BIOETHICS
NCM 108 | M.C.S | BSN, Level 2 Username
PRELIMS What is Moral Distress/Ethical dilemma by
professional nurses
● This occurs when one knows the ethically
correct action to take but feels powerless
1 Introduction to Bioethics to take that action (Epstein, E.G.,
Delgado, S, 2010)
2 Ethical Theories ● These challenges can bring moral or
ethical distress to nurses, it can affect
3 Ethical Principles their nursing behavior and nursing
practice to the detriment of patient health
4 Other Relevant Ethical Principles outcomes.
5 Topic
What are the feelings of moral distress
associated with?:
● Professional anguish over patient decision
Introduction to
● Team and unit level concern
● System-level factors
Bioethics What can unaddressed moral distress lead to?
● Withdrawal from the moral dimensions of
Week One patient care
● Moral disengagement leading to ethical
insensitivity
Summary: ● Burn-out
● Nurses leave the profession
Foundational Ethical Concepts and Historical
Perspectives of Ethics in Nursing. Nurses’ ethical conflicts were related to
situations such as:
Notes: ● Violated the rights, safety of the patients
and relatives
Moral Dilemma, Human Acts, Acts of Man, Ethics, ● Those that threatened nurses dignity and
Morality, Bioethics, ERICE Document professionalism
● Inadequate attention to the moral conflicts
of nurses’ values
1.0 Difficult Ethical Encounters in Clinical
● the influence of culture and insufficiency of
Settings
patient care
● Professional conflict
Nurses encounter ethical dilemma more
frequently in terms of;
● Resuscitation state of the patient 1.1 Basic Ethical Concepts
● Futile treatment
● Not telling the truth
BEC 1: Human Acts
● Dying with dignity ● Acts done consciously and freely by the
● Conflicting values in pain management agent (man).
● Use of resource Essential Qualities/Elements:
● Decision making at the end-of-life care ● Knowledge of the act
● Giving bad news ● Freedom
● Voluntariness
Man takes into responsibility of these actions
NCM 108 Reference Material | Prepared By: JRD
, BIOETHICS
NCM 108 | M.C.S | BSN, Level 2 Username
BEC 2: Acts of Man
● Actions beyond one’s consciousness; not 1.3 Ethics
dependent on the intellect and the will
Essential Qualities/Elements: What is Ethics?
● Done without knowledge
● Without consent ● Comes from the Greek word “ethos”
● Involuntary means, custom, way of behaving,
Acts of man can become human acts when he character
employs his intellect and will in performing the ● A branch of philosophy that deals with the
act principles of morality and the well-defined
standards of right and wrong that
When are acts not morally accountable? prescribe the human character and conduct,
● Acts of person asleep or under hypnosis
in terms of obligations, rights, rules,
● Reflex actions where the will has no time to
intervene benefit to society, fairness, etc.
● Acts performed under serious physical ● The practices or beliefs of a certain group
violence (e.g. medical ethics & nursing ethics).
● It is the process of questioning,
Through the study of Human Acts in different discovering and defending our values,
bioethical issues, one is able to develop sound principles and purpose.
ethical judgement. It is necessary to resolve an
ethical/moral dilemma/distress.
1.4 Ethics VS Morality
1.2 Ethical Dilemma
What is an Ethical Dilemma? Ethics Morality
● A situation where a choice has to be made
between competing values, and no matter ● Guiding ● Principles on
principles of which one’s
what choice is made, it will have
conduct of an judgements of
consequences. individual or right and
group. wrong are
Examples of Ethical Dilemma Nurses Encounter: ● influences by based.
● A young woman asking for an abortion profession, ● Influenced by
because she is not ready. field, society, culture
organization, and religion
● A cancer patient in pain asking for morphine
etc. ● Not related to
despite being given already the prescribed ● Related to professional
dosage. professional work
● A young man selling his kidney so he can work ● Vary according
support his ailing child. ● Uniformed, to different
compared to cultures and
What are the 4 Reference Points for Human morals religions
Acts?
1. Natural Law
2. Civil Laws
3. Cultural Laws
4. Code of Ethics
NCM 108 Reference Material | Prepared By: JRD
, BIOETHICS
NCM 108 | M.C.S | BSN, Level 2 Username
1.5 Bioethics 1.6 Critical Concerns of Bioethics
What is Bioethics? What are the 5 Critical Concerns of Bioethics?
● Human Experimentation
● Derived from the two words “Bio” (life) and ● Organ Transplantation
“Ethics” (behavior). ● End of Life Issues
● The study of the behavior of human life. ● The Beginning of Life & Human Procreation
● It is concerned with the ethics and ● The Discovery of Genetics
philosophical implications of certain
biological and medical procedures,
1.6 4 Areas of Bioethics Competency
technologies, and treatments such as:
Organ Transplants, Genetic Engineering, and
Care of the Terminally ill. What is the ERICE Document?
1. Ethical Problems in the Healthcare
profession.
1.5 Threatening Conditions that birthed
2. Ethical Problems arising in the field of
Bioethics
human research even if it is not directly
therapeutic.
3. Social problems connected with public
health policies & healthcare jobs and with
1930-1970 Tuskegee, Alabama, US
government had a syphilis family planning & population control
experiment among 400 Black policies.
Americans (1947) who were not 4. Problems related to interventions on the life
treated despite the discovery of of other living things and generally to
Penicillin. anything having to do with equilibrium of
the ecosystem.
1947 Nuremberg Code. Condemned all
experimentation on human
subjects without their consent in
response to Nazi’s experiment
1 Introduction to Bioethics
1963 Tumor cells were injected without
consent to elderlies at the Jewish 2 Ethical Theories
Chronic Disease Hospital in
Brooklyn New York 3 Ethical Principles
1965-1971 Studies on viral hepatitis 4 Other Relevant Ethical Principles
immunization at Willowbrook
State Hospital in New York where 5 Topic
handicapped children were
inoculated with the virus
Ethical Theories
Week Two
Summary:
NCM 108 Reference Material | Prepared By: JRD
, BIOETHICS
NCM 108 | M.C.S | BSN, Level 2 Username
Ethical Theories, Virtue Ethics, and Core Values of a
● Duty to respect the autonomy and dignity
Professional Nurse
of the patient
● Duty to advocate for the patient and to
Notes: uphold their rights.
● Duty to the respective hospital, to the
Research, deontology, teleology, ethical egoism, health care institution, and to the
eudaimonism, utilitarianism, Jeremy Bentham, Virtue community in which nurses work.
ethics, wisdom, practical wisdom, choice, goal, virtue
of healthcare workers, core values
2.2 Deontology Ethical Theory
2.0 Research
What are the 3 barriers in disclosing medical
What is research? errors to clients?
● Ethical theories are philosophical ● Fear of litigation
attempts at explaining and systematizing ● Shame about the error
human morality. ● Lack of training on how to discuss errors
● Most ethical theory is an attempt to with clients
describe or prescribe what philosophers call May lead providers to believe that bringing the
“right action” and “wrong action.” error to light does more harm than good.
Additional Information Applying Deontological Theory
● It provides part of the decision-making ● Clearly favors truth-telling and full
foundation for Decision Making When disclosure of errors.
Ethics Are in Play because these theories ● Patients want their providers to show
represent the viewpoints from which respect for them by being honest about
errors.
individuals seek guidance as they make
● Part of the disclosure process involves
decisions. issuing an apology for the error, which is
an important move in the direction of
soothing distress, maintaining a trusting
client-provider relationship, and restoring
client dignity.
2.1 Ethical Theories
Criticisms/Challenges
What is deontology? ● In difficult circumstances, deontology
● Deon, means obligation/duty may not provide acceptable solutions. In
that regard, healthcare providers should
● Logos, an inquiry or study
be knowledgeable of other common
● Literally, it means an ethical study or ethical ethical philosophies.
inquiry regarding duty. ● In the realm of triage or public health.
● Also known as, duty-based theory.
● Deontology; motives and actions are
morally right independent of their
consequences 2.3 Teleological Ethical Theory
Duties of a Professional Nurse What is teleology?
● Duty of care towards a patient ● Telos, end or purpose
irrespective of class, race or religion; a ● Logos, science
duty to respect the privacy and
confidentiality of the patient.
NCM 108 Reference Material | Prepared By: JRD
NCM 108 | M.C.S | BSN, Level 2 Username
PRELIMS What is Moral Distress/Ethical dilemma by
professional nurses
● This occurs when one knows the ethically
correct action to take but feels powerless
1 Introduction to Bioethics to take that action (Epstein, E.G.,
Delgado, S, 2010)
2 Ethical Theories ● These challenges can bring moral or
ethical distress to nurses, it can affect
3 Ethical Principles their nursing behavior and nursing
practice to the detriment of patient health
4 Other Relevant Ethical Principles outcomes.
5 Topic
What are the feelings of moral distress
associated with?:
● Professional anguish over patient decision
Introduction to
● Team and unit level concern
● System-level factors
Bioethics What can unaddressed moral distress lead to?
● Withdrawal from the moral dimensions of
Week One patient care
● Moral disengagement leading to ethical
insensitivity
Summary: ● Burn-out
● Nurses leave the profession
Foundational Ethical Concepts and Historical
Perspectives of Ethics in Nursing. Nurses’ ethical conflicts were related to
situations such as:
Notes: ● Violated the rights, safety of the patients
and relatives
Moral Dilemma, Human Acts, Acts of Man, Ethics, ● Those that threatened nurses dignity and
Morality, Bioethics, ERICE Document professionalism
● Inadequate attention to the moral conflicts
of nurses’ values
1.0 Difficult Ethical Encounters in Clinical
● the influence of culture and insufficiency of
Settings
patient care
● Professional conflict
Nurses encounter ethical dilemma more
frequently in terms of;
● Resuscitation state of the patient 1.1 Basic Ethical Concepts
● Futile treatment
● Not telling the truth
BEC 1: Human Acts
● Dying with dignity ● Acts done consciously and freely by the
● Conflicting values in pain management agent (man).
● Use of resource Essential Qualities/Elements:
● Decision making at the end-of-life care ● Knowledge of the act
● Giving bad news ● Freedom
● Voluntariness
Man takes into responsibility of these actions
NCM 108 Reference Material | Prepared By: JRD
, BIOETHICS
NCM 108 | M.C.S | BSN, Level 2 Username
BEC 2: Acts of Man
● Actions beyond one’s consciousness; not 1.3 Ethics
dependent on the intellect and the will
Essential Qualities/Elements: What is Ethics?
● Done without knowledge
● Without consent ● Comes from the Greek word “ethos”
● Involuntary means, custom, way of behaving,
Acts of man can become human acts when he character
employs his intellect and will in performing the ● A branch of philosophy that deals with the
act principles of morality and the well-defined
standards of right and wrong that
When are acts not morally accountable? prescribe the human character and conduct,
● Acts of person asleep or under hypnosis
in terms of obligations, rights, rules,
● Reflex actions where the will has no time to
intervene benefit to society, fairness, etc.
● Acts performed under serious physical ● The practices or beliefs of a certain group
violence (e.g. medical ethics & nursing ethics).
● It is the process of questioning,
Through the study of Human Acts in different discovering and defending our values,
bioethical issues, one is able to develop sound principles and purpose.
ethical judgement. It is necessary to resolve an
ethical/moral dilemma/distress.
1.4 Ethics VS Morality
1.2 Ethical Dilemma
What is an Ethical Dilemma? Ethics Morality
● A situation where a choice has to be made
between competing values, and no matter ● Guiding ● Principles on
principles of which one’s
what choice is made, it will have
conduct of an judgements of
consequences. individual or right and
group. wrong are
Examples of Ethical Dilemma Nurses Encounter: ● influences by based.
● A young woman asking for an abortion profession, ● Influenced by
because she is not ready. field, society, culture
organization, and religion
● A cancer patient in pain asking for morphine
etc. ● Not related to
despite being given already the prescribed ● Related to professional
dosage. professional work
● A young man selling his kidney so he can work ● Vary according
support his ailing child. ● Uniformed, to different
compared to cultures and
What are the 4 Reference Points for Human morals religions
Acts?
1. Natural Law
2. Civil Laws
3. Cultural Laws
4. Code of Ethics
NCM 108 Reference Material | Prepared By: JRD
, BIOETHICS
NCM 108 | M.C.S | BSN, Level 2 Username
1.5 Bioethics 1.6 Critical Concerns of Bioethics
What is Bioethics? What are the 5 Critical Concerns of Bioethics?
● Human Experimentation
● Derived from the two words “Bio” (life) and ● Organ Transplantation
“Ethics” (behavior). ● End of Life Issues
● The study of the behavior of human life. ● The Beginning of Life & Human Procreation
● It is concerned with the ethics and ● The Discovery of Genetics
philosophical implications of certain
biological and medical procedures,
1.6 4 Areas of Bioethics Competency
technologies, and treatments such as:
Organ Transplants, Genetic Engineering, and
Care of the Terminally ill. What is the ERICE Document?
1. Ethical Problems in the Healthcare
profession.
1.5 Threatening Conditions that birthed
2. Ethical Problems arising in the field of
Bioethics
human research even if it is not directly
therapeutic.
3. Social problems connected with public
health policies & healthcare jobs and with
1930-1970 Tuskegee, Alabama, US
government had a syphilis family planning & population control
experiment among 400 Black policies.
Americans (1947) who were not 4. Problems related to interventions on the life
treated despite the discovery of of other living things and generally to
Penicillin. anything having to do with equilibrium of
the ecosystem.
1947 Nuremberg Code. Condemned all
experimentation on human
subjects without their consent in
response to Nazi’s experiment
1 Introduction to Bioethics
1963 Tumor cells were injected without
consent to elderlies at the Jewish 2 Ethical Theories
Chronic Disease Hospital in
Brooklyn New York 3 Ethical Principles
1965-1971 Studies on viral hepatitis 4 Other Relevant Ethical Principles
immunization at Willowbrook
State Hospital in New York where 5 Topic
handicapped children were
inoculated with the virus
Ethical Theories
Week Two
Summary:
NCM 108 Reference Material | Prepared By: JRD
, BIOETHICS
NCM 108 | M.C.S | BSN, Level 2 Username
Ethical Theories, Virtue Ethics, and Core Values of a
● Duty to respect the autonomy and dignity
Professional Nurse
of the patient
● Duty to advocate for the patient and to
Notes: uphold their rights.
● Duty to the respective hospital, to the
Research, deontology, teleology, ethical egoism, health care institution, and to the
eudaimonism, utilitarianism, Jeremy Bentham, Virtue community in which nurses work.
ethics, wisdom, practical wisdom, choice, goal, virtue
of healthcare workers, core values
2.2 Deontology Ethical Theory
2.0 Research
What are the 3 barriers in disclosing medical
What is research? errors to clients?
● Ethical theories are philosophical ● Fear of litigation
attempts at explaining and systematizing ● Shame about the error
human morality. ● Lack of training on how to discuss errors
● Most ethical theory is an attempt to with clients
describe or prescribe what philosophers call May lead providers to believe that bringing the
“right action” and “wrong action.” error to light does more harm than good.
Additional Information Applying Deontological Theory
● It provides part of the decision-making ● Clearly favors truth-telling and full
foundation for Decision Making When disclosure of errors.
Ethics Are in Play because these theories ● Patients want their providers to show
represent the viewpoints from which respect for them by being honest about
errors.
individuals seek guidance as they make
● Part of the disclosure process involves
decisions. issuing an apology for the error, which is
an important move in the direction of
soothing distress, maintaining a trusting
client-provider relationship, and restoring
client dignity.
2.1 Ethical Theories
Criticisms/Challenges
What is deontology? ● In difficult circumstances, deontology
● Deon, means obligation/duty may not provide acceptable solutions. In
that regard, healthcare providers should
● Logos, an inquiry or study
be knowledgeable of other common
● Literally, it means an ethical study or ethical ethical philosophies.
inquiry regarding duty. ● In the realm of triage or public health.
● Also known as, duty-based theory.
● Deontology; motives and actions are
morally right independent of their
consequences 2.3 Teleological Ethical Theory
Duties of a Professional Nurse What is teleology?
● Duty of care towards a patient ● Telos, end or purpose
irrespective of class, race or religion; a ● Logos, science
duty to respect the privacy and
confidentiality of the patient.
NCM 108 Reference Material | Prepared By: JRD
