BIOETHICS 2YO-1

Ethics

Ethics is a philosophical and practically science that deals with the study of the morality of
human acts or human conducts
What is ethics?
 Ethics is a way of understanding and examining what is “right” and what is “wrong”
 Bioethics is a way of understanding and examining what is “right” and what is “wrong” in
biomedical research and practice.
The GOLDEN RULE “ Do unto others as you would have them do unto you.”

The HIPPOCRATIC OATH “first of all. do no harm.”

Aphorisms of CONFUCIUS
The TEN Commandments

Ethics
Ethical principles that govern the complex nature of human behaviour

A declaration of right or wrong „. Reflects the “should” of human behaviour

Science of ideas -guides our judgement concerning morality of human acts

Study of moral conduct or principles of underlying desirable types of human conduct

ETHICS
AS A Science
Ethics comprises data on the morality of human acts that are put together and
arranged in order along with the causes and reason by which said data are held to be factual thereby
making a systematised body of knowledge

AS A Philosophical Science
Ethics deals with the ultimatum of the cause, principle, the truth concerning the
morality conduct in the light of human reason alone.

Why study Ethics?

 Why one act is better than the other
 To have an orderly social life.

OBJECTIVITY OF MORALITY
1.Norms are purely internal.
“Be true to yourself ”
2.Norms based on current opinions and customs
“Socially acceptable”
3.Norm of expediency/ practicality
“What is useful is morally good”
4. Norm of preference
5. Situation ethics

MORAL PRINCIPLES GOVERNING THE MOTIVE OF THE AGENT

1. A Good ACT which is done for a GOOD MOTIVE becomes DOUBLY GOOD.
“caring nurse to honor god
2. An EVIL ACT which is done for an EVIL MOTIVE becomes DOUBLY EVIL
“ Cuts classes, premarital sex
3. A GOOD ACT which is done for an EVIL MOTIVE becomes EVIL.
“Taking advantage, you help because you have motives.
4. An EVIL ACT which is done for a GOOD MOTIVE does NOT BECOME GOOD.
“Prostitution to help the family”
5. An INDIFFERENT ACT which is done with a GOOD MOTIVE becomes GOOD.
“Singing to entertain, caring
6. An INDIFFERENT ACT which is done for an EVIL MOTIVE becomes EVIL
“Singing to annoy, abortion

What is Bioethics?
 The term “bioethics ” was introduced in the 70’s by Van Rensselaer Potter for a study
aiming at ensuring the preservation of the environment.
 It was later used to refer a study of the ethical issues arising from health care, biological
and medical sciences.
 It is a major are in applied ethics.

What is “BIOETHICS” ?
 BIOETHICS: “ a field of study concerned with the ethics and philosophical implications
of certain biological and medical procedures, technologies, and treatment, such as organ
transplant, genetic engineering, and care of the terminally ill”
 Discipline dealing with the ethical implications of biological research and the applications
of that research
 Deals with the questions relating to the appropriate use of new technologies

DIVISIONS OF ETHICS
Ethics has two principal parts.
1. GENERAL ETHICS – presents truth about human acts, and from these truths deduces the
general principles of morality
2. SPECIAL ETHICS – applied ethics. It applies the principles of general ethics in different
departments of human activity both individual and social.

 Individual Ethics
 As regards God
 As regards self
 As regards fellowmen
 Social Ethics
 In the family
  In the state
 In the world
BIOETHICS AND HEALTH ETHICS
1. Bioethics – refer to the broad terrain of the moral problems of the life sciences ordinarily taken
to encompass medicine , biology and some important aspects of the environment population
and social sciences.

 Also define as a science that deals with the study of morality of human conduct
concerning human life in all its aspect from the moment of its conception to its
natural end.
2. Health Ethics – is a science that deals with the study of the morality of human conducts
concerning health and health care.

MORALITY OF HUMAN ACTS

Human act- an act that proceeds from the DELIBERATE free will of man.
DELIBERATE- advertence, knowledge in the intellect of what is about and what it means.

3 ELEMENTS OF HUMAN ACT:

1.knowlegde -the act is done in the light of the agent’s knowing capability and awareness
e.g. Reading, walking, measuring
2. FREEDOM- the act is performed in accordance and not against your will.
Blind Faculty- need knowledge to act.
e.g.: Reading, studying
3. VOLUNTARINESS- international. Product of his decision

MORAL THEOLOGY
Is a sacred science which deals with the study of the morality of human conduct in the light of
human reason guided by faith.

SOURCES:
 Divine revelation as interpreted by the church magisterium
 Human reason
 Experiences

MORALITY of HUMAN ACT or Conduct

Morality is that quality of human acts where the acts could be either be good or right, evil or
wrong

Sources of ethics / moral Philosophy

 Human reason as its primary source
 Contemporary and historical experiences
 Personal experience
 Experience of others

MORAL PRINCIPLES IN THE JUDGEMENT OF MORALITY

Moral Principles In Governing the Circumstances of the Act.
 1. Circumstances can make an indifferent act good or evil.
- Singing (good or evil)
2. Circumstances can make a good act evil.
- Loving a married man
3. Circumstances can never make evil act good.
- Telling a lie to a dying patient
4. Circumstances can make good or evil acts better or worse.
- Telling stories
5. Circumstances can cause new goodness in a good act or a malice in an evil act.
- Contraception, oophorectomy
6. A gravely evil circumstances destroys the entire goodness of an objectively good act.
- Abortion, murder
7. A not so gravely evil circumstance does not destroy the entire goodness of an objectively
good act.
- Carelessly praying

BASIC BIOETHICS PRINCIPLES

 RESPECT for people’s rights

- Autonomy
- Dignity
 BENEFICENCE: Benefits must be proportionate to risks
- Potential harm = potential good
 JUSTICE: The even distribution of benefits and risks throughout society
 NONMALEFICENCE: Do no harm
- Experiment must stop if cause harm.

COMMON BIOETHICS ISSUES

 Disagreements between family and clinicians regarding the patient/ resident’s best interest
 Living at risk (eating, wandering, falling)
 Deciding appropriate forms of care
 Determining legitimate level of restraint
 Determining patient preferences without clear instruction (Terri Schiavo)
 Providing services that take up tremendous resources (e.g., multiple transplants)

HISTORY of BIOETHICS
 Started as concerns regarding research ethics
 Nuremberg Doctor’s Trial—23 German physicians who either participated in the Nazi
program to euthanize persons deemed “unworthy of life” or who conducted experiments
on concentration camp prisoners without their consent were tried. The trial lasted 140 days.
85 witnesses testified and almost 1,500 documents were introduced. 16 of the doctors
charged were found guilty. 7 were executed.
 The distinct academic field began in the 1960s in the United states
 Philosophers and theologians were later joined by physician-ethicist and lawyers
 Scientific advances couples with cultural changes
  New emphasis on individual autonomy and rights-suspicion of medical paternalism
 Focused on individual research participant and patient

THE NUREMBERG COLDE (1947)

 Voluntary consent
 Anticipate scientific benefits
 Benefits outweigh risks
 Animal experience first
 Avoid suffering
 No intentional death or disability
 Protection from harm
 Subject free to stop / withdraw
 Qualified investigators
 Investigator will stop if harm occurs

MAJOR PRINCIPLES IN BIOETHICS

1. Non- maleficence and Beneficence
- Utilitarian- harm- benefit analysis
- Do no harm
- Best interest standard
2. Autonomy
- respect for one’s rights and dignity
- informed and voluntary consent
3. Justice
- Fairness
- Caring for the most vulnerable
ETHICS is natural science.
Ethics is not a physical science.
Ethics is the science of human acts with reference to right and wrong
Ethics is the study of the rectitude of human conduct; and
Ethics is the scientific inquiry into the principles of morality.

The Material and Formal Objects of Ethics- Human act or human conduct (rational and higher
faculties of intelligence ad free will) \
The Formal Object of Ethics - is very viewpoint, setting or perspective employed in dealing with
its material object

MORALITY OF HUMAN ACT OR CONDUCT

What is morality?
The quality of human acts where the acts could be either good or right, evil or wrong. This
quality indicates and determines whether the kind of human act that is performed is good or bad.

What makes good, good?

What makes evil, evil?
ETHICS AND MORALITY
RELATION DISTINCTION
Both deal with human act Ethics – pertains to the knowledge of what to
study.
Morality- application of knowledge in the
performance of human act
Ethics studies about morality Ethics provides learning about the morality of
a human conduct
Morality provides ways in practicing what is
learned
Morality gives ethics a perspective of what Ethics- word
to study about-whether an act is good or bad Morality- deed
Morality- provides ethics with a quality that Ethics- theory
determines and distinguishes right from Morality-practice
wrong conduct

ETHICS / MORAL PHILOSOPHY AND MORAL THEOLOGY

To reach its conclusion, ethics/ moral philosophy draws upon the following sources.
1. Human reason as its primary source
2. Contemporary and historical experiences
a. Personal experiences
b. Experiences of others

Moral Theology
Is a sacred science which deals with the study of the morality of human conduct in the light of
human reason guided by faith.
Being guided by faith, moral theology arrives at its conclusions by drawing upon the following
sources:
a) Divine Revelations
b) Human Reason
c) Experiences

MORAL PHILOSOPHY AND MORAL THEOLOGY

RELATION DISTINCTION
Both deal with morality of human conduct Ethics and moral philosophy employs human
reason alone
Moral theology- with faith
 Both employ the rational operation of Source of conclusion
human reason Ethics and moral philosophy- human reason
and experience
Moral theology- with Divine Revelation
Both make us of experience as one of the Ethics and moral philosophy- natural end
sources from which their conclusions are Moral theology- supernatural end
drawn

OBJECTIVITY OF MORALITY
1.Norms are purely internal.
“Be true to yourself”
2.Norms based on current opinions and customs
“Socially acceptable”
3.Norm of expediency/ practicality
“What is useful is morally good”
4. Norm of preference

BIOETHICS AND HEALTH ETHICS

RELATION DISTINCTION
Both are concerned about health and life Health ethics-concerned about life in relation
to health
Bioethics- plus other fields in relation to life

Both regulate human conduct by means of Health ethics- regulate human conducts in the
moral principles in relation to health and practice of health care
life Bioethics – and all aspects of human life
Health ethics is a part of bioethics Bioethics is an encompassing scope of
discipline

What is health care?

- The prevention, treatment, and management of illness and the preservation of
mental and physical well-being through the services offered by the medical and
allied health professions.
Pointers for health care practitioners
- Be constantly aware of and learn by heart the essential roles ethics play in the
practice of health care for which you are responsible.
- Live the knowledge of ethics in the practice of your profession and share it with
other health care practitioner and patients.
- In case of doubt, seek counsel from persons in authority, such as priests, ethicist,
and moral theologians so as to be enlightened and guided by moral truth in the
practice of health care.
- Be brave in adhering to the objective norm or standard of morality at all times
even despite contrasting advocacies in the health care milieu.
MORALITY OF HUMAN ACTS

What is human act?

- An act that proceeds from the deliberate free will of man.
- Agent? Us / person

Elements of human Act?

1. Knowledge
2. Freedom
3. Voluntariness
Knowledge – act is done in the light of the agent’s knowing faculty.
Freedom – act is performed in accordance with and not against the will.
Voluntariness – act done by the agent is intentional.

Human Act?
- A voluntary act acting with native freedom in the light of intellectual knowledge
- ALL 3 must be present
- Only a person capable of thinking and willing can perform a human act.
IS health care practice a human act? Yessss

TERMINOLOGIES
 INDIFFERENT ACT- neither in agreement or disagreement with the right reason, human
nature and god
 IMPUTABILITY- act is attributable for the agent (responsible and accountable for the act)

Is the act of man imputable to the agent?

 Responsibility comes in when knowledge and freedom are present – voluntary act

DEGREE OF VOLUNTARINESS OF HUMAN ACTS

1. Perfect vs. IMPERFECT

PERFECT Voluntariness – agent fully knows and fully intends the act. Ex. Dx of the doctor
IMPERFECT Voluntariness- there is some defect in the agent’s knowledge or intention or in both.
Ex. Still a product of the will- assist tubal ligation.
2. SIMPLE vs. Conditional
Simple Voluntariness – is present is an act performed whether the agents like or dislike doing it;
an act done for it is simply intended or undone for it is simply unintended. Ex. Taking up medicine.
Conditional Voluntariness- is present in the agent’s wish to do something other than that what he
is actually doing but doing with hatred or dislike. Ex. Hospital closure, business closure
3. Direct vs. Indirect
Direct Voluntariness – is present in a human act willed in itself; done as a means to achieve an
end (goal) .ex. Injecting IM to reduce fever
Indirect Voluntariness – is present in a human act which is the foreseen result (could and should
have been foreseen result) of another act directly willed. (the unintended effect is capable of being
foreseen). Ex. Using other person.
4. Positive Vs Negative
Positive Voluntariness- is present in human act of doing and of performing; “act of commission”
Negative Voluntariness – present in human act of omitting “act of omission”
- Refraining from doing
5. Actual, virtual, Habitual, Interpretative
1. Actual Voluntariness – is present in a human act willed here and now. There is intention
for doing an act.
2. Virtual Voluntariness – is present in a human act done as a result of or by virtue of a
formerly elicited actual intention, even if that intention be here and now forgotten.
3. Habitual Voluntariness- is present in a human act done in harmony with, but not as a result
of, a formerly elicited and unrevoked actual intention
Ex. Baptism of an non believer to become a believer before he dies- emergency baptism
4. Interpretative Voluntariness – Voluntariness which is the judgement of prudence and
common sense, would be actually present if opportunity or ability for it were given.
Ex. Do a thing with proper information

DETERMINANTS OF THE MORALITY OF HUMAN ACT

1. The Act itself
2. The Motive of the Agent
3. The Circumstances

1. The Act itself- the dead done performed: primarily determinant of m0orality (goodness or
evil resides in the act itself)
2. Intrinsically good Act- it is good because it is good in itself
3. Intrinsically evil act – it is evil because it is evil in itself
2.The Motive of the agent – end to be achieved by means of an act (intention of the agent in
performing the act)
- plays a qualifying role in the morality of an act (A good act may be evil if the motive is
evil but it is not strong enough to make an evil act good influential)
3. The Circumstances – the condition in which the act is done (exists outside of the nature of the
act and are not of the essence of the act)
- Circumstances – intensifies goodness or evil of an act
- (They can increase or diminish the goodness of an act… or aggravate an evil act)

The Circumstances
1. The circumstances of person- agent
2. The circumstances of Quantity or Quality of the Act- the extent of the evil act? Serious or
slight?
3. The circumstances of place – venue
4. The circumstances of means or instrument- used in performance of act – semen, blood
sample
5. The circumstances of Manner – lack of respect
6. The circumstances of time – abortion
 7. The circumstances of motive of the agent

MORAL PRINCIPLES IN THE JUDGEMENT OF MORALITY

Moral Principle in Governing the motive of the Agent

1. A good act which is done for a good motive becomes doubly good
2. An evil act which is done for an evil motive becomes doubly evil.
3. A good act which is done for an evil motive becomes evil
4. An evil act which is done for a good motive does not become good
5. An indifferent act which is done for a good motive becomes good
6. An indifferent act which is done for an evil motive becomes evil.
Moral Principle in Governing the circumstances of the act
1. Circumstances can make an indifferent cat good or evil
2. Circumstances can make a good act evil.
3. Circumstances can never make evil act good
4. Circumstances can makegood or evil acts better or worse.
5. Circumstances can cause new goodness in a good act or a malice in an evil act.
6. A gravely evil Circumstance destroys the entire goodness of an objectively good act.
7. A not so gravely evil Circumstance does not destroy the entire goodness of an objectively
good act.
CONDITONS AFFECTING THE MORALITY OF HUMAN ACTS

Morality of human act

- It refers to the sense of righteousness or wrongness of an act
CONCEPT OF HUMAN ACT
HUMAN ACT – (actus humani) are actions that proceed from insight into the nature and purpose
of one’s doing and from consent of free will
- Are acts which proceed from insight and free will.
- Can also rightly be called personal act.
- ( actus humani) is an action that is considered to be carried out voluntarily
HUMAN ACT INCLUDES:
1. Thought
2. Speech
3. Action
HUMAN ACT compose of words, deeds, action either the act is good or bad.
“ALL HUMAN ACT ARE SUBJECTED TO MORALITY”

MORAL DETERMINANTS OF HHUMAN ACT

1. Object of the act
- Nature of the action
- Object specifies the “ACT of the Will”
2. Intention
- Motive of the agent
- Purpose of the human agent
3. Circumstances
- Event, occasion and condition of an act
JUDGING THE MORALITY OF HHUMAN ACT

The moral object can either be:

- GOOD (PRAYING)
- BAD (STEALING)
- INDIFFERENT (EATING)
The INTENTION can either be good or bad

DISTINGUISH FROM ACTS of MAN

 ACTS OF MAN (ACTUS HUMANI) are the actions performed without intervention of
intellect and free will.
IT COMPRISES:
 All spontaneous biological and sensual processes, like nutrition, breathing, sensual
impressions
 All acts preformed by those who have not the use of reason, like people asleep, lunatics,
drunken people
 Actions which merely happen in the body or through the body without the awareness of
the mind or the control of the will.
QUALITIES OF ACTS OF MAN
1. Done without knowledge
2. Done without consent
3. Done involuntary
Acts of Man – it is an action beyond one’s consciousness
ELEMENTS OF HUMAN ACT
Any act, thought or word
1. That is done with full knowledge & deliberate – alam niya
2. The person is free to do it – Hindi siya pinwersa
3. The person does it intentionally or voluntarily – NAIS NIYA TALAGANG GAWIN

FREE ACTS
Freedom is the power to choose between two or more courses of action without being forced to
take one or the other by anything except our won will.
o Every human act is a free act for it is under the control of the will
o AUNTHENTIC FREEDOM is not “the right to say and do anything” but to” do the
good and truth
o The whole moral life revolves around the use of freedom
o The good use of freedom guarantees man the affirmation of his better self and the
achievement of the purpose of life.
o The abuse of freedom is the origin of man ‘s guilty conduct
INTENTIONAL/VOLUNTARY ACTS
o A voluntary act is defined as the act which proceeds from an intrinsic principle with
knowledge of the end
o A voluntary act proceeds from the will and depends upon the will
o A voluntary act is a will-act, not only a “willed act”
o When man knows the end of his work to the greatest degree and moves towards it, the
voluntary character of his action is present to the greatest degree
CONDITIONS AFFECTING THE MORALITY OF HUMAN ACTS
IGNORANCE
o Means absence or lack of knowledge.
1. IGNORANCE OF THE LAW- absence or lack of knowledge of the existence of a certain
law
2. IGNORANCE OF THE FACT- the absence or lack of knowledge of the violation of a
certain law.
FEAR – Agitation of the mind brought about by the apprehension of an impending evil.
TYPES OF FEAR
1. Light of fear- is that in which the evil threatening is present but slight or serious but remote
2. Grave fear – present when the evil threatening is considered as serious.
3. Intrinsic Fear- Agitation of the mind which arises because of a disposition within one’s
own mind or body
VIOLENCE
o External force applied by a free cause for the purpose of compelling a person to perform
an act against his will.
1. Perfect violence Victim gives a complete resistance to the application of external force.
TYPES OF PERFECT VIOLENCE
 Physical Perfect Violence – all physical means to resist the violence
 Morally perfect Violence – All powers pf resistance should be used but not employed for
a good reason
 Imperfect Violence- sufficient resistance is not exerted despite the opportunity and capacity
to terminate the violence.
LAW
 An ordinance of reason promulgated by competent authority for the common good.
3 elements of law
1. Ordinance or reason – it is dictated by reason
2. Competent authority- it is publicly known
3. Common good – public and general welfare is ensured.
Characteristics of a true law:
1. JUST- for the common good or the general welfare of its subjects
2. Honest- does not contradict the provision of higher law.
3. Can be fulfilled
4. Useful-cater the needs of its subjects.
5. Permanent
6. Promulgated- make widely known s
CLASSES OF LAW
1. Eternal law – the Divine reason and will commanding that the natural order of things be
preserved and forbidding that it be distributed
2. Natural law- is the Eternal laws as known to man by his reason. General rule “the good is
to be done and evil is to be avoided”
3. Human Positive Law- the ordinance of reason derived or application form natural law from
common good for the society.
a. State law – (legal or civil law) enacted by the state through its legitimate body.
b. Church law (Ecclesiastical law) enacted by church through its ecclesiastical governing
authority.
NATURAL LAW- is the eternal law as known to man by his reason. General. “the good is to be
done and evil to be avoided”
- “Natural” because the goals and the major values human beings seek are innate, that is,
they are from the nature and are not selected freely by individual persons and communities.
- Natural law is a system in which actions are seen as morally or ethically correct if it accords
with the end purpose of human nature and human goals.
- Natural law follows the fundamental maxim: “DO GOOD and Avoid Evil”
HUMAN ACTS- Expressed proceeds from the will.
- (you do it because you want it)
ACT OF MAN – is an action that does not proceeds from the will.
- (you were unconsciously to do it)
MORAL OBJECTS- can be described as the intention inherent in the action that one is actually
performing, it specifies the human act and is the purpose that the act accomplishes as a means to
the ultimate goal of life.
CIRCUMSTANCE – is a part of the human act that must be considered in order to evaluate the
total moral act
- “who, when, how much or in what manner?

INTENTIONS/MOTIVES – is a means towards the attainment of true happiness both of the agent
and the common good

PRINCIPLES OF DOUBLE- EFFECT- this principle is used in order to judge the moral
acceptability of the human act that has 2 effects: one is good, the other one is Evil.

4 CONDITIONS for the DOUBLE EFFECT PRINCIPLE

1. The action is good in itself or at least indifferent
2. The good effect must come first before the evil effect or at least simultaneously
3. The good effect must be intended
4. There must be a proportionately grave reason for the evil effect to happen
ULITARIANISM – This is from the Greek word “Utilitas” means Used or utility
- Also called Consequentialism or Consequence- based theory
- It is an ethical theory, universal ideas such as freedom, justice, charity and knowledge.
2 CLASSIFICATION OF UTILITARIANISM
1. (AU)- act Utilitarianism
2. (RU)- Rule Utilitarianism
(AU)- ACT Utilitarianism
- It is essentially expressed a dictum, each one must perform the act that will bring about the
greatest amount of good over bad to everyone affected by the act.
- Example: better to tell the truth , maybe to lie keep your promises if it will be good result
to everyone
(RU) – RULE Utilitarianism
- It is an attempt to answer the problem raised to AU. It suggest that person must act
according to the demand of the rules by which it tends to maximise happiness and diminish
unhappiness
- Rule of truth telling
ADVANTAGE OF Utilitarianism:
1. It is also beneficence- based theory, that it seems morality primarily in terms of promoting
the welfare of the client.
2. Utilitarianism is regarded as responsive in constructive ways to changing social conditions.
3. It advices to rely less in traditional convictions rather than bend more on judgements of
overall social benefits.
4. Its requirement on assessing the over all interests as accepted as norms of public policy and
law making
5. Honesty and truthfulness are not an absolute requirement
6. It is established on the basis of individual’s need for happiness
DEONTOLOGY- form a Greek word “deon” means “duty”
- This is duty that one must consider in deciding for an action
- This duty is that ability of a person to observe and follow the moral law with the use of his
reason
- It implies that ethics is derived from the observance of the moral law and is derived from
fulfilling one’s own duty.
VIRTUE ETHICS- from a latin word “virtus” means “manhood or worth”
- Virtue ethics holds that it is not only important to do right thing but equally one must have
the right disposition, motivation and traits for being good and doing right.
CONSCIENCE
- Is a practical judgement of reason on the goodness of an act that has to be done
TYPE OF CONSCIENCE:
1. Correct Conscience- judgement of an acts as good when it is truly good
Ex. Euthanasia is evil so the nurse refused to give lethal injection
2. Erroneous Conscience- judgement of an acts a good when it is evil
Ex. Doctor reject teaching of church about therapeutic abortion is evil.
PRINCIPLE
- Is from which something proceeds in any manner
- “the greater the knowledge and freedom, the greater the voluntariness and moral
responsibility involved, and conversely.”
What do you think? Why only human acts can be judge as moral or immoral?