BACHELOR OF SCIENCE IN NURSING:

BIOETHICS
COURSE MODULE COURSE UNIT WEEK
1 2 2

Theories and principles of health ethics and virtue ethics in nursing

 Understand the course and unit objectives

 Study the entire module prior to class attendance
 Research and comprehend required learning resources; refer to unit
terminologies for jargons
 Proactively participate in classroom discussions
 Participate in weekly discussion board (Canvas)
 Answer and submit course unit tasks

At the end of this unit, the students are expected to:

Cognitive:
1. Understand the meaning of Bioethics, health care ethics and Nursing ethics
2. Recognize the importance of bioethics in the field of nursing
3. Identify the difference between deontology, utilitarianism and teleology
4. Explain the importance of virtue ethics in the field of nursing
5. Demonstrate the core values of a professional nurse

Affective:
6. Practice effective listening during class discussion
 7. Inquire on topics that are not completely understood
8. Share opinions on the subject matter that can enhance class discussion

Psychomotor:

9. Follow class rules and netiquettes

10. Participate during class discussion

Theories and Principles of Health Care Ethics

Moral philosophy is the branch of philosophy that examines beliefs and assumptions about certain human
values. Ethics is the practical application of moral philosophy; that is, given the moral context of good or bad,
right or wrong, “What should I do in this situation?” The philosopher reveals an integrated global vision in
which elements, like pieces of a puzzle, have a logical fit. By developing theories of ethics, the philosopher
hopes to explain values and behavior related to cultural and moral norms. Each theory is based upon the
particular viewpoint of the individual philosopher, and maintains, within itself, philosophical consistency.

1. Deontology- Deontological theories of ethics are based upon the rationalist view that the rightness or
wrongness of an act depends upon the nature of the act, rather than its consequences. The term
deontology is taken from the Greek word for duty. Occasionally, deontology is called formalism; some
writers refer to this type of ethical theory as Kantianism. Kantianism is based upon the writings of the
German philosopher Immanuel Kant, who shaped many deontological formulations.

 Act only according to that maxim by which you can at the same time will that it should become a
universal law.
 Act so that you treat humanity, whether in your own person or that of another, always as an end
and never as a means only.

Deontology also implies that ethics are derived from fulfilling duties. One must act for the sake of duty or
obligation. Most professional codes of ethics are based upon Kantian principles. Nurses’ codes of ethics
stress both the importance of fulfilling duties that are inherently owed to patients and the importance of
preserving the dignity and autonomy of each individual patient. For example, section 1.2 of the ANA Code
of Ethics for Nurses (Appendix A) notes that, “The nurse establishes relationships and delivers nursing
services with respect for patient needs and values, and without prejudice.” This statement presumes that
the nurse has a duty to respect and care for the patient in terms of the patient’s own needs and values. It
demonstrates the principles of respect for person, beneficence, and autonomy. These principles are so
pervasive in the profession that they often go unnoticed. When you maintain confidentiality, when you
advocate for a patient, when you keep your promises, when you tell the truth, and when you practice with
expert skill, you are utilizing deontic principles.
2. Utilitarianism- Utilitarianism is a pivotal form of moral philosophy for health care delivery. Sometimes
called consequentialism, utilitarianism is a type of teleological theory. Telos comes from the ancient Greek
language and literally means end: Utilitarianism is the moral theory that holds that an action can be
considered good or bad in relation to its end result. Utilitarianism is an important ethical philosophy that
has its basis in naturalism. According to the utilitarian school of thought, the right action is that which has
the greatest utility or usefulness. No action is, in itself, either good or bad. Utilitarian hold that the only
factors that make actions good or bad are the outcomes, or end results, that are derived from them.

 The end justifies the means

Utilitarianism is widely used in the health care system. It is the basis for many policy-level decisions about
the distribution of health care services and can be integral to medical emergency triage decisions. Policy
makers attempt to wisely appropriate public funds. The debates about funding are often in the news and
include topics on a variety of public programs, such as Medicare, Medicaid, managed care, family planning,
pediatric services, mental health, and others. As these programs focus on delivering cost-effective health
care to large numbers of people, they serve very specific narrow populations (denying resources to others)
and provide or deny very specific services—all based upon utilitarian principles. In emergency situations
such as war or natural disasters, utilitarianism may become the default method of making these types of
decisions.

3. Consequentialism/Teleology- Consequentialist moral theories evaluate the morality of actions in terms

of progress toward a goal or end. The consequences of the action are what matter, not their intent. This is
in contrast to previously noted theories (e.g., deontology, virtue ethics, and natural law) that consider
intent. Consequentialism is sometimes called teleology, using the Greek term telos, which refers to “ends.”
Thus, one finds that the goal of consequentialism is often stated as the greatest good for the greatest
number.

Virtue Ethics in Nursing

Virtue ethics, sometimes called character ethics, represents the idea that individuals’ actions are based
upon a certain degree of innate moral virtue. First noted in the writings of Plato, Aristotle, and early
Christian thinkers, there has been a contemporary resurgence of interest in virtue ethics. Western
moralism emerged with the idea of the cardinal virtues of wisdom, courage, temperance, justice,
generosity, faith, hope, and charity (Kitwood, 1990). Modern and contemporary writers also include such
virtues as honesty, compassion, caring, responsibility, integrity, discernment, trustworthiness, and
prudence. Though nearly absent in nursing ethics texts in the past 20 years, virtue ethics is re-emerging as
an important framework for examining moral behavior.

Focal Virtues

In the discussion of virtue as related to biomedical ethics, Beauchamp and Childress (2008) define character
as being made up of a set of stable traits that affect a person’s judgment and action. Like Aristotle, these
authors suggest that although people have different character traits, all have the capacity to learn or
cultivate those that are important to morality. Beauchamp and Childress propose that there are four focal
virtues that are more pivotal than others in characterizing a virtuous person: compassion, discernment,
trustworthiness, and integrity.
Virtue Ethics in Nursing

How does the concept of virtue or character ethics fit with nursing as a principled profession? It is likely
that principled behavior, while not the sole domain of a good moral character, is more likely to occur in the
presence of one. Certainly Florence Nightingale thought virtue was an important trait of the good nurse.
Nightingale learned Greek as a child. She was inspired by Plato and translated parts of Phaedo, Crito, and
Apology. Nightingale was intrigued by Plato’s description of elite people with rare gifts who command
many kinds of knowledge. The characteristics, or virtues, of these people resonated with Nightingale and
were reflected in her writings throughout her life (Dossey, 2000). She believed that one of the aims of
philosophy was to cultivate in gifted people their potential intellectual and moral qualities. The Nightingale
Pledge, composed by Lystra Gretter in 1893 and traditionally recited by graduating nurses, implies virtue of
character as nurses promise purity, faith, loyalty, devotion, trustworthiness, and temperance. It is
reasonable to say that good character is the cornerstone of good nursing, and that the nurse with virtue
will act according to principle. If Aristotle was correct in his belief that virtue can be practiced and learned,
then we can learn, through practice, those acts that, by their doing, create a virtuous person.

Core Values of a Professional Nurse

Nursing is a caring profession. Caring encompasses empathy for and connection with people. Teaching and
role-modeling caring is a nursing curriculum challenge. Caring is best demonstrated by a nurse's ability to
embody the five core values of professional nursing. Core nursing values essential to baccalaureate
education include human dignity, integrity, autonomy, altruism, and social justice. The caring professional
nurse integrates these values in clinical practice. Strategies for integrating and teaching core values are
outlined and outcomes of value-based nursing education are described. Carefully integrated values
education ensures that the legacy of caring behavior embodied by nurses is strengthened for the future
nursing workforce.

Ethics- Moral principles that govern a person's behavior or the conducting of an activity.
Autonomy- The capacity of an agent to act in accordance with objective morality rather than under the
influence of desires
Altruism – unselfish concern for other people

Overview and Summary: Ethics in Healthcare: Nurses Respond -

https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/
Vol-23-2018/No1-Jan-2018/O-S-Ethics-in-Healthcare.html
During the 90's a slum in Metro Manila became popular in the medical world because it has become a place
to harvest kidneys. For a good amount of money residence in that area allowed themselves to become
donor to "help" patients with renal failure get a transplant.
Do you think it is unethical? Why or why not? What is your stand?

Instructions:

Please write your essay and submit it in canvas minimum of 200 words

Textbook

Ethics Issue in Contemporary Nursing 4th edition by Margaret Burkhardt

and Alvita Nathaniel
Health Care Ethics, critical issues for the 21st century by Eileen Morrison
and Beth Furlong