HEALTHCARE ETHICS

( BIO-ETHICS)

BY: WALBERT F. DELOS SANTOS, RN

BIOETHICS INSTRUCTOR
AY: 2020-2021
 INTRODUCTION TO
BIOETHICS
Objectives:
1. Define what healthcare ethics is
comprehensively.
2. Discuss the history of health care
ethics in Nursing.
3. Explain the different bioethical
issues correctly.
 ETHICS

Based on its etymological source:

ethics is derived from the Greek word Ethicos,
which means “custom” or “character.”

In its vernacular or formal context:

ethics is defined as the philosophical (normative
and theoretical) science that deals with the
morality of human conduct.
 Definition of Terms
Ethics- a study of morality’s effect Bioethics- study of the ethical
on conduct; the study of moral and moral implications of new
standards and how they affect biological discoveries and
conduct. It is also a branch of biomedical advances, as in the
philosophy concerned with fields of genetic engineering and
judgment about right and wrong; drug research.
goodness and badness.
Biology- study of life. A branch of
the natural sciences which studies
living organism and how they
interact with each other and their
environment
 BIOETHICS
a. Bioethics is a discipline that deals with the ethical
implications of bioethical research.
b. Bioethics is the study of ethical issues that emanate
from the changes and developments in the life science
technologies.
c. It is a branch of ethics that deals with the life sciences
and their impact in society.
d. It is a branch of ethics that analyzes moral values
in the context of biomedical sciences.
 continuation: MEANING OF BIOETHICS

e. It is a branch of ethics of biological science and

medicine.
f. It is a systematic study of human conduct in the
areas of the life sciences and healthcare.
g. It belongs to the auspices of medical ethics and
is loosely anchored in the avenues of life
sciences.
h. It is the study of the moral problems in medicine
and biological technology.
 Based on the definitions above, it is clear that
bioethics deals with the life sciences, namely:
medicine, healthcare, genetics, biology, research
and the like. In fact, its etymological root is
derived from bio, meaning life and ethos (ethics) or
the philosophical discipline that deals with the
morality of human conduct. bioethics is
multidisplinary.
 It is the result of the collective efforts in
philosophy, theology, law and medicine as it
confronts that complex crisscrossing and
intertwining of science and technology in the ambit
of human life.
 ISSUES AND CONCERNS
(1) human life
(2) health
(3) research
(4) science
(5) technology
(6) the overarching discipline that dominates
all these which is philosophy in the context of
Ethics, along with theology, law and medicine.
 HEALTHCARE ETHICS
deal and treats ethical issues such as withdrawal of life
support system ,testing of diseases, access to healthcare
services, brain death, clinical death, suicide, euthanasia,
vices and virtues, conscience, law and the like.

 healthcare ethics is interested on the processes that

involve the maintenance of health of people.

Deals with the study of concepts and principles of health

ethics and their implications to the individuals, schools,
hospitals, community. And society.
PROFESSIONAL ETHICS
 pertains to the normative moral system that injects a
kind of behavior that is expected of a professional. It
demands a professional behavior not only of an individual
but also as a group like nurses, physicians, engineers,
lawyers, teachers, accountants, scientist, clerics and etc.

 Concern on one’s conduct of behaviors and practice when

carrying out professional work. Codes of practices is
common with many professional bodies for their
members to observe.
 ABORTION
 Safe Abortion: if they are done with a method
recommended by WHO that is appropriate to the
pregnancy duration and if the person providing or
supporting the abortion is trained. Such abortions can be
done using tablets (medical abortion) or a simple
outpatient procedure.

 Unsafe Abortion: pregnancy is terminated either by

persons lacking the necessary skills or in an environment
that does not conform to minimal medical standards or
both.
 UNSAFE ABORTION
PROCEDURE
1. insertion of an object or substance (root, twig, or
catheter or traditional concoction) into the uterus;
2. dilatation and curettage performed incorrectly by
an unskilled provider;
3. ingestion of harmful substances;
4. and application of external force.
5. In some settings, traditional practitioners
vigorously pummel the woman's lower abdomen
to disrupt the pregnancy, which can cause the
uterus to rupture, killing the woman
 2 TYPES OF
ABORTION
 Spontaneous Abortion: without medical or
other intervention called miscarriage which
20% of all pregnancies may result.

 Induced Abortion: drugs or instruments are

used to stop normal course of pregnancy,
which is done through several methods or
techniques.
 REASONS
1. Health problems of the mother
2. Mother’s age- young and immature
3. Incest rape
4. Pressure from the partner or from parents
5. Problem with relationship
6. Financial reasons
7. Shame
8. Unwanted baby
9. Physiological worries related to pregnancy
10. Fetal health problem
11. Unready for responsibility
 PERSONAL OPINION
(1) Does a woman truly have a right
(absolute/relative) over her body?

(2) Does a woman have a right to have a child

of her own born from copulation?

(3) Does a fetus also have a right to be born,

cared for and loved?
 EUTHANASIA
 Practice of ending life in a painless way.
Euthanasia is the termination of a very sick
person's life in order to relieve them of their
suffering. A person who undergoes euthanasia
usually has an incurable condition.

 2 Greek words:
Eu- “ well or good “
Thanatos- “ Death “
 Forms of Euthanasia
A. Forms:
o Voluntary- occurs at the request of
the person who dies.
o Involuntary- occurs when the person is
unconscious or otherwise unable to make a
meaningful choice between living and dying,
and an appropriate person takes the decision on
their behalf.
B. Ways to administer:
o Passive- avoiding the intake of common
treatments (avoiding antibiotics or
chemotherapy) based on the patient’s knowledge
that the avoidance will lead to death.
o Non-active- life support systems shall be
withdrawn from the patient.
o Active- when death is brought about by an act -
for example when a person is killed by being
given an overdose of pain-killers.
 SUICIDE
Latin word “suicidium”- “to kill oneself”

some scholars- as “the direct killing of oneself on owns own

authority.”
Webster’s college dictionary- as “the intentional killing of one’s
own life” or “the destruction of one’s interests and prospects.”
This means that the agent of death is nobody else but the person
himself.
 In other words, all acts that result to death is non-other but
suicide, if the death of a person is caused by the person
himself/herself.
 CAUSES
a. Physical pain j. mental disorder
b. Illness k. culture and religion
c. Anxiety
d. Emotional pressure
e. Financial difficulties
f. Shame
g. Guilt
h. Depression
i. Psychological disturbance
COMMON METHODS
 DEATH
Death may be glimpsed as one of the most
ineffable words that man has ever invented. Truth
is, there is no accurate and most fitting definition
of it.
Filipinos believe that death is not the end of life; it
is rather a beginning of another journey.
Reserved only for those who have totally and
absolutely departed from life.
 CHARACTERISTICS
 Itis ineffable
 It is inescapable
 It is beyond experience
 It is personal
 It is ontological
 It is the grand equalizer
 MEANING IN DIFFERENT VIEWS

Medical definition
“death is the permanent cessation of all body
functions” or “the permanent cessation of vital
functions(heart, lungs, and brain stop working)”

Legal definition
“death is the cessation of life as indicated by the
absence of blood circulation, respiration, pulse, and
other vital functions” or “the death person is fit to be
buried.”
 Legal and Medical purposes definition

Death is the irreversible cessation of all the

following;

a) EEG-assessed flat lined total cerebral function.

b) Spontaneous function of the respiratory system
c) Spontaneous function of the respiratory system
 BRAIN DEAD
Brain death is not to be mistaken for persistent
vegetative state (PVS). When someone is
diagnosed as being in a PVS, this means that the
person does not have higher brain function, but
maintains lower brain function. There is brain
stem activity, which regulates involuntary actions
such as breathing, circulation, and digestion.
Someone in a PVS will undergo sleep-wake
cycles and can respond to stimuli.
Loss of higher brain function is different
from whole-brain death or losing both higher
and lower brain function. In this case (brain
death) there is no brain function, even in the
brain stem. All involuntary actions must be
maintained by machines and medication. Whole
brain death is only declared after a series of tests,
which include physical tests, EEGs and imaging.
The traditional definition of death is based
on cardiopulmonary (heart-lung) function. If the
heart stops pumping and there is no respiration,
then the person is considered dead.
Often the controversy surrounding brain
death involves patients who have lost higher brain function,
but maintain brain stem activity.

whole-brain death involves making a distinction between

biological death and mental death, even though a human
being is both mind and body.

Although the biological tissue is being kept alive by

artificial means, to what extent must one be kept
artificially alive to be considered technically dead? For
example, a person with a pacemaker is being kept
artificially alive by a machine, but we typically consider
these people alive.
 IN-VITRO FERTILIZATION
An artificial process through which the egg cells
are fertilized by the sperm outside of the woman’s
reproductive tract (technique used in achieving
fertilization of the male and female gametes(sperm
and egg) outside the body of a woman.
In-vitro: Latin word which means “ in glass”
(beakers, test tubes, petri dishes).
Glass containers “acted” like the artificial womb
(test tube babies).
 METHODS
A. Transvaginal Ovum retrieval (TVOR)
a small needle is inserted through the back of the
vagina upon the guide of an ultrasound machine for
the needle to reach the ovarian follicles and collect the
egg-containing fluid.
B. Assisted Zona Hatching (AZH)
done before the embryo will be transferred to the
uterus. Outer layer of the egg is opened in order to aid
the embryo hatch and help the implantation process.
 MORAL
CONCERNS/WEAKNESSES/FAILURE
o Must be made available only to legally married
couples/can single woman avail?
(who bears the responsibility of rearing the
child).
o Issue of surrogate mother.
o Process of fertilization is done in an artificial
method (fetal life and development does not occur
in a normal copulation but in petri dish)
o Discarding excess or unwanted embryos
(tantamount to killing)
 STEM CELL TECHNOLOGY
Stem cell is a cell that has the ability to divide
or self replicate for infinite periods. Under right
conditions/given the right signal, stem cell have
the potential to develop into mature cells that
have the characteristics, shapes, and specialized
functions such as heart cell, skin cell, nerve cell.
220 types of stem cells in the human body. The
problem lies in their scarcity. Their supply in
human body is so limited contrary to the case of
stem cells found in embryo.
 EMBRYONIC STEM CELL
 3 kinds of ESC
1. Totipotent: total potential to develop into
different types of cell.
2. Multipotent: minimal or limited potential to
develop into different types of cell.
3. Pluripotent: develop into different cell type
but not naturally bound to become a fetus.
 DISEASES THAT CAN BE HEALED BY
STEM CELL FOM HUMAN EMBRYOS
1. Cancer 2. Broken Bone
3. Brain Damage 4. Bone Loss
(hypoxia)
5. Incomplete Bladder6. Hepatitis
Control
7. Severe Burns 8. Diabetes
9. Heart Disease 10. Leukemia
11. Muscular Dystrophy 12. Lupus
13. Spinal Cord Injuries 14. Osteoarthritis
15. Multiple Sclerosis 16. Stroke
17. Parkinson’s Disease