Bioethics

Republic of the Philippines

Nueva Ecija University of Science and Technology Cabanatuan City

Submitted by:

Laira Gaye Arreola Cherry Belle Ayroso Marie Oslenica Balajadia Mica Rose Bajade Aimee Rose Biscante

Submitted to:

Mr. Arthur Jerome Gan Instructor

DESCRIPTION AND RATIONALE •

This lesson discusses the Fundamental Principles of Philosophy and Bioethics that are utilized in the professional setting.

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Every aspect of medical practice is governed by sets of ethical standards that are to be followed. In order to understand the

context of Bioethics, students should be familiar to philosophical domains, since the latter will enable them to seek the truth out of these bioethical issues to impersonality and impartiality. •

The content of this lesson will give students a perspective on how philosophy affects the action and decision-making and capability of the students in any setting.

OBJECTIVES •

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Define Philosophy and trace its history Explain the nature of man Differentiate professional ethics and bioethics and identify its role and objectives with regard to nursing practice/and duty. And, analyze and discuss the relationship of negligence and malpractice to professional ethics.

SCOPE 1. Nature of Philosophy

2. 3. 4. 5. 6. 7.

History of Philosophy Philosophy in man The concept of Professional ethics and bioethics Norms of Human Acts Prescribed Ethics among Professional Nurses Fundamentals of negligence and malpractice in relation to professional ethics

NATURE OF PHILOSOPHY Philosophy – Thinking •

The act of questioning or wanting to know initiates philosophy, and most of the time, we relate philosophy to thinking.

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Philosophy comes from the Greek words philos meaning love and sophia meaning wisdom. It means “the love of wisdom”.

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Love of wisdom – to the task that requires a deliberate effort to seek the truth.

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Philosophy is a systematic body of knowledge which is not only based on opinions, hypothesis and theories, but on ideal knowledge.

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Philosopher – lover of knowledge; a person who seeks knowledge for its own sake and not for any other motive.

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Generally – philosophy is defined as the knowledge of all things through these ultimate causes, acquired through the use of reasoning. Its main objective is to seek the deepest explanation of existence and the nature of being. It specifically uses reasoning to show its natural scope in deriving those explanations.

BRIEF HISTORY OF PHILOSOPHY Ancient/Pre Socratic (7th Century B.C.) •

Great thinkers called themselves “wise men”, but out of humility.

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Pythagoras – (one of the Greek thinkers), wanted to call himself a person who just love wisdom or a “philosopher”. From then on, Greek used the word philosophy for love of wisdom and philosopher as a lover of that wisdom.

Medieval / Middle Ages •

Christian Scholars and Arab philosophers – First philosophers who directly linked philosophy to theology, one of its main inspirations in the Christian Faith which became a stimulus to reason.

Modern (17th – 18th Century A.D.) • • •

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Rene Descartes – was known as the Father of Modern Philosophy, to his philosophy of rationalism and empiricism Rationalism – a philosophical Doctrine that specifically uses reasoning and proof in explaining reality. Empiricism – regards experience as the only source of knowledge. It was during this time that the abundance of knowledge in science became a challenge for all philosophers to prove their discoveries and breakthrough to the aid of the aforementioned doctrines.

Contemporary (20th Century) • The existence of a great variety of doctrine of philosophy strengthened its grasp in seeking the truth, Among these are the doctrines of Marxism by Karl Marx, Kantianism by Immanuel Kant and Essentialism by Jean Paul Sarte. •

The succeeding philosophies further discussed the use of inductive and deductive reasoning to prove their theories. These philosophies were developed among the ideas and perceptions of the discoveries themselves which geared in leading people towards progress and development.

PHILOSOPHY AND THE NATURE OF MAN 1. As a living organism, man is capable of:

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Feeding himself for nutrition. Growing Reproducing in order to preserve hi race.

2. As an organism to senses, man acquires sensory knowledge through: 2.1 External Senses e.q.

– Smell, taste and touch for nutrition. – Hearing and sigh for cignition 2.2Internal Senses e.q. – Consciousness – awareness of sensation and the operation of external senses. – Imagination – form of mental images or perceived objects that are reproduced even in their absence. – Memory – ability to recall past objects and states of consciousness. – Instincts – actions conducive to the well being of the person. 3. As an organism to senses, man tends to be aware of good things through his emotions. 4. As a rational organism to senses, man acquires knowledge by using his free will in judging and reasoning. 5. As an intellectual organism, man uses his conscience to do practical judgment in choosing a good from an evil action.

THE CONCEPT OF PROFESSIONAL ETHICS AND BIOETHICS What is Ethics?

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Ethics comes from the Greek word Ethos meaning characteristic way of acting and in Latin word Mos, morrs meaning way of acting.

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Ethics is a study of human acts or conduct from a moral perspective as to whether they are good or they are bad.

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We commonly associated ethics to customs, morals and etiquette and even used them interchangeably.  

Customs are acts approved by a group or society. Etiquette social observance required by good breeding. (i.e. table manners, dress codes)

Parts of Ethics • •

General Ethics – deals with the basic principles which are the morality of human acts. Social Ethics – tackles the basic principles in the life of man as a member of the society.

Objectives of Ethics • • • •

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To make clear to us why one act is better than another. To live an orderly social life. To appraise and criticize intelligently the moral conduct and ethical system. To seek the true value of life.

Professional Ethics – branch of moral science that treats of the obligations which a member of a profession owes to the public, to his profession and to his clients.

What is Bioethics?

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Bios + ethics ↓ ↓ Life way of acting

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Bioethics – is the term used to describe the application of ethics to biological sciences, medicine and related fields.

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It is the philosophical study of the ethical controversies brought about by advances in biology and medicine.

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It is a systematic study of moral conduct in life sciences and medicines.

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For M.T. Reich, it is a systematic study of human behavior, specifically, in the fields of life sciences and health care, as examined in the light of moral values and principles.

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Bioethics is ethics to a special focus on challenges arising from modern biotechnology. Biotechnology is any technology using micro-organism or biological materials for technological purposes (example is modifying things for better quality, cloning).

SCOPE OF BIOETHICS •

In its initial stages, bioethics was concerned with ethical problems associated to medical practices but later, the subjects matter was broadened to include all biosciences. Bioethics does not deal only but solely to the doctor-patience of relationship from a moral stand point, but it expanded to social issues related to health, animal welfare, environmental concerns, however, biomedical ethics remains central to this paradigmatic discipline.

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The problem of bioethics has something to do to the challenges posted by the biotechnological advances and its power over life and death.

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In our study we will deal to the questions about human life in 3 different points. – The beginning of life (Contraception and Family Planning) – In the midst of life (Genetic Engineering and Abortion_ – At the end of life (Death penalty and Euthanasia)

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The field of bioethics addresses a broad swath of human inquiry, ranging from debates over the boundaries of life (e.g. abortion, euthanasia) to the allocation of scarce health care resources (e.g. organ donation, health care rationing) to the right to turn down medical care for religious or cultural reasons.

IMPORTANCE OR SIGNIFICANCE OF BIOETHICS 1. To provide awareness to the health team or workers of the “do’s and don’ts” of medical practice. 2. To enrich one’s competence by understanding that the patient is a person and a holistic individual. –

This field of study was developed in countries that had to face many ethical challenges due to the bioscientific developments, but the same moral problem challenges us even in the Philippines. As medical interventions became more powerful, ethical problems associated to medical and health practices also grow.

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Along this line of development, it is vital for every member of the health profession to be acquainted to ethical principles involved in the biomedical procedures. Biological sciences will continue to grow, as it will, there is a great need for us to take a moral stand on these “development”. Indeed, no end is in sight for the need of health professionals who are conversant to bioethics, for they alone will be the most efficient and effective, at the same time morally responsible health service provider.

NORMS OF HUMAN ACTS •

These are directives or guides in making decisions on what we ought to do or to be.

a. Law – an ordinance of reason, promulgated for the common good by

one who has legitimate authority. It is an authoritative order that should be just, honest, possible of fulfillment, useful, to a certain degrees of permanency and promulgated or made known to the subject. b. Conscience – the practical judgment of reason upon an individual act as good and to be performed or as evil and to be avoided.

IMPORTANT CLASSES OF LAWS a. Eternal Law – It is God’s eternal plan and providence for the universe.

It is the diverse reason or will commanding the preservation of the natural order of things and forbidding its disturbance. According to St. Thomas, it is the plan flowing from God’s wisdom directing all acts and movements. b. Natural Law – it is the eternal law as known to human through

reason. It is nothing than the rational creatures’ participation in the eternal law of God and Human comes to the knowledge of this law by natural light of his/her reason. e.g. do good and avoid evil. (St. Thomas) •

The reason why it is called Natural is because it is neither communicated in a supernatural way, nor a result of a command of a legislative or authority. The precept of natural law is found and derived for the very nature of human beings.

PROPERTIES OF NATURAL LAW a. Universality – the natural moral law binds every person at all times

and in all places or its basis is the very nature of human. One cannot remain ignorant of the natural law, at least not of its basic precepts. However, human beings do not possess the knowledge of this law, in a fully developed form from the beginning. She or he must develop it just as the development of other forms of knowledge. E.g. respect for life b. Immutability – as soon as the human being has the capacity of using his/her reason, certain fundamental norms will become self-evident to humans. These fundamental norms are imprinted in human nature, so that they exist as long as human nature exists. The genuine commands and prohibitions of natural law cannot be changed. c. Indispensability – no one is dispended or excused in the observance of the natural law. Why? Because, the origin of natural law is God. Natural law is identical to God’s will. Evidently, human has no authority over a law of this status. This means that if there is dispensation of this law, there is a violation in God’s Law.

TYPES OF NATURAL LAW AS PRESENTED OR FORBID AN ACT 1. Affirmative – laws which bind always, but not at very moment. It

states that human is morally obliged to adopt all ordinary means of preserving health and life. However, not morally obliged to adopt extraordinary means of preserving life, except if the point is not spiritually prepared for death. Humans may adopt extraordinary means to conserve health and life. If it appears to be useful, desirable and prudent thing to do. 2. Negative – laws that are prohibitory. These are laws of the natural order, which bind always and at every moment. It states that no act – (+) or (-). Maybe directly, deliberately willed as a means of destroying health or life. At this point, it is good that we identify the ordinary from extraordinary means of preserving life, from the standpoints of physicians and moralists.

VIEWPOINTS

ORDINARY MEANS

EXTRAORDINARY MEANS

PHYSICIANS

Standard, recognized,

A medicine or

established medicines

procedure that might be

or procedure of the

fanciful, bizarre,

period at the level of

experimental,

medical practice.

incompletely establishes and not

MORALISTS

Include not only normal

recognized. All medicines,

food, drink and rest but

treatments and

also in terms of hospital

operations which cannot

practice, all medicines

be obtained or used of

and treatment

excessive expense, pain

procedures which offer

or other inconvenience

reasonable hope or

for the point or for

benefit for the patient

others, or which if used

which can be obtained

would offer a reasonable

and used of excessive

hope for the point.

expense, pain or other inconvenience. 3. HUMAN POSITIVE LAW • •

Law enhanced by the church or state. An ordinance of reason derived from the natural law or making a concrete and determinate application of the natural law, promulgated for the common good by a human institution in charge of society.

Note: Whenever we perform actions that are in conformity to the law, it is good. We are talking now of laws that are also morally sound, this will guide us not only to become citizens who abide to certain rules but also develop us to become moral individuals. The

knowledge on the different aspects of laws will enable us to become more careful in following the norms to fulfill our duty in the preservation of human life.

PROFESSIONAL ETHICS •

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It is a branch of moral science which treats of the obligations which a member of a profession owes to the public, to his / her clients. A professional medical ethics expresses responsibility in medical codes and ethical treatises. All socially authorized professional power requires a public accountability, and this is especially true of medical or community health professional power.

MALPRACTICE AND NEGLIGENCE •

Malpractice – any professional misconduct or any unreasonable lack of skill or fidelity in the performance of professional or fiduciary duties.

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Profit Negligence – doing failure to do that action which a reasonably prudent person would have done or would have not done in like or similar circumstance.

ELEMENTS OF NEGLIGENCE Note: Before one is accused of negligence, there are certain elements that should be present. If one of these is not present, negligence cannot be declared: 1. Existence of duty – there must be a moral obligation incumbent upon

the person of doing or omitting something as mandated by her/his profession. 2. Failure to perform the duty – one fails to respond the call of his/her

profession. 3. Injury resulting from failure – there was a grave harm that results

from not doing his/her duty or from doing the wrong thing due to lack of knowledge.

Note: It is therefore very important to a member of a certain profession, to know his/her rights and duties as a professional.