ETHICS

Foundation of Bioethics

TOPIC OUTLINE

Definition
Human Acts

Definition
Elements
Modifiers
Norms

Law
Conscience

Sanctity of Human Life

Universal Principles of Biomedical Ethics

DEFINITION

bios - life + ethics

Application of ethics to biological
sciences, medicine and related fields
A systematic study of human
behavior specifically in the fields of
life sciences and health care, as
examined in the light of moral values
and principles

HUMAN ACTS

Actions that proceed from the

deliberate free will of man

* Acts of man actions that do not

require mans rationality

Elements

Knowledge

Freedom

Voluntariness

Modifiers

Ignorance
Concupiscence
Fear
Violence
Habit

Ignorance

Absence of knowledge in a person

who is required to know what he
does not know
*Innocence absence of knowledge in
person who is not required to know what
he doesnt know

Concupiscence

Refer to emotions and feelings of man

in relation to his actions, Passions

Concupiscible passions

Inclined to favor good as their objects

Irascible passions
Perceived by the sensation as evil
Offer hardship in the acquisition of their
objects

Fear

Induces the will to do what it would

not do otherwise
Emotion that apprehends evil and
manifests itself in the desire to get
away, avoid, or escape as far as
possible, from the impending threat

Violence

Application or use of physical power

or external force on a person by
another for the purpose of
compelling him to do something
against his will

Habit

A constant and easy way of doing

things acquired by repetition of the
same act

Norms

set of directives that guide us in

making decisions on what we ought
to do or to be, dictated LAWS and our
own CONSCIENCE

Laws

an ordinance of reason promulgated for

the common good by one who has
legitimate authority
an authoritative order that is just, honest,
useful to a certain degree of permanency,
promulgated or made known to the
subject, and can possibly be fulfilled.
is a body of authoritative rules by which
civilized society regulates the conduct of
its members

Classifications of Law
Not enforced by state

Eternal Law

Divine reason or will commanding the

preservation of the natural order of things
and forbidding its disturbance
Applies intrinsically and absolute
perfection in every human act
Model of all laws

Classifications of Law
Not enforced by state

Natural Law

Eternal law as known to humans through reason

Neither communicated in a supernatural way nor
as a result of a command of legislature or authority
Derived from the very nature of human beings,
identical to Gods will
Properties:

Universal binds every person at all times and in all places

Immutability unchanging
Indispensability no one is dispensed or excused from its
observance

Classifications of Law
Not enforced by state

Moral law

Dictate of ones conscience to be the right

conduct

Classifications of Law

Enforced by state as to purpose

Substantive law

Prescribes the right and obligations of

persons with each other and with society

Procedural law
aka adjective or remedial
Concerned with mechanical rules that
govern the means by which substantive
rights and duties are vindicated & enforced

Classifications of Law

Enforced by state as to subjectmatter

Public law

Regulates the relationship between state

and subject

Private law

Regulates the relationship of individuals

Conscience

Is the practical judgement of reason

upon an individual act as good and to
be performed, or as evil and to be
avoided
Judgement on the goodness or
evilness of the action, not on its
usefulness or other practical
considerations

Concepts of Conscience

Heteronymous conscience

Is tied to normative ethics, focusing

solely on laws and obligations,
commands and prohibitions

Autonomous conscience

Is totally subjective, ignores the law

and determines by itself what is right
and what is wrong

Levels of Conscience
Antecedent

Whole process of making a judgement in

conscience before the moral act

Concomitant

Actual awareness of being morally

responsible for the goodness or the badness
of the particular which we are carrying out.

Consequent

Process of reflection on ones moral

responsibility relative to past actions.

SANCTITY OF HUMAN LIFE

Religious Approach

Human life has dignity and there is

something sacred about it because it
comes from God

Rational/Humanistic Approach

The idea of sacredness of life is

generated by the experience of being
alive and of the experiencing the
elemental fear of extinction

UNIVERSAL PRINCIPLES OF
BIOMEDICAL ETHICS

Autonomy / Self-Determination
Veracity / Truth-telling
Beneficence
Nonmaleficence
Confidentiality
Justice
Role Fidelity

Autonomy / Self-Determination

autos self, nomos governance

The individual is free to choose and
implement ones own decision, free from
deceit, duress, constraint, or coercion
3 basic elements: Ability to decide, The
power to act upon your decisions and a
Respect for the individual autonomy of
others
* Paternalism intentional limitation of the autonomy
of one person by another, where the person who
limits the autonomy appeals exclusively to
grounds of benefit to the other person

Veracity / Truth-telling

Binds both the health practitioner

and the patient in close association
of truth

Beneficence

Acts of mercy or charity, may

include any action that benefits
another

Nonmaleficence
To refrain from inflicting harm
Primum Non Nocere First do no harm

*Principle of Double Effect

The course chosen must be good or at least

morally neutral
The good must not follow as a consequence
of the secondary harmful effects
The harm must never be intended but merely
tolerated as casually connected with the
good intended
The good must outweigh the harm

Confidentiality
Include the American Hospital
Associations Patients Bill of Rights rules
5 and 6 right of privacy

5. The patient has the right to every

consideration of his privacy concerning his
own medical care program. Case discussion,
consultation, examination, and treatments are
confidential and should be treated discreetly.
Those not directly involved in his case must
have permission of the patient to be present
6. The patient has the right to expect that all
communications and records pertaining to his
care should be treated as confidential

Justice

Aristotle : Equals must be treated

equals and un-equals must be treated
un-equals
WHO definition: A state of complete
physical, mental and social well being,
and not merely the absence of
infirmity
*Compensatory justice individuals seek
compensation for the wrong being done
*Retributive justice calls for equal suffering

Role Fidelity

Requires the practitioner to practice

faithfully within the constraints of
the role