Study sheet: Health Care Ethics

📋 Course Outline

1. Foundations of Ethics and Morals
2. Human Acts and Ethical Frameworks
3. Nursing Codes and Professional Duties
4. Conscience Values and Moral Distress
5. Ethical Theories and Deliberation
6. Law Obligations and Healthcare Ethics
7. Patient Rights and Consent
8. Patient Information and Responsibilities

📖 1. Foundations of Ethics and Morals

🔑 Key Concepts & Definitions

• Ethics : Studies how human persons should act and whether human actions are right or wrong, guiding healthcare professionals toward integrity and respect in patient care.
• Bioethics : Concerns ethical issues involving life, biomedical research, medicines, healthcare, and the medical profession.
• Nursing Ethics : Consists of the moral principles, standards, and values that guide nurses in professional practice and support safe, compassionate, respectful, and fair care.
• Morals : Socrates — Personal guiding principles about right and wrong, derived from the Latin word “mos,” meaning custom, habit, or manner of behavior.

📝 Essential Points

📌 Descriptive ethics describes the health and illness values of cultural, religious, and social groups, normative ethics identifies right and wrong actions, and analytical ethics examines the meaning and reasons behind moral terms and judgments.

💡 Memory Hook

Ethics evaluates human action; morals guide personal conduct.

📖 2. Human Acts and Ethical Frameworks

🔑 Key Concepts & Definitions

• Common Good : Achieved when the burdens and benefits of life function together to create a sustainable society, such as a healthcare system that benefits everyone.

📝 Essential Points

📌 A human act is performed by a moral agent with reasoning, such as observing a prescribed diet or preparing for a board examination, whereas an act of a human occurs without conscious mental awareness, such as breathing or a knee jerk.

• The three elements of a human act are:

  • knowledge
  • freedom
  • voluntariness

• The determinants of a human act are:

  • the object of the act
  • the motive of the agent or volition
  • the circumstances

💡 Memory Hook

Knowledge → Freedom → Voluntariness

📖 3. Nursing Codes and Professional Duties

🔑 Key Concepts & Definitions

• Code of Ethics : A formal statement of a group’s ideas and values that sets standards and guidelines for professional actions and informs the public of the group’s commitment.

★ Must-know

• The Philippine Code of Ethics for Nurses is Board Resolution 220, series of 2004, based on the Code of Good Governance for Professions in the Philippines.

• The five responsibility areas are:

  • promotion of health
  • prevention of illness
  • alleviation of suffering
  • restoration of health
  • assistance with peaceful death

• The Code of Ethics requires nurses to respect people’s values, customs, spiritual beliefs, freedom, and confidentiality; provide quality care and accurate documentation; advocate for patient rights; collaborate with coworkers; preserve life and human rights; and maintain professional loyalty, integrity, and continuing learning.

Further detail

• The first official ANA Code of Ethics was issued in 1950.

📌 Under R.A. 9173, Section 9(f), the Board of Nursing must create and issue a Code of Ethics with the accredited professional organization of nurses within one year after the law took effect.

💡 Memory Hook

PNA: People, Practice, Co-workers, Society, Profession

📖 4. Conscience Values and Moral Distress

🔑 Key Concepts & Definitions

• Conscience : A personal internal judgment about whether something is right or wrong in a specific situation, based on knowledge and values.
• Moral Distress : Occurs when a nurse knows the correct action but is prevented from carrying it out.
• Moral Resilience : The capacity to sustain or restore personal integrity in response to moral complexity, confusion, distress, or setback.

★ Must-know

• 🔄 The response to moral distress follows four actions:
  1. ask why the person is distressed
  2. affirm the concern with others
  3. assess the source and severity
  4. act toward the desired change

Further detail

• The seven types of conscience are:
  • correct
  • erroneous
  • certain
  • doubtful
  • lax
  • scrupulous
  • delicate

💡 Memory Hook

Ask → Affirm → Assess → Act

📖 5. Ethical Theories and Deliberation

🔑 Key Concepts & Definitions

• Virtue Ethics : Holds that a virtue is a mean between the vice of deficiency and the vice of excess, known as the Golden Mean.
• Casuistry : A case-based method of reasoning that analyzes concrete cases to resolve moral dilemmas.

📝 Essential Points

📌 Teleological theories judge an action by its consequences, whereas deontological theories judge morality by the nature of the action and its duty. — Immanuel Kant

• 🔄 Scott B. Rae’s moral reasoning model: gathers the facts, determines the ethical issues, identifies relevant virtues or principles, lists the alternatives, compares alternatives with the virtues or principles, considers the consequences, makes a decision

💡 Memory Hook

Deontology judges the action; teleology judges the consequence.

📖 6. Law Obligations and Healthcare Ethics

🔑 Key Concepts & Definitions

• Law : St. Thomas Aquinas — An ordinance of reason made by proper authority and directed toward the common good.
• Social Media Model : Considers a decision ethical if it can withstand public scrutiny.

★ Must-know

📌 Civil law governs private rights and obligations, criminal law defines major crimes, and administrative law regulates the organization and functioning of government agencies.

📌 Legal obligations are formal obligations enforceable under law, whereas moral obligations arise from ethical principles and are not enforceable under law.

Further detail

• The five elements of law are that it is:
  • an ordinance
  • reasonable
  • promulgated
  • enacted by legitimate authority
  • directed toward the common good

💡 Memory Hook

Civil, Criminal, Administrative: CCA

📖 7. Patient Rights and Consent

🔑 Key Concepts & Definitions

• Informed Consent : The patient’s right to receive an honest and adequate explanation of a proposed procedure in a language and manner the patient understands.

★ Must-know

• The four major elements of informed consent are:
  • competence
  • disclosure
  • comprehension
  • voluntariness

📌 A legally capable patient may refuse diagnostic or medical treatment, and healthcare providers are released from responsibility for consequences resulting from that informed decision.

• Patients have rights to quality humane care without discrimination, dignity, choice of provider and facility, privacy and confidentiality, religious belief and assistance, access to information and records, health education, visitors, grievance expression, and leaving against medical advice after being informed of consequences.

Further detail

📌 Consent may be written through a signed consent form or verbal after the physician explains the medical process to the patient.

💡 Memory Hook

Competence → Disclosure → Comprehension → Voluntariness

📖 8. Patient Information and Responsibilities

★ Must-know

• Patients are expected to exercise their rights responsibly, report symptoms, ask questions, understand informed-consent consequences, provide accurate health, demographic, and insurance information, follow hospital rules, communicate transparently, and maintain wellness.

Further detail

• Patients may request information about their disease, treatment, administered care, prescribed medication, an itemized bill, a written treatment summary, and a medical certificate after confinement.

• Reasonable visitor restrictions may involve:

  • infection
  • being very young at seven years old
  • specific items such as flowers
  • location such as an ICU or cancer center
  • visiting time

📌 A patient leaving against medical advice must be informed of the consequences, release the healthcare institution from obligation, and ensure that the decision will not affect public health and safety.

📊 Synthesis Tables

Types of Ethics

Type	Focus	Question
Descriptive	Cultural, religious, and social beliefs	What do groups believe?
Normative	Right and wrong actions	What should a person do?
Analytical	Meaning and reasons of moral terms	Why is an action right or wrong?

Ethical Obligations and Law

Category	Basis	Enforceability
Legal obligation	Formal law	Enforceable
Moral obligation	Ethical or moral principles	Not enforceable under law