BIOETHICS

BSN III BPUC

Introduction
Definition of Terms
 INTRODUCTION
• From the days of Hippocrates to the time of
Florence Nightingale up to circa 1970’s
medical ethics enjoyed a remarkable degree of
continuous traditional practice. A nurse was
typified as an obedient health care helper who
executed health care services mainly upon the
physician’s orders. The physician sort of owns
the patient because he had the overall control
of the patient’s life. It was in this line of
philosophy during that time that medical ethics
was practiced.
To enter the practice of health care
provision is to enter into a social compact
not only with the patients you serve but
with all other practitioners and the
community at large. The honoring of this
social compact will require a
commitment to excellence in clinical
practice and a commitment to a set of
appropriate moral, ethical, and social
behaviors.
• Health care practice is rapidly revolving.
Many changes in the biological sciences and
in health care delivery have occurred due to
rapid scientific, technological and social
developments. Research discoveries and
development challenged many prevalent
conceptions of the moral obligations of health
professionals and society in meeting the needs
of the sick, handicapped injured, and the older
people.
Nursing has come a long way towards
advancement and expertise in its academic and
technological aspects. Academic preparation has
gone from hospital based apprenticeship to
higher education in the university setting.
Nursing now has a minimum baccalaureate
degree, making the nurse a professional
practitioner in hospitals, as well as home and
community settings. Nursing courses has
become so advanced that specialization, masters’
and doctoral preparations are now at par with
any behavioral or scientific discipline.
With the advances in biotechnology
and biomedicine, there is a need to
establish bioethical guidelines in
order to draw a line between what is
morally and ethically correct and
what is not. Because nurses are on
the front line of health care, there is a
need to know which practice respect
life and which do not.
 DEFINITION OF TERMS
ETHICS: is a major branch of philosophy, encompassing right
conduct and good life. It is significantly considered broader
than the common conception of analyzing right and wrong. A
central aspect of ethics is "the good life", the life worth living
or life that is satisfying, which is held by many philosophers to
be more important than moral conduct
It is grounded on socio-cultural, philosophical or religious
convictions of what is good or evil. ……as the effort to find
justifiable grounds for distinguishing what is right or wrong in
human actions and ways of life. Ethics incorporates social
dimensions; it is concerned with justice, rights, respect of
human dignity, autonomy of the individual and respect of the
community. Health policy ethics is
concerned with organization financing and delivering health care.
In this respect, ethics is a bridge between health policy and
values, where values are recognized as guides and
justifications people use for choosing goals, priorities and
measures. Ethics examines the moral validity of the choice
Bioethics is a MUST knowledge. It is
a living science of the conduct of
human life. Nursing’s raison d’etre is
the care of life, and improving the
quality of life of the clients we care
for. Bioethics is considered a
foundation of our nursing activities.
 Morality issues, medical ethics,
reproductive medicine, etc.
ABORTION and EUTHANASIA
Reproductive Medicine:
Birth control: condoms/diaphrams/ oral
contraceptives (pills), parenteral (injectables),
MORNING AFTER PILLS taken 72 hours
after unprotected sexual intercourse
surgical: tubal ligation/vasectomy
• BIOLOGY: (from Greek, bio, "life"; and, logos, "speech" lit.
"to talk about life")
• is a branch of Natural Science, and is the study of living
organisms and how they react to their environment.
• deals with every aspect of life in a living organism and
examines the structure, function, growth, origin, evolution,
and distribution of living things.
• It classifies and describes organisms, their functions, how
species come into existence, and the interactions they have
with each other and with the natural environment. Four
• unifying principles form the foundation of modern biology:
cell theory, evolution, genetics and homeostasis (state of
equilibrium This tendency ranges from systems of internal
balance in individual organisms to ecological patterns of
balance in a communi of organisms, as between numbers
of predators and prey.
 BIOETHICS
Medical Ethics or Bioethics, study and application of
moral values, rights, and duties in the fields of
medical treatment and research.
it is the philosophical study of the ethical
controversies brought about by advances in
biology and medicine. Bioethicists are concerned
with the ethical questions that arise in the
relationships among life sciences, biotechnology,
medicine, politics, law, philosophy, and theology.
 Medical ethics
Infertility: also an important area of medical ethics.
Many couples unable to have children turn to
fertility-enhancing technologies for help.
Artificial insemination: a method in which doctors
introduce semen into the cervix, raised new ethical
issues about how potential parents should choose
sperm or egg donors, on what basis and with what
assurances of privacy donors should be recruited, and
whether donors are entitled to parental rights or
financial
 INVITRO INSEMINATION
1978 1ST IVF: method in which fertilization of the ovum with
sperm was conducted in a laboratory and the resulting embryo
was subsequently implanted in the mother's uterus.
ethical questions, including some about the safety of the costly
technique.
• To increase the chance for success, doctors may fertilize and
implant more than one embryo into a woman’s uterus. Some
experts have raised concerns about this practice because
• it increases the incidence of multiple births, which can create
a health risk for the mother and babies
• When more than one embryo implants in the uterus, doctors
can selectively remove one or more of the embryos to
improve the chances that the others will survive, but this
raises additional ethical issues related to abortioN
 Morality issues, medical ethics,
reproductive medicine, etc.
Infertility: also an important area of medical ethics.
Many couples unable to have children turn to
fertility-enhancing technologies for help.
Artificial insemination: a method in which doctors
introduce semen into the cervix, raised new
ethical issues about how potential parents should
choose sperm or egg donors, on what basis and
with what assurances of privacy donors should be
recruited, and whether donors are entitled to
parental rights or financial
 FILIPINO PRIMARY PRINCIPLES OF BIOETHICS

1) Goodness:
it is demonstrated through the practice of
justice, respect for autonomy, compassion,
veracity, fidelity and confidentiality. Filipinos
practice this through delicate and generous
hospitality. It is also shown in the community
sharing of goods including lending of money,
materials, equipment and even human resources.
The concept of utang na loob (indebtness or
gratitude) runs through generations because it is
a traditional that good favors done to one
member should be perpetuated in acts of
gratefulness forever.
• It also extends to keeping secrets even if it would
have been more charitable to reveal a secret.
example: a good friend having a bad odor
• It is also a veracity (truth/fulness), but telling
the truth should be done with compassion and
with full respect – appropriate timing and suitable
occasion. This is where the Filipino’s gift of
pakiramdam (sensitivity) is of big help.
• In Nursing the primary principle of goodness
should be the motivating guidelines in caring for
patients because goodness in health care means
giving and caring so that the patient will feel
better.
2) Beneficence: doing good/charitable acts: as a primary principle
of bioethics includes
NONMALIFICENSE – doing no harm to anyone
ATTENTIVENESS
PREVENANCE - anticipating one’s needs
POSITIVE REINFORCEMENT, helpfulness, positive
paternalism, sharing and also truth telling in beneficence, all
persons should be treated autonomously.
the role of others to take positive steps to help others is
emphasized, no harm should be done to anyone and we should
contribute to their welfare and growth.
It connotes blessings, acts or mercy, kindness, charity,
altruism, love, humanity and kindness. The principle of
beneficence refers to the moral obligation to act for the benefit
of others. It asserts an obligation to help others achieve their
important and legitimate interests as well as help the attain full
• It also extends to keeping secrets even if it
would have been more charitable to reveal a
secret. example: a good friend having a bad
odor
• It is also a veracity, but telling the truth
should be done with compassion and with full
respect – appropriate timing and suitable
occasion. This is where the Filipino’s gift of
pakiramdam (sensitivity) is of big help.
3) Family: very important in the Filipino culture. It is
the SOLID BANK one can rely on where withdrawal or
help and support is endless and the resource is never
exhausted.
Everything revolved around the family all principles
of human conduct of life begin and end in the family.
Family encompasses all bioethical principles and
concepts. Parents are looked up to as mature,
respectable, responsible adults. The family therefore is
the source of all right conduct, ethics, morals, justice,
autonomy, beneficence, respect and goodness that
flow in continuity among the children from the eldest
down to the youngest. The quality of our personhood
often depends on the nurturance, rearing and breeding
we have received from the family.
• In Nursing the primary principle
of goodness should be the
motivating guidelines in caring
for patients because goodness in
health care means giving and
caring so that the patient will feel
better.
HEALTH ETHICS: evolved into four phases
during the last few decades. Traditional
ethics, which mainly prevailed until the
sixties, involved the relationship between
the health care provider and the patient,
and was dominated by the Hippocratic
culture which had provided it with a core
of values for more than 2000 years.
 Advances in bio-sciences and
biotechnology, such as organ
transplantation, genetics, and molecular
biology, introduced an additional ethical
dimension usually referred to as
bioethics. The democratization and
market liberalization which swept the
world resulted in an increasing cost of
health services.
• A new ethical dilemma developed because of
the growing gap between health needs and
available health resources. The concept of
health ethics was broadened to what is
sometimes referred to as "health policy
ethics". This would cover such issues as
health policy priorities, cost effectiveness,
coverage, quality, delivery and research. Ethics
moved from being a personal matter limited
to the satisfaction or dissatisfaction of the
individual to a social matter dealing with the
mental and social well being of the people.
• As we move into the twenty-first century, the
promotion and protection of human rights is
gaining greater momentum. "The enjoyment of
the highest standard of health is one of the
fundamental rights of every human being without
distinction of race, religion, political belief,
economic or social condition," stated the WHO
constitution in 1946. It is relatively recent that
the implications of this statement on ethics and
equity in health care have been receiving more
support. The dual relationship between human
rights and the right to health will impose a fourth
dimension on our interpretation of health ethics.
• The ethical principles that have been
developed to allow health
professionals to determine right and
wrong in regard to value issues
involving these goals are: autonomy,
veracity, confidentiality, beneficence,
nonmaleficense, justice and role
fidelity.
Autonomy: personal self-determination, the
right of patients to participate in and finally
decide questions involving their care.
Veracity: Truth telling. The practice of health
care is best served in a relationship of trust
where practitioner and patient are bound to the
truth.
Confidentiality: the principle that binds the
practitioner to hold in strict confidence those
things learned about a patient in the course of
medical practice.
Beneficence: the principle that imposes upon the
practitioner to seek the good for the patients
under all circumstances.
Nonmalificence: The principle that imposes the
duty to avoid or refrain from harming the
patient. The practitioner who cannot bring
about good for the patient is bound by duty to at
least avoid harm.
Justice: The basic principle that deals with
fairness, just deserts, and entitlements in the
distribution of goods and services.
Role Fidelity:
• PROFESSIONAL ETHICS: such as those found
in medicine and law, are applied ethics designed
to bring about the ethical conduct of the
profession. In health care delivery the major
purpose might be the pursuit of health, with the
prevention of death and the alleviation of
suffering as secondary goals. The ethical
principles that have been developed to allow
health professionals to determine right and wrong
in regard to value issues involving these goals are:
autonomy, veracity, confidentiality, beneficence,
nonmalefecense, justice and role fidelity.
 Prevalence of Bioethical Issues
ABORTION: termination of a living fetus
from the mother’s womb before it is
viability
- termination of pregnancy spontaneously or
by induction prior to viability
Viability – child’s capacity to live
independently of the mother after it has left
the womb. (normally @ 28 week)
 types of abortion
1. NATURAL/ 2. SPONTANEOUS A. or expulsion of
the fetus through natural or accidental causes.
(MISCARRIAGE)
- uninententional/involuntary – devoid of moral
significance.
e.q. Scrubs the floor w/ all her might
willfully steps on banana peel to slip w/ intention
of inducing abortion-act voluntary/morally
responsible.
jogging, horseback riding, biking and aerobic
dancing – inflammation of the uterine wall –
inducing abortion.
3. THERAPEUTIC A. deliberately induced
expulsion of a living fetus in order to save the
mother from the danger of death brought on
by pregnancy.
e.q. pregnant woman who has a heart condition
will probably have a heart attack if she carries
her pregnancy to term
- note that the health & life of the mother
are considered paramount in this case.
4. EUGENIC A. – to get rid of abnormal babies.
(w/ defects & abnormality) prevent from
“contaminating” the human species.
– recommended in certain cases when certain
defects are discovered in the developing
fetus. The argument is that it is better for a
child not to be born than for it to lead a
miserable life, burdened w/ cripping genetic
disorders.
5. INDIRECT Abortion
- Removal of the fetus occurs as a secondary
effect of a legitimate action, w/c is direct &
primary object of the intention.
- This is an instance of double effect principle w/c
applies to a situation where a good effect as well
as an evil effect will result from a good cause.
- Accdg. to this principle not every evil must be
avoided simply because it flows from a good
cause. Some evil acts, voluntary in cause, may
be premitted provided certain conditions are
fulfilled
 Conditions
1. Pregnant woman who has a cancerous uterus:
ethical principle to follow, it is maintained, to
save the life of the mother, if both lives
cannot be saved. It would be unreasonable not
to remove the fetus and let both human lives
perish to let both human beings die.
2. Who has ectopic pregnancy – wherein
embryo can’t grow into viability –
rupture/bleeding & endangering the life of the
mother. Parenthetically E.P. is attributed to
several cases:
 THE MORAL ISSUE
• Moralist point to the difficult question re: the beginning of
human life as the moral issue of this practice.
• WHEN DOES LIFE BEGIN?
• IS THE FETUS A PERSON?
• WHEN DOES THE HUMAN SOULS FUSE OR UNITE
WITH THE BODY?
- FROM THE MOMENT OF CONCEPTION
- DURING A CERTAIN STAGE OF FETAL
DEVELOPMENT?
- AT VIABILITY
- AT BIRTH ? OR AFTER?
here lies the moral impact of the matter. If the phenomenon or
ensoulment occurs from the moment of conception, then the
newly fertilized ovum is already a person, hence, to expel
THE THEORY OF DELAYED ANIMATION (fusoin
of spiritual soul into the embryo)
-upholds that ensoulment occurs at a later time but
not from the moment of conception.
-the STAGERITE & PERIPATETIC thinker, taught
that ensoulment occurs about the 40th (>5-7 weeks)
day for males & 80th (> 11 weeks) day For females
ST. THOMAS AQUINAS, asserted that the rational
soul is not “infused until sometime later”
- rational soul – is not engendered by coition or
sexual intercourse
To expel or abort it is to commit murder, but if the
ensoulment phenomenon occurs not from conception
but at a certain stage or fetal dev’t, then eugenic
abortion as well as abortion before implantation may
be morally licit.
THEORIES formulated by philosophers (plato, aristotle) &
theologians:
THEORY OF IMMEDIATE HORNIZATION: new human
person exists immediately upon conception. That the
soul enters at conception was upheld by Greek
philosophers (335-395 A.D.) a NEOPLANTONIST
himself, St. Gregory of Nyssa –one of the most learned
among greek fathers, taught that the sould is infused at
the 1st moment of conception.- catholics-, explains,
why church forbids abortion as the life of a young
innocent person is at stake.
- Any interference or prevention (such as IUD
or morning after pill=controversial drug
MIFEPRISTONE blocks progesterone, a
hormone required to maintain pregnancy. A
woman receives mifepristone in her
physician's office. She then returns to the
doctor's office within 48 hours to take the
drug misoprostol, a hormone-like substance
that makes the uterus contract and expel
fetal tissue. A woman typically experiences
bleeding and cramping that may last from 9
to 16 days.
He argued “the intellectual principle is
immaterial, hence it can’t be produced by the
semen w/c is material. – the effect can’t be
greater than the cause.” – moreover the
intellectual principle in man.
Intellectual soul is an immaterial substance, can’t
be cause through (seminal) generation, but
only through creation of God. Upon this view
based the Catholic church’s claim that the
rational soul is immediately created by God.
Therefore, ensoulment (fusion of the
• spiritual soul into the embryo (also known
as animation) occurs when the matter (body)
is sufficiently organized to sustain the
intellectual principle of the so-called
substantial form of man. –crucial ? When?
Leads to various types of interpretations of
delayed animation:
1)IMPLANTATION – geneticists state that
nidation or implantation takes place 6 to 7
days after conception. ARGUMENTS:
Morally permissible and just in cases of
conception caused by rape or incest
e.q. a father raping his own daughter or
granddaughter.
2) UNITY & UNIQUENESS: when it is
identified. Happens b/w 2-4 wks after
conception. At this the fetus has already
implanted itself in the endometrium, approx.
28 – 30 days after conception. - no longer
permissible.
3) UNITY & UNIQUENESS: when definitely
established. Happens 2-4 wks (28-30 days)
after conception. Abortion is no longer
permissible.
4) “LOOKS” HUMAN: photo of the 1st cell
having divided in half clearly does not depict
the “looks” of a human being. Even the 4 wk
old embryo does not look human, whereas the
6-wk old one is beginning to. Ensoulment
takes place during the 5th & 6th wk of fetal
dev’t. when fetus already looks human
Catholics: written in the book of genesis “ and
the Lord God formed man out of the dust of
the ground and breathed his nostrils the breath
of life”
- seems the infusion of the spiritual soul into the
embryo happens when the “nostrils” of the
fetus are complete, which appears from the 6th
to the 7th wk of the fetal dev’t.
5) ELECTRICAL ACTIVITY: ensoulment
occurs when electrical activities are first
detectable from the brain, around the 8th wk of
pregnancy.
- It indicates that the brain starts functioning and
it is advocated as the criterion for human life
among the dying. (death is the cessation of
electrical activity of the brain.)
- Inasmuch as brain activity is the basis of
intellectual life, the first sign of brain activity
is the time the intellectual soul is infused into
the fetus. Thus abortion would not imply
killing before electrical impulses are
detectable, only afterward.
6) QUICKENING: ensoulment takes place
when the mother can feel the spontaneous
movements of the fetus during the 10-12th
week of life. Aristotle was against abortion
after quickening of the feture – traditionalist
approve abortion before quickening.
7) VIABILITY: ensoulment occurs – when
fetus is considered viable during the 28th wk
or 7th month of pregnancy; the fetus can
survive outside the womb, & capable of
living independtly of the mother
 CURETTAGE
• What is significance of the fetus’s 8th-day stay
in the oviduct after conception to the abortion
issue? It is very crucial for rape and/or incest
victims. IF within the 8th-say period ff. the
sexual assault the linings of the uterus can be
scraped or rasped off by curettage,
implantation can be prevented and pregnancy
will not continue.
• Curettage is performed on a rape and/or incest
victim within the 8th day period after the
sexual attack.
8) BIRTH: ensoulment occurs at birth…when
the child has become biologically independent
of hi mother. The early stoics believed that the
soul entered at birth, abortion is not murder.
- they have confirmed that the problem about
the infusion of the spiritual soul into the fetus
is a philosophical, ethical and religious
questions, not a specific one – although some
biological & embryological finds of medical
science may also be employed to support our
moral options or judgments.
Other consideration:
1) The pills & intrauterine devices may act
during the 8th days
2) This stage precedes the period when a
diagnoses of pregnancy can be made i.e.,
stage commonly described as the 2nd half of
the normal menstrual cycle
3) Stage when the “morning-after-pill” may act
4) It is not covered under current abortion laws,
it precedes the stage when a woman knows
she is pregnant (missed a period), diagnoses
can be taken.
GENERAL VIEWPOINTS OF ABORTION:
1) The conservative: declares abortion is never
permissible, is permissible if & only if it is
required to save the pregnant woman’s life, as
in the case of the removal of a cancerous
uterus or the removal of the Fallopian tube or
part of it, coz of ectopic pregnancy.
2) The liberal position: always permissible,
whatever the state of fetal development may
be. Advocated by adherents of women’s
rights, this stand stresses the right of a woman
to make decisions w/c affect her own body.
3) Moderate position: holds that abortion is
morally permissible up to a certain stage of
fetal dev’t, for some limited set of reasons
sufficient to justify the taking of life in this or
that special circumstances.

4) Liberal position: pro-choice movement

PRO-LIFE
PRO-CHOICE
 Pro Life Movement
Both abortion and infaticide are condemnable
crimes.
- Human live is sacred coz from its beginning it
involves the creative action of God and it
remains forever in special relationship with the
creator who is its end.
- It is clear, committed, to respect an
individual’s right to life even if that right is
uncertain or in doubt.
 Effects of Abortion
• There is physical and psychological effects of
abortion on the woman concerned.
• Physical: habitual miscarriages, ectopic
pregnancy, menstrual disturbances or
discomfort, stillbirths, bleeding, shock, coma,
perforated uterus, fever, frigidity
• Psychological: guilt, suicidal tendencies, loss
of fulfillment, low self-esteem, loss of interest
in sex, inability to forgive oneself
 Pro-Choice Movement
• Justification of the fetus may be classified :
1) Personal
2) Social
3) Fetal
Personal and familial reasons of pro-choice:
1) It underscores freedom of choice, giving
centrality of the individual’s conscience.
2) Liberates procreation decisions from the control
of the church, even if it realizes that a religiously
directed choice vs. abortion is not fully free at all
3) Safeguards the mother from a pregnancy that
would threaten her life by possibly resulting
in cancerous uterus, therapeutic abortion or
ectopic pregnancy
4) Protects the reputation of the woman in cases
of pregnancy due to rape and incest.
5) In the name of justice, those who suffer the
consequences of their moral decisions shld.
be the ones to make those to make judgments
such women subject to pregnancy and
childbearing.
 Social Reasons
1) Pro choice position helps promote an
adaptation to a world that no longer needs nor
can afford unlimited childbearing
2) Alleviates economic, sociological or
demographic problems
3) Anticipates the social costs involved in the
care, support and education of a severely
handicapped individual during her/his
lifetime
4) Makes an [Link] to bldg. a society
in w/c there is no bias vs. the poor in favor of the
affluent and the powerful
5) Checks the overpopulation & reduces
unwanted pregnancy, child abuse or
prostitution, maternal deaths thru illegal or
dangerous abortions, poverty and illness
 Fetal reasons:
1) Prevents the births of terribly malformed
defective children (genetic defects of severe
variety, malformed fetus)
2) Child deformity will cause the family to incur
staggering financial & psychological costs.
3) Abortion is a postnatal method of eliminating
a couple’s offspring if its sex is found to be
undesirable.
 Moral issues of Euthanasia
• Everyone if destines to die, just as everyone is
born in an accidental place, time & manner.
WE did not choose to be born, nor did we
choose our parents, the time & place where we
were thrown sexually into this world
(existentialists)
• To some extent there is freedom to die, for we
can choose to die now or later, we can elect
either to die with dignity of in humiliation, as a
her or a villain.
From birth to growing up – as baby goes thru life &
grows older,everyone invetably does, he finally
reaches the end of his rope, so to speak
• Questions to answer:
1) Can a doctor help him to die w/ as little pain
& suffering as possible?
2) May he expect to die as painlessly, easily &
comfortably as when he was born?
Such considerations gives euthanasia a strong
appeal.
EUTHANASIA:g.w. “good death” english word-
“easy death” painless inducement of quick
death, it is the deliberate putting to death, in an
easy, painless way, of an individual suffering
from an incurable & agonizing disease –
known as mercy killing. Regarded as merciful
release from an incurable & prolonged
suffering.
By implication-euthanasia is a theory w/c affirms
an individual’s right to die in a painless &
peaceful manner when he is confronted w/ a
horrible dse. & the quality of his life
deteriorates.
Classifications:(self administered/other administered)
1) Active & voluntary: one in w/c either a
physician, spouse or a friend of the patient will
terminate the latter’s life upon the latter’s
request. (by the patient)
2) Passive & voluntary: terminally ill patient is
simply allowed to die by the physician, spouse or
an immediate relative, upon the patient’s request
3) Active & involuntary: physician, spouse, close
friend or relative who decides that the life of the
terminally ill patient shld be terminated.
(decision other than the patient)
4) Passive & involuntary: terminally ill patient
is simply allowed to die as requested by
immediate family members.
other persons makes the moral decision to
terminate the patient’s life
PROBLEM OF HUMAN DIGNITY
- Moral issue revolves around the preservation
of human dignity in death even to the
individual’s last breath.
there is a positive & negative side
• Positive side:
- one shld be able to make the decision to die
when dying would be better than to go on
living with an incurable & distressing sickness
• Negative side:
- It erodes human dignity
- Crossroads of moral issue
- Mercy killing preserves human dignity –
claims the opposite since this act hastens the
death of an individual
 Other def of euthanasia
• Assisted suicide: Someone provides an individual with
the information, guidance, and means to take his or her
own life with the intention that they will be used for
this purpose. When it is a doctor who helps another
person to kill themselves it is called "physician assisted
suicide."

• Euthanasia By Action: Intentionally causing a person's

death by performing an action such as by giving a lethal
injection.

• Euthanasia By Omission: Intentionally causing death

by not providing necessary and ordinary (usual and
customary) care or food and water.
 The problem of human dignity
Moral issue of euthanasia revolves around the
preservation of human dignity in death even to
the individual’s last breath.
Not only does one have a duty to preserve life,
but one has also the duty to die with dignity.
To die w/ dignity: when dying shld be able to
make the decision to die when dying would be
better than to go on living with an incurable &
dismissing sickness. Negative side: declares
that euthanasia erodes human dignity.
 APPLICATION OF ETHICAL THEORIES
• Natural law ethics condemns mercy killing.
Euthanasia is intrinsically wrong because it
implies the direct, deliberate killing of an
individual hence, it is murder (e.q. the pt. is
better off dead than suffering from prolonged
agony), the good ones justify the evil means in
this case. The PRINCIPLE OF
STEWARDSHIP & the inviolability of life
maybe be appealed to in this connection.
MORAL ISSUE: positive side insists that mercy killing
preserves human dignity in death even to the individual’s
last breath.
To die w/ dignity means that one shld. Be able to
make the decision to die when dying would be
better than to go on living w/ an incurable &
distressing sickness.
The negative side declares euthanasia erodes human
dignity – crossroads of moral issue: positive side
insist that mercy killing preserve human dignity,
neg. side claims the opposite since this act hastens
the death of an individual.
The Principle of DOUBLE EFFECT maybe
legitimate under certain circumstances.
• To give medication for the relief of pain, for
instance, even if the INDIRECT OUTCOME
of the medication will be to shorten the
patient’s life, may be morally permitted.
• Patient’s death ff. the medication is never
intended directly – secondary
• It becomes the secondary, Indirect result of the
act of medication
• There is no moral obligation to continue
medical treatment if and when a terminally ill
patient becomes hopeless. Even if one’s life
might be lengthened thru extraordinary
measures w/c are already useless anyway, it is
legitimate to allow the pt. to die as a result of
his/her own illness or injury as the case may
be. The same oral reasoning & decision may
be applied to us.
• Kant’s ethics: human dignity of an autonomous
ration being. Bounden duty to preserve our
life.
But once a person becomes comatose & unknowing
coz of illness & injury, this person loses his
autonomous status, & it is not clear whether there is
Still a duty to maintain one’s life under such
conditions. Active & nonvoluntary euthanasia
may be regarded as our duty to comatose &
hopeless pts. As a way of recognizing the
dignity w/c that person possessed in his/her
previous state.
Terminally ill pt. in vegetative state is NO
LONGER an autonomous person w/ a self-
regulating will.
 OLD MAN’S PRAYER
Pardon me, doctor, may I die?
I know your oath requires you try
As long as there’s spark of life
To keep it there with tube and knife;
To do cut-down and heart massages,
Tracheotomies and gavages,
But here I am, well past four-score
I’ve lived my lifetime (a little more)
I’ve raised my children, buried my wife
My friends are gone, so spare the knife
This is the way it seems to be
I deserve a little dignity……………….
Of slipping gently off to sleep
And no one has the right to keep
Me from God; when the call is clear
No mortal man should keep me here.
Your motive’s noble, but now I pray
You’ll read my eyes, what my lips can’t say
Listen to my heart! You’ll hear it cry;
“Pardon me, Doctor, but may I die?
 An ETHICs of EUTHANASIA
1) An individual’s life belongs to that individual to
dispose of entirely as he or she wishes;
2) The dignity that attaches to personhood by
reason of the freedom to make choices demands
also the freedom to take one’s own life.
3) There is such thing as life not worth living
whether the cause be distress, illness, physical
mental handicaps, or even sheer despair for
whatever reason
4) What is supreme in value is the human dignity
that resides in the human’s rational capacity to
choose and control life & death.
 The Hospice Alternative
For the pt. who are terminally ill, the balance
b/w. minimizing pain and suffering & the
potential for hastening death is clearly struck
in favor of relief of pain & suffering. Families
are encouraged to stay all day & take their
meals w/ the pts. Dying persons, are
encouraged to take home visits whenever
stamina allows for them. The physician and
staff do not make rounds in white coats, rather
there is a lot of touching, hand-holding &
listening.
For dying pts. the need for palliative care to
relieve pain & suffering may rival the intensity
of curative efforts found in the acute hospital
setting.
Palliative care: you want to feel better.
When you are facing a serious illness, you need
relief. Relief from pain. Relief from other
symptoms, such as fatigue, nausea, loss of
appetite and shortness of breath. Relief from
stress.
 Other issues
• T. GARY Williams – considers euthanasia to be
morally wrong.
1) natural inclination to preserve life
2) may be performed for purposes of self-interest
or other consequences
- mistaken diagnoses is always possible
- recovery from a serious illness requires that we
fight for our life (argument from self-interest)
3) Health care members may be tempted not to do
their best to save the patient
 JAMES Rachles – humane insofar as it allows
suffering to be brought to a speedy end
• Moves & circumstances under which it takes
place
• Simply allow a patient to die when you have
some motive in mind, your act of omission
• On the contrary, help an agonizing medically
hopeless patient to die painlessly (by lethal
injections or drugs)
PHILIPPA Foot: endorsed active & passice E.

• Patient gives consent.

• Everyone has a right to life, what a person wants
that counts
RICHARD Brandt: prima facie (at first appearance
– on initial examination or consideration) duty not
to injure others in his analysis of the issued at
hand – irreversible coma
- instructions have been left for the patient’s life to
be ended painlessly…not to follow would be
remiss in our prima facie obligation to keep others
from further harm or pain
• Natural law condemns mercy killing.
• The good does not justify the evil means
(principle of stewardship)
Principle of dbl effect : give medication for the
relief of pain, to shorten the patient’s life.
indirect outcome of the medication will be to
shorten the patient’s life.
- No moral obligation to continue medical
treatment when terminally ill patient becomes
hopeless
 Kant’s ethics
• Human dignity of an autonomous rational being
- A terminally ill patient in a vegetative state is no
longer an autonomous person with a self-
regulating will
- Organ transplant advocates may argue that a
comatose patient is going to die anyway
- Pragmatic theory – of the good and truth seems
justify euthanasia in general
- Most realistic, beneficial & useful thing to do in a
situation where recovery is nil, is to offer one’s
healthy organs to people who can still benefit
from them.
 The Moral issue of SUICIDE
• Bible replete suicide cases:
• Story of samson & delilah – great samson
chose to die w/ his enemies after they had
plucked his eyes.
• Philistines were celebrating samson’s defeat he
wrecked down the 2 pillars holding up the
house they were in & it tell upon them all.
• Samson was able to die in dignity avenging his
foes rather than living in ignominy & in
darkness for the rest of his life.
 The Moral Issues of SUICIDE
Bible replete w/ suicide cases:
Samson (Judges 16:23-31) hold 2 pillars, able to
die w/ dignity.
Samuel(1 sam 31:4-5) together w/ armor bearer
committed suicide during the final battle vs.
the philistines
Judas Iscariot (Mat. 27:5) betrayed Jesus,
committed suicide hanging himself rather than
to be alive forever haunted by his ignominious
act of betrayal & treachery vs. Lord Jesus.
SUICIDE: direct, willful destruction of
one’s own life
Direct-insofar as the primary object of the
act itself is the killing of oneself
Willful-it is deliberate, voluntary &
intentional
Destructive-means of terminating one’s
own life is more often than not, violent,
brutal or very harsh.
 Diff/comparison of suicide & euthanasia
Suicide euthanasia
Presupposes one’s healthy -presupposes incurable
physical condition ailment or terminal
condition
Sudden interruption or -easy, painless,quiet
destruction of the life acceleration of immi-
process nent or certain death
in order to get rid one-
self of prolonged
suffering
 Causes of suicide:
1) Personal reason: includes misfortune &
frustration in love or marriage (dissertion by
one’s beloved spouse) making one a victim of a
broken home or marriage.
2) Parental indifference or apathy (lack of interest)
towards ones’ bf or gf.
3) In-law problems, esp. if victims live w/ their
parents in-law
4) Failure in an examination
5) Loss of honor & integrity (shame & self-pity
resulting from pregnancy caused by rape and/or
incest
6) Nervous breakdown due to one’s inability to
cope with life’s problems (culture shock,
inability to adjust to new situations and/or
responsibilities)
FINANCIAL causes:
a) Poverty & impoverishment (parents &
children burn themselves to death because of
extreme deprivation
b) Great loss of money or collapse in bus.
Venture.
 Social & political reasons:
1) Failed coup d’etat (many of the coup plotters
who failed resorted to suicide)
2) Protest against man’s inhumanity to man (the
practice of self immolation among Buddhist
monks)
 The Cons of suicide
St. Thomas Aquinas gave 3-fold argument:
1) Suicide is vs. the natural law (our natural
inclination of self-preservation & conservation)
this is a sort of self-kindness or charity that one
owes to oneself.
2) Being a member of a society, a person who kills
himself will deprive the community of his
activity – they likewise will be greatly by his
sudden, if not violent, death
3) Suicide is a usurpation of God’s function – life is
God’s gift to man – involves an arrogant act w/c
is not liberty to perform
 The pros of suicide
• David Hume:
1) The removal of misery makes suicide morally
justifiable & permissible to bear unbearable
pain is in no way part of a natural inclination
2) Moral duty is reciprocal-while alive &
healthy
3) There is no such thing as order designated by
God, man’s life is as disposable as that of an
oyster’s.
 Application to ethical theories
• Natural law ethics, w/ its principle of
stewardship, considers suicide as self-murder.
• An individual has no right to murder himself
as he has no right to murder someone else.
• Only an individual who has dominion over a
things has the right to destroy it. No
individual, has dominion over his life, for it is
but a gift to him. No person has acquire it
through his own effort & industry.