[ NCMA218 – HEALTH ETHICS (BIOETHICS) ]

GROUP 4
BSN 2 – Y0 – 19

PROF. MARIA DIOSUL ROQUE

Application of Bioethical Principles

Course Task 5-6

Group 4 Members:
✓ Jarilla, Jan Isabelle
✓ Laurio, Zelcy
✓ Leonardo, Michael Angelo
✓ Malvar, Andrea Kate
✓ Matociños, Lanz Andrei
✓ Mempin, Aira
✓ Molo, Aisha Janine
✓ Orbe, Roselyn
✓ Orepol, Ivan Regz
✓ Paunil, Khaye

 Direction: Answer the following questions:

1. During the 90's, a slum in Metro Manila became popular in the medical world because it has
become a place to harvest kidneys. For a good amount of money residents in that area allowed
themselves to become donors to "help" patients with renal failure get a transplant. State your
stand in this by citing applicable ethical/bioethical principles based from our discussions.
(Laurio & Mempin)

The scenario you have described raises several ethical and bioethical
concerns. As a nursing student, I can provide you with an analysis of the
situation based on general principles of medical ethics. However, it's important
to note that ethical principles can vary among individuals and cultures, and
specific contexts may influence the application of these principles.

✓ Autonomy: Autonomy refers to an individual's right to make decisions about

their own body and healthcare. In this case, the residents of the slum
are willingly choosing to become kidney donors in exchange for money.
However, it is essential to consider whether their decision is truly
autonomous. Factors such as financial desperation, lack of education or
information, and limited options may compromise their ability to give
informed consent freely.

✓ Informed Consent: Informed consent is a fundamental ethical principle

that requires individuals to be adequately informed about the benefits,
risks, and alternatives of any medical procedure or intervention before
providing their consent. In the context of organ donation, it is crucial
to ensure that potential donors fully understand the risks and long-term
consequences of donating a kidney, both physically and emotionally.
Additionally, it is important to assess whether the individuals in
question have been provided with all the necessary information and have
the capacity to comprehend and make an informed decision.

✓ Distributive Justice: Distributive justice involves the fair distribution

of resources and benefits within society. While it is commendable to
strive to help patients with renal failure, it is unethical to exploit
vulnerable individuals, such as those living in slums, by incentivizing
organ donation for financial gain. This practice perpetuates socio-

GROUP 4 1
[ NCMA218 – HEALTH ETHICS (BIOETHICS) ]
GROUP 4
BSN 2 – Y0 – 19

PROF. MARIA DIOSUL ROQUE

economic inequalities and fails to address the root causes of the

disparity in access to healthcare.

✓ Organ Trafficking and Exploitation: The scenario you described appears to

involve organ trafficking, which is illegal and highly unethical. Organ
trafficking exploits vulnerable populations and perpetuates a black
market for organs. It undermines the principles of fairness, justice, and
respect for human dignity.

In summary, the situation you presented involving the slum in Metro Manila
raises significant ethical concerns. The principles of autonomy, informed
consent, distributive justice, and the prohibition of organ trafficking all
suggest that this practice is ethically problematic. It is crucial to prioritize
the well-being and autonomy of individuals, protect vulnerable populations from
exploitation, and ensure fair and equitable access to healthcare resources.

2. What can you, as student nurses do to manifest Stewardship in the following aspects: (40 points)
a. Personal (Matociños & Molo)

We can demonstrate stewardship in our personal life in a variety of ways

as student nurses. By eating a good diet and taking care of our own well-being,
we may learn to be responsible with our own health and better prepare to care
for others. Supporting environmental protection will help us advance
sustainability. By urging people to embrace sustainable activities, we may help
others understand the significance of preserving the environment. We can show
personal responsibility by looking after our own health, minimizing waste,
conserving resources, and encouraging sustainability. By doing these things, we
not only help ourselves but also the communities we live in.

Stewardship requires ongoing education and staying up-to-date with the

latest evidenced-based practice. As a student nurse I am committed to
continuously expanding my knowledge and improving my skills in order to provide
the best care possible. By seeking out opportunities for professional
development, I ensure that I am equipped to make informed decisions and deliver
safe, effective, and compassionate care.

In summary stewardship is a core value that I integrate into my personal

life as a student nurse. By prioritizing my own health caring- for the
environment promoting, community health advocating for social justice and
pursuing lifelong learning I strive to make a positive impact both within and
beyond the healthcare setting.

b. Social (Malvar & Orbe)

Considering that the people of slums in Metro Manila chose to resort to

selling their body organs, or kidneys, as a source of income, this means that
they are lacking in the aspect of being educated about the risks of living with
one kidney after donation. On these terms, nursing education is a must in order
for them to realize the consequences of their actions. Although donating your
kidney is considered a gesture of goodwill plus many donors have led healthy

GROUP 4 2
[ NCMA218 – HEALTH ETHICS (BIOETHICS) ]
GROUP 4
BSN 2 – Y0 – 19

PROF. MARIA DIOSUL ROQUE

lives with just one kidney. However, if we take a look at the economic situation
of people in the slum, the likelihood of the mortality of the donors increases
as time passes.

When the kidney is removed, the single normal kidney will increase in
size to compensate for the loss of the donated kidney. The remaining kidney
compensates for the loss of one kidney through a process called hyperfiltration.
The remaining kidney will increase in size and function. Kidney donation has
few long-term risks for generally healthy people. It is important to drink
plenty of water, eat a healthy diet, exercise regularly, and maintain a healthy
weight as part of maintaining good health after donation. The latter part enters
when you damage your other kidney, which will increase the chance of having
chronic kidney failure that leads to total kidney failure.

On the other hand, we can also help them in other ways especially if it’s
inevitable. As student nurses, we can help the residents in the slum by providing
emotional and psychological support, assisting them to cope and deal with things
like the possible risks of being a donor. The risks of being a donor may cause
mental health issues such as anxiety and depression. They should not feel
pressured to donate and should carefully think and talk about their decision
regarding that matter. Donating an organ is a personal decision that requires
careful thought and consideration of both risks and benefits. If they aren't
sure about their choice, they can discuss it with their family, friends, and
other trusted people. Ask themselves questions like "How do I feel if they
rejected me during the evaluation process?" or "How will I feel if the recipient
does not do well after the transplant?".

We can assist them by joining support groups where they can talk about
their feelings and share experiences they encounter during the donation process
with others, which can ease their fears and anxiety. They can ask questions
about things that they don't know or understand. Additionally, Educate them
about becoming donors so they can learn as much as they can about the procedure.

c. Ecological (Orepol & Paunil)

As a student nurse, epitomizing the ecology and environment into the

stewardships of nursing practice would be significant in maintaining and
providing healthcare since the environment itself plays a vital role and
influence on individuals, families, and even the community. These influences of
ecology, such as disturbance, air quality, light, any exposures, temperature,
and quality of sanitization, have been analyzed for their effects on both
patients and nurses regards to stewardship. Ecological stewardship pertains to
promoting, advocating for, and defending the rights, health, and safety of
everyone, not only specific patients but also of the community living in a
certain environment. This is accomplished through offering compassionate care
as well as service in hazardous settings. Based on the scenario, during the
'90s in the slums of Metro Manila, the harvesting of kidneys was quite in demand
as the medical world progressed. However, because of the environment, "slums"
it shows could lead to risk and contamination due to the failure of ecological
conditions. Therefore, as a student nurses could help with waste management or
even advocate the communities. Since nurses are on the front lines of treatment,
they can be useful in developing rules about hospital waste segregation and
recycling. The healthcare sector creates tons of waste from the hospitals.

GROUP 4 3
[ NCMA218 – HEALTH ETHICS (BIOETHICS) ]
GROUP 4
BSN 2 – Y0 – 19

PROF. MARIA DIOSUL ROQUE

Communities can adopt a more sustainable lifestyle with the help of nurses to
be able to secure the integrity of transplanting and harvesting of kidneys.

Ecologically responsible stewardship would prioritize the well-being of

individuals and communities while ensuring the sustainability of organ
transplantation systems. This might involve implementing regulations and
ethical frameworks to prevent exploitation, promoting education and awareness
about organ donation, and improving access to transplantation services. As a
student nurse, I believe in promoting initiatives that advance fair and
equitable access to organ transplantation, raise public awareness of the value
of organ donation, and take part in discussions and research to address ethical
issues related to organ transplantation. In the end, opinions on kidney donation
and sale vary among people and healthcare systems. Policies and practices
relating to organ transplantation are heavily influenced by ethical issues,
legal frameworks, and societal attitudes. Ecologically responsible stewardship
would prioritize the well-being of individuals and communities while ensuring
the sustainability of organ transplantation systems. This might involve
implementing regulations and ethical frameworks to prevent exploitation,
promoting education and awareness about organ donation, and improving access to
transplantation services. As a student nurse, I believe promote initiatives
that advance fair and equitable access to organ transplantation, raise public
awareness of the value of organ donation, and take part in discussions and
research to address ethical issues related to organ transplantation. In the
end, opinions on kidney donation and sale vary among people and healthcare
systems. Policies and practices relating to organ transplantation are heavily
influenced by ethical issues, legal frameworks, and societal attitudes.

d. Technological (Jarilla & Leonardo)

Analyzing the technological impact of kidney transplantation in the 1990s

in the slums of Metro Manila, Philippines, requires considering various aspects,
including the available medical infrastructure, advancements in surgical
techniques, and the accessibility of transplantation services for the local
population.

During the 1990s, kidney transplantation as a medical procedure had seen

significant developments globally. Technological advancements in this field
would have included improved surgical techniques, refined immunosuppressant
drugs, and better organ preservation methods. However, it is essential to note
that the utilization of such advanced technology might have been limited in the
slums of Metro Manila due to resource constraints. Slums often lack adequate
healthcare facilities and face challenges in providing comprehensive medical
services to residents. One crucial factor affecting technological impact would
have been the availability and affordability of advanced medical infrastructure
specific to kidney transplantation. High-tech equipment, such as organ
preservation systems, advanced surgical tools, and specialized diagnostic
devices, require significant investments and maintenance costs.

Moreover, in the 1990s, the Philippines, like many developing countries,

faced limitations in healthcare expenditure and infrastructure development.
These limitations may have affected the availability and accessibility of
advanced technological resources to slum dwellers in Metro Manila. However, it
should be acknowledged that advancements in technology during the 1990s

GROUP 4 4
[ NCMA218 – HEALTH ETHICS (BIOETHICS) ]
GROUP 4
BSN 2 – Y0 – 19

PROF. MARIA DIOSUL ROQUE

positively impacted kidney transplantation across the world, including the

Philippines. These advancements led to better success rates, reduced rejection
rates, and improved long-term outcomes for transplant recipients. While the
utilization of modern technology would have been limited in the slums, it is
crucial to recognize efforts made towards ensuring access to basic healthcare
services. Public hospitals and non-governmental organizations might have played
a role in providing access to kidney transplantation services, albeit with
limitations.

Overall, the technological impact of kidney transplantation in the 1990s

in the slums of Metro Manila, Philippines, would have been influenced by the
existing healthcare infrastructure, financial limitations, and accessibility to
advanced medical resources. Limited access to high-tech equipment and
advancements might have affected the quality and availability of kidney
transplantation services for slum residents during that time.

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