Health Care Ethics

(Bioethics)

Module #6 Student Activity Sheet

care ethics in our ethical codes;
2. Define the basic principle found in health care ethics; 3.
Name: Understand the historical background of rights;
4. Explain how rights and their attendant correlative
_______________________________________________ obligations are grounded in the same overarching principles
and rules.
__________________ Section: ____________ Schedule:

________________________________________
A. LESSON PREVIEW/REVIEW
Class number: _______ Date: ________________
Brain Teaser: Answer the questions below:
Materials:

Pen, paper, index card, book, and class List

Lesson Title: Basic Principles of Health Care and the

Nature of Rights in Ethical Discourse References:

Ethics of Health Care: A Guide for Clinical Practice Fourth

Learning Targets:
Edition, Raymond S. Edge, J. Randall Groves
At the end of the module, students will be able to:
1. Identify the applications of the basic principles of health

1. A competent elderly tells you,” I want to go home.” You respond with, “We won’t let you go home; you’re not capable
of taking care of yourself.” You may have just created the elements for what tort?
ANSWER: :_______________________________________________________________________________________
________________________________________________________________________________________________
_
________________________________________________________________________________________________
__

2. The patient tells you, “I don’t want the treatment.” You respond with, “Your doctor ordered the treatment and told me
to make sure you take it, even If I have to hold you down.” You may have just created the elements of what tort?

ANSWER: :_______________________________________________________________________________________
________________________________________________________________________________________________
_
________________________________________________________________________________________________
__

B. MAIN LESSON

Basic Ethical Principles

Determine right and wrong regarding:

∙ Autonomy
∙ Veracity
∙ Confidentiality
∙ Beneficence
∙ Nonmaleficence
∙ Justice
∙ Role fidelity
Hierarchy of thinking regarding biomedical ethics: proceed from general worldview to universal principles, to rules
and codes, to decisions

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 1

Health Care Ethics
(Bioethics)

Module #6 Student Activity Sheet

--- Self-determination often used synonymously with
autonomy
Name:

________________________________________________
∙ Informed consent- derived from basic principles of
_________________ Section: ____________ Schedule: autonomy
o Legal exceptions: under therapeutic privilege and implied
________________________________________ consent ∙ Paternalism: intentional limitation of autonomy of
one person by another ∙ Health care professionals fiduciary
relationship with patients
UNIVERSAL PRINCIPLES
1. Veracity
∙ Autonomy
- Binds both health practitioner and patient in an association
∙ Form of personal liberty
of truth
∙ Ability to decide
Class number: _______ Date: ________________
∙ Power to act on your decisions

Respect for the individual autonomy of other

- Harm to patient autonomy and potential loss of practitioner credibility makes lying to patients a practice
to be avoided

2. Beneficence
- Acts of mercy and charity
- Any action that benefits another
Hippocratic Oath: physician will “apply measures for the benefit of the sick”

3. Non-malefiecnce
- One ought not to inflict evil or harm
Beneficence
- One ought to prevent evil or harm
 - One ought to remove evil or harm
- One ought to do or promote good

Nonmaleficence
- Principle of double effect: secondary effects may be foreseen but can never be intended outcomes.
E.g., administering morphine for pain, ethically prescribe but the analgesics suppresses respiration -
Under what circumstances can one act morally when some of the foreseeable effects of that action are
harmful?

Principles of Double Effect (Guiding Elements)

∙ Course chosen must be good or at least morally neutral
∙ Good must not follow because of secondary harmful effects
∙ Harm must never be intended but merely tolerated as casually connected with good intended ∙ Good
must outweigh harm

4. Confidentiality
- American Hospital Association’s The Patient Care Partnership: Understanding Expectations, Rights and
Responsibilities
- Outline of current state of practice with regard to individual’s right to privacy in health care THIS

DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 2

Health Care Ethics

(Bioethics)

Module #6 Student Activity Sheet

- Entitlements, interests, powers, claims, needs
- If one possesses a right, one need not feel gratitude to
Name: others for its possession - In moral philosophy and political
theory thought of as justified claims - A right creates
________________________________________________ obligation in others to behave in a certain way
- Symbolic language of covenants, charters, manifestos, and
_________________ Section: ____________ Schedule: conventions - Expressions of hope for future of humanity
- Not meant to outline a reality grounded in law or claims that
________________________________________
can be enforced

Right to Health Care?

5. Justice
- Many claim health care as a human right. Is it?
- Procedural justice or due process: disputes between - And if it is, where would such a right come from, and who
individuals has obligation to provide it? - Health care as a right difficult
- Distributive justice: distribution of scarce resources to define
- Compensatory justice: individuals seek compensation for a - Is it a positive or recipient, right?
wrong that has been done
Historical Background of Rights Reasoning
6. Role Fidelity ⎯ Natural Rights
- Modern health care is the practice of a team – Equated to the law of God such as Golden Rule
- Allied health over 100 individual professions
- Ethics of health care require practitioner practice faithfully ⎯ Natural Liberties
within constraints of role - Prescribed by scope of practice of Class number: _______ Date: ________________
state legislation

Rights
 – Universal moral rights exist prior to and independent of guarantees of social contract or
institutionalized government
– Negative rights: obligate others from interference

⎯ Human Rights
– All humans equally separated from beasts of the field and are unique unto themselves
– Positive rights: basic needs we all share, recognize, and respect as a person’s just due – Basic
truths understood and known by human reason alone not dependent on outside dictates

⎯ Traditions of Natural Law

– Humans possess rational nature as a gift from God
– Natural laws are not dependent on social contract
– Natural laws are unchangeable and universal
– Inability to effect natural rights does not distinguish them
– Natural laws discovered even without knowledge of God

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 3

Health Care Ethics
(Bioethics)

Module #6 Student Activity Sheet

________________________________________________

Name: _________________ Section: ____________ Schedule:

________________________________________ correlative rights – Duties of imperfect obligation: do not give
birth to any right
– Moral rights: backed up by force of law or public opinion

Contractarian and Consequentialist Rights Theory ✔ Contractarian Theory

✔ John Stuart Mill Class number: _______ Date: ________________
– Duties of perfect obligation: inherent within them assigned

– Force or mechanism for selection of correct principles is agreement or bargain reached by initial agents –
Moral agents come to initial situation and bargain to a choice

✔ Hobbesian Model
– Those living in the state of nature do not come to the table as equals
– Only law of self-preservation existed
– World where strong and ruthless armed with force and fraud are only ones allowed to come to
bargaining table

✔ John Rawls
– Original position: all individuals are free and equal
– Veil of ignorance denies each agents’ knowledge of who is to receive rights to goods and services –
Seen in the fair opportunity rule

Fair Opportunity Rule

✔ Contractarians
– Individual rights grounded in principle of justice and collective choice
– Collective choice forms basis of morality

✔ Original Position
- Posited concept of moral right to equal concern and respect
- Rights existed prior to collective choice procedure

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.

1.The principle that deals with the need to tell the truth.
A. Beneficence
B. Veracity
C. Confidentiality
D. Role fidelity
Answer: B
Rationale:Veracity - Binds both health practitioner and patient in an association of truth.

2. The legal principle of a right to privacy is matched to the ethical principle of .

A. Confidentiality
B. Justice
C. Veracity
D. Nonmaleficence
Answer:A
Rationale:Confidentiality - American Hospital Association’s The Patient Care Partnership: Understanding
Expectations, Rights and Responsibilities - Outline of current state of practice with regard to individual’s right to
privacy in health care
3. The use of placebos is most problematic when you are considering the principle of .
A. Veracity
B. Beneficence
C. Role fidelity
D. Maleficence
Answer: A
Rationale:Veracity - Harm to patient autonomy and potential loss of practitioner credibility makes lying to
patients a practice to be avoided.

4. The famous admonition “If you can’t do the patient good, at least avoid harm,” speaks of the two important principles of
beneficence and .
A. Confidentiality
B. Justice
C. Veracity
D. Non maleficence
Answer: D
Rationale: Nonmaleficence - Principle of double effect: secondary effects may be foreseen but can never be
intended outcomes. E.g., administering morphine for pain, ethically prescribed but the analgesics suppresses
respiration - Under what circumstances can one act morally when some of the foreseeable effects of that action
are harmful?

5. “Nurses should practice nursing and allied health specialist should only practice within their specialty areas” is an
application of the basic principle of .
A. Veracity
B. Beneficence
C. Role fidelity
D. Maleficence
Answer: C
Rationale:When nurses practice fidelity, patients experience more favorable outcomes. Several factors affect
patient outcomes.

6. When one person has a right, others have obligations to either refrain from hindrance or provide the required goods
and services associated with the right. What type of obligation is this?
A. Imperfect obligation
B. Perfect obligation
C. Correlative obligation
D. Personal obligation
Answer: C
Rationale:The correlative obligation of the society is a service right that provides the inventor the ability to benefit
from a duty of forbearance imposed on the rest of the society.

7. Perhaps the most famous moralized contractarian theory of rights that includes the concept of an original position
comes from the work of .
A. John Locke
B. John Stuart Mill
C. John Rawls
D. Thomas Aquinas
Answer: C
Rationale:John Rawls
– Original position: all individuals are free and equal
– Veil of ignorance denies each agents’ knowledge of who is to receive rights to goods and services
– Seen in the fair opportunity rule.
8. What rights are generally equated to the law of God?
A. Artificial Rights
B. Natural Rights
C. Legal Rights
D. Moral Rights
Answer: B
Rationale:Natural Rights – Equated to the law of God such as Golden Rule.

9. We have different Golden rules across religions, what religion has its golden rule which says “Hurt not others which
you would find hurtful?”
A. Buddhism
B. Brahmanism
C. Islam
D. Taoism
Answer: A
Rationale:Buddhism- Hurt not others which you would find hurtful.

10. He is an English philosopher where in his model he assumes that the state of nature was a state of social chaos, and
that the origins of law, which are simultaneous with those of morality, are in social contract.
A. John Rawls
B. John Locke
C. Thomas Aquinas
D. Thomas Hobbes
Answer: D
Rationale:Thomas Hobbes was an English philosopher who talked about the social contract theories in his work
called Leviathan. In political philosophy, a social contract implies an agreement between the people to be
governed and protected by a higher authority. According to him, the state of nature is characterized by anarchy.
With no set rules or a sense of right and wrong, the people fall into a warlike state resulting in utter chaos and
confusion.

C. LESSON WRAP-UP

AL Activity: Minute Paper

1) What was the most useful or the most meaningful thing you have learned this session?
In session I’v learned the different historical background of Right Reasoning that will affect the patient and
nurses relationship.

2) What question(s) do you have as we end this session?

None :)