VALUES AND PROFESSIONAL ETHICS

Ethical Principles (2)

MADE BY: JAILOUISE A. PEREZ, JOEY VENEGAS, MIRA MARAVILLA, TRIESHA ICBAN, KRISHLAINE TIU, LINUS ORDONIO,
ARIANE SALIBIO, SHARMAINE ZIPAGAN
PAMANTASAN NG LUNGSOD NG MAYNILA - BACHELOR OF SCIENCE IN NURSING - BATCH 2021-2022 (2ND SEM)

TOPIC OUTLINE
1 Principle of double effect
2 Principle of legitimate cooperation
3 Principles of common good and subsidiarity
4 Principle of stewardship
5 Bioethical role of nurses in stewardship
6 Principle of totality and integrity
7 Ethico moral responsibility of nurse in surgery
8 Preservation of bodily functional

DOUBLE EFFECT REASONING

CONDITION 1:
PRINCIPLE OF DOUBLE EFFECT ➔ An example of the first condition of the rule of RDE is
PRINCIPLE OF DOUBLE EFFECT
applied when a nurse administers a medication that
➔ According to Cavanaugh (2006), it is based on an
is, “apart from circumstances and intent, whether
individual’s reasoning that an act causing good
good or bad.”
permitted when the act meets the following conditions:
CONDITION 2:
1. The act considered independently of its
➔ It involves the intention of a nurse or physician.
evil effect is not in itself wrong
2. The agent intends the good and does CONDITION 3:
not intend the evil either as an end or ➔ The bad effect cannot be means to the intended good
as a means effect.
3. The agent has proportionately grave
reasons for acting, addressing his PRINCIPLE OF LEGITIMATE COOPERATION
LEGITIMATE
relevant obligations, comparing the
➔ The term “legitimate” refers to moral acceptability
consequences, and considering the mot the legal meaning of conforming to a set of
necessity of the evil, exercising due to standards and requirements to be acceptable.
care to eliminate or mitigate it.
➔ In times when nurses feel uncomfortable, nurses COOPERATION
need to explore their attitudes and opinions with ➔ Cooperation with evil as understood in the
their supervisor and, when appropriate, in clinical context of this principle does not mean working
team meetings together in agreement with all aspects of the
act.
➔ Ex. ANA has consistently uphold the right of
➔ Rather, it means working together despite
patients or if the patient is incapacitated, the
disagreement about the ends or means of the
right of designated surrogate, to decide whether
act.
to submit or continue medical treatment. The
➔ In other words, cooperation does not imply
ANA believes that it is the responsibility of nurses
condoning evil.
to facilitate informed decision-making for patients
and families who are making choices about end- PRINCIPLE OF LEGITIMATE COOPERATION
of-life care. TWO MAJOR DISTINCTIONS
➔ The code of ethics for nurses specifically outlines FIRST DISTINCTION: FORMAL AND MATERIAL
the nurse’s obligation to protect the patient’s COOPERATION
right to self-determination and the role of a ➔ Formal cooperation means that the person
designated surrogate in situations where the cooperating intends, desire, or approves the
patient lacks capacity. wrongdoer’s conduct.

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 ➔ Thus, if the nurse helps in the operation COMMON
because she wants the operation performed, if ➔ Involves all members in society, none are exempt
the servant transports the letters because he from cooperating according to each one’s possibilities
approves of the liaison, if the priest intends in attaining and developing it.
that the sinner receive communion, or if the
judge applauds the couple’s divorce. Then, GOOD
regardless of any other distinction, the ➔ It is the respect for and integral promotion of the
cooperator is also wrong. person and their fundamental rights.
➔ In short, formal cooperation occurs when the
evil end or evil means are directly chosen by ON HEALTHCARE, NURSING AND THE COMMON GOOD
means of encouragement, praise, advice, or ➔ The literature examining the relationship of the
other forms of support. common good to nursing and other health professions
➔ On the other hand, material cooperation simply mainly cites the common good as an impetus for
means that although we do not share the action.
intention of the wrong doer, we are involved in ➔ Nursing is viewed as promoting the common good.
the matter or the actual doing of the action. ➔ In addition to development of nursing as a discrete
➔ This occurs when the evil end and means are profession reflects societal recognition that the
indirectly chosen by a person who has chosen constellation of services provided by nurses is
a good and good means. supportive of the common good.
➔ Thus, the distinction between formal and ➔ Nursing also addresses the need to bal;ance the
material asks whether we intend desire or preservation of individual dignity and respect against
approve the wrong activity. If we do, we are societal integrity.
wrongdoers too. If not, then we should ➔ The “added value” of the common good to existing
consider the other issues. nursing concepts may be illustrated by examining
instances of ethical misconduct in clinical research
SECOND DISTINCTION: MEDIATE AND IMMEDIATE and the evolution of the health care delivery system.
COOPERATION
➔ This distinction concerns the action and not the UNETHICAL MISCONDUCT AGAINST COMMON GOOD
intention ➔ Ex. 1: in the 40 year Tuskegee study, the natural
➔ Mediate material cooperation is when the history of syphilis was studied in poor, black male
cooperator’s involvement is only contingent or sharecroppers. Even after penicillin was shown to be
accidental to the wrongdoing. effective ofn the treatment of syphilis, study subjects
➔ In other words, the cooperation does not were not informed of the availability of treatment and
contribute to the perpetuation of the evil. were actively discouraged from seeking helop by the
➔ Immediate material cooperation is when the research nurses and the physicians conducting the
cooperator’s involvement is necessary for the study.
evil to continue. ➔ Ex. 2: in the willow brook Hepatitis study, which
➔ It is morally equivalent to formal cooperation. lasted form 1963 to 1966, mentally deficient children
➔ The best way to know if your cooperation is were required to enroll in a research study to gain
immediate is to ask yourself if the vil would placement in a residential facility.
cease if you did not cooperate in the act. ➔ In 1963, Jewish chronic disease study, older and
senile patients were injected with cancer cells to
PRINCIPLES OF COMMON GOOD AND examine cell rejection.
SUBSIDIARITY
COMMON GOOD STEMS FROM: SUBSIDIARITY
• Dignity ➔ It is a principle of social doctrine that all social bodies
• Unity exist for the sake of the individual so that what
• Equality individuals are able to do, society should not take
➔ Common good is the social and community over, and what small societies can do, larger societies
dimension of the moral good. should not take over.
➔ It is the sum total of social conditions which ➔ It is in relation of individual and group lower and
allow people, either as groups or individuals, to higher, subordinate, and superior.
reach their fulfillment fully and more easily. ➔ The principle of subsidiarity reminds us that larger
institutions in society should not overwhelm or

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 interfere with smaller or local institutions, yet larger satisfaction of self-interests and the need of the
institutions have essential responsibilities when the environment.
more local institutions cannot adequately protect ➔ French urges nurse leaders to engage other and work
human dignity, meet human needs and advance collaboratively to establish and achieve a vision and
common good. purpose that affects the well-being of a system or
organization rather than promote their self-interests.
DOCTRINE OF PARTICIPATION
➔ It contributes to the cultural, economic, political, and THE STEWARDSHIP OF SELF
social life of the civil community to which one ➔ To meet the concept of lifelong learning, nurse
belongs. leaders or stewards will need to use the mentors and
➔ It is also duty to be fulfilled consciously by all, with personal coaches to assist them in refining skills and
responsibility and with a view to the common good. improving competencies.
➔ Healthy nurse leader stewards will thus become
APPLICATIONS OF SUBSIDIARITY visible and sound role models within their institutions
APPLICATIONS OF SUBSIDIARITY to maintain the balance between self and professional
➔ If a man can do it, a woman can do it fulfillment.
➔ Kung kaya ni Mister, kaya ni Misis
➔ The position of the Roman catholic Church is that THE POTENTIAL OF STEWARDSHIP IN SOCIETY
parents should have maximum reasonable amount of ➔ The potential for improving and enhancing policy
authority over, and responsibility for, the raising of outcomes is the predominant positive potential of
their children. stewardship.
➔ Another prospect of stewardship is to revive a sense
PRINCIPLE OF STEWARDSHIP of social purpose among public sectors of
STEWARDSHIP management, together with assisting role of the state
➔ Refers to one’s responsibility to take care, nurture
and cultivate what has been entrusted to him. BIOETHICAL ROLE OF NURSES IN STEWARDSHIP
➔ Trails, Education, Leadership and Generations BIOETHICS
o In healthcare practice, stewardship refers ➔ A branch of applied ethics that refers the discipline
to the execution of responsibility of the dealing with the ethical implications of
health care practitioners to look after. biological research and applications of especially
medicine.
WELCHMAN ➔ It involves issues relating to the beginning and
➔ Asserts that stewardship is a role individual’s adopt end of human life.
towards some other.
➔ Also stresses that to be steward is to devote a FOUR MAIN BIOETHICS PRINCIPLES THAT APPLY TO
substantial percentage of one’s thoughts and efforts NURSES
to maintaining or enhancing the conditions of some 1. Autonomy
things, persons, and not primarily of one’s own sake. ➔ Patient has the right to make decisions.
➔ In neutral resource management, as well as in 2. Beneficence
theology, the domination framework is premised on ➔ To act in the best interest of the patient.
the belief that the earth exist tp serve the people. 3. Justice
➔ Nurses will be fair and equitable.
PATERSON 4. Nonmaleficence
➔ Contends that a hierarchy exists between human and ➔ Nurses follow a code of ethics and pledge to bring no
non-humans harm.
➔ Paterson argues that exploitation and depletion of the PRINCIPLE OF TOTALITY AND INTEGRITY
environment has given rise to the keeping framework PRINCIPLE OF TOTALITY AND INTEGRITY
➔ In Paterson terms, stewards ‘till and keep’ the ➔ To enhance human dignity in the community,
environment; or, ashe explains stewards serve and everyone must develop, use, care, for, and conserve
preserve the environment all of their inherent bodily and psychological functions
➔ Paterson stresses that all persons are mutually in such a way that:
responsible for the well-being of the environment, a.) Lower functions are never surrendered unless for
and that serving the environment not only entails the greater functioning of the entire person, and
sacrifice but embraces a balance between the

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 even then only with an attempt to compensate ➔ It is allowed if and only if it is for the good of the
for the sacrifice. entire person, be it ohysical, mental or spiritual.
b.) The fundamental capacities that determine AMPUTATION
human beings are never sacrificed unless it si ➔ It is the removal or loss of a limb either through
absolutely required to protect life. surgical or non-surgical means.
ECTOMY
CONDITIONS FOR PRINCIPLE OF TOTALITY ➔ Ectomies are any surgical procedures that remove a
1. That the organ’s decline in function may cause harm body part.
to the entire body or, at the very least constitute a STERILIZATION
major threat to it. ➔ A permanent method of birth control that renders the
2. That there is no other option except to take the person incapable of sexual reproduction
suggested action against it or get the intended ➔ The two procedures performed for sterilization is
beneficial result. tubal ligation and vasectomy for women and men,
3. That the harm saved to the whole is appropriate to respectively.
the damage produced by the part’s mutilation or IS STERILIZATION MUTILATION?
incapacity ➔ G.R No. 170723
o Gloria Pilar S. Aguirre v. Secretary of the
ETHICO MORAL RESPONSIBILITY OF A NURSE IN Department of Justice, Michelina S. Aguirre-
SURGERY Olondriz, Dr, Juvido Agatep, Dra. Marissa B.
ETHICO MORAL RESPONSIBILITY OF A NURSE IN Pascual, Pedro B. Aguirre and John and Jane
SURGERY Does
• Values
• Ethics PRESERVATION OF BODILY FUNCTIONAL
• Etiquette CATHOLIC HEALTH CARE ETHICS SELECT MORAL
• Professional ethics PRINCIPLES
• Nursing ethics ➔ “All persons saved by Catholic health care have the
MORAL PRINCIPLES right and duty to protect and preserve their bodily
1. Autonomy and functional integrity. The functional integrity of the
2. Nonmaleficence person may be sacrificed to maintain the health or life
3. Beneficence of the person when no other morally permissible
4. Justice means is available.”- Ethical Religious Directives for
5. Veracity Catholic Health Care Services.
6. Accountability ➔ Principle of totality
7. Responsibility o Based on the natural law which says that life
is to be preserved and maintained
SCOPE OG NURSING PRACTICE o This does not mean using life-prolonging
➔ Republic act 9173 :The Philippine Nursing Act of procedures that are insufficiently beneficial.
2002” (Articles VI Sec. 28) o For instance, surgery for the good of human
➔ A person is considered to be practicing nursing within body is directly opposed to mutilation- a
the meaning of this Act when he or she initiated and destruction of the body.
provides nursing services to people, families, and o The principle of totality aims to preserve life
communities in any health care environment whether in its totality, in its whole and sometimes
alone or in conjunction with another. that may mean sacrificing a part of the body
➔ Nurses are primarily responsible for health promotion o Ex. Amputation, cancerous tissue removal
and sickness prevention their work. and organ removal
➔ Nurses cooperate with other health care providers to o However, this principle may not be applied
offer curative, preventative, and rehabilitative to generative organs (sterilization) when the
elements of care, health restoration, pain relief, and health of the individual is not at stake.
when recovery is not possible, a peaceful death. o Here the end of preserving life is not
present. Organ transplants are permissible
MUTILATION as long as the life of the donor is not placed
➔ The act or instance of destroying, removing, or at risk.
severely damaging a limb or other body part ISSUES IN BODY DONATION

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➔ For deceased: the donation of organs should, in all
circumstances, respect the last will of the donor, or
the consent of the family present
➔ For living: when a living person donates and organ as
a result of a personal decision, then the oragn’s
transplant is to be carried out with due attention, and
post-operative medical care of the donors as well as
recipients must be provided.
o Further consideration must be given so that
no problems develop in the relationship
between the donor and recipients
(dependence, excessive gratitude, guilt
feeling).