M4 Lesson: Ethical Principles ● refer to a person’s choosing and acting on the basis of

his/her values, principles or ideals of conduct, goals and

There are many bioethical issues as there are principles, rights, duties, purposes.
and values to be analyzed or appealed to in the discussion of such ● ALSO KNOWN AS: RIGHT OF SELF-DETERMINATION.
issues. (Timbreza, 2007). And to aid the health care providers to arrive ● Gives rise to INFORMED CONSENT
in certain actions for client care and welfare, ethical principles may be
considered such as: INFORMED CONSENT
Principle of Autonomy, this principle marks the significance of ● the right to determine what shall be done with his own body
individual autonomy which mandates a strong sense of personal ● He may choose whether to be treated or not and to what
responsibility for one’s own life. extent no matter how necessary medical care, or how
Principle of Justice, rendering of what is due or merited. imminent the danger to his life or health
Beneficence, the practice of doing acts of kindness, goodness, and ● Material rights if any
charity. ● The prognosis, if the recommended care is refused
And, Non-Maleficence, “not to do harm”. ● Other elements: disclosure, competence, comprehension,
voluntariness.
A.BASIC ETHICAL PRINCIPLES ESSENTIAL ELEMENTS OF INFORMED CONSENT
● The diagnosis and explanation of condition
1. STEWARDSHIP ● A fair explanation of the procedures to be done and
● Management and supervision for others used
● Entails virtues of RESPONSIBILITY and ACCOUNTABILITY ● and the consequences
● RESPONSIBILITY- the duty involved when one accepts a ● A description of alternative treatments and procedure
task ● A description of the benefits to be expected
● ACCOUNTABILITY – being answerable or liable
● Nurses are charged by the society as stewards in the health
care services CONSENT
● Free and rational act
2.PRINCIPLE OF TOTALITY ● presupposes knowledge of the thing
● Wholeness, completeness, entirety ● is being given by person who is legally capable to give
● The whole is greater than any of its parts consent
● The whole physical body is more important than any of its ● It is signed by the patient or his authorize representative/
parts. legal guardian
● It states that an individual has the right to cut off, mutilate, or ● upon admission for initial diagnosis and treatment.
remove any defective or worn out nonfunctioning part of his
body; to dispose of his organs or to destroy their capacity to QUALIFICATIONS OF A PERSON WHO CAN GIVE A CONSENT
function “ only insofar as the general well- being of the whole ● Legal age
body requires it.” ● Physically and mentally capable
● Of sound mind free from duress, coercion or force
3. THE TWO-FOLD EFFECT (DOUBLE EFFECT)
● good and bad effects VULNERABLE SUBJECTS
● contemplates on 2 effects/outcomes ● mentally ill, mentally retarded
● The basis of action maybe on the following: ● Legally incompetent such as the unconscious, or are in
a. The action must be morally good or at least unique situations, like fetuses
morally indifferent or neutral ● Minors
b. that the good effect must be willed and bad ● They are incapable of evaluating the risks involved and
effect merely allowed cannot be given consent in their own behalf.
c. That the good effect must not come from evil ● Consent of parents and guardians are required.
action but from the initial action itself directly; and ● Fetuses shall have the consent of the third person because
d. that the good effect must be greater than the of the possible danger or injury to it.
bad effect or at least be of equal importance. ● The Philippine constitution guarantees the protection of
the life of the mother and the life of the unborn.
4. PRINCIPLE OF COOPERATION
● one works with others in the performance of an act REFUSAL TO CONSENT
accomplish a goal ● A patient has the right to refuse consent
● poses moral problems when and where the acts done ● May refuse consent due to inadequate information regarding
are evil, immoral or illegal the procedure to be done
● one who acts through an agent is himself responsible ● Must fill out the release form/waiver
● conspiracy to commit a crime
RESTRICTION OF AUTONOMY
5. SOLIDARITY ● The welfare of the patient shall take precedence
● Firmly united ● If the patient is sick with communicable disease and public
● Unity or fellowship arising from common responsibility and safety is jeopardized.
interest
● Ability of the members to organize and standardize the VERACITY – bound to tell the truth
professional values
● One for all; All for one policy is a tall order The patient has the responsibility to
● provide the best of his knowledge accurate and complete
B. MAJOR BIOETHICAL PRINCIPLES information about:
o his complaints,
1. PRINCIPLE OF RESPECT FOR AUTONOMY o previous hospitalizations,
● greek word Autos meaning self o past illness,
● nomos meaning governance. o medications being taken,
● “LIVING OR ACTING ACCORDING TO ONE’S OWN o allergies, religious restrictions and other matters
RULE, PRINCIPLE, OR LAW.” relevant to health.
● self- determination and freedom; self-rule; self- governance The physician tells the patient and his Family
● to choose and implement one’s decision, ● plan of care
● free from deceit, duress, constraint or coercion. ● length of treatment, possible expenses and other options
they
 ● may take if there’ll be any needs of patients competing for the same medical resource
● treatment is the crucial point of comparative justice.
● His diagnosis
● and possible risks involved NONCOMPARATIVE JUSTICE
● is one in which the distribution of medical goods or resources
Confidential information may only be revealed only when: is determined by a certain standard rather than by the needs
1. the patient himself permits such revelation as in the case or claims of individuals.
of claim for hospitalization, insurance benefits, among others ● Medical treatment is determined by principle (rule/policy), not
2. the case is medico-legal such as attempted suicide, by need.
gunshot wounds which have to be reported to the local ● a principle of treatment or a policy distribution is formulated
police or NBI which prescribes a strict numerical equality of treatment,
3. the patient is ill of CD and public safety may be irrespective of the needs of an individual.
jeopardized ● a certain procedure or system to be followed in distributing
4. given to members of the health team if information is treatment is thus made, especially if medical resources are
relevant to health care scarce or limited.
● To cope with the problem, a certain policy may be devised,
Article IV, Section 4 (1) of the new constitution, which states that: such as “ FIRST COME FIRST SERVED”
“ The privacy of communication and correspondence shall be inviolable
except upon lawful order of the court or when public safety and order
require otherwise”

2. BENEFICENCE
● Doing what is good
● Promotes doing acts of kindness and mercy that directly
benefit the patient.
3 MAJOR COMPONENT
o Do or promote good
o Prevent harm
o Remove evil or harm

Nurses Responsibilities in Research on Human Subjects:

Helsinki Declaration emphasizes that the research subjects must be
informed when a clinical or non- clinical study will be of no personal
benefit to them to avoid any suspicion to the contrary.

The ANA Human rights guidelines for nurses in clinical and other
research :
1. Employment in settings where research is conducted
2. Vigilant protection of human subjects’ rights
3. Scope of Application
4. Supporting Accrual of Knowledge
5. Informed Consent
6. Representation on Human rights Committee

Basic Human Rights of Research Subjects:

1. Right to informed consent
2. the right to refuse or withdraw from participation
3. Right to privacy
4. Right to Confidentiality or Anonymity of Data
5. Right to be protected from Harm

3. NON-MALEFICENCE
stated as an admonition in the negative form to remind health
practitioner not to do harm.

4. JUSTICE
● rendering of what is due or merited.
● right to demand to be treated justly, fairly and equally
● refers to a PRINCIPLE OF EQUITY

PRINCIPLE OF EQUITY
prescribes fairness and impartiality regarding equal access to health
care and allocation of scarce medical resources between two
individuals or to a group of persons who are in dire need of treatment.

TYPES OF JUSTICE

COMPARATIVE JUSTICE
● is one in which what an individual patient or group receives
is determined by balancing the competing claims of others
individuals or groups.
● A particular patient receives is determined by the gravity of
the condition or need.
● Eg: one patient may need a kidney transplant more than
another patient because Patient no. 1 is dying of renal
failure, while Patient no. 2 has just been diagnosed as
having a kidney problem. The balancing or weighing of the