NCM108-Chapter-1.pdf

September 5, 2024 | 1st Quarter NCM108 – Health Care Ethics (Bioethics) Chapter 1 Prof. Diadima D. Lucas, RN, MAN Outline 1. Introduction to Bioeth...

September 5, 2024 | 1st Quarter NCM108 – Health Care Ethics (Bioethics) Chapter 1 Prof. Diadima D. Lucas, RN, MAN Outline 1. Introduction to Bioethics 2. Foundation Ethical Concepts and Historical Perspective of Ethics in Nursing 1 BIOETHICS ought to act or execute our o This course deals with the duties and responsibilities in the application of ethico-moral field of nursing concepts and principles ¾ Enhance the competence by affecting care of individuals, understanding that the patient families, population group, and is a person and a holistic community. individual—meaning human o concerned with the principles of being in not only consist of right and wrong behavior and physical, but also mental and the goodness or badness of emotional aspect, so when we human character. care, we care/consider them o The term is made up of two parts: all 3. (from the Greek word bios means life; and ethos, means behaviour) PURPOSE OF BIOETHICS was coined in 1926 by Fritz Jahr. ¾ It entails the objective o It is the ethics of life. appraisal of how our values, o Bioethics is the application of desires and actions affect ethics to the field of medicine others, including animals and and healthcare and Ethics the environment. In short, it will means the science of right make us careful in executing doing/what is good behavior our duties and responsibilities to and what is bad behavior. avoid any untoward results/or to avoid hurting someone including animals and our environment. SIGNIFICANCE OF BIOETHICS ¾ It mandates that equal and fair ¾ To provide awareness to the consideration be given to: (1) members of the health human rights issues, (2) animal profession of the do’s and rights issues, and (3) don’t(s) of medical and nursing environmental concern. Be fair practice in everything you do… ¾ It will enlighten us on what, why, regardless of status. where, when and how we Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter TERMS RELATED TO BIOETHICS HEALTH ETHICS o Health – the state of being ¾ branch of ethics that deals free from illness or injury. with ethical issues in According to World Health health, health care, Organization (WHO), it is a medicine and science. It state of complete physical, involves discussions about mental, and social well- treatment choices and being, not merely the care options that absence of disease or individuals, families, and infirmity. health care providers must o Ethics - studies of human face. acts or conduct from a moral perspective as to HEALTH CARE ETHICS whether they are good or ¾ (a.k.a “medical ethics”) is they are bad. the application of the core principles of bioethics to medical and health care decisions. SCOPE OF BIOETHICS ¾ All aspects of human life – before birth, during his life and after death – fall within the scope of bioethics. ¾ It consists of human conducts that directly and particularly relate to the application of technology in his natural life…. Morality vs Ethics E.g., Genetic engineering ¾ Ethics pertain to the standards of good and bad. It is the science of right doing. CONCEPT OF NURSING ETHICS ¾ Morality is more personal and ¾ Nursing is consistently rated as normative. the most honest and ethical ¾ Knowledge vs. wisdom profession (Louisiana State University at Alexandria) o Etiquette - the rules indicating ¾ Dean Recio: once said that the proper and polite way to “you can not be a nurse if you behave (e.g., good manners, are not honest” acceptable behavior, table ¾ So here in Nursing “honesty is etiquette, and work). the best policy”. o Custom - is a pattern of ¾ Nurses practice and use ethics behaviour that is followed by on a daily basis members of a particular ¾ In everything we do , we use culture, an action approved ethics.. by group or society (e.g., ¾ Ethical decisions have become shaking hands upon meeting routine and someone). inherent/inseparable part of Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter clinical practice for registered out of love… with dignity… nurses. and with compassion … ¾ Many times nurses experience And in everything we do, moral distress when faced with do it with our might as unto making ethical decisions in the Lord… and not unto practice, partly because of men… trying to honor and lack of knowledge and please God rather than education about ethical men… content and the ethical topic itself and partly because nurses > Bioethics is ethics of life, and are placed in volatile ethical ethics is the science of right situations where they feel doing, (good manners and forced to continue treatment right conduct) beyond a possible cure. > Ethics is the principles we have ¾ This profession is a profession of in mind and Morality is the decisions, we always make execution of the principles we decision whenever we have, the application of those perform, so be careful in your principles, philosophy and decision-making. belief we have learned in life. > It is related to Morals, Etiquette, attitude, character and quality PRINCIPLES OF THE NURSING of our actions in executions or PROFESSION implementing our duties and ¾ Patients entrust their dignity responsibilities as health care to nurses, so nurses must providers in the life sciences: guard their privacy, listen human life, animal life, and to their concerns and environmental concerns. consider their wishes > Significance of Bioethics: To concerning the care they give us the caution how we want to receive… ought to act as nurses in caring ¾ Our patient is our every patient knowing that boss…and client, they they are human being which have all the right to receive compose of body, soul and their rights as patients…so spirit. give their dues… > Purpose of Bioethics: it gives us ¾ Ethics is fundamental to the precautionary measure nursing. All nurses should that our actions will affect respect their patients, others. maintain patients’ dignity > Concept of Nursing Ethics: and protect patients’ Consistently rated as the most rights. Nurses must create honest and ethical profession. an environment of mutual In everything we do, we use trust and respect between ethics... Especially in decision- patients and healthcare making. This profession is a professionals. profession of decisions, we ¾ In Summary, Nursing is a always make decision calling…we must do our whenever we perform, so be duties and responsibilities Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter careful in your decision- 2. team & unit level concerns – making. e.g. – poor communications 3. system level factors – feeling FOUNDATION ETHICAL unsupported CONCEPTS AND HISTORICAL 2 Clinicians experience a sense of PERSPECTIVE OF ETHICS IN NURSING awareness when ethical dilemmas as a consequence of the Why study ethics in Nursing? challenging reality of providing healthcare within a complex health Ethics within healthcare are care system. important because workers must recognize healthcare dilemmas, RESULT OF MORAL DISTRESS make good judgments and o Burn – out decisions based on their values while o Leaving the profession keeping within the laws that govern o Moral disengagement them. leading to ethical insensitivity 1. Difficult ethical encounter o Withdrawal from the moral experienced by nurse in the dimensions of pt care clinical setting (Ethical The vulnerability of new nursing Challenges) graduates to negative workplace A. oncology nurses culture because of distress is from the B. emergency care following: providers 1. Bullying 2. Unsupportive organizational 2. Exclusion environments 3. Being a scapegoat A. Low staffing levels 4. Collegial incivility B. Overload of work 5. Disillusionment C. Hierarchical interactions that do not promote the Meanwhile, nursing students dignity of nurses encounter morally-distressing 3. Moral Distress/Ethical situations that compromise quality Dilemma by professional patient care. The perceive nurses, newly-graduates and themselves as being inexperienced nursing students among the health care team. Moral Distress – is an international BASIC ETHICAL CONCEPT and significantly occurring health and social care phenomenon when What are human acts? one knows the right thing to do, but ¾ The concept of human acts constraints make it nearly impossible is central to the study of to pursue the right course of actions. ethics. ¾ Human acts are voluntary 1. personal anguish over pt acts which proceeds from care decisions - e.g. life the free will. These depend support on human’s judgment and Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter choice hence entail a dependent on the intellect moral responsibility. & the will ¾ Human acts form the ESSENTIAL QUALITIES of Acts human personality and of Man structure. 1. Done with out ¾ The doing or the absence knowledge of doing builds the kind of 2. Without consent life the person lives. 3. Involuntary ¾ St. Thomas Aquinas (in the Ex: unconscious, study of moral philosophy involuntary, semi- or ethics) asserted that deliberate, spontaneous human acts are said to be actions proceeding from man’s Acts of man can become will according to the human acts when he dictates of reason. Acts employs his intellect & will performed by the in performing the act individual which are not Acts not morally accountable subject to his will and Acts of persons asleep or reason are not called under hypnosis. strictly human acts but Reflex actions where the rather are natural acts. will has no time to ¾ Human acts are proper to intervene. man since it is performed Acts of performed under by a human being. serious physical violence However, not every act o e.g. a hostage that a human being does is obliged to do an distinct to man. There are evil action. acts which are also o Since the will is performed by animals. constrained, then it is not a moral act HUMAN ACTS VS ACTS OF MAN which could be Human acts evaluated Actions done Consciously and freely by the agent/or Why do we need to study human by man acts? ESSENTIAL QUALITIES/ Human act is central to the Constituent Elements of study of ethic because of the Human Acts responsibility and/or 1. Knowledge of the accountability that comes act with it. 2. Freedom Ethics is the field of 3. Voluntariness philosophy that specifically Man takes into studies human acts in the responsibility of these light of morality. actions The issue of man’s action in Natural Acts of Man every stage of life will always Actions beyond one's be a source of enduring consciousness; not philosophical wonder. Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter Socrates – “the unexamined what is good in the world life is not worth living” and what is good in human Socratic Method is realized in action. conversation, in dialogue. Agora – marketplace What is good? For Greeks, true knowledge ¾ Dr. Ma. Liza Ocampo, the has been forged with author of Ethics Primer, criticism and judicious wrote an exhaustive chapter reflections, tested and tried. on the Moral Good. One will be able to develop ¾ Aristotle critiqued Plato’s sound ethical judgment from form of good. studying human acts. ¾ Plato believed that there is a single form of good and ETHICAL DILEMMA/ MORAL virtue. DISTRESS ¾ Aristotle argues that there ¾ Jameton first introduced exists multiple virtues of moral distress, known as varying degrees, which can moral dilemma in his book be acquired in the practice in 1984, which means of habit. ethical distress. ¾ He asserted in his ¾ He believed that a person Nicomachean Ethics (after will encounter such a the name of his son negative experience when Nicomachus), that that person knows the right goodness in the moral world way of performing for him, allows for degrees, something but levels, and different. organizational limits would make the execution Key Points on Moral Good impossible for him. o The sense of good or the ¾ Wilkinson presented the good of man is determined first model of moral distress how the said good affects which he defined as not only himself but also experienced mental those around him since man imbalance and negative is a political animal. emotion when the o It can also be sensed in an individual makes an ethical empirical manner. The good decision but is not able to (of human experience) has act in line with their to be seen, heard, touched, decision. tasted, and felt. ¾ Human acts take on the o One does not grow in true ethical feature when it is understanding if the soul is examined based on its unknown. value as good or bad. o The content of moral ¾ Ethics of Aristotle goodness passes through investigates the goodness reason and will, the mark of of human acts that build a moral goodness passes good life. Humans are through rationality among equipped to search for Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter different people, places, and times in the end is culture. transformed into pain. o Moral goodness has to be o Goodness is objective and is contextualized in different not a matter of man’s times and places. subjective take on the o Moral goodness can be goodness of things in the described in terms of the world. following: o The honorable good are 1. Honorable good – good acquired through the which is desired in itself exercise of virtue and reason. because of its intrinsic goodness. Man naturally LAWS, NORMS, AND CODES AS tends toward these REFERENCE POINTS FOR HUMAN goods. Examples include ACTS any virtue, health, ¾ Man is able to discern the science, and wellness right thing to do through 2. Pleasurable good - It is internal examination of the same honorable human acts and what is good in as much as its good. possession silences desire and produces joy. 3. Useful good – a good NATURAL LAW which is not desired for its ¾ Eternal law refers to the plan of own goodness but for the divine Wisdom leading all sake of attaining some creation towards its goal. other good. ¾ Natural moral law is the o These three are analogous participation in the eternal law and relate to each other in by the rational creature. varying situations. Honorable ¾ The natural law is itself the and pleasurable are linked eternal law, beings are together since the source of endowed with reason which joy is the good and the root inclines them toward right of pain is evil. The good is action and end. It is, therefore, delightful and causes greater a divine law. satisfaction while privation of ¾ It consists of the very light of good/ evil or bad results to reason that enables man to sadness and pain. discern good from evil, and has o The honorable good is the force of law as the voice sometimes dissociated from and interpreter of the higher the pleasurable good. reason of the divine Lawgiver, Badness or evil can be in which our spirit participates pleasing because of some and to which our freedom good that accompanies it adheres. but not necessarily ¾ It is called natural because it honorable. The delight consists of the light of reason produced by this is transitory that each person has by and deceptive and often nature. Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter ¾ Natural law = rule of reason; ¾ These are ever-changing promulgated by God in depending on the cultural human’s nature whereby man decisions surrounding it. can discern through the use of ¾ These emerge from people of his intellect. the same culture aiming for ¾ This law is designed to help survival and pursuing the good God’s creature to find and for themselves at a particular realize his purpose and final time and space. end. ¾ The Natural Law is basically the CODE OF ETHICS principle of Beneficence and ¾ These are formal statements of Non-maleficence. It was not the group’s ideals and values designed for Good to be that is: pursued only for the greater 1. Shared by group members majority and harm the minority. 2. Reflects their moral Instead, it is just said to do good judgment over time and avoid harm or evil. 3. Serves as standard for their CIVIL LAW professional actions ¾ Civil laws are designed to protect the freedom of the Professional Code of Ethics people: to lead a good life ¾ Contract with the society away from harm and evil. on how professionals will ¾ Freedom comes with behave in accordance responsibility. In retrospect, with the rules dictated by responsibility to adhere to the the society limitations of the civil laws so as ¾ Professional Code of Ethics to avoid evil and do good. – nursing profession ¾ These are designed by Men of ¾ When one performs goodwill who are also guided actions that are in by the use of their reason and conformity of the law, it is intellect. good. ¾ Civil laws – designed out of ¾ Human activity stems from reason, whereas Natural law – freedom and is directed rule of reason. Therefore, it is towards a final goal. logical to say that all civil laws ¾ Human acts must be are anchored on the Natural voluntary, no coercion, Law. The reason why the and done with full preamble of the constitution is knowledge, and based on stated in this manner. an intention towards achieving a certain end. CULTURAL NORMS ¾ Good is the basic reality of ¾ These are a product of the time moral order and the end of and space related concerns. man because the default ¾ Living conditions and needs of mode of the rational a particular culture in the appetite of man is to go context of time and space it is after the good. happening are to be ¾ Ethics is then considered considered. an important practical Aron James C. Tuazon BSN-2A  September 5, 2024 | 1st Quarter science since it studies how makers then choose humans are directed among the courses of towards man’s purpose or action identified in end. common components. ¾ It does not stop at the They make judgments contemplation of truths but about what is the right or applies that learning into wrong thing to do in this actions, providing the specific context. necessary knowledge so 3. Moral Motivation - After man can choose what is reaching a conclusion good and consequently about the best course of live in a morally upright action, decision-makers way. must be motivated to follow through on their choices. Moral values often conflict with other important values like job JAMES REST’S FOUR COMPONENT security, career MODEL OF MORAL BEHAVIOR advancement, social ¾ James Rest is a moral acceptance, and wealth. psychologist who identified 4. Moral Character - Moral four psychological agents must overcome processes that occur active opposition, cope before moral behavior with fatigue, resist takes place. distractions, and develop sophisticated strategies for Moral behavior refers to actions reaching their goals. In and decisions that are guided by sum, there must persist in a an individual's character, and are moral task or action consistent with their values and despite obstacles. beliefs. 1. Moral Sensitivity – It is the recognition that an ethical problem exists. Such recognition requires being aware of how our behavior impacts others, identifying possible courses of action, and determining the consequences of each potential strategy. Moral sensitivity is key to transformational ethics. 2. Moral Judgment or Reasoning - After determining there is an ethical problem, decision Aron James C. Tuazon BSN-2A