leeling deserted Ask if
there are any questions Develop a plan
for follow up when you will meet again
How to reach you in the meantime.
ADVANCE. CARE PLANNING
- A communication process rather than a
legal process. A way of planning for
future medical care A mechanism of
ensuring that core received matches the
patient's values and goals two main
products Living Will Advance Directive
Health care agent or proxy.
17
5 STEPS FOR ADVANCED CARE PLANNING
● Introduce topic
● Structure the discussion
● Document patient preferences
● Review and update when clinical course
changes
● Apply directives when need arises.
INTRODUCE THE TOPIC
- What have you been thinking about a
living will?
- Explain the process
- Determine the patient's comfort level
- "Do you feel ready to talk more about
this today?"
STRUCTURE THE DISCUSSION
- When do you want to make healthcare
decisions for you when you can't make
them?
- What kind of medical treatment do you
went/dor's want?
- Life support, coma, bram damage
- How comfortable do you want to be?
- Pain, cleanliness, spiritual readings,
music, personal care
- How do you want people to treat you?
- Company, prayers, hand holding,
pictures, home death
- What do you want your loved ones to
know?
- Forgiveness, fear, respect for wishes,
counseling, remains.
DOCCUMENT PATIENT PREPERENCES
- topics to Consider
- Pain management
- Artificial nutrition and hydration
- Mechanical ventilation
- Dialysis
- Blood transfusion
- Sign the documentation & place in chart
- Encourage patient to keep coples
REVIEW UPDATES
- Occurs after a clinical event as a result
of disease progression
- As disease progresses allow for
evolution in
- Patient understanding
- Patient preferences
- Document changes
APPLY
- Review the Advance Directive
- Consult with proxy
- Use ethics committee for disagreements
- Carry out the treatment plan
NATURAL SIGNS AND SYPMTOMS OF
APPROACHING DEATH
- Changes in patterns of elimination
- incontinence, darker urine, decreased
urine output, constipation
- Reduced strength and mobility
- Needs more assistance with ADLs,
increasingly confined to a smaller space
in the home, frequent napping, dozing
- Decreased interest and Involvement in
activities
- Level of consciousness changes
- Re prioritizing interests and energy
- Concrete thinking
- Less planning and interest in the future
- Fluid and food reductions
- Patient's decreased interest in
food/need for small frequent amounts of
food
- softer pudding like consistency in food
Commonly described supernatural experiences
- Visitation from people who have died
- References to a mode of transportation
- Less fear and death anxiety after these
experiences
- Wittempt at completion of personal
tasks of the dying "I'm sorry." "Please
forgive me. I forgive you "I love you."
"Goodbye."
- Energy surge
- Quice transition from coma-like rest to
agitated movement, taling desire to eat
- Often with acute mental clarity
- Very time limited
- Issues of personal safety
18
 - Circulation changes
- Hands and feet increasingly cooler to
the touch
- Nail bed begin to darken
- Skin mottling
- Respiratory changes-apnea, Cheyne-
Stokes
ELEMENTS OF GOOD DEATH
- Comprehensive symptom management
- Completion of unfinished business
- Balancing the needs/goals of and their
loved ones
Death with Dignity
- without focus on inappropriate use of
technology
- without unrelenting pain
- in surrounding that are familiar and
comfortable
- in the presence of people who can
relate as compassionate human beings
DNR (DO NOT RESUSCITATE)
- is a clear concept in most developed
countries. It involves not initiating
resuscitation in the event of a cardiac or
respiratory arrest.
CANDIDATES FOR DNR
- Wisere life sustaining treatment is likely
to be ineffective or futile.
- Where a patient has prolonged
unconsciousness which is unlikely to
recover.
- where patient has a terminal condition
for which there is no definitive therapy
- Where a patient has a chronic
debilitating disorder where burden of
resuscitation far outweighs the benefits.
DNR PROCEDURE
● Clean airway
● Inotropic support
● Provide Oxygen
● Position for Comfort
● splint
● Control bleeding
● Provide pain medication
● Provide emotional support
● nutrition
36. Not done in DNR
- perform chest compression
- insert advanced airway
- administered cardiac resuscitation drugs
- Provide ventilator assistance including
noninvasive ventilation
- defribrillate
NOT DONE IN DNR
- Operform chest compressions
- Limert advanced sirway
- Administer Cardiac resuscitation drugs
- Provide ventilator assistance including
non invasive ventilation
- Defibrillate
CARE OF DEAD BODY
- After death the body undergoes many
physical changes. So care must be
provided as early to prevent tissue
damage/disfigurement of body parts.
PURPOSE OF DEAD BODY CARE
1. To prepare the body for the morgue.
2. To prevent discoloration or deformity of the
body.
3. To protect the body from post mortem
discharge
PURPOSE OF DEAD BODY CARE
1. Check orders for any specimens
2. As for special requests to family (eg: shaving,
a special gown. Bible in hand)
19
5. Remove all equipments, tubes, supplies and
dirty linens
4. Cleanse the body thoroughly, apply clean
sheets
5. Brush and comb the hairs
6. The eyelids are closed and hold in place for a
few seconds, so they romain closed.
7. Dentures should be in the mouth to maintain
facial alignment.
8. Mouth should be closed
9. Remove all the ornaments
10. Absorbent pads are placed under the
buttocks to take us any feaces and urine
released because of muscle sphincter
relaxation
11. All the offices should be closed.
12. Cover with a clean sheet up to the chin
13 Spray a deodorizer to remove unpleasant
odor
14. Apply name tag | wrist, right big toe
15. Allow the family members to view the dead
body
16. The body is wrapped in a large piece or
plastic or cotton material used to enclose a
body after death. Identification is then applied
outside of the wrapper
17. Hand over all the belongings to the relatives
18. Do complete documentation in the nursing
notes, Time of death and actions taken to
prevent the death. Who pronounced the death.
Any organ donation Personal articles left on the
body Personal Items given to family Time of
discharge and destination of the body Location
of name tags on the body Special request by
family
19. Hand over the dead body to the
relatives/sent to the mortuar
WEEK 5
ETHICS RESEARCH
INTRODUCTION
● lesearch contributes to sursing
inowledge
● Research influence patient care
stanterds
● Professional nurses are obliged to
ensure safe, robust and ethical research
DEFINITION
ETHICS
- Greek word ethos custom or convention,
or the spirit of community
- Moral principles that govern a person's
behaviour or the conducting of an
activity: Oxford dictionary (2014)
- The branch of philosophy that deals with
morality ethics is concerned with
distinguishing between good and evil in
the world, between night and wrong
human actions, and between virtuous
and non virtuous characteristics of
● Nursing ethics is defined as the
principles of proper professional conduct
concerning the rights and duties of
nurses themselves, their patients, and
their fellow practitioners, as well as their
actions in the care of patients and in
relations with their families.
ETHICAL. THEORIES
Deontology -duty is the basis of all action
Teleology actions can only judged on the basis
of consequences they produce
utilitarianion-central concern is the general
welfare rather than individual's interest.
WHAT ETHICS IS AND WHAT IT IS NOT
20

HISTORICAL EVENTS AND DEVELOPMENT
OF CODE ETHICS
CODE OF ETHICS
NAZI MEDICAL EXPERIMENTS (1933-1945)
● Atrocious, unethical activities
implemented in Third Reich in Europe
from 1933-1945
● Programs included sterilisation,
euthanasia, and numerous medical
experiments in Nazi concentration
camps
● Sterilised Jews whom Nazis considered
as racial enemies
● Medical experiments involved exposing
to high altitudes, freezing temperature,
malaria, poisons, typhus fever, untested
drugs and surgery without anaesthesia
● Selection of subjects was racially based
Subjects had no opportunity to refuse
the participation.
● Subjects had no opportunity to refuse
the participation.
NUREMBERG CODE 1949
● Mistreatment of numan subjects in Nari
experiments led to the development of
Nuremberg Code (1949)
● Nuremberg Code contains guidelines for
● Voluntary coment
● Withdrawal of subjects from study
● Protection of subjects from physical and
mental suffering, mury disability, and
deuth
● The bellance of benefits and risks in the
statfy
DECLARATION OF HELSINKI (1964)
● Greater care can be exercised to protect
subjects from harm
● Strong, independent Bustification for
exposing healthy volunteer to
substantial sk of harm
● Investigators must protect life and health
of research subjects.
TUSKEGEE SYPHILIS STUDY (1932)
● US Public Health Service initiated the
study in town of Tuskegee, Alabama
● Research subjects were divided into two
groups
● One group of 400 men who had
suntreated syphilis
● Control group of 200 men without
syphilis
WILLOWBROOK STUDY (1950-1970)
● Research on hepatitis by Dr. Krugman
at Willowbrookamang mentally retarded
children
● Early subjects were fed extracts et stool
from infected individuals
● Later cobbjects received Ingections of
purified virus
● Parents were forced to give permission
for the child to be a subject
JEWISH CHRONIC DISEASE HOSPITAL
STUDY (1960)
● Study conducted to determine patients'
rejection responses to live cancer cells
● Twenty two patients were injected with a
suspension containing live cancer cells
● Physician from Sloan-Kettering institute
for cancer research directed the study
● Study conducted without the informed
consent
IMPORTANCE OF ETHICS IN RESEARCH
● Protects the vulnerable grous and other
study participants
21
 ● Participants are safeguarded from - Deception is an act or statement which
exploitation misleads, hides the truth, or promotes a
● Establishes risk benefit ratio for study bellet, concept, or idco that is not true
subjects
● Ensures fullest respect, dignity, privacy,
disclosure and fair treatment for subject
● Builds capability of subjects to accept or ETHICAL. PRINCIPLES
reject participation in study. - honesty,
- objectivity
ETHICAL. PRINCIPLES
- integrity
● Beneficence - carefulness.
- imposes duty on researchers to - openness,
minimise harm and to maximise benefits - respect for intellectual property,
- The right to protect from harm and - confidentiality,
discomfort - responsible publication
- Freedom from exploitation - responsible mentoring
- Senefits from research - respects for colleagues,
- social responsibility
RISK BENEFIT RATIO - non discrimination,
- compence,
- legality
- Stigmatization,
- animal care and
- human subject protection

● Justice
- The right to fair treatment
- The right to privacy

● Respect for human dignity

THE PRINCCIPLE OF RESPECT FOR INFORMED CONSENT
HUMAN DIGNITY - Participants have adequate knowledge
regarding research, have the power of
- The right to self determination-Humans
choice, enabling to decline participation
should be treated as autonomous
voluntarily.
agents, capable of controlling their own
- Informed assent-the process where by
activities
- The right to full disclosure-Researcher minors may agree to participate in
should fully describe the nature of study, clinical trials.
subject's right to refuse partizipation,
researcher's responsibility and risks and
benefits VULNERABLE SUBJECTS
- Inability of individuals to make well
informed judgements
- Bias - consider to be unfair
- Concealment - the action of hiding
something or preventing it from being
known.

22

THERAPEUTIC MISCONCEPTION
- Research subject misinterpret and enrol
in the study thinking it to be routine
medical care
- Misinterpret the information and
believes that research directly benefits
him.
POST TRIAL. ACCESS
- molds special importance for clinical
research
- Pharmaceutical companies from
developed countries collect data from
developing countries
- Most of these drugs would never be
used by the communities from where
the experimental data is collected.
ETHICAL DILEMMAS
ETHICAL ISSUES IN NURSING RESEARCH
- Issues of ethical behavior are central to
health professions.
- in conducting clinical trials and research
projects ethical issues should be taken
in to consideration
- It is unethical for an investigator not to
give patients the best possible treatment
- Other way, it is unethical not to discover
whether a new treatment is an
improvement, since this would deny
future patients the possibility of a cure
CODE OF ETHICS FOR DIFFERENT
DISCIPLINES
RESEARCH MISCONDUCT
● FABRICATION
● FALSIFICATION
● PLAGIARISM
AREAS OF SCIENTIFIC DISHONESTY
1. Plagiarims
- Using other peoples work without
acknowledging their contribution
2. Fabrication and falsification
- Pabrication is making up results and
recording or reporting them. This is
xomtimes melorred to as "dry labbing"
- falsification a manipulating rearth
mutesla, nquipment, se procesnes or
changing or omitting data or results
such that the research is not accurately
represamind in the rematanch rora
3. Non publication of data
- Data was supressed. It is not elhice to
ignore exations and set try to explain to
oneself the reason for the exception
4. Faulty data gathering:
- machines are not callbrated correctly, if
subjects do not follow pramoderns
correctly, il andmined chandants an
ward (may giv different instructionst, if
testing occurs at cifferent times of the
day.
5. Poor data storage and retention
- Should be pestubble for verbization of
others.
6. Misleading authorship
23
 - People take credit who really make very
little contribution to the study. If fellow
graduate students assist you they
should not expect to be named.The
same is true with faculty advisors unless
they have made significant
contributions to the study (which often
occurs).

RESEARCH CONDUCT
CONCLUSION
- Research ethics in a medical context is
it research is based on a robust design and in a
dominated by principalism
safe and ethical manner, it can be of benefit to
all Professional codes, laws, regulations, and
ethics committees con provide guidance but
Ethical Issues Regarding Copyright:
ultimate determinant rests with researcher's
● You need permission to use figures and value system and moral.code
tables from other published sources
● Quotes are okay if properly referenced.
Usually it is no problem getting permission for
educational purposes Bottom line is that bad
things may happen to you intentionally
unethical.

ROLE OF PEER REVIEWERS, JOURNAL

EDITORS AND RESEARCHERS
- Fraudulent if there is documentation or
testimony from co-authors that
publication did not reflect what hird
actually been done
- Questionable-if no co-author could
produce the original data or had
personally chserved ar performed or
participated in research publication

24