BIOETHICS

LECTURE 1
BIOETHICS
BIOETHICS
➢ It is the application of the principles of ethics to the field ENVIRONMENTAL ETHICS
of medicine and healthcare. ➢ Emerged from issues on the global threat to the natural
➢ Involves the basic concerns of human beings and their basis of existence
close relationship with other organisms. ➢ Examples: increasing number of extinct species,
➢ Used interchangeably with medical ethics but are ecosystem destruction, inventions of nuclear power, etc
different THEORIES OF BIOETHICS
❖ Medical Ethics deals with moral values and DEONTOLOGICAL THEORY
decisions as they are applied to medicine. ➢ Derived from the Greek word “deon” which means
Example: The use of reagents in the laboratory, in our “obligation or duty”
experimentations or discoveries we usually use other ➢ Focused on the rightness or wrongness of an action
organisms such as the mice or rabbit, through bioethics they’re rather than on the consequence of the action done
being protected. DIVINE COMMAND THEORY
➢ Bioethics, being a combination of personal field and
● An action done is right if declared by the Almighty God to
social ethics, is said to be a neutral network that deals
be right.
with issues and problems as human beings interact with
● The rightness of an action depends on the action being
the environment.
performed and it is a duty to do so. (Ex: Euthanasia)
DEVELOPMENT OF BIOETHICS
● Bioethics grew progressively when the professionalization
NATURAL LIGHT THEORY
of nursing started. ● Proposed by John Locke and Thomas Hobbes
● Bioethics took the challenge of answering the wider issues ● Humans have absolute human rights which is inherent in
of health care and humans. the field of ethics and not parallel to human action and
OBJECTIVES OF BIOETHICS belief.
● Build a positive attitude towards the chosen profession KANT’S CATEGORICAL IMPERATIVE
(Ex: MedTech should show confidence and initiative in ● Proposed by Immanuel Kant, a German Philosopher of
doing laboratory exams) the 18th century
● Show concern for human life and those of other living ● defined a person as a rational human being with freedom
organisms and moral worth.
● Produce professionals in body, mind and spirit ● A person is morally good and admirable if actions are
● Establish a functional philosophy in life (A MT should done from a sense of duty.
follow positive clinical decision as dictated by our God ● “A man must treat other people as an end and not only a
through his or her conscience) means to an end”; every human creature has a worth in
GOALS OF BIOETHICS itself.
● Ethical Guidance ROSS’ ETHICS
● Clarification ● Proposed by W.D. Ross, who rejected the utilitarian notion
● Disciplines ● An action is made right by its consequence alone
● Structures ● Outlined the 7 Prima Facie Duties
● Internal Auditing ❖ PRIMA FACIE DUTIES
● Interdisciplinary approach – one that dictates what I should do when other
SUB-DISCIPLINES OF BIOETHICS relevant factors in a situation are not considered
1. Medical Ethics – Is a Latin term that is commonly to mean “on the
2. Animal Ethics first appearance” or “based on the first
3. Environmental Ethics impression”
MEDICAL ETHICS – A duty that is binding or obligatory, other things
➢ Derived from the introduction of the Hippocratic Oath being equal.
➢ “what one should do or ought to do”
➢ So what’s important here is the Doctor’s attitude, our
physicians’ attitude, the nonmaleficence and
beneficence.
➢ With interrelationship between the physician and the
patient, an example is the patient’s right to live.
ANIMAL ETHICS
➢ Evolved with the onset of utilitarianism principle and in
consonance with the philosophy of Jeremy Bentham
➢ “animals cannot have ethical reason, the most important
consideration is that animals usually suffer from the
decision of humans” PLURALISTIC DEONTOLOGY THEORY
● Affirms the importance of the 7 Prima Facie Duties
● All 7 duties are morally right and morally good

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CONTRACTARIAN OR MORAL THEORY OF ALTRUISM THEORY

CONTRACTARIANISM ● Speaks of Auguste Comte’s dictum: “live for others”
● Derived from moral obligation as stipulated in the contract ● Man should act to bring the best consequence for others
● Follows Kant’s idea that man’s action, whether right or at the expense of his/her own personal interest.
wrong, must be justified in accordance with what has been RULE CONSEQUENTIALIST THEORY
agreed upon. ● A moral behavior or action should follow a certain rule, but
NATURAL LAW ETHICS such rule should be based on the consequence.
● Introduced by St. Thomas Aquinas NEGATIVE CONSEQUENTIALISM THEORY
● It is the rightness of actions and is self–evident and is ● The passive avoidance of bad outcomes
determined by nature, not by customs and human ● One way of minimizing bad consequences and promoting
preferences. the good ones
● Through the application of reason, it should be possible to VIRTUE THEORY
establish a body of moral principles and rules. (ex. Using ➢ Based on the inherent nature of an individual rather than
of natural methods in controlling our population) on the consequence of the acts.
● Principles relevant to bioethics: principle of double effect PRINCIPLES OF BIOETHICS
and principle of totality
● There are four important principles which are applicable in
❖ PRINCIPLE OF DOUBLE EFFECT
medical health service delivery:
– Signifies that an action should be performed only if
❖ Respect for Autonomy
the intention is to bring about the good effect.
❖ Beneficence
– The bad effect will be an unintended or an indirect
❖ Non-Maleficence
consequence.
❖ Justice
– However, four conditions must be satisfied.
– The four conditions:
RESPECT FOR AUTONOMY
1. The action itself must be morally indifferent ➢ The act of respecting the decisions of others.
or morally good. ➢ There are two views with respect to autonomy:
2. The bad effect must not be the means by 1. Prioritization of one’s decision
which the good effect is achieved. 2. Intervention from others
3. The motive must be the achievement of the ➢ Operationalized into the so called “informed consent”
good effect only. – the process in which a health care provider educates
4. The good effect must be at least equivalent a patient about the risks, benefits, and alternatives of a
in importance to the bad effect. given procedure or intervention
❖ PRINCIPLE OF TOTALITY ➢ Requirements for informed consent:
– Holds that an individual has the right to dispose of 1. Patient/surrogate must be competent
his or her organs or to destroy their capacity to 2. Patient must be presented with the right information
function only to the extent that the general well-being before deciding
of the whole body demands it. 3. HCP must recommend the optimum option free
– Everyone has a duty to preserve the integrity of from force or pressure
one’s body. ➢ Standard rules of full disclosure:
TELEOLOGICAL THEORY 1. Prudent Person Rule
➢ Otherwise known as the consequentialist theory 2. Subjective Substantial Disclosure
➢ This theory posits that an action is morally right if the BENEFICENCE
consequence or outcome is good. ➢ The principle of doing an action that benefits others.
UTILITARIAN THEORY ➢ Propositions include:
● An action is morally right if it results in happiness and 1. Prevent the infliction of needless pain
satisfaction. 2. Prevent killing a person
● “Happiness” can be described as the greatest 3. Prevent incapacitating others
happiness for the greatest number of people. NON-MALEFICENCE
● According to the Principle of Utility, “people should do an ➢ The avoidance of doing harm to others
action that may bring happiness for the greatest number of ➢ Propositions include:
people” 1. Do not kill
HEDONISM THEORY 2. Do not cause needless pain (unnecessary pain)
● This theory holds that the pursuit of humankind is pleasure 3. Do not incapacitate others
on its maximum level. JUSTICE
● Also, hedonists state that the only way to attain maximum ➢ Application of legal ethics in professional practices
pleasure is happiness. ➢ Holds that clinical decisions should be consistent with
EGOISM THEORY ethical theories
● This theory argues that a right action is maximized when it ➢ A theory was formulated by John Rawls
benefits oneself.
● Subdivided into individual egoism, personal egoism
and universal egoism.
ASCETISM THEORY
● Contradicts Egoism theory
● Holds that life should have no pleasure in order to achieve
a spiritual goal.