MODULE

Republic of the Philippines
Bulacan State University

City of Malolos
NCM 108
BIOETHICS
Authors:
Gil Benedict C. Llamelo, RN
Jane Marie M. Sumodlayon, RN, MAN
Maria Corazon De Guzman, RN, LPT, MSN
1
Overview of the Module
In our everyday lives, we always make decisions and sometimes, that put us in
dilemmas wherein we have to balance the possible benefits and consequences of each
and every actions that will surely affect our ways and our possibly, our own selves. That
is the reason why the study of Bioethics for future healthcare professionals is necessary
to prepare and equip them with the knowledge about the principles of human
development and decision making with the use of ethical principles. Having this
knowledge will help them understand that for every behavior, there are many reason
that needs to be understand before we make judgement and actions. In healthcare
setting and industry, dilemmas are always there and there will always be a fight
between the things that needs to be done, the provisions of the law and the human
conscience. Decision making process will be easier when the concept of this lesson and
modules are learned by heart. The lessons of this chapter will be delivered with the
help of technology of the present generation like social applications that can help us
connect with each other.
This module was designed with the latest norms and cultures of the 21 st century
readers to catch their interest and attention. This was also an adjustment for the
ongoing COVID-19 pandemic that affected the face-to-face interaction in the school
community. This is a proof that no matter what the obstacles, we can still provide quality
education to the future student nurses of the country.
- The Author
2
TABLE OF CONTENTS
Course Syllabus ………………………………………………………………….5
UNIT 1 Theories of Health Ethics……………………………………..……….... 34
Lesson 1: Human Value Development …………………………………….37
Lesson 2: Theories of Human Development…..……………….…………38
Lesson 3: Ethical Theories…………………..…………………………..…...40
Lesson 4: Divine Command Ethics…………………………………………41
UNIT 2 Principles of Health Ethics…………..………………………..………...48
Lesson 1: Virtue Ethics………………………………………………………..50
Lesson 2: Ethical Principles…………………………………………..………51
Lesson 3: Other relevant Ethical Principles……………………………….53
Lesson 4: Other principles of Bioethics……………………………..…......53
UNIT 3 Bioethics and its Application in Various Health Care Situations...59
Lesson 1: Sexuality and Human Reproduction………………….………..61
Lesson 2: Dignity in Death and Dying……………..………………………...63
Lesson 3: Nursing Roles and Responsibilities

At the end of life care…………………………………………………………..63
Lessson 4: Ethical Decision Making Process.……………………………66
UNIT 4 Bioethics and Research…………………………………………..…......71
Lesson 1:Principles of Ethics in Research…………..……………………..74
Lesson 2:Ethical issues in Evidence Based Practice………..…………...76
Lesson 3: Ethico-moral Obligations of the

Nurse in Evidence-based Practices………………………………………….76
Lesson 4: Introduction to Good Clinical

Practice Guidelines……………………………………………………….…….77
3
UNIT 5 Ethical Consideration
in Leadership and Management……………………………………….……………...82
Lesson 1: Moral Decision Making……………………………………….…...84
Lesson 2: Strategies of Moral Decision Making Process……...………...86
Lesson 3:Meaning and Service

Value of Medical Care……………………………………………...…………...87
UNIT 6 Ethical Issues Related to Technology in

the Delivery of Health Care………………………………………………….…….……89
Lesson 1: Data Protection

Security………………………………………………………………………..…..92
Lesson 2:Benefits and Challenges of

Technology………………………………………………..……………………...94
Lesson 3: Current Technology: Issues and

Dilemma………………………………………………………..………………….97
UNIT 7Continuing Education Programs on

Ethico-Moral Practice in Nursing…………………………………………………….105
Lesson 1: Lobbying/ Advocating for Ethical Issues

Related to HealthCare…………………………………………………………108
Lesson 2: Code of Ethics for

Nurses…………………………………………………………………………....112
Lesson 3: Registered Nurses and People………………………………….114
Lesson 4: Registered Nurses and Society and Environment.,………….116
Glossary…………………………………………………………………………..112
Answer Keys…… ……………………………………………………………….117
References………………………………………………………………………...119
4
COURSE SYLLABUS
(SUBJECT)
1st Semester, AY 2020-2021
COLLEGE: NURSING
DEPARTMENT: NURSING
COURSE CODE: NCM 108
COURSE TITLE: HEALTH CARE ETHICS (BIOETHICS)
CREDIT UNITS: 3 UNITS
PRE-REQUISITE: NONE
FACULTY: GIL BENEDICT C. LLAMELO, RN; MARIA CORAZON DE
GUZMAN, MSN, RN, LPT
CONSULTATION HOURS:
COURSE DESCRIPTION:
This course deals with the ethico-moral concepts and principles affecting care of
the individuals, families, population group and community. It involves discussion of
issues and concerns in varied health care situations. The learners are expected to apply
sound ethical decision-making in varied health scenarios.
University Vision
Bulacan State University is a progressive knowledge-generating institution,
globally-recognized for excellent instruction, pioneering research, and responsive
community engagements.
University Mission
Bulacan State University exists to produce highly competent, ethical and service-
oriented professionals that contribute to the sustainable socio-economic growth and
development of the nation
Core Values: SOAR BulSU!
Service to God and Community

Order and Peace
Assurance of Quality and Accountability
5
Respect and Responsibility
The BulSU Ideal Graduates Attributes (BIG A) reflect the graduate’s capacity as:
a. highly and globally competent;
b. ethical and service-oriented citizen;
c. analytical and critical thinker; and
d. reflective life-long learner.
Program Educational Objectives (PEO)
University Mission
Program Educational Objectives (PEO) AIG- AIG- AIG- AIG-
a b c d
1. To produce nurses capable of demonstrating
proficiency in the following competencies: (a) safe
and quality nursing care; (b) evidence-based nursing
practice; (c)ethico-moral and legal responsibility; (d)
✔ ✔ ✔ ✔
communication; (e) record management, (h)
personal and professional development; (i)
responsible citizenry; (j) technological advancement;
(k) core values; and (i) entrepreneurship.
2. To keep faculty and staff abreast with the global
development in healthcare delivery through advance
trainings and workshops.
3. To initiate research and extension services that
generates evidenced-based practices in the delivery of ✔ ✔ ✔ ✔
care.
Program Outcomes (PO)

On completion of the course, the student is expected to be able to do the following:
Program
Educational
PROGRAM OUTCOMES Objectives
PEO1 PEO2 PEO3
(PO can be found at your respective course/program CMO or
PSG)
a. Apply knowledge of physical, social, natural and health sciences and
✔
humanities in the practice of nursing.
b. Provide safe, appropriate, and holistic care to individuals, families,
✔
population groups, and the community utilizing nursing process.
c. Apply guidelines and principles of evidence-based practice in the delivery of
✔ ✔
care.
6
d. Practice nursing in accordance with existing laws, legal, ethical, and moral
✔
principles.
e. Communicate effectively in speaking, writing and presenting using
✔
culturally-appropriate language.
f. Document to include reporting up-to-date client care accurately and
✔
comprehensively.
g. Work effectively in collaboration with inter-, intra-, and multi-disciplinary and
✔ ✔
multi-cultural terms.
h. Practice beginning management and leadership skills in the delivery of
✔
client care using a systems approach
i. Conduct research with an experienced researcher.
j. Engage in lifelong learning in passion to keep current with national and
global development in general, and nursing health developments in ✔
particular.
k. Engage in lifelong learning in passion to keep current with national and
global development in general, and nursing health developments in ✔
particular.
l. Apply techno-intelligent care systems and processes in health care delivery. ✔
m. Adopt the nursing core values in the practices of the profession. ✔
n. Apply entrepreneurial skills in the delivery of nursing care.
Course Outcomes and Relationship to Program Outcomes
Course Outcomes Program Outcomes

After completing this course the
a b C d e f g h i j k l M n
student must be able to:
LO1. Apply the concept of different
E
ethical theories in different scenarios
LO2. Conduct ethical assessment in a
given case scenario. E
LO3. Use evidence-based practice in
health care ethics. I
LO4. Adhere to ethico-legal
considerations in varied personal and E
professional applications.
LO5.Apply ethical reasoning and
decision making process to address
situations of ethical distress and moral E
dilemma.
LO6. Protect clients rights based on
Patient's Bill of Rights and Obligations" E
as applied in different scenarios.
LO8. Display communication skills
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with client and/or support system
based on trust, respect and shared
decision making using appropriate D
communication / interpersonal
techniques / strategies.
LO9. Comply with the guidelines and
protocols in documentation following
the criteria such as completeness, E
integrity, safety and accessibility.
LO10. Observe the Code of Ethics
when dealing with members of the E
health team in the delivery of quality
nursing care.
LO11. Apply management and
leadership principles in creating a
favorable organizational climate for the E
employees.
LO12.Manage resources (human,
physical, financial, time) efficiency and E
effectively.
LO13. Assume responsibility for
lifelong learning, own personal E
development, and maintenance of
competence.
LO14. Demonstrate Filipino ethico-
moral culture and values appropriate E
to the health care needs of the
individual and family.
LO15. Identify the ethical
considerations in the use of I
appropriate technology in delivering
safe and efficient health care services.
LO16. Manifest professionalism,
integrity and excellence. E
LO17. Demonstrate caring as the core
of nursing, love of God, love of country E
and love of people.
Note: (I) Introductory Course to an Outcome (E) Enabling Course to an Outcome (D) Demonstrative
Course to an Outcome
LEARNING EPISODES:
Learning
TOPIC Week Learning Activities
Outcomes
8
Guided by the course
syllabus, students will be
prepped in the subject in
terms of its:
Orientation in the 1. Description
Course Subject 2. Topics to cover for the
semester
3. Grading system criteria
4. Online learning set up
LO14 1
5. Other concerns
University VMGO Online/ Recorded discussion

Discussion among with share of ideas on how
the students one can contribute in the
society following VMGO of the
institution
Theories of Health
Ethics
A. Human Value
Development
1. Growth and
Development
LO1,LO2,LO3,LO Online/recorded discussions
4,L05,LO6,LO7,L 2. Needs and values Online Practical Quizzes and
O8,LO9,LO10,LO Week 2 to Exams
12,LO13,LO14 B. Theories of 10 Open discussions
Human Recorded oral Revalida
Development Video/Situation analysis
1.Biological Theory
2. Psychoanalytic
Theory
3. Psychosocial
Theory
4. Cognitive Theories
5. Bandura’s Social
Learning Theory
9
6.Ecological Theory
C. Ethical Theories
1.Deontology
2.Teleology
3.Utilitarianism
D.Divine Command
Ethics
Principles of Health
Ethics
A. Virtue Ethics
1.Virtue Ethics in
Nursing
2.Core Values of a
Professional Nurse
B. Ethical
Principles
1.Autonomy
● Patient’s Rights
● Patient’s Bill of
Rights
● Informed
Consent
● Proxy Consent/
Legally Acceptable
Representative
● Confidentiality
● Privacy
2.Confidentiality
3.Veracity
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● Truth Telling and
Right to Information
4.Fidelity
5.Justice
6.Beneficence
7.Non-maleficence
C. Other relevant
Ethical Principles
1.Principle of Double
Effect
2.Principle of
Legitimate
Cooperation
3. Principle of
Common Good and
Subsidiarity
D.Principles of
Bioethics
1.Principle of
Stewardship and
Role of Nurses as
Stewards
●Personal
●Social
●Ecological
●Biomedical
2.Principle of Totality
and its Integrity
●Ethico-moral
Responsibility of
Nurses in Surgery
●Sterilization/
Mutilation
●Issues of Organ
Donation
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3.Principle of
Ordinary and
Extraordinary Means
Bioethics and its

Application in
Various Health Care
Situations
A.Sexuality and
Human
Reproduction
1.Human Sexuality
and its Moral
Evaluation
2.Marriage
●Fundamentals of
Marriage Issues on
Sex Outside
Marriage and
Online/recorded discussions
LO1,LO2,LO3,LO Homosexuality
Online Practical Quizzes and
4,LO5,LO6,LO7,L ●Issues on
Week 11 to Exams
O9,LO10,LO11,L Contraception, its
13 Open discussions
O12,LO13,LO14,L Morality, and Ethico-
Recorded Oral revalida
O5 moral Responsibility
Video/Situation analysis
of Nurses
●Ethical Issues of
AIDS
3.Issues on Artificial
Reproduction, its
Morality and. Ethico-
moral Responsibility
of Nurses
●Artificial
Insemination
●In-vitro Fertilization
●Surrogate
Motherhood
4.Morality of
Abortion. Rape and
12
other Problems
Related to
Destruction of Life
B. Dignity in Death
and Dying
1.Euthanasia and
Prolongation of Life
2.Inviolability of
Human Life
3.Euthanasia and
Suicide
4.Dysthanasia
5.Orthothanasia
6.Administration of
Drugs to the Dying
7.Advance Directives
8.DNR or End of Life
Care Plan
C. Nursing Roles
and
Responsibilities
D. Ethical Decision
Making Process
Bioethics and
Research
A.Principles of
Ethics in Research
1.Nuremberg Code
2.Declaration of
Helsinki Online/recorded discussions
LO1,LO3,LO7,LO 3.Belmont Report Online Practical Quizzes and
Week 14
9 exams
B.Ethical issues in Research Paper
Evidence Based
Practice
C.Ethico-moral
Obligations of the
Nurse in Evidence-
based Practices
D.Introduction to
Good Clinical
13
Practice Guidelines
Guidelines and
Protocol in
Online/recorded discussion
LO6,LO11 Documentation and Week 15
Home work activity
Health Care
Records
Ethical
Consideration in
Leadership and
LO4,LO5,LO10,L Management
O11,LO16
A.Moral Decision
Making
1.Principle of Moral
Discernment
2.Principle of Well- Online/recorded discussions
Formed Conscience Online Practical Quizzes and
Week 16 to Exams
B..Strategies of 17 Open discussion
Moral Decision Video/Situation analysis
Making Process Reaction Paper
●Ethical Dilemma
C.Meaning and
Service Value of
Medical Care
1.Allocation of Health
Resources
2.Issues involving
Access to Care
Ethical Issues
Related to
Technology in the Online/recorded discussions
Delivery of Health Online Practical Quizzes and
LO6,LO11 Care Week 18
Exams
Open discussions
A. Data Protection
and Security
1.Data Privacy Act
14
2012 (RA 10173
Series of 2012)
B. Benefits and
Challenges of
Technology
C. Current
Technology: Issues
and Dilemma
Continuing
Education
Programs on
Ethico-Moral
Practice in Nursing
A.Lobbying/
Advocating for
Ethical Issues
Related to Health
Care
B.Code of Ethics
Online/recorded discussions
for Nurses
Online Practical Quizzes and
LO5,LO11,LO13,L
Week 19 Exams
O16,LO17 1.International Code
Home work activities
of Ethics
Final Term Examination
2.Code of Ethics for
Filipino Nurses
C. Registered
Nurses and People
●Registered Nu
rses and Practice
●Registered
Nurses and Co-
Workers
D. Registered
Nurses and Society
and Environment
FINAL COURSE OUTPUT:
Portfolio - Application of daily experiences (past and present) to each theory of human
development and assigned topics.
15
RUBRICS FOR ASSESSMENT:
Rubric for Oral Revalida
Criteria Exemplary Proficient Needs

Improvement
5 pts 4 pts 3 pts
Organization · The information · Student presents · Sequence of

(20%) is in logical, information in information is
interesting logical sequence difficult to follow
sequence which audience · Lacks beginning,
which audience can follow middle, and end
can follow · Uses an · Does not move
· Uses an appropriate smoothly from
engaging beginning or one point to
beginning and/or ending another
thoughtful ending · Moves smoothly
· Moves smoothly from one idea to
from one idea to the next some of
the next all of the the time.
time
Language · Effectively uses · Maintains eye · Maintains eye

use and eye contact contact contact
Delivery · Speaks clearly, · Speaks clearly · Speaks clearly
(20%) effectively and and uses suitable and uses suitable
confidently using volume and pace volume and pace
16
suitable · Takes steps to · Takes steps to
volume and pace engage the engage the
· Fully engages the audience audience
audience · Dresses · Dresses
· Dresses appropriately appropriately
appropriately · Selects words · Selects words
· Selects rich and appropriate for appropriate for
varied words for context and uses context and uses
context and uses correct correct grammar.
correct grammar.
grammar.
Content · Clearly defines · Defines the topic · The information
(20%) the topic and its · Supports the is in logical,
significance topic with interesting
· Supports the key some evidence sequence which
findings with an · Presents some audience can
analysis of evidence of follow
relevant and research with · Uses an
accurate evidence sources. engaging
· Provides beginning and/or
evidence of thoughtful ending
extensive and · Moves smoothly
valid research from one idea to
with multiple and the next
varied source all of the time
Question and · Demonstrates · Demonstrates · Demonstrates

Answer extensive some knowledge incomplete
(20%) knowledge ofthe topic by knowledge of the
of the topic by responding topic by
responding accuratelyand responding
confidently, appropriately to inaccurately and
precisely and questions inappropriately
appropriately to all andfeedback. to questions
audience andfeedback.
questions and
feedback.
17
Time · Management of · Manages and · Poor time
Management his presentation organizes his management that
(20%) within the given presentation requires extra
timeframe is within the given supervision and
exceptionally timeframe but inputs from the
smooth and with with minimal instructor
ease pauses or delays
in between
Rubrics for Written Report Presentation
(applies to requirements such as homework/assignments, project

documentation, & other related)

Improvement
5 pts 4 pts 3 pts
Organizatio · Struct · Struct · Organiz

n & ure of the ure of the ation and
Structure paper is paper is not structure
(30%) clear and easy to detract from
easy to follow. the message-
follow. · Paragr · Paragra
· Parag aph phs are
raph transitions disjointed
transitions need and lack
are logical improvement transition of
and thoughts
maintain the
flow of
thought
throughout
the paper
Format · Stude · Studen · Student

(20%) nt is t is is
consistent consistent in inconsistent
in correct the correct in the correct
18
use of use of use of format.
formatting. format, with · Several
· Forma a few formatting
tting is free formatting errors.
from errors. errors. · Assign
· Stude · Assign ment does
nt follows ment may not meet all
assignment not meet all requirements
instructions requirement as instructed,
, including s as including
length of instructed, length of
assignment. including assignment.
length of
assignment.
Content/su · Stude · Studen · Student
bject nt exhibits t does not
knowledge proficient demonstrate demonstrate
(30%) command s a general a clear
of the understandi understandin
subject ng of the g of the
matter. subject subject
· Stude matter. matter.
nt · Minima · Minimal
demonstrat l linkages or no
es ability to between linkages
relate course between
course content and course
content to practical content and
practical examples or practical
examples applications. examples or
and · Seque applications.
applications nce of paper · Paper
. is somewhat is not
· Paper difficult to outlined in a
is laid out in follow. logical
logical sequence.
sequence
19
Grammar, · Stude · Paper · Paper
Punctuatio nt contains few contains
n & demonstrat grammatical, numerous
Spelling es punctuation grammatical,
(20%) consistent and spelling punctuation,
correct use errors. and spelling
of the rules · Langu errors.
of grammar, age lacks · Langua
usage, clarity or ge uses
punctuation includes the jargon or
and use of some conversation
spelling. jargon or al tone.
· Langu conversation
age is clear al tone..
and precise;
sentences
display
consistently
strong,
varied
structure
Rubric for Journal/Reflection Paper

Improvement
5 pts 4 pts 3 pts
20
Organization/Communic · The · The · There
ation Holistic paper is paper is is no
(25%) very well- organized, discernible
organized but there organizatio
with no are a few nal pattern,
detectable distracting and the
errors in errors in paper is
grammar, grammar, difficult to
spelling, or spelling, or follow.
punctuation punctuation There are
. It is well- . The major
written with language is errors in
clear, not very grammar,
concise clear, the spelling, or
language, tone is punctuatio
consistent inconsisten n. The
tone, and t. language is
appealing unclear.
style.
Tone & Style · The · The · The

paper paper is not paper is
(25%) shows an very not at all
extraordina reflective in reflective. It
ry reflective tone and does not
tone and style. This appear that
style that indicates the student
indicates some self- is looking
acute self- awareness inwardly
awareness that needs which
and further indicates a
honesty. developme lack of self-
nt. awareness.
21
Discusses Major · Hone · Four · Less
Concepts st, personal to six than two
(25%) reflection practices specific
and insight are practices
in the 12 evaluated are
areas of against the evaluated
specific student's against the
practices as mindset student's
indicated in with insight mindset.
the and
syllabus. apparent
honesty.
Reflective thoughts · Provi · Provi · Fails

(25%) des des few to provide
multiple examples of any
examples of how examples
how personal of self-
personal reflection reflection
reflection will improve or plan to
will improve future improve
future nursing practice.
nursing practice.
practice.
Rubrics for Classroom Attendance/Preparation/Attitude/Participation

Improvement
5pts 4pts 3pts
Attendance
Student has not Student has Student has
(25%) missed any class missed 1 class missed more
days. Student is day. Problem than 1 class
on time and in with lateness day. Serious
seat ready to and/or leaving problem with
lateness and/or
22
learn. early. leaving early.
Attitude
Student is always Student has a Student is rarely
(25%) respectful to fair attitude respectful to
teacher and towards teacher and rest
classmates. classmates and of class.
Student actively instructor, Student has a
participates with interacts bad attitude
classmates and minimally, and toward others,
instructor, occasionally makes rude
displays interest disengages in comments or
in content being classroom lashes out in
discussed, and is activities. class.
engaged in the
classroom
environment.
Preparation
Student Student usually Student rarely
(25%) completes completes completes
assigned assigned assigned
activities (e.g. activities (e.g. activities (e.g.
term papers) term papers) term papers)
and/or is ready and/or has and/or
with required materials for the assignments.
materials for the class. Student Student
class. Student has completed contributed little
has done all some required to the overall
assignments with assignments activity.
best effort and is and is ready for
ready for class. class.
23
Participation
Student is Student could Student is rarely
(25%) constantly participate in involved with
engaged in the class activities the class
class activities but sometimes activity. Student
and recites causing a frequently
actively. distraction engages in
and/or is outside
sometimes activities during
engaged in lecture.
outside
activities.
Note: Similar rubric expectations shall apply on class sessions that will be
conducted via online or internet-based platforms. Additional class decorum
must be reflecting to every course syllabi which will be thoroughly explained
by the handling instructor as well.
OTHER REQUIREMENTS AND ASSESSMENTS:
Activities and home works
GRADING SYSTEM:
Term Examinations 20%
Quizzes/Activities 20%
Project 30%
Participation/Recitation 20%
Attendance/ Promptness 10%
TOTAL 100%
Final Grade = Midterm Grade + Tentative Final Grade Period
2
Range Grade
97-100 1.00
94 – 96 1.25
91 – 93 1.50
88 – 90 1.75
85 – 87 2.00
82 – 84 2.25
79 – 81 2.50
76 – 78 2.75
75 3.00
74 and below 5.00
24
References:
Laganao, E., Robles, R., Sanga, C. (2015) Child and Adolescent Development.
St.Andrew Publishing, Culilanin, Plaridel, Bulacan.
Edge, R., Groves, J. (2019) Ethics of Health Care: A Guide for Clinical Practice. 4th
Edition. Cencage Learning Asia Pte Ltd
Berman A, Snyder S, Frandsen G. (2016). Kozier&Erb's Fundamentals of Nursing.

10th Edition. Pearson Education Limited. England
Tan-Alora, A. (2015). 100 Most Frequently Asked Bioethics Questions. 839 EDSA,
South Triangle , Quezon City.
Online Resources: None
Required Readings:
Advance reading to all topics is a must for a better discussion
Class Policies:
1. Attendance is mandatory and since we are using online platforms, it will be checked
through the activities asked for the day. A student with accumulated absences of more
than 20% of the total class hours will be dropped from the roll.
2. Maximum participation is expected in all online and technological activities
3. In all instances, respect for classmates and instructors are expected.
4. Come in proper and respectable attire every time we do an online meeting. No

jerseys or sandos allowed.
5. Use of cell phones, tablets, and other gadgets is allowed since we are using online
platforms. Being honest all the time is a must especially during time of online
examination
7. All general policies of the College will also be implemented as part of the policies
for this course.
25
Prepared by
Gil Benedict C. Llamelo, RN
Maria Corazon S. De Guzman, LPT, RN, MSN

Instructor
Evaluated by:
Mart Juaresa Cabantog -Yambao, RN, MAN

Program/Area Chair
Approved:
Dr. Gina Panganiban, RN, MAN

Dean
26
27
City of Malolos
Bioethics
Unit 1
Theories of Health Ethics
Prepared by:
Gil Benedict Llamelo,RN
Jane Marie Sumodlayon,RN,MAN
Maria Corazon S. De Guzman,RN,LPT,MSN
A.Y. 2020-2021- 1 Semester

st
28
Introduction
My dear student nurses, welcome back to class! I hope you are doing well, safe and
sound and above all else, already adopted to the NEW NORMAL! So, it’s me, your
humble Bioethics Instructor, Nurse Gilbeys!
You already had your ethics, last semester, am I right? If yes, then that is great because
you already have the knowledge about ethics but this time, we will apply the knowledge
not just in our daily lives but in our clinical knowledge and practice as well for us to
become not just witty nurses but also compassionate, understanding nurses of the
future , isn’t that great?! Let’s have an introduction first, shall we?
Ethics are often difficult to define because people's perceptions of ethical behavior are
most of the time, tied to their belief systems, like religious beliefs, but religious beliefs
vary widely. Others believe that ethical behavior consists of following the laws, however,
there are ones who believe that ethical behavior also consists of norms, traditions and
the eternal debate about religious beliefs. Ethical action is usually considered and
accepted by society, but some theories and principles do not support that view. We
grow in different environments, which is one of the major factors of our differences in
experiences and knowledge. Despite these challenges, there are ethical standards that
apply to the sector. Nurses are expected to stick to a code of ethics altogether,
provisions of care also as in their personal and professional lives. Additionally to moral
standards, nurses must abide the laws that impact their personal conduct and their
profession. In this module, you'll learn about the theories and principles that are the
origin of studying the ethics of life
So, let us begin!

This particular module is divided into 4 lessons:
Lesson 1.1 Human Value Development

Lesson 1.2 Theories of Human Development
Lesson 1.3 Ethical Theories
Lesson 1.4 Divine Command Ethics
Objectives/Competencies
Upon completion of this module, you are expected to:
1. Differentiate the meaning of growth and development
2. Explain the core meaning of each theories of health care ethics
3. Develop ethical reasoning and decision making process to address situations for
ethical distress and moral dilemma
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4. Analyze difficult situations and solve them with the use of theory of personalities
and ethical theories
Pre-test
Hello my dear Student Nurse, before we proceed to the lesson proper,let’s have a stock
knowledge check. Write your answer on the space before the number.
1. Which of the following is an example of development?
a. Enlargement of the chest
b. Improving knowledge
c. Increase in height
d. Getting heavy on the weighing scale due to ECQ.
2. All but one is an example of growth.
a. Improving knowledge
b. Increase in height
c. Getting heavy on the weighing scale due to ECQ.
d. Enlargement of the chest
3. Choose the right word/s for ethics.
a. life c. religious belief
b. moral standards d. experience
4. Synonym of voluntary
a. unwillingness c. conditional
b. autonomy d. forcefully
5. What is the best word word for Dignity
a. significance c. price
b. worth d.importance
6. Give the other word that is near for the word “Ethics”
a. dignity c. behavior
b. worthy c. religion
7. Theory means.
a. proven ideas c. proven assumption
b. speculation d. outcome-base
8. Choose the best meaning for beneficence
a. positive result c. positive judgement
b. positive act d. positive laboratories
9. Choose the best meaning for non-maleficence
a. do no harm b. promote harm c. enjoy harm d. save harm
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10. Bioethics meaning
a. study of life b. ethics of life c. lesson of life d. worth of life
Title of the Lesson: Lesson 1 Human Value Development
Duration: 3 hours
Lesson Proper:
You did a great job in answering the pre-test! Thank you so much for that. So, let us
start the discussion, for our first lesson which is about human value development. But
before that, let us talk about the difference between growth and development, any
ideas? Okay, for more information Please play my recorded discussion for that topic.
___________________link here______________
So, you are done with the topic! That’s great! I hope everything is clear about the
differences of those two. I know the discussion was long so let’s first do our self - check!
Self-Check 1.
Instruction: I need you to compare growth and development using the circle graph
below. BE ARTISTIC! Let us awaken the sleeping artist within you! You may put colors,
pictures, emojis or any form of art that will allow you to express yourself.
You did a great job doing the activity. Now, future nurses, let me tell you something,
there are many studies conducted about development because we cannot deny that
everything around us is contributing to our development. The reason why researchers
established basic principles that govern development in the life cycle of human beings.
Here are the list of the PRINCIPLES OF DEVELOPMENT:
1. Early foundations are critical
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2. Development and learning result from interaction of heredity and environment
3. Development proceeds in definite and predictable directions
4. There are individual differences in development
5. Each phase of development has hazards
6. Development is aided by stimulation
7. Domains of human development - physical, social, emotional and cognitive- are
closely related
8. Development is affected by cultural changes
9. There are social expectations for every stage of development
These are the proof of the saying “ THERE ARE ABSOLUTE REASONS FOR EACH
AND EVERY BEHAVIOR.” Please play the recorded discussion for each principle. For
the discussion, please play the link below:
___________________link here______________
You are done with the discussion and you may ask questions by sending me a video-
recorded file and send it to Messenger App. It may take time for me to answer your
questions but promise, I will! :) This is really the NEW NORMAL, haist, I pray that soon,
we can go back to the OLD NORMAL.
NEEDS AND VALUES
I hope you are having fun! Let us now talk about the needs and values. NEEDS are the
things that we always get to survive. We may not have the same needs but we have
one goal in achieving it everyday, and that is TO LIVE! But living is not all about
consumption, because we have to LIVE WITH VALUES! For more discussions about
needs and values. Get ready to turn your audio on and play the file titled NEEDS AND
VALUES. Enjoy listening!
___________________link here______________
Title of the Lesson: Lesson 2 Theories of Human Development
Duration: 3.6
Lesson Proper
You made a thesis way back Senior High School time, right? We all know that a thesis
starts with THEORY, it is the set of general statements or ideas that are used to explain
facts. There are many theories explaining the meaning of development however,
conflicting ideas have been raised, been debated for so long till now. Below are the
conflicting theories about DEVELOPMENT.
1. Nature vs. Nurture
2. Continuity vs. Discontinuity
3. Passivity vs. Activity
4. Early Experience vs. Later experience
For the discussion, please play the link below:
___________________link here______________
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Now, after that conflicting theories, let us now focus on the theories of known
researchers and psychologists worldwide! These theories are the foundations of
studying human behavior of the 21st century. The major theories and its founder that
are acknowledged internationally include the following:
1. Biological theory ( Mendelian Law) - Gregor Mendel
2. Psychoanalytic Theory - Sigmund Freud
3. Psychosocial Theory - Erik Erikson
4. Cognitive Theory - Jean Piaget
5. Social Development Theory - Lev Vygotsky
6. Social Learning Theory - Albert Bandura
7. Ecological Theory - Urie Bronfenbrenner
8. Theory of Moral Reasoning - Lawrence Kohlberg
This topic is too long so the link below is the soft copy of the powerpoint presentation
and I suggest that you download it or print it so that you can take down notes. And also,
for more information, prepare your audio to play the link for discussion
___________________link here______________
Self-Check 2
I hope you learned something from the discussion. Let us stop right here for now and do
a case scenario. Now, in one of those major theories above, I picked the Theory of
Moral Reasoning of Lawrence Kohlberg which is my favorite and very related to our
subject. The given scenario below is from Kohlberg himself. Yes! He wrote that story to
test his theory.
Now, what you need to do is to read and understand that story and then answer those
questions based on your own belief. And then you categorize what level and stage of
mortality your answers are. Write your answers on Google Docs. Let us exercise our
extremely little neurons!
A woman was on her deathbed. There was one drug that the doctors thought might save
her. It was a form of radium that a druggist in the same town had recently discovered. The drug
was expensive to make, but the druggist was charging ten times what the drug cost him to
produce. He paid $200 for the radium and charged $2,000 for a small dose of the drug. The sick
woman's husband, Heinz, went to everyone he knew to borrow the money, but he could only get
together about $1,000 which is half of what it cost. He told the druggist that his wife was dying
and asked him to sell it cheaper or let him pay later. But the druggist said: “No, I discovered the
drug and I'm going to make money from it.” So Heinz got desperate and broke into the man's
laboratory to steal the drug for his wife. Should Heinz break into the laboratory to steal the drug
for his wife? Why or why not?
Would it change anything if Heinz did not love his wife?
What if the person dying was a stranger,would it make any difference?
Should the police arrest the chemist for muder if the woman died?
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Title of the Lesson: Lesson 3 Ethical Theories
Duration: 3.6 hours
Lesson Proper:
For our next lesson, we will be dealing with the theories

of ethics. Student nurses, let me tell you a
gossip. These theories, just like the theory of human
development, are the foundations of the evolution of
studying ethics in applied medicine, to guide the
medical professionals in making moral decisions
especially in dilemmas and arguments when it comes
to clinical practice. In our profession, in the arena of
values, there is often disagreement, and rarely are the
answers comfortable.
Oftentimes, it is our values that tell us what is right or

wrong, good and evil and that differences in our values
due to differences in our environment and experiences
sometimes make the question unanswered. Let us
deepen our understanding and go to other theories of
our subject. So, what are the ethical theories that we will be dealing in this subject?
Here it is:
1. Teological (Consequence-Oriented) Theories

2. Utilitarianism
3. Deontological (Duty-Oriented) Theories
So let us proceed to discuss each for us to understand the differences.

___________________link here______________
So, you are done with the topic? That’s great! I hope everything is clear about the
differences of the theories in line with our subject. I know the discussion was long so
let’s first do our self - check!
Self-Check 3
Let us pause for a while and do an activity! In this activity, you need to compare the
theories of ethics,based on your own understanding and words. Just fill up the table
below. After that, make a short story of your past experiences for each theory.
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Teological Deontological Utilitarianism
Wow! You did a good job in answering. I hope you learned from our discussion
and broaden your knowledge in lieu to the subject matter.
Title of the Lesson: Lesson 4 Divine Command Ethics

Duration: 3 hours
Lesson Proper:
We are now on the last part of the first unit in

understanding our course subject. On this topic, we will
be expecting to talk all about Divine Command Ethics
and how it was different from other theories we tackled
in the past lesson. We will be also dealing with the
criticism on this because we have differences in our
religious beliefs and different understanding and
interpretations of the holy scriptures and its application
to our daily lives. And most of us, our beliefs and
interpretations from our religion makes them our moral
guide for everyday life. I suggest to keep an open mind
for this last part of our lesson. So, let us
proceed.

___________________link here______________
Alright, so is there any question before we proceed to the activity in line with our topic?
Just send me a message via Messenger App, record your answer in video and I will
answer it too in video! :)
Okay, let us proceed now to our activity.
Self-Check 4
A reflection Paper
I want you to reflect on this phrase. Write your short reflection ( half-page only) in a
blank Google Docs.
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“The Ten Commandments taken from Judeo-Chrisitian traditions, provide rules against
stealing, adultery and murder. These basic rules are taken as guides to behavior in a
wide range of cases by extending the reasoning behind each of the rules to related
kinds of cases. Hence the rule against murder is claimed by some to imply that
euthanasia and abortions are wrong.”
Great! You did well.
So, before we end this chapter, please do remember all we learned and keep this as we
go along to our journey, my dear future nurses. Let us keep this by heart and mind so
that we will be on track. We may hate this now but as we face the real world for nurses,
we will understand the importance of all the topics we have discussed. Not because this
will be encountered in the board exam, but because this will keep us from doing good in
our patients and all. Not because this is a prerequisite subject, but because we are
starting to mold and prepare for the future as full grown nurses.
Alright. Before we proceed to our next activity, please have a review from the start of
our lesson and be ready for the post test.
Alright. Let us now proceed to our post test. Please do answer the questions by all
means of your learning. You may open your notes but close your eyes. Hahahaha
kidding aside. Relax. Enjoy answering because all of the questions here are discussed.
So, let us start.
Post-test
In order to recall and check our understanding for this lesson, let us do a post-test for
this unit. Make sure that you are in a quiet environment so that you can analyze each
item better.
Let’s proceed. Questions were discussed from Lesson 1 up to Lesson 4. We have two
types of tests. For Test I, Write TRUE in the space provided if the sentence is correct
and FALSE if it is incorrect.
_______1. Psychosocial Development says that our development is affected by
innate biological process.
_______2. Ego represents our orientation to the current date, time, and happening to
our environment.
_______3. Law of Segregations says that the traits were formed because of an
assortment of genes from different ancestors.
_______4. Jean Piaget says that our intellect develops even when there are gaps in
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stages.
_______5. Examples of Recessive Traits are black hair and beautiful brown eyes.
_______6. Psychosexual Developments says that maladaptation occurs if satisfaction

of each stage or if successfully completed will lead to a healthy personality.
_______7. Electra Complex develops at Anal Stage because it focuses on discovering

the sexuality.
_______8. During Latency Stage, libido is still present at this stage and directed only to
the parents of opposite sex that they desire.
_______9. Toddlers are the focus of Oral Stage because it is the stage where the
pleasure of sucking occurs.
_______10. Shame and Doubt Stage means pushing the free-will of the students.
For Test II, It will be multiple choice. Choose the best answer and encircle the letter.
1. Who are the fathers of Utilitarianism?
a. Jeremy Bentham and John Stuart Mill
b. Gordon Graham and Alexander Grahambell
c. Sigmund Freud and Eric Erickson
d. None of the above
2. It is the moral framework in which actions are judged primarily by their results
a. Human acts
b. Acts of man
c. Utilitarianism
d. Republic Act
3. Moral grounding is categorical imperative.
a. Virtue Ethics
b. Deontology
c. Natural Law Theory
d. Divine Command Theory
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4. Moral grounding is character traits
a. Divine Command Theory
b. Teological
c. Utilitarianism
d. Virtue Ethics
5. Moral grounding is supernatural commands
b. Natural Law Theory
c. Virtue Ethics
d. Deontology
6. Taken from the Greek word which means duty.
a. Teological
b. Deontology
c. Biology
d. Anatomy
7. The criticism is situational psychology
a. Virtue Ethics
b. Deontology
c. Teological Theory
d. Utilitarianism
8. There is divine being who set down the finite series of rules is the idea in:
a. Deontology
b. Telogical Theory
c. Divine Command Theory
d. Virtue Ethics
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9. Known as consequence oriented
b. Virtue Ethics
c. Deontology
d. Teological Theory
10. It is defined as considering what virtues make a good public relations

professionals
b. Virtue Ethics
c. Deontology
d. Teological Theory
Congratulations! You did well. Please do not stop remembering all of the topics we
discussed after this session. Learn by heart to enjoy your journey towards the real
world, my dear future nurses.
Final Requirement
For your final requirement, you just need to understand each given scenario and write
down your reflection for it. Apply your learnings and find out what theory may best fit the
given scenario and why.
Write it down on word and submit it in our Google Classroom on ___. Stay safe and
good luck!
Case #1
For this case, justify your decision using duty-oriented reasoning and then follow using
consequence-oriented reasoning.
As a neighborhood nurse, you have known the Santibanez family for years and consider
them friends as well as long patient or client. Senora Santibanez has always been a
favorite of yours and you have watched her grow into a very beautiful sixteen year old.
One day, when no other patients are present and you are the nurse-on-duty, You saw
her and waved at her and she waved back to you. You asked, “ What are you doing
here? Where is your Mom?”. She says, “I came here because I need your help.” You
39
says, “Sure! What’s going on?” and you got shocked because she asks you for a
pregnancy kit and she begs you not to tell her mom that she is sexually active.
Suggested Readings and Websites
Chapter 1 and 2
Chapter 1 and 2
Edge, R., Groves, J. (2019) Ethics of Health Care: A Guide for Clinical Practice. 4
th
References:
th

Chapter 1 and 2
Chapter 1 and 2
th
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City of Malolos
Bachelor of Science in Nursing
Unit 2 Principles of Health Ethics
Prepared by:
Maria Corazon S.De Guzman,RN,LPT,MSN
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Introduction
Student Nurses, we are now in the Second Unit of our lesson. Time flies really fast, isn't
it? . I hope you've had fun and you learned a lot during our discussion on the first
lesson. We are now on the part of our subject wherein we will talk about basic ethical
principles that will help us morally decide during dilemmas. But I have a question for
you: what is the difference between Moral and Ethics? Any ideas? Here it is:
According to our friend, Joseph Fletcher, a pioneer in the field of bioethics who died on
1992, he says that "Morality is what people believed to be right and good while Ethics,
then, is nothing more than a generic term for the study of how we make judgments
concerning right and wrong."
Meaning, we based morality on our beliefs in our everyday life, what is right and wrong
for us. When a difficult situation comes or we face a particular dilemma, ethics will come
into play. It is when we will interpret the problem if it is against our beliefs, norms,
traditions, or divine law.
But in our profession, Bioethics is a study of the moral conduct of life science and
medicine. This is to promote awareness for us, medical professionals of do's and dont's
in our practice and enable us to live with orderly social way of life. In health care setting,
the major purpose might be the pursuit of health, alleviation of suffering and prevention
of death. For the latter, some nurses face a dilemma in a situation when the end of life
is better than to prolong the suffering.

Lesson 2.1 Virtue Ethics
Lesson 2.2 Ethical Principles
Lesson 2.3 Other relevant Ethical Principles
Lesson 2.4 Principles of Bioethics
1. Analyze how the principles of health ethics play a vital role in ensuring ideal patient
safety and care.
2. Reflect/assess one’s value and apply ethical decision making in real
settings/scenarios.
3. Differentiate each ethical principle and cite personal ethical decision making you have
made/effected.
4. Embody the core values of becoming a Professional Nurse
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Pre-test
Hello my dear Student Nurse, before we proceed to the lesson proper,let’s have a stock
knowledge check. Choose and write your answer on the space provided.
Privacy Health Care Ethics Justice Fidelity

Veracity Bioethics Autonomy Beneficence
Morality Ethics Confidentiality Nonmaleficence
1._________is what people believe to be right and good.

2. _________is the critical reflection of morality and rationally analysis of it
3. _________application of moral philosophy to the health care arena
4. _________ it means truthfulness
5. _________a principle means self-will
6. _________ keeping one’s promise/ faithfulness
7. _________one ought not to inflict evil or harm
8. _________one ought to do or promote good
9. _________restricted access to information
10. _________fairness and equality
Title of the Lesson: Virtue Ethics

Duration: 3.6
Lesson Proper:
So. my dearest student nurses, what is the meaning of Virtue? Any ideas? Well, Virtue
is a moral excellence of a person. So, the primary focus of Virtue Ethics is the heart of
the moral agent making the decision rather than the reasoning to a right action.
Meaning, your decision will be based on your moral beliefs for a certain situation. It is
not the consequences and the reasons for your good or bad actions but primarily about
personal character and moral habit rather than a particular action.
Our famous Aristotle also has a contribution to ethics, in his teachings, he saw a
function or essence for humanity. For example, doctors and nurses were to make the
sick well, rulers were to govern wisely, and citizens were placed for their individual
reasons in the pursuit of a good life. Nurses, I want to keep an open mind because we
have different beliefs and virtues that might be contradicting with each other. Please
play the link below for the discussion:
_____________________link__________________________________
Self-Check 1
I hope you still have your energy after the discussion hehe. Anyways, let us test your
virtues. Below is the given scenario. Read and understand then write your answer on
blank page of google docs.
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Case Study #2
Maria is a student in your clinical laboratory science class that you as a teacher think is
least likely to make a good healthcare provider. Although very bright, she comes from a
rough-and -tumble background, and while she is making satisfactory progress inside
your class, she is also the one who appears to be cutting the most corners.
On your way out of your office, you leave your office open and the final examination on
your desk. Maria works in the building as a work-study student. She knows that you
have gone for that whole day and notices that the door is open wide. She entered your
office and saw the examination paper
It would be very easy to copy the whole examination, she thinks as she moves towards
it. However, at the last moment of that time, she stops and thinks to herself that she
knows she is prepared for the said examination, and she doesn't need the grief if she
should ace the examination and someone sees her leave the office.
She backs out of the office door, looks to be sure that no one has seen her and locks
the door securely. She thinks to herself, " If I cannot see this examination, I will be sure
that no one else will either.
"
Jace is the model student in your clinical laboratory class. You often wish of the perfect
class, and in every seat the student who is sitting there looks like Jace.
On your way out of your office, you leave your office door open wide and the final
examination on your desk. Jace works in the building as a work-study student. He
knows that you have gone for that day and notices that the door of your office is widely
open. He enters your office and sees the exam.
Once Arthur sees that the exam is on the desk in the office ,he backs out of the office
door and locks it. He thinks, "I will warn the instructor to be more careful with the door
next time to secure the credibility of the examination." It never occur to him to copy and
write the answer of the whole examination because he feels well prepared.
1. In virtue ethics, which of the those situation is more noble: the tempted sinner
who makes the right choice or the unconcerned saint? Defend your answer.
Title of the Lesson: Lesson 2 Ethical Principles

Duration: 3.6 hours
Lesson Proper:
So, nurses, here it is! The 7 ethical principles that derived the rules from our
professional code of ethics. These principles will guide us in carrying out our duties and
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responsibilities as nurses. Although the principles below are listed in a set of orders, it is
doesn't mean that the order are to be considered in any hierarchy of importance. Let me
tell you something, dear. These ethical principles came out on my Nursing Licensure
Examination! So, take it seriously because it might save your life. HAHA
Bioethical or Biomedical Principles:

1. Autonomy
2. Veracity
3. Beneficence
4. Nonmaleficence
5. Role Fidelity
6. Confidentiality
7. Justice
This topic is a little bit long so below is the link for a powerpoint presentation that you
may print and as well as the recorded-discussion for each bioethical/biomedical
principle.
___________________link powerpoint_____________
___________________link discussion______________
Welcome back! I hope each principle is clear to you. If you have questions, you may
send a video message again and I will answer back though it may take sometime.
Hehe. Again, this is the favorite part of the board exam. The Theories of Human
Development as well!
In the board exam, questions will be surely in situations and you will find out which
ethical principles or stages of human development best fits. :)
Self-check 2:
THis is one very easy as you will be an artist again. I want you to draw graph in any
shape for ethical principles. BE ARTISTIC huh. Put some colors, emojis. Just express
yourself. Do it on blank google docs or blank sheet of paper, picture it and send it. It’s
easy! Happy drawing!
Title of the Lesson: Lesson 3 Other Relevant Ethical Principles

Duration: 3.6 hours
Lesson Proper:
There are other principles that are important to know so that you may understand some
situations that need to be done which you might think contradicting other principles.
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Student Nurses, in the
medical profession, our goal
is to do no harm and
promote good, but there are
situations that harm is
expected but
unintended such as side
effects of the medicine or
procedures. There are also situations that the needs of the majority outweigh the
needs of the few and these few might be in danger or might harm them with the needs
of the majority. Common interest needs to be achieved even though the few will have
twice the needs of the common.
Such situations above can be defended with the following other relevant ethical
principles:
1. Principle of Double Effect

2. Principle of Legitimate Cooperation
3. Principle of Common Good and Subsidiarity
For the discussion of each relevant ethical principle, please click the link below:
_____________________link______________
Self-Check 3
Identify what principle will fit to the situation below. Defend your answer.
*Analgesics such as morphine given for pain may lead to a suppression of respiration.
Title of the Lesson: Lesson 4 Other Principles of Bioethics

Duration: 3 hours
Lesson Proper:
In this last lesson for the unit 2, student nurses are about situations wherein a part of a
person or a community is necessary to be sacrificed in order to preserve life and
maintain peace. Another, there are some situations that the distribution of the limited
resources is sometimes based on ethical management because as they say, the
greatest good for the greatest number. Lastly, there are also situations that will incur
pain to the person or community but morally justifiable to preserve life. And those
situations will fall under the following the principles:
1. Principle of Stewardship
2. Principle of Totality and Integrity
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3. Principle of Ordinary and Extraordinary Means.
For the discussions of each, please click the link below.
______________________________________link_____________________________
So, how was it? I hope every principle we have discussed above is clear. Remember
that chances that these principles will be included in the Nursing Licensure Examination
is high! Sure and brightly as the sun!
Self-Check 4
So, for your self- check number 4, I want you to think about your past experiences that
you can fit to to these principles. Just fill in the table below.
Stewardship Totality and Integrity Ordinary and Extraodinary Means
So, we are done with the unit 2 and you were great in doing those activities! Thank you
so much!
Before I end this chapter, I want you to know by heart these principles because they are
not only applicable to clinical setting but of course, to our daily lives. We cannot deny
the fact that there are time that you will experience a dilemma or might think that a
certain situation is against your belief or other principles but, always remember that
good intentions and actions can always be justified at the end.
Last but not the least, we have Golden Rules from the Natural Law which was decreed
by our Creator. This Natural Law appears to have almost universal application and
understanding.
Student Nurse, always remember, LALABAS TO SA BOARD EXAM. Hahaha. :)
Post Test
Try to answer the following Code of Ethics for Nurses made by the Board of Nursing
in the Philippines, identify the universal principle that is being addressed with each
rule. For example, a rule that requires a nurse not to disclose personal information
would be addressing the universal principle of confidentiality.
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REGISTERED Nurses must:
*consider the individuality and totality of patients when they administer care.
• Principles involved:_____________________________________________
respect the spiritual beliefs and practices of patients regarding diet and treatment.
uphold the rights of individuals.
take into consideration the culture and values of patients in providing nursing care.
However, in the event of conflicts, their welfare and safety must take precedence.
if they are administrators, be responsible in providing favorable environment for the

growth and developments of Registered Nurses in their charge.
ensure that patients’ records shall be available only if they are to be issued to those who
are professionally and directly involved in their care and when they are required by law.
provide the patients or their families with all pertinent information except those which
may be deemed harmful to their well-being.
honor and safeguard the reputation and dignity of the members of nursing and other
professions; refrain from making unfair and unwarranted comments or criticisms on their
competence, conduct, and procedures; or not do anything that will bring discredit to a
colleague and to any member of other professions.
see to it that quality nursing care and practice meet the optimum standard of safe
nursing practice.
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insure that modification of practice shall consider the principles of safe nursing practice.
if in position of authority in a work environment, be normally and legally responsible for

devising a system of minimizing occurrences of ineffective and unlawful nursing practice
perform their professional duties in conformity with existing laws, rules regulations.
measures, and generally accepted principles of moral conduct and proper decorum.
.not allow themselves to be used in advertisements that should demean the image of
the profession (i.e. indecent exposure, violation of dress code, seductive behavior, etc.).
decline any gift, favor or hospitality which might be interpreted as capitalizing on

patients.
not demand and receive any commission, fee or emolument for recommending or
referring a patient to a physician, a co-nurse or another PRC-BN health care worker; not
to pay any commission, fee or other compensations to the one referring or
recommending a patient to them for nursing care.
avoid any abuse of the privilege relationship which exists with patients and of the
privilege access allowed to their property, residence or workplace
(Source: Prc.gov.ph(2004). Code of Ethics for Nurses.

https://www.prc.gov.ph/uploaded/documents/Board%20of%20Nursing-CE.pdf)
Congratulations! You did well again!. Please do not stop remembering all of the topics
we discussed after this session kasi lumalabas talaga ito sa board exam! . Learn by
heart and apply to your daily lives to enjoy your journey towards the real world, my dear
future nurses.
Final Requirement
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Case #1
Instruction: Read and understand the situation carefully. Then write your answer for the
question on the blank page of google form. Answer it based on your opinion and
understanding.
In a voluntary outpatient psychiatric clinic in California, a young man disclosed to his
psychologist that he intended to kill a young woman. From the previous conversation,
the psychologist knew the identity of the woman and became very concerned. After the
young man had left his office, the psychologist consulted with his superior and they
decided to have the man stopped by the security person at the gate.
When security stopped the man as he was leaving the clinic, they became concerned
about his legal rights in that he appeared to them to be rational and to threaten no
danger to himself or others. They related this information to the psychiatrist on duty,
who then decided to allow the man to leave and ordered the records of the events
destroyed.
The young man then proceeded to carry out his intentions and shortly after took the life
of the young woman. The parents of the woman, upon finding out about what had
occurred, sued the clinic.
The clinic staff defended their actions on the basis that (1) many individuals fantasize
about doing harm to others without carrying out the threat, and (2) to repeat the
information gathered during therapy would bring them into an ethical problem of
breaching confidentiality. They held that if the parents did not have faith that what they
said during therapy was going to be held in confidence,in actual fact they would not
continue to reveal anything of significance.
* Principles involved____________________________________________________
* What is your own personal decision concerning the lawsuit case?*
References
Edge, R., Groves, J. (2019) Ethics of Health Care: A Guide for Clinical Practice. 4 th
Prc.gov.ph(2004). Code of Ethics for Nurses. Retrieved from:

https://www.prc.gov.ph/uploaded/documents/Board%20of%20Nursing-CE.pdf
Chapter 3

City of Malolos
50
Bioethics
Unit 3
Bioethics and its Application in Various Health Care Situations
Prepared by:
Maria Corazon S. De Guzman,RN,LPT,MSN
Introduction
51
In this world full of poverty and suffering, some part of other peoples' lives choose to
remove to go back to their normal lives and that part might be the consequences of their
actions, chosen or not, such as abortion and euthanasia. We cannot deny that sexual
practices are somehow a part of our bodily needs. Lust is dormant at early years but
eventually, at later life, it would need to be satisfied.
Some people believe that doing experiments in the laboratory with the source of life,
sperm cell, egg cell or stem, is against the order of nature or even the Natural Law of
God. However, some people believe that these experiments with the creations of God
could help someone who could not bear a child or relieve the symptoms of a particular
disease. On the other note, some people who believe that there is only a man and
woman who have the rights to the sanctity of marriage but as the evolution of lust,
knowledge and community happens, people of the so-called third gender have been
fighting for their rights to marriage and adoption of a child for decades. They are also
being stigmatized about HIV/AIDS.
One of our profession's core values is to promote life and prevent death, but there are
times that death is the answer to end the suffering of a person. We are the advocate of
life but when the time comes that ending life is the choice of the family or the patient, we
would experience a dilemma.
Future Nurses, I want you to open your mind in this unit because endless debate of
pro’s and anti’s have been happening for ages.
Let us begin!
Lesson 3.1 Human Sexuality and its Moral Evaluation

Lesson 3.2 Dignity in Death and Dying
Lesson 3.3 Nursing Roles and Responsibilities
Lesson 3.4 Ethical Decision Making Process
1. reflect that sex practices is part of human nature
2. explain the importance of individual dignity as a person even in death
3. integrate the role and responsibilities of nurses in everyday life
4. adapt the ethical decision making in all aspects and situations
Pre-test
52
Choose your answer for each in a box and write it on the space provided before the
number.
Orthonasia Missed abortion Contraception Dysthanasia
Threatened Abortion Suicide Euthanasia Family
Incomplete abortion Abortion In-Virto Fetilization
________1. This type of ending life confronts life and favors death
________2.Basic autonomous social institutions
________3. This word means against pregnancy
________4. Type of ending life that confronts death
________5. Intentionally end of life by non-medical means
________6. Union of Sperm Cell and the Egg Cell in the Laboratory
________7. Loss of pregnancy before fetus is viable
________8. Type of abortion that fetus expelled but placenta retained
________9. Type of abortion which fetus dies inside the utero
_______10. Type of death in its due time. / Do not Resuscitate(DNR)
Title of the Lesson: Lesson 3.1 Human Sexuality & its Moral Evaluation
Duration: 3 hours
Lesson Proper:
My dear future colleagues, let us start

the lesson with a question. Can you
compare the differences between a
person and a human? Any ideas?
According to Mary Anne Warren,
human is by virtue of genetic code
while a person is a member of the
moral community. One can be
member of the moral community by
having certain characteristics recognized by the community as grounded by moral
status and, in particular, right. This is why the right to the sanctity of marriage is for a
man and woman only, because the right to marriage is not being bestowed to members
of the third gender. No single law has ever been passed in the country allowing gays,
transgender or bisexual to the sanctity of marriage because for others, their needs and
wants is not a priority and until now, the stigma is still there..
53
Though man, women and the members of the same gender are still persons even
though the rights for each gender have not been equal since the old ages, because
there are various characteristics that might qualify an individual for personhood. The
following list of traits central to personhood is worth considering:
1. Consciousness of objects and events.
2. The ability to feel pain
3. Reasoning
4. Self-motivated activity
5. The capacity to communicate
6. A concept of the self
Another criterion for personhood not mentioned by Warren and that is viability, it
focuses on the characteristics of biological independence. That viability begins when we
first come out to this world. Why? I will answer that in our discussion. I hope you are still
on the track, my dear because the link below is a recorded discussion of the criterion for
personhood mentioned above. Enjoy listening!
_______________link_________________
So for our next topic is about ethical issues on artificial reproduction, abortion and AIDS
They say that the moment the sperm cell and egg cell unites, life begins. Yes, that is
true. But not in all cases that this life inside the utero begins because of love, but
forcefully and unwanted such as rape and abuse. Some women, because of the
unwanted life inside her think about abortion.
The Philippine Constitution and as a Christian country, value the sanctity of life. Taking
life is against the law of the people and absolutely, to the law of God. That whoever take
life will be facing punishment like lifetime imprisonment and according to the teaching of
the church, to those who believe, forever punishment in hell.
But for some people, women as a viable person, has a right to her own body and
therefore, she may do anything she wants with it including the fetus inside her and in
some cases, the fetus is being removed therapeutically to save the life of a mother and
that is called abortion. What are the types of abortion, student nurses? Any ideas? Here
it is:
a. Threatened abortion
b. Inevitable abortion
c. Incomplete abortion
d. Complete abortion
e. Missed abortion
What about the ethical issues on the AIDS patient. We all know that there is no cure for
this syndrome but people living with HIV face a lot of stigma because some people think
that AIDS can be transferred to others easily like an airborne disease and it affects not
just their physical health but their mental and social health as well. We, nurses, must be
the one to understand what they are going through and it is our duty to promote
54
awareness that AIDS can only be transferred to other via direct contact to blood, semen
and vaginal fluids.
For the explanation and discussion, hit the link (_______link_____________)
Self-Check 1
Thank you so much for listening, student nurses and I hope that the topic is clear with
you. Now, let us do an activity. Since Anne Warren has criterion for the personhood, I
want you to create criteria for a HUMAN. You may use this question, What makes us
human? Write you own criterion in the middle of a woman and man.
Title of the Lesson: Lesson 3.2 Dignity in Death and Dying

Duration: 3 hours
Lesson Proper:
Before we start, Future Nurses, get some tissue first that you might cry on this topic. We
all know that death comes in a very unexpected way. But I have a question, is death the
end? Is there a life beyond death just like what the teachings of the church say? Well, I
cannot answer that question, but I believe that our faith will help us answer it.
As I have said that the Philippine Constitution and the Church value the sanctity of life ,
that whoever take life will face severe punishment. But in some cases, a person or the
kin choose to face death rather than to prolong suffering with life. We have this so-
called Euthanasia, patients wtih terminal conditions choose to confront life and face
death. But there is no legal law in the country saying that Euthanasia is legal unless the
patient signed the DNR order with the knowledge of the family member.
But how can one die with dignity? Well, it varies , maybe we can just fulfill his death
wishes or give him a proper and elegan burial or grant him his wish and the right to die
even though the family aches for it? Granting the Eutanasia for a patient?
There types of Eutanasia:
1. Active - with intervention; request of a patient

2. Passive- omission of intervention that is useful to patient; no participation of
patient
55
Dysthanasia - confronts death
Orthonasia - death in its due time/DNR
For the detailed discussion, please play the link (__________link_____________)
How about those who died because death penalty? Well,that is another topic. They died
as a punishment, not because they wished for it. But someone ordered it and assisted
in the process. But on the last day of those in death row, anything they want will be
granted especially the food, the clothes and meeting with family.
Self-Check 2
Since we are talking about afterlife, death and dying in this lesson, I want to see your
opinion about the death penalty. Below is the movie about the death penalty and I want
you to writen your reflecion on a blank page of google docs.
https://drive.google.com/file/d/1sDN3cJB8LZOkaM9DlaiSZZ_Wo4eet6qj/view?ts=5f33d
8b9
Title of the Lesson: Lesson 3.3 Nurses’ Roles and Responsibilities at the
End of Life Care
Duration: 3 hours
Lesson Proper:
According to Nambayan and Lu (2015), they stated that every culture, traditions,
beliefs, and religion play an important part in every Filipino's life and death. In addition
to this, the family is central and carries a significant importance especially in healthcare
decisions making. Families are generally very involved in caring for their loved ones
who are dying and equally expect healthcare providers to do the same. These are the
hospice or palliative care activists who, against all odds are continuously try to improve
their clients' quality of life and provide them with elements of dignity even in their last
breath."
We noticed that in our culture, when someone dies, we honor the memory of the
late by burial where the families, relatives and friends will gather for days. But before
that, what exactly are the roles of nurses in the end of life care? Below are some of
Nurse’s Roles and Responbilities at the end of life care according to the American
Nurses Association:
> Nurses are frequently in a position to guide patients and families confronting difficult
decisions and adapting to painful realities.
> Nurses are obliged to provide comprehensive and compassionate end-of-life care.
> This includes recognizing when death is near and conveying that information to
families.
56
> Nurses should collaborate with other members of the health care team to ensure
optimal symptom management and to provide support for the patient and family. Nurses
and other health care providers have a responsibility to establish decision-making
processes that reflect physiologic realities, patient preferences, and the recognition of
what, clinically, may or may not be accomplished. Establishing goals of care for this
patient at this time may provide a framework for discussion about what care should be
provided. This process often involves collaboration with experts in decision making,
such as ethics committees or palliative care teams.
> Nurses are obligated to provide care that includes the promotion of comfort, relief of
pain and other symptoms, and support for patients, families, and others close to the
patient.
> Nurses can be a resource and support for patients and families at the end of a
patient’s life and in the decision-making process that precedes it.
>Nurses are often ideally positioned to contribute to conversations about end-of-life care
and decisions, including maintaining a focus on patients’ preferences, and to establish
mechanisms to respect the patient’s autonomy.
>There are times when the preferences of the family do not represent, or conflict with,
the preferences of the patient. In those cases, the nurse's primary responsibility is to
provide care and support to the patient and to respect the patient's autonomy while
continuing to support the family as they struggle to adjust to the impending reality of the
patient's death. Standards for excellent care for patients at the end of life should be
evidence based, and should integrate national and international standards of care.
(Source: https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics/endoflife-
positionstatement.pdf)
Self-check 3
Let us do an activity again. The research says that our culture has an impact to our
belief about death. Now, I want you to reflect and answer the question, “Is death the
end?”. Write your reflection on the blank of google docs.
Title of the Lesson: Lesson 3.4 Ethical Decision Making Process

Duration: 3 hours
Lesson Proper:
When it comes down to the unexpected decision making process in the medical
community, medical professionals will often face a dilemma which needs to be carefully
assessed to avoid conflict at the result. According to Douglas R. May, a professor in
international ethics for business in University of Kansas, 9 steps of ethical decision-
making can be applied to any profession field, especially in medical science because
ethical principle is a universal and general guide. The 9 steps of ethical decision making
process are as follows:
1. Gather the facts

2. Define the ethical issues
57
3. Identify the affected parties (stakeholders)
4. Identify the consequences
5. Identify the obligations (principles, rights, justice)
6. Consider your character and integrity
7. Think creatively about potential actions
8. Check your gut
9. Decide on the proper ethical action and be prepared to deal with opposing
arguments.
For each explanation, click the link and turn on the audio (__________link________)
So we are just done with the last part of the Unit 3 and I hope everything is clear. Just
send me a video message thru Messenger App if you have questions.
Self- Check 4
Are you still on track? I hope you are. Hehe. Let us do a last activity for Unit 3. I want
you to write your explanation and understanding about the steps of ethical decision
making. Make a short situation for each and make sure that they are related to each
other. . Do it on the blank page in Google Docs.
So we are done with the Unit 3 of our subject. Though we are dealing with the new
normal and are not in face-to-face discussion, you must reflect about the lessons that
we have because it will help you pass the board exam and become better nurses of the
future. Nurses must indeed be understanding, compassionate and open-minded
because we are the first person whom the patient will open up with. Being a nurse isn't
just about caring but also it has privileges, one of those privileges is to witness the end
of life and as well as the beginning of it.
Post- test
Now! Let us check your retained knowledge of our lessons in Unit 3. Just write your
answer on the spaces provided before the number. Be honest in answering the
questions. There’s a pair of Divine Eyes watching us.
1.All but one can be the source of Human - Immunodeficiency VIrus

a. Blood b. Semen c. Vaginal Fluids d.Saliva
2. The father of a dying 17-year old patient with intubate, congested heart and pleural
effusion signed the Do Not Resuscitate form because there is no hope for her optimum
level of functioning to be back. You saw the father, very sad and crying while holding
her daughter's hands telling her to wake up. You empathize with him and you know the
feeling of losing a loved one. Then you heard the cardiac monitor beeping and you saw
that the heart rate dropped to 40 bpm, 50 O2Sat and 12 RR. What will you do?
58
a. Do nothing and emphatize with the father
b. Declare a code blue
c. Revive the patient
d. Perform CPR
3. Same situation with number 2, you chose to revive the patient. What will happen to
you?
a. The patient will be alive and she will thank you

b. You will receive an honor from the medical director because the patient is alive
even though she is still intubated
c. You might face a criminal case with severe punishment for reviving the patient
d. The father will give you thanks and money for reviving her intubated daughter.
4. Same situation with number 2, you chose to do nothing and comfort the father. What
will happen to you?
a. You as a nurse will face a criminal charges for doing nothing and your license
might be revoked depends on the decision of the judge or the Board of Nursing
b. You will provide end-of -life care to the patient
c. You will contact the funeral homes and arrange the funeral with the family and as
well as the burial and flower
d. The father will be angry with you and will file a case before the court for
negligence.
5. What type of category of dying happens in the situation above?
a. Euthanasia c. Orthonasia
b. Dysthanasia d.Orthopedic
6. All but one defines a Man
a. Man has an ultimate destiny

b. Created in the image of God
c. Born only to consume
d. Has a purpose in life
7. Loss of pregnancy before fetus is viable (<20 weeks)
a. Fetal death syndrome c. Ectopic Pregnancy

b. Abortion d. Abruptio Placenta
8. This type of abortion that is imminent due to dilatation of cervix, contractions and
vaginal bleeding may be heavy.
59
a. Threatened Abortion c. Incomplete Abortion
b. Inevitable Abortion d. Missed Abortion
9. This type of abortion which the whole product of concepcion expelled
a. Inevitable c. Missed
b. Complete d. Threatened
10. This criterion of personhood says that a person has his judgement in a certain
situation that differs from others.
a. The Capacity to Communicate c.Reasoning

b. Self-motivated activity d. A concept of the self
11. In order for an individual or man to be qualified to a personhood and recognized by

the community as grounded by moral status, he/ she must be oriented to time, place,
date and happenings.
a. Self-Motivated activity c.The ability to feel pain

b. Consciousness of objects and events d.A concept of the self
12. It is the collection of one’s belief, perception, abilities and unique characteristics.
a. A concept of the self c. Consciousness of objects and events

b. Self Motivated activity d. The ability to feel pain
13. One must be able to sense physical and mental hazards and response to stimuli to
avoid danger and maintain the optimum level of functioning
a. The capacity to communicate c. Consciousness of objects and events

b. Self Motivated activity d. The ability to feel pain
14. He or she must have a hobby aside from their daily general routine and habit for his
mind and soul to be relaxed.
a. A concept of the self c. Consciousness of objects and events

b.Self Motivated activity d. The ability to feel pain
15. To be included in a productive society, one must be able to express what's on his
mind and feeling and hear what the other person says.
a.The capacity to communicate c. Consciousness of objects and events

b.Self Motivated activity d. The ability to feel pain
II. For numbers 16-20, write your answer in essay format for this question, Viability, is
nature or nurtured?
60
Final Requirement
For your final requirement, I want you to fill up the circles below. Make two of these
circles on a blank page of google docs, one for positive self-concept and one for
negative self-concept. Below is an example of negative self-concept. Be artistic.
References
Nambayan,A & Lu, H., (2015) Palliative care in the Philippines. Oxford University.
Retrieved from:
https://oxfordmedicine.com/view/10.1093/med/9780199332342.001.0001/med-
9780199332342-chapter-81
American Nurses Association (2016) Code of Ethics for Nurses.

https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics/endoflife-
positionstatement.pdf
Douglas, M. Summary of the Steps of Decision Making Process. University of

Kansas. Retrieved from:
https://research.ku.edu/sites/research.ku.edu/files/docs/EESE_EthicalDecisionma
kingFramework.pdf

61
City of Malolos
Unit 4
Bioethics and Research
Prepared by:
Introduction
62
My dear future Nurses, we are now in the fourth unit in this subject, more than half for
this semester, right? . I hope you enjoyed and remembered a lot during our discussion
from the first lesson. In this topic, we will be talking about Bioethics and Research.
What about those topics? We will be tackling the ethical issues in doing research in the
field of medicine and what might be the possible ethical principles that can be violated
during the process of the study and must take in consideration.
In the field of medicine where experimental research is very much more common than
the descriptive ones, we cannot deny that there are some humans and animals involved
in clinical trials. For some, Natural Law will somehow be violated because of
manipulation of the creations. For some, experimental research in the field of medical
science will benefit the majority and few is necessary for sacrifice. Just the current
issues that are happening in research around the world in searching for the vaccine that
could possibly end the pandemic and fight the CoronaVirus.
Research is the reason why there are evidence-based practices that are helpful for
medical professionals in rendering their service. I know that some of you hate research
but it is one of the requirements before you graduate just like what you had during
Senior High School. But why do we need this to understand all these? Any idea aside
from pre-requisite? Hahaha. Kidding aside. It is because when the time comes that you
will write a research for experimental studies, you already have an idea about the
ethical principles that you might violate and for you to apply good practices and mold
into a well known Professional Nurse.
Aside from understanding the ethical issues, we must also learn our obligations. To
have the title as Registered Nurse is not the end or final. Of course, we must keep
ourselves responsible for our obligations as professionals. So let me introduce to you
what is the body of this unit.

Lesson 4.1 Principles of Ethics in Research
Lesson 4.2 Ethical Issues in Evidence-Based Practice
Lesson 4.3 Ethico-Moral Obligations of the Nurse
Lesson 4.4 Introduction to Good Clinical Practice
Objectives/Competencies:
1. to adapt the moral decision making process in writing research especially in

experimental research
2. explain the strategies of moral decision making process
3. integrate the core value of service in medical care in your life and in clinical setting
63
Pre-test
Hello my future colleagues, before we proceed to the lesson proper,let’s have

a stock knowledge assessment. Our pre-test will be multiple choice. Please
choose wisely.
1. This is the form to be accomplished before any procedures to be done.

a. Informed Consent
b. Waiver
c. Application Form
d. DNR Form
2. The state of keeping or being kept secret or private.

a. Lock
b. Confidentiality
c. Hidden Treasure
d. Conformity
3. This is the state of giving the utmost care to the client

a. Respect for others
b. Commitment to patient
c. Honesty and Integrity
d. Professional responsibility
4. __________ is the practice of being ____________ and showing a consistent and

uncompromising adherence to strong moral and ethical principles and values.
5. It is an act for being accountable to judgement and actions.

6. This is the basic but most important to protect the Nurse as well as the patient for
every procedure done.
a. Documentation
b. Application
c. Apprehension
64
d. Communication
7. Nurse Angie is doing the examination to the patient without closing the curtain. The
other patients saw what was done to the patient exposed. What was the right that is
violated by Nurse Angie?
a. Right to withdraw
b. Right to privacy
c. Right of choice
d. Right to self determination
8. The beginning of informed consent

a. Nuremberg Code
b. Declaration of Helsinki
c. Belmont Report
d. Code of Ethics
9.The states that there should be an element of fairness in all medical decisions.
a. Justice
b. Respect
c. Honesty
d. Diligence
10. The condition of being anonymous

a. Wanted
b. Hostage
c. Anonimity
d. Antagonist
Whoooaaahh!!! You did it great!! So, my beloved students, are you ready? Let us start
our discussion now.
Title of the Lesson: Principles of Ethics in Research

Duration: 3
Lesson Proper:
Alright Nurses, let us proceed on our first topic for this unit. Do you have any idea about
the principles of ethics in research? Or it's your first time to hear about this?. Another
question before we proceed, why do we need to understand this? Any idea? Such a
good answer to hear. You are all learning. Here we go.
So, let me enumerate first the five fundamental principles and differentiate the following:
• PRINCIPLE ONE: Minimising the risk of harm.

• PRINCIPLE TWO: Obtaining informed consent.
• PRINCIPLE THREE: Protecting anonymity and confidentiality.
65
• PRINCIPLE FOUR: Avoiding deceptive practices.
• PRINCIPLE FIVE: Providing the right to withdraw.
All of the above are fundamentals in doing research but the general ethical principle will
still be applied in these ethical principles of research. If you notice, the general
principles and research principle is almost the same because the general ethical
principle is the basis in doing these principles for research . These will guide you in the
process to protect you and your subject in doing experiments. So please learn it by
heart.
We will be also talking about the following:
1.Nuremberg Code
2.Declaration of Helsinki
3.Belmont Report
Please play the link below for the discussion:
_____________________link__________________________________
Self-Check 1
Let’s have some exercise to check if the lesson is well discussed and understood.
In the situation below, let us identify how we are going to decide if you are the one
involved.
Nurse Carla is doing her research in line with the project for development of their
department. As part of it, she needs to collate information from her prospect patient.
If you were Nurse Carla, what is the will you do to:
PRINCIPLE ONE: Minimising the risk of harm.
PRINCIPLE TWO: Obtaining informed consent.
66
PRINCIPLE THREE: Protecting anonymity and confidentiality.
PRINCIPLE FOUR: Avoiding deceptive practices.
PRINCIPLE FIVE: Providing the right to withdraw.
Wow! What wonderful answers! Truly amazing.
It may be too long but if you will fully understand, to make it simple, it is all about
protecting you, your patient, and the environment. No rights will be abused. Always
remember that nurses.
Student Nurses, I want you to remember this. These principles are considered to be
universal—they apply everywhere in the world. These principles do not have national,
cultural, legal, or economic boundaries. Everyone involved in human research studies
should understand and follow these principles to do what is right and to prevent harm
not only to our patients but also to us. Remember the hardship days to win and get the
PRC License so don’t waste your efforts by not applying what we have learned.
Are we clear?Are there any questions or concerns? So, let us proceed to a self check.
Hahaha undying self check? This is for you to be trained in comprehension especially
when you reach the board examination.
Title of the Lesson: Ethical Issues in Evidence-Based Practice

Duration: 3 hours
Lesson Proper:
Hi Nurses! How are you? Are we still in line?Yes yes of course. We are now almost
near to finish this subject. So, let us now proceed to the second lesson in this unit. I
have a question, my dear. No wrong answer. Just give me an idea. Uhmm what do you
mean by evidence-based practice? Then let us connect the issues. Not just simple
issues like what you commonly heard to the neighborhood or so called “chismis” ha.
Hahaha. Yes yes we also have issues. Ethical issues which will be usually encountered
by nurses.
Let us proceed to our discussion. But let me leave you a question, can we prevent this?
So, let me enumerate first the topics that will be encountered in line with the ethical
issues in evidence-based practice:
1. Consumer autonomy
2. Conflict of interest
3. Informed consent
4. Status of evidence
5. Bias in research selection
67
___________________link discussion______________
So, let us have a self assessment to check the retainment of what we have discussed,
Self-check 2:
Please read carefully. All of this is in line with our previous discussion. Identify what part
of the situation is an ethical issue and what is violated.
1. Nurse Tony is on duty at the medical ward for his completion of the research
assigned to him. He cannot complete it well because he really does not want the
assignment. As he completed the assignment, he selected only those in favor of what
he wanted.
2. Nurse Carol is already preparing the chart for the upcoming operation of her patient.
After the operation, the patient demanded and said she did not know what procedure
was undergone.
3. Nurse Paul is explaining to his patient regarding the medical procedure. Without any
words from his patient, he endorsed it to the operating room about the chosen
procedure.
Good Job my dear students! Indeed you are all learning our lesson. Class, are you still
with me? What I have discussed is the most common that will be encountered and of
course to be considered because it has a major factor in preventing the involvement in
ethical issues. So please consider this to save your licenses in the future.
Title of the Lesson: Ethico-Moral Obligations of the Nurse

Duration: 3 hours
Lesson Proper:
My dear future Nurses, we will be talking about your obligations as Professional Nurses
in the future. Why do we need to know this? Our obligations will not end with charting,
carrying out doctor’s orders, giving medication, and the undying taking of vital signs.
We have a lot of ethical and moral obligations as Nurses my dear but let me highlight
the most common. These are the following:
1. Respect for others

2. Commitment to patient
68
3. Honesty and Integrity
4. Professional responsibility
For the discussion, please click the link below:
_____________________link______________
As usual my dear students. Hahahaha do we need to memorize? Let us have a self

check to assess the learning if it is retained.
Self-Check 3
During this pandemic situation, as a future nurse, how can you show the ethical and
moral obligations you can apply? Give atleast 5 to 10 sentences.
Great! We are done now to the discussion. So, my dear colleagues, like what I keep on
telling you, being a professional nurse doesn’t end with having a license, the attitude
defines you more as human. My beloved students, please do remember always what
you’ve learned.
Title of the Lesson: Introduction to Good Clinical Practice

Duration: 3 hours
Lesson Proper:
Hi Nurses. Are we still in? So we are now on the last lesson for this unit. I have a
question my dear students. How can we say if our practice is really good? Do we have
any standards to follow to make it good or should I say it is within ourselves that we are
really doing good? By the way, what do you mean by good practice? Let us specify.
What do you mean by good clinical practice? Any idea?
Our topic for today is about good clinical practice. So, are you ready to be molded,
young professionals? This is also related to the topic we have talked about last
principles. Here, we are going to deepen the topic and details as follows:
1. Definition of good clinical practice

2. Historical Background
3. Principles
For the discussions of each, please click the link below.
69
______________________________________link_____________________________
Now, before we end the topic, let us have self assessment first if the lesson was clearly
understood.
Self-Check 4
As a student, cite an example of a good clinical practice from our current situation.
Attach a picture and an explanation why you choose it. Because Nursing is an art, be
artistic. Feel free to do all the art you know.
Post Test
Write True if the statement is correct and False if it is incorrect.
____1. A nurse on duty is the only responsible in keeping the privacy of the patient.
____2. Everyone is allowed to see the chart of the patient
____3. Informed consent must be secure after the procedure is done.
____4. Commitment to the patient will end after the discharge from the hospital.
____5. The information in the chart is owned by the patient.
____6. Only things remembered can be documented.
____7. Professional Responsibility will stop at the end of duty.
____8. Confidentiality is keeping with co-workers the information about the patient of
the on duty nurse.
____9. A patient has the right to know all the details before signing the informed
consent.
____10. There is no difference between being exposed and not exposed as long as the
procedure needed is delivered.
Final Requirement:
Please read the situation below. Write in five to ten sentences.
“A hospitalized patient with a serious necrotizing ulcer of the lower leg is planning for a
removal. The patient tells the medical caretaker that he won't sign the assent structure
and he doesn't need any medical procedure or therapy as a result of strict convictions
about resurrection. If you are the nurse, how will you handle this?”
The situation above may be tough but possibly be encountered in reality. So, student
nurses, I hope you will still decide wisely until the real life as nurses come.
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As we end this chapter, I want you to keep this by heart what we have discussed
because they are not only applicable to clinical settings or practice but of course, to our
daily lives. We might experience a certain situation that is against your belief or other
principles but, always remember and consider the good intentions and actions. And
always prioritize the safety of the patient as well as you keep yours.
Student Nurse, always remember, you are responsible in every action especially to the
intervention you will be giving to your patients

Imperial College Clinical Research Governance Office. Good Clinical Practice [Web
Page] 2007. Available at http://www.imperial.ac.uk/clinicalresearchoffice.
Otte A, et al. Good Clinical Practice: Historical background and key aspects.
2005;26:563–74. [PubMed] [Google Scholar]
Office of Human Subjects Research. The Nuremberg Code [Web Page] 1949. Available
athttp://ohsr.od.nih.gov/guidelines/nuremberg.
The Doctors Trial (the Medical Case of the Subsequent Nuremberg Proceedings) [Web
Page] Available at http://www.ushmm.org/research/doctors/Nuremberg_Code.htm.
The World Medical Association. Declaration of Helsinki [Web Page] 2004. Available
athttp://www.wma.net/e/policy/b3.htm.
Vadivale M. ICH-GCP Guidelines for Clinical Trials. Berita MMA. 1999;7(29)

[GoogleScholar]
European Medicines Agency. ICH Harmonised Tripartite Guideline E6: Note for
Guidance on Good Clinical Practice (PMP/ICH/135/95) London: European Medicines
Agency; 2002. [Google Scholar]
71
City of Malolos
Unit 5
Ethical Consideration in Leadership and Management
Prepared by:
72
Introduction
Hi future colleagues! So how are you my dear student nurses? We are now in the fifth
unit in our course subject. We are almost nearly done. I hope you are still on track and
please do remember not because required, but because this will be your weapon too in
the real world. But before we proceed, I have a question. What do you mean by ethical
consideration? Just an idea. So, let me define this for you.
Ethical Consideration characterized as authority showing and advancing 'normatively

suitable direct through close to home activities and relational relations. In ethical
consideration, you must have integrity to make the decision. Integrity includes
straightforwardness and trustworthiness or honesty as well as thought for the sufficiency
of the entire substance that one oversees just as of the general public wherein the
association is found. Honesty additionally implies firm adherence to a code, for
example, a moral implicit rule.
Aside from understanding the ethical issues, we must also learn our obligations. To
have the title as Registered Nurse is not the end or final. Of course, we must keep
ourselves responsible for our obligations as professionals. So, what will be the expected
topics to be encountered here? Let me introduce to you what is the body of this unit.

Lesson 5.1 Moral Decision Making
Lesson 5.2 Strategies of Moral Decision Making Process
Lesson 5.3 Meaning and Service Value of Medical Care
Objectives/Competencies:
1. adapt the moral decision making process in everyday life especially in the clinical
setting
2. explain the strategies of moral decision making process
3. integrate the core value of service in medical care in your life and in clinical setting
Pre-test
Hello my future colleagues, before we proceed to the lesson proper,let’s have a stock
knowledge assessment. This will be multiple choice. Because the board exam is
multiple choice. So, choose the correct answer.
1. This is an inner feelings or voices viewed as a guide to the rightness or wrongness

of one's behavior.
a. Temptation
73
b. Conscience
c. Morality
d. Hallucinations
2. This is an action of choosing between two or more courses of action.

a. Judgement
b. Action making
c. Decision Making
d. Planning
3. _____ is the maintenance or improvement of health via the prevention, diagnosis,

treatment, recovery, or cure of disease, illness, injury, and other physical and mental
impairments in people.
a. Health Care
b. Medical Care
c. Health Link
d. Health Assessment
4. It is a decision-making problem between two possible moral imperatives, neither of

which is unambiguously acceptable or preferable.
a. Ethical considerations
b. Ethico-moral
c. Ethical issues
d. Ethical dilemma
5. _____ are defined as all materials, personnel, facilities, funds, and anything else that
can be used for providing health care services.
a. Health care resources
b. Medical resources
c. Emergency Funds
d. Organization Fund
6. Concerned with the principles of right and wrong behavior and the goodness or
badness of human character.
a. Manners
b. Conduct
c. Moral
d. Ethics
7. It is a cognitive process that elicits emotion and rational associations based on an
individual's moral philosophy or value system.
a. Illusion
b. Imagination
c. Hallucination
d. Conscience
8. This is the ability to produce a reasonable and defensible answer to an ethical
question.
74
a. Maturity
b. Moral Decision Making
c. Ethical Decision Making
d. Professionalism
9. This is a result or effect of an action or condition.
a. Outsource
b. Output
c. Consequence
d. Conclusion
10. It involves going past the mere perception of something and making nuanced
judgments about its properties or qualities.
a. Morality
b. Ethics
c. Conscience
d. Discernment
. You are really showing the learnings in this subject. So, just stay on the track as we go
along to our discussion. So, let us proceed on the first lesson for this unit.
Title of the Lesson: Moral Decision Making

Duration: 3
Lesson Proper:
Alright my dear colleagues..so we are now in the fifth part of our subject. So before we
start our class,I want to ask something. When we say Moral Decision Making, what
comes to your mind? How can we say if we decided in the right way? What are the
considerations in decision making? Any idea? Any guess?
All my questions are related to our topic for today. The title of our lesson is Moral
Decision Making. So let me lay down what is inside:
1. Principle of Moral Discernment

2. Principle of Well-Formed Conscience
_____________________link__________________________________
75
So upon understanding our discussion, I hope it will be retained. Not only retained in
mind but also in your heart. Please keep it by heart. Give some space not only for your
girlfriends and boyfriends. What we discussed is relevant not only being professional
but also in general. By this, we can tell the maturity in handling situations in life. So let
us test it by answering our activity.
Self-Check 1
Below is a situation where we can apply the topic we have talked about. Read carefully
and answer the questions after.
A 42-year old pregnant woman was taken to the hospital following an accident in the
home. In the hospital, it was determined that the near-term fetus was not getting
sufficient oxygenation. According to medical opinion, both mother and child needed a
blood transfusion. The woman, a member of Jehovah's Witness faith, refused the blood
on the basis of her religion.
It is clear that the woman had the right to refuse the blood herself, but the situation is
complicated by the fact that her choice adversely affected the child, who was delivered
by cesarean section. After the birth, the father refused a blood transfusion for the child,
indicating that he never wanted to go against the wishes of his wife in the matter.
The baby nevertheless was given a transfusion over the decision of the father, but by
the time he received it, he was already too compromised and died shortly after.
Should the clinical staff have accepted the father’s wishes? Provide a rationale for your
decision.
Awesome. What a good answer. You really show the learnings you’ve earned from our
discussion. Decision making is not easy. So, always remember that in making
decisions, you really have to consider everything and as much as possible you have to
think many times before deciding. Do you believe in the power of tongue? In decision
making, you cannot change your decision as easily as deleting using your eraser.
Example is social media wherein you have to think before you click. So, choose wisely
students
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Title of the Lesson: Strategies of Moral Decision Making Process
Duration: 3 hours
Lesson Proper:
My dear nurses, let us proceed to the second topic of this unit. When you are in a kind
of situation, how do you decide? Do you have any basis that makes you come to think
of that way or you just do it what comes first to your mind? Do we have to make ways
before ending to a good decision? The questions are leading to our topic. So, let us
proceed to our discussion.
The title of our topic is Strategies of Moral Decision Making Process. Under this topic,
we have the so-called Ethical Dilemma.
_____________________link__________________________________
So, we are done to our discussion. Let us now have the self assessment activity.
Self-Check 2
Draw two hands in a short bond paper. You may choose the color you want. Be
creative. In the left hand, please put the decision you made that you regret in the end. In
the right hand, put the decision you made that you think it is right. Then below the two
hands, please write at least 5 sentences explaining why it is remarkable to you.
Nursing is an art. You are awesome and creative in doing our activity. Decision making
is very important and it is hard to do. So, my beloved students, please always
remember, that for every decision you make, you must keep yourself responsible for its
outcome, may it be good or not. You must think several times before deciding, for we
don’t have the power to reverse it.
77
Title of the Lesson: Meaning and Service Value of Medical Care
Duration: 3 hours
Lesson Proper:
My dear students, we are now on the last part of this unit. So, here, we are going to talk
about medical care. When we say medical care, what comes first to your mind? Any
idea? Come’on don’t be shy. Any idea will do. Is it different with health care?
In health care, service is provided to individuals, family and community whereas in

Medical care, service is provided only to the person who needs medical attention.
Health care is provided by agents of a health service( includes a doctor as well) but
Medical care can be provided only by a physician.
Objective of Health Care is promote, maintain, restore and monitor the health of the
public which is its right whereas Medical Care aims at the cure of a person who is in a
diseased condition.
So basically, Health Care includes Medical Care. In other words, Medical Care is
actually a subset of Health Care.
Let us go through the topics under this unit. Details are as follows:
1. Allocation of Health Resources
2. Issues involving Access to Care
_____________________link__________________________________
Alright. We are now done with our discussion. But before we end this, let us have an
assessment for the retention of our lesson.
Self-Check 3
78
Below is a situation where we can apply the topic we have talked about. Read carefully
and answer the questions after.
With managed care, the charges that can be made for a particular condition are often
predetermined and fixed; hospitals make or lose money depending on whether they are
able to treat the patient within the confines of the predetermined payment. This has
resulted in pressure on health care providers to reduce staff and personnel, reduce
length of hospital stay, and reduce necessary services provided. Can a health care
provider serve both the society's need for cost containment and yet be the advocate for
the patient as required by the basic principles of role duty and beneficence?
You made it right! As we ended the lesson, did you learn? Are we still here? Let me tell
you this. Sooner or later, you all will be working. Please choose wisely. Make sure that
your health is not compromised. Consider the good compensation and the benefits in
choosing a job where you will fit in. Don’t choose because your best friend or your
boyfriend/girlfriend is there. And as much as possible, please save for your health.
Because it is the only wealth that no one can get from you.
Post Test
Arrange the following in order according to steps in decision making.
__Consider your character and integrity

__Gather the facts
__Check your gut
__Define the ethical issues
__Identify the affected parties
__Decide on the proper ethical action and be prepared to deal with opposing arguments.
__Identify the consequences
__Think creatively about potential actions
__Identify the obligations
__Know what is the problem
Final requirement:
Please read the situation carefully. Answer the question in five to ten sentences.
You have treated a patient who supported minor facial wounds. Not long after he is
released, you are drawn closer by a cop needing to know his name and address as he
is associated with leaving the location of a burglary. What do you do?
79
John Gallagher, The Basis For Christian Ethics (New York: Paulist Press, 1985)
Richard Gula, Reason Informed by Faith: Foundations of Catholic Morality (New York:
Paulist Press, 1989)
Ethics of Health Care: An Introductory Textbook (Washington, D.C.: Georgetown
University Press, 1994)
Strech D, Hurst S,Danis M.The role of ethics committees and ethics consultation in
allocation decisions: a 4-stage process. Med Care. 2010;48(9):821–826
Beauchamp TL, Childress JF. A distinction between traditional theories of justice and
more recent theories like capabilities and well-being. In: Beauchamp TL, Childress JF,
eds. Principles of Biomedical Ethics, 7th ed. New York, NY: Oxford University Press;
2013:279–280
National Center for Health Statistics. Health, United States, 2015: with special feature
on racial and ethnic health disparities. 2016; DHHS Publication No. 2016-1232
80
City of Malolos
Unit 6
Ethical Issues Related to Technology in the Delivery of Health Care
Prepared by:
A.Y. 2020-2021- 1 Semester

st
81
Introduction
Evolution of technology as we know it is unstoppable. It changes through time, and its

impact has a huge effect in each one of us. It's impact is undeniable because we can
see and feel it not just in our everyday lives but also in every profession. In medical
science, as the technology evolves, so are the medical practices of each medical
profession. From diagnostic laboratories, treatment of diseases to the documentation,
we use technology. It really helps in almost everything because it saves time and
energy but each technology has a cost.
Though there are so many benefits from the use of technology, there are also some
disadvantages of it. The invasion of privacy, breaching of confidentiality and lack of
knowledge about technological advancement which can lead to some problems are one
of the challenges and issues of the technology of the 21st century. The very reason why
some local and international laws with regards to technology and information have
been passed to protect the privacy of an individual.
In this time of pandemic and facing the new normal, technology is in demand. In the
medical setting, the current trend of practice is telemedicine and jobs and positions in
regards to this new practice is now being established. It became the new access for
some to health because the majority of us have gadgets and social media accounts that
we can use for communication with the health care workers for our health care needs
and information.
So, dear student nurse, let us explore the wonders of the technology to our profession
through this lesson. Students, let us equip ourselves with the knowledge about the
benefits, disadvantages and the limitations of technology in our profession.
Let us begin!

Lesson 6.1 Data Protection and Security
Lessn 6.2 Benefits and Challenges of Technology
Lesson 6.3 Current Technology: Issues and Dilemma
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1. Defend the national law for data protection and security if the situation
needs it
2. Appreciate the emerging technologies and be open minded to the changes it has
brought to the health care delivery system.
3. integrate the core value of service in medical care in your life and in the clinical
setting.
Pre-test
Hello my dear Student Nurse, before we proceed to the lesson proper,let's have a stock
knowledge check. Write your correct answer on the space before the number.
TRUE OR FALSE
____________1. Telehealth is a new nursing career path that allows nurses to deliver
exceptional patient care in a “hands off way”.
____________2. Telemedicine is a medical care that comes from a distance or away
from the office.
____________3. Telenursing is the use of technology to deliver nursing care and to
remotely
conduct nursing practice.
____________4. Data subject in the data privacy act refers to an individual whose
personal information is processed.
____________5. Sensitive personal information is limited only to name, age, sex,
religion, ethnic group.
____________6. Consent of data subject in the data privacy act can be written,
electronic or recorded means of authorized person.
____________7. Republic Act 10173 is also known as the Data Privacy Act of 2012.
____________8. Among the disadvantages in the use of technology in nursing is
internet access, malfunctioning of equipment and kept records.
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____________9. One of the biggest issues facing healthcare today is on Privacy/Security.
____________10.The incorporation of telehealth solutions into these new age smart drug
delivery systems provides health professionals with real-time patient
data and equips them to deal better with more chronic diseases.
You did a good job in answering this pre-test! Thank you so much for that. So, let us
start the discussion, for our first lesson is about DATA PROTECTION AND SECURITY.
Please play my recorded discussion for that topic.
___________________link here______________
Title of the Lesson: Lesson 6.1 Data Protection and Security

Duration: 3 hours
Lesson Proper:
REPUBLIC ACT NO. 10173 or also known as the Data Privacy Act of 2012, is an act
protecting individual personal information in information and communications systems in
the government and the private sector, creating for this purpose a national privacy
commission, and for other purposes.
I.GENERAL PROVISIONS
II.THE NATIONAL PRIVACY COMMISSION
III.PROCESSING OF PERSONAL INFORMATION
IV.RIGHTS OF THE DATA SUBJECT
V.SECURITY OF PERSONAL INFORMATION
VI.ACCOUNTABILITY FOR TRANSFER OF
PERSONAL INFORMATION
VII.SECURITY OF SENSITIVE PERSONAL
INFORMATION IN GOVERNMENT
VIII.PENALTIES
IX.MISCELLANEOUS PROVISIONS
Refer to the link below for more readings
Source: Republic Act 10173 – Data Privacy Act of 2012

https://www.privacy.gov.ph/data-privacy-act/
84
You did a great job in answering the pre-test! Thank you so much for that. So, let us
start the discussion, Okay, for more information Please play my recorded discussion for
that topic.
___________________link here______________
So, you are done with the topic! That’s great! I hope everything is clear about the
differences of those two. I know the discussion was long so let’s first do our self - check!
Self-Check 1.
REPUBLIC ACT NO. 10173
You are done with the discussion and you may ask questions by sending me a video-
recorded file and send it to Messenger App. I might surely take time for me to answer
your questions but promise, I will! :) This is really the NEW NORMAL.
___________________link here______________
85
Title of the Lesson: Lesson 6.2 Benefits and Challenges of Technology
Duration: 3.6
Lesson Proper
We are re living in a digital era where

almost everything is touched by
technology. Our homes, our vehicles, our
communication, our relationships, and of
course, our jobs are all connected to
technology in a way or another. While
technology has a clear place and
significance in certain professions, like
engineering, design, IT experts and business, other professions are now welcoming
technology as it advances and grows with it. One such profession is nursing. While it
makes sense for healthcare industries at large to use technology for diagnosis and
treatment like MRI machines, lab work, ultrasounds, sonograms, X-rays, nursing is
much more personal and dependent on human interaction and relationship building
because nursing care needs compassion and empathy. How, then, does technology fit
in with the nursing profession? The answer is split into different two categories:
advantages and disadvantages of technology in nursing profession. To learn more how
technology is helping and hurting nursing, read on….(let's proceed with our discussion)
A. Technology and Nursing Profession: What is Telehealth Nursing and

Telemedicine?
>New job developments that combine technology and nursing are known as
telehealth and telemedicine which are very trendy this time of pandemic.
• Telehealth is a new nursing career path that allows nurses to deliver

exceptional and quality patient care in a "hands-off way" with the use of
available technology and social application. In other words, telehealth
allows patients to get healthcare advice, medication, and some treatment
from a distance or remotely, via Messenger App, Google Meet or Zoom
• Telemedicine is a delivery system that is now become popular amongst
various healthcare industry that includes patients. It is medical care that
comes from a distance or away from the office.
• Telenursing is defined as "the use of technology to deliver nursing care
and conduct nursing practice to the patients remotely"
B. Advantages of Technology in Nursing

1. Improved Communication Leading to Improved Patient Care
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2. Better Education
3. Improved Treatment
4. Better Kept Records
C. Disadvantages of Technology in Nursing

1. Set Up and Internet Access
2. Malfunctioning Equipment
3. At the Mercy of the Server/Power
4. Potential Lack of Attention to Detail
Technology will always have its undeniable advantages and disadvantages, but
the bottom line is that it really does make our lives easier. Makes our job effective
and efficient. The thing to we need to remember is that we must always use our
own human intelligence and ingenuity in conjunction with technology for the best
and accurate results. If registered nurses keep this in mind, there's no telling
how far and wide the nursing field can go further.
Source:4 Advantages & 4 Disadvantages of Technology in Nursing

https://www.healthcarepros.net/4-advantages-4-disadvantages-of-technology-in-
nursing/

___________________link here______________
This topic is too long so the link below is the soft copy of the powerpoint
presentation and I suggest that you download it or print it so that you can take
down notes. And also, for more information, prepare your audio to play the link
for discussion
`__________________link here______________
So, you are done with the topic! That’s great! I hope everything is clear about
data privacy. We must all be aware of this because our name is at stake. I know the
discussion was long so let’s first do our self - check!
Self-Check 2 (Within Lesson Assessment from Workshop 2 for Lesson 2)
let's do it technology!
87
UNSCRAMBLE THE WORDS
Title of the Lesson: Lesson 6.3 Current Technology: Issues

and Dilemma
Duration: 3.6 hours
Lesson Proper:
A. Emerging Technology Trends

Shaping the Healthcare Industry
The challenge that the healthcare sector
faces today especially in this time of
pandemic is how to make use of these
advances in technology while maintaining the
high quality of patient care, effective and
efficient services and without compromising
on the privacy of patient information and data. Let us take a closer look at the emerging
trends in healthcare technologies by analyzing patents in these areas in the last five
years
1. Artificial Intelligence in Healthcare
> it is being applied in areas such as using data for personalized medications,
automated treatment plans wellness management and patient monitoring, among
others.
88
Some of the ways in which AI technologies are changing the healthcare industry
• Information gathering and analysis (medical records and patient

information) using AI and digital automation.
• Medical diagnostics – tests, X-Rays, CT scans, data entry, and
other task that is necessary for diagnosis and treament
• Predictive analytics – early detection of diseases and better
treatment plans using patient historical data as a baseline data for
planning.
• Monitoring the client's fitness level and delivering optimal patient
care.
> It is observed that the larger organizations such as Philips, Samsung and IBM hold a
large number of devices related to Bio-sensors, which is emerging technology in the
healthcare industry.
2. Internet of Things (IoT) in Healthcare

> Various devices and mobile applications are being used now by health
professionals for contact tracing, prevent the spread of diseases like
COVID-19 p and early detection and treatment of chronic illnesses. This
has led to the emergence of the Internet of Medical Things (IoMT). A
variety of wearable gadgets are in use for gathering and tracking the data
accurately, including ECG/EKG monitors.
The use of these novel devices mainly involves the following:
• Collection of data using sensors,

• Gathering data over the network, and
• Analyzing data for decision making.
3. Digital Health
> Innovations directed to digital health are on
now the rise. Novel devices and health
applications have now entered the healthcare
industry, from wearables to genomics to
personalized medicine, that aid in disease
diagnosis, treatment, prediction and
management. In this increasingly connected
world because of the social applications and
with the ubiquitousness of data collection, the
healthcare industry is employing advanced
analytical techniques to optimize patient care
and doing so in a cost-effective manner.
89
> Philips, Samsung and GE are one of the top companies and providers in digital
health-related applications.
> Mobile and digital health applications provide flexibility and convenience to both
medical professionals and patients as well as improve healthcare outcomes
4. Smart Drug Delivery Systems
> Smart drug delivery systems or (SDDS) cover intelligent approaches in formulation
technologies that transport a right and computed drug dosage to its target site in the
body in a timely manner. These systems use sensors and other monitoring devices to
accurately track and analyze patient information and progress.
> The incorporation of telehealth process into these new era smart drug delivery
systems provides health professionals with real-time patient data and information and
equips them to deal better with future chronic diseases.
Quick Takeaways
• Artificial Intelligence or AI technologies in healthcare sector are
significantly impacting the healthcare ecosystem, especially in the
areas of diagnostics and pathology.
• IoMT is emerging as a critical and vital component of healthcare
systems in the current age and is now being increasingly adopted
by the providers for leveraging patient data and improved care
management.
• Digital health is now transforming the healthcare industry with
accurate treatment, monitoring and diagnostics.
• Smart drug delivery systems or SDDS deliver improved safe,
accurate and therapeutic benefits to the patients. They also have
real-time analysis of the client's health data and as well as patient's
progress
Source: Emerging Technology Trends Shaping the Healthcare Industry

https://blog.relecura.com/2019/02/emerging-technology-trends-shaping-
the-healthcare-industry/
B. The Biggest Issues Facing Healthcare Today
A hundred or more C-suite and director-level executives voted on and then ranked the
top 10 critical challenges, issues, trends, and opportunities they expect to face in the
coming year, during the 2019 HCEG Annual Forum or the HealthCare Executive Group
90
(HCEG), a 31-year-old networking and leadership organization, facilitated discussion
around the issues of the Forum, which took place September 9 to 11, in Boston, USA
Different executives from payer, business manager, provider, and technology
partner organizations were presented with a list of more than 25 topics. Initially
compiled from different webinars, roundtables, and the 2019 Industry Pulse Survey, the
list was augmented by in-depth discussions during the Forum of executives, where
industry and business experts have expounded on a broad range of current and
important priorities within their organizations. HCEG Board Members announced the
results of the year-long process that will determined the 2020 HCEG.
Top 10 Challenges, Issues, and Opportunities

1. Costs and transparency
2. Consumer experience
3. Delivery system transformation
4. Data and analytics
5. Interoperability/consumer data access
6. Holistic individual health.
7. Next-generation payment models
8. Accessible points of care
9. Healthcare policy
10. Privacy/security
Source:The Biggest Issues Facing Healthcare Today/Managed healthcare executive

https://www.managedhealthcareexecutive.com/view/biggest-issues-facing-healthcare-
today
.
___________________link here______________
I know the discussion was long so let’s first do our self - check!
Self-Check 3
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Let us pause for a while and do an activity! In this activity, you need to
Fill-in the box below appropriate answers to the following questions

List 5 Current Advantage Disadvantage Personal Opinion or Possible
Issues Discussed Solution to create a positive
effect
1.
2.
3.
4.
5.
Wow! You did a good job in answering. I hope you learned from our discussion
and broaden your knowledge in lieu to the subject matter.
Post-test
In order to recall and check our understanding for this lesson, let us do a post-test for
this unit. Just assure that you are in a quiet and peaceful environment so that you can
analyze each
item better.
92
Instruction: Identify what is asked and write your answer on the space provided before
each number.
_________________________ 1. It is an act protecting individual personal information
in information and communications systems in the
government and the private sector.
_________________________2. It is a delivery system that has become popular
amongst various healthcare circles.
_________________________3. This refers to any information whether recorded in a
material form or not that will certainly identify an individual.
_________________________4. It allows people to get healthcare advice, medication,
and some treatment from a distance.
_________________________5. It is defined as “the use of technology to deliver
nursing care and conduct nursing practice.”
Enumeration:
1-5. Cite 5 examples that refer to sensitive personal information.
6-8. Cite 3 advantages of technology in nursing
9-11. Cite 3 disadvantages of technology in nursing.
Congratulations! You did well. Please do not stop remembering all of the topics we
discussed after this session. Learn by heart to enjoy your journey towards the real
world, my dear future nurses.
Final Requirement
For your final requirement, you just need to play the link below and write a reflection
paper for it.
_________________________play this link___________________________________
https://www.youtube.com/watch?v=Il3LjtTYNtM&has_verified=1&ab_channel=kriznalyn
You have apply what you have learned from our discussion and of the previous
discussions. Submit it in our Google Classroom on ___. Stay safe and good luck!
1. What are those ethical issues that we can get from this video?Explain your
answer and cite specific lessons.
93
2. If you were the patient who underwent such surgery, how would you react to this
and what would be your immediate action?
3. Being a student nurse, and training to become a professional nurse what would
be your appropriate action taking into account your knowledge on bioethics.

Republic Act 10173 – Data Privacy Act of 2012. Privacy.gov. Retrieved from:
4 Advantages & 4 Disadvantages of Technology in Nursing. (2019, January 29).

Healthcarepros.net. Retrieved from
https://www.healthcarepros.net/4-advantages-4-disadvantages-of-technology-in-
nursing/
Mishra, R. 2019. Emerging Technology Trends Shaping the Healthcare Industry.

Retrived from
https://blog.relecura.com/2019/02/emerging-technology-trends-shaping-the-healthcare-
industry/
Grajek, S. 2019. Top 10 IT Issues, 2020: The Drive to Digital Transformation Begins.
Retrieved from
https://er.educause.edu/articles/2020/1/top-10-it-issues-2020-the-drive-to-digital-
transformation-begins
Canister Scandal, (2008 September 9). Youtube.com. Retrieved from:


City of Malolos
94
Unit 7
Continuing Education Programs on Ethico-Moral Practice in Nursing
Prepared by:
Introduction
My dear student nurses, let me tell you something, when you get your licenses in the
future and become a full-pledged Registered Nurse, everything will not stop there
because that is only the beginning for more mountains to take. You will encounter a lot
of problems that have not been taught during your college years, the reason why you
must always equip yourself with knowledge in order for you to survive the real world out
there and give a better service to your patient.
95
This is the very reason why continuing education programs such as seminars,
convention, Masters and Doctoral degree is highly recommended for you to explore the
other areas of your profession. When you attend any of these, ethico-moral practices is
always on the topic or included in the topics because we cannot deny that in healthcare
setting there will always be a dilemma and ethics within healthcare are important for us
to make good judgement and decisions while keeping the value within the national law,
rules and regulations that govern us.
When you get your license after the oath-taking ceremony, you will have a contract with
the society to behave in accordance with rules & regulations dictated by the community
and the nursing profession, to promote good and well- being and honor the patients’
autonomy.
Lesson 7.1 Lobbying/ Advocating for Ethical Issues Related to Health Care
Lesson 7.2 Code of Ethics for Nurses
1. to reflect on the standards set by the society and the nursing profession
2. judge accurately the moral goodness of any human action
3.integrate the core value of the nursing profession in everyday life
4.to create a good atmosphere with the members of healthcare team for an excellent
delivery of care
Pre-test
INSTRUCTION: Write capital T if the statement is Correct and capital F if the statement
is incorrect.
_________1. One of the challenges healthcare managers face is how to influence
public policy.
_________2. Lobbying is the appropriate thing to do when it is done with the intention
of
Improving the common good.
_________3. All methods used in trying to influence legislation corrupt the legislative
96
system by providing personal advantages to policymakers.
_________4. Advocacy is an effort to influence public rules and policy for the benefit of
those who
are not recognized by the powers.
_________5. Good lobbying is a citizen behavior, not consumer behavior.
_________6. Nurse at all times maintains standards of personal conduct which reflect
well
on the profession and enhance its image and public confidence.
_________7. The nurse takes appropriate action to safeguard selected individuals,
families &
communities when their health is endangered by a co-worker or any other
person.
_________8. The nurse is active in developing and sustaining a core of professional
values.
_________9. The preservation of life, respect for human rights, and promotion of a
healthy
environment is not a commitment of a Registered Nurse.
___________10.As a Registered Nurse, you must be a member of the Accredited
Professional
Organization, PHILIPPINE NURSES ASSOCIATION (PNA).
Title of the Lesson: Lesson 1 Lobbying/ Advocating for Ethical Issues
Related to Health Care

Duration: 3 hours
Lesson Proper:
Healthcare Management Ethics and thePositive View of Lobbying
According to Dr. Weber, director of the Ethics Institute, University of Detroit

Mercy, Detroit. He's a member of the Catholic Health Association's Task Force on
Healthcare Management Ethics, a challenge that healthcare manage face is how to
influence public policy in a peaceful and legal way
97
Healthcare managers and supervisor know that some changes in public policy
promote appropriate and effective healthcare delivery and some do not. They also know
that it's not responsible to stand back in silence, let others set policies, and then react
later. The word "lobbying" may suggest behaviors that are somewhat questionable from
an ethical explanation, when done with the intention and goal of improving the common
good for the majority, lobbying is often the appropriate or best thing to do.
Lobbying's Negative Reputation

Lobbying has always acquired a questionable reputation among ethically sensitive
people for two possible reasons:
• The methods that sometimes used in

trying to influence legislation corrupt
the legislative system by providing
personal advantages and benefits to
policy maker.
• Lobbyists often appear to some to be
less interested in good policy than in
protecting their own gain and interests.
Philosopher Mark Sagoff always makes a distinction between our role as consumers
and our role as country citizens. Sagoff stated that when we act as consumer, we seek
to acquire what we want and the best for ourselves: Each person follows his own
concept of the good life, his own self-interest. On the other hand, when we act as
citizens, we seek to achieve and implement what is right or best for the entire
community; we try to promote a good society.
The problem with so much of lobbying is that personal or institutional self-interest is
sometimes placed above concern for the public greatest good.
Lobbying as Advocacy
On the contrary to this view, another way of
thinking about lobbying is as an advocacy
which is an effort to positively influence public
policy for the benefit of those who are not
recognized in the lower level by those in
power. Although those people who seek
greater protection from increased
environmental degradation or more low-
income housing for homeless people are
examples of special interests, their advocacy
is a different kind of lobbying from those which
seeks simply a better deal for oneself. Self-interest is always legitimate in many
circumstances, but it is not ordinarily an adequate enough basis on which and how to
determine good public policy.
98
Healthcare managers' responsibility is to work for a just, efficient and effective
healthcare system, and not just for the benefit of interests of their own organizations, is
recognized in the Code of Ethics of the American College of Healthcare Executives.
According to the preamble of the code (as amended in 1992):
It stated that the fundamental objectives of the healthcare management profession are
to enhance the overall quality of life, dignity and well-being of every human needing
and seeking healthcare services, management and to create a more equitable,
accessible, effective and efficient healthcare system.
Good Citizens, Good Lobbyists

It seems essential, therefore, that healthcare
managers and supervisors support and promote
lobbying with good intetions. They need to review
frequently the goals and objectives of lobbying
efforts to ensure that they remain focused on
creating "a more equitable, accessible, effective
and efficient healthcare system in the country."
Given the nature of so much of the lobbying that
takes place in our political system, it is important
for healthcare managers to guard against the
tendency to focus almost exclusively on the
institution's more immediate and narrowly defined goals to set goals that is good for the
majority. Good lobbying is citizen behavior, not consumer behavior.
Lobbying Methods
A third dimension to the lobbying ethics is how it is done.
Public officials are obligated to put the
public interest first. The Government
Ethics Center of the Josephson Institute
stated that public servants should treat
their office as a public trust, only using
the powers and resources of public office
to advance public interests, and not to
attain personal benefits or pursue any
other private interest incompatible with
the public good. (Preserving the Public
Trust: Principles of Public Service Ethics, Marina del Rey, CA, 1990)
The responsibility of those trying to influence public policy is to interact with public
officials in such a way that they do not ask or tempt those officials to put private
interests above the public good.
Conflict-of-interest analysis is an important tool that identifies public officials' ethical
responsibility. I believe conflict-of-interest analysis could be equally important in
identifying ethically unacceptable lobbying techniques and strategies that encourage
public officials to put private interest above the public good.
99
Healthcare managers and supervisors must pay careful attention to the methods of
lobbying their organizations use to save time, effort and energy. What message is sent
when a healthcare political action committee contributes to the campaign of a particular
legislator? What are the implications of hiring a professional lobbyist to represent the
organization?
A healthcare manager should not assume that professional lobbyists have the same
ethical commitments that he or she does. Unless healthcare managers make an explicit
effort to know and monitor the methods of the lobbyists they hire, they cannot assume
that those methods will always be appropriate.
Lobbying's Good Is Widespread

Lobbying can be an activity in which ethically sensitive persons take pride. Advocating
effectively and with political integrity for public policies that contribute to a more just
healthcare system is fulfilling a professional responsibility, achieving an institutional
goal, and performing a major public service.
Source:Journal of the Catholic Health Association of the United States HEALTH

PROGRESS
https://www.chausa.org/publications/health-progress/article/november-1993/healthcare-
management-ethics---a-positive-view-of-
lobbying?fbclid=IwAR0hvivYN8ImsJAuxy6iTfYZXn0lV3bh3_O89OHIzI61wyTa0B0RVF8
oBY8
Self-Check 1
Write down below as many as you could what is asked in the column:
Good aspect/effect of lobbying Negative aspect/effect of lobbying
Title of the Lesson: Lesson 2 Code of Ethics for Nurses

Duration: 3 hours
100
Lesson Proper:
7.2.1 “ INTERNATIONAL CODE OF ETHICS

>An international code of ethics for nurses was first
adopted by the International Council of Nurses (ICN) in
1953. It has been revised and reaffirmed at various times
since, most recently with this review and revision
completed in 2012
ELEMENTS OF THE CODE
Nurses and People
> the nurses’ primary professional responsibility is to people requiring nursing care.
>In providing care, the nurse promotes an environment in which the human rights,
values, customs and spiritual beliefs of the individual, family and community are
respected.
>The nurse ensures that the individual receives accurate, sufficient and timely
information in a culturally appropriate manner on which to base consent for care and
related treatment.
>The nurse holds in confidence personal information and uses judgement in sharing this
information.
>The nurse shares with society the responsibility for initiating
and supporting action to meet the health and social needs of the public, in particular
those of vulnerable populations.
>The nurse advocates for equity and social justice in resource allocation, access to
health care and other social and economic services.
>The nurse demonstrates professional values such as respectfulness, responsiveness,
compassion, trustworthiness and integrity
B. Nurses and Practice

>the nurse carries personal responsibility and accountability for nursing practice, and for
maintaining competence by continual learning.
>The nurse maintains a standard of personal health such that the ability to provide care
is not compromised.
>The nurse uses judgement regarding individual competence when accepting and
delegating responsibility.
>The nurse at all times maintains standards of personal conduct which reflect well on
the profession and enhance its image and public confidence.
>The nurse, in providing care, ensures that use of technology and scientific advances
are compatible with the safety, dignity and rights of people.
101
>The nurse strives to foster and maintain a practice culture promoting ethical behaviour
and open dialogue.
C. Nurses and the Profession

>the nurse assumes the major role in determining and implementing acceptable
standards of clinical nursing practice,
management, research and education.
>The nurse is active in developing a core
of research-based professional knowledge
that supports evidence-based practice.
>The nurse is active in developing and
sustaining a core of professional values.
>The nurse, acting through the
professional organisation, participates in
creating a positive practice environment
and maintaining safe, equitable social and economic working conditions in nursing.
>The nurse practices to sustain and protect the natural environment and is aware of its
consequences on health.
>The nurse contributes to an ethical organisational environment and challenges
unethical practices and settings.
D. Nurses as Co-workers
>the nurse takes appropriate action to safeguard individuals, families and communities
when their health is endangered by a co-worker or any other person.
>The nurse sustains a collaborative and respectful relationship with co-workers in
nursing and other fields.
>The nurse takes appropriate action to safeguard individuals, families and communities
when their health is endangered by a co-worker or any other person. “
- (Source: THE ICN CODE OF ETHICS FOR NURSES)

https://www.icn.ch/sites/default/files/inline-files/2012_ICN... · PDF file
7.2.2 CODE OF ETHICS FOR FILIPINO NURSES
A. Registered Nurses and People
Ethical Principles under Section 4 Article 2
1. Values, customs, and spiritual beliefs held by individuals shall be respected.

2. Individual freedom to make rational and unconstrained decisions shall be respected.
3. Personal information acquired in the process of giving nursing care shall be held in
strict confidence.
102
a. consider the individuality and totality of patients when they administer care.
b. respect the spiritual beliefs and practices of patients regarding diet and treatment.
c. uphold the rights of individuals.
d. take into consideration the culture and values of patients in providing nursing care.
However, in the event of conflicts, their welfare and safety must take precedence.
B. Registered Nurses and Practice
1. Human life is inviolable.

2. Quality and excellence in the care of the patients are the goals of nursing practice.
3. Accurate documentation of actions and outcomes of delivered care is the hallmark of
nursing ac
a. know the definition and scope of nursing practice which are in the provisions of R. A.
No. 9173, known as the “Philippine Nursing Act of 2002” and Board Res. No. 425,
Series of 2003, the “Rules and Regulations Implementing the Philippine Nursing Act. of
2002”, (the IRR).
b. be aware of their duties and responsibilities in the practice of their profession as
defined in the “Philippine Nursing Act of 2002” and the IRR.
c. acquire and develop the necessary competence in knowledge, skills, and attitudes to
effectively render appropriate nursing services through varied learning situations. PRC-
BN
d. if they are administrators, be responsible in providing a favorable environment for the
growth and developments of Registered Nurses in their charge.
e. be cognizant that professional programs for specialty certification by the BON are
accredited through the Nursing Specialty Certification Council (NSCC). g. see to it that
quality nursing care and practice meet the optimum standard of safe nursing practice.
h. insure that modification of practice shall consider the principles of safe nursing
practice.
i. if in position of authority in a work environment, be normally and legally responsible for
devising a system of minimizing occurrences of ineffective and unlawful nursing
practice.
j. ensure that patients' records shall be available only if they are to be issued to those
who are professionally and directly involved in their care and when they are required by
law".
103
Ethical Principle under Section 8 Article 3
4. Registered Nurses are the advocates of the patients: they shall take appropriate
steps to safeguard their rights and privileges.

a. respect the “Patients’ Bill of Rights” in the delivery of nursing care.
b. provide the patients or their families with all pertinent information except those which
may be deemed harmful to their well-being.
c. uphold the patients’ rights when conflict arises regarding management of their care
Ethical Principle under Section 10 Article 3
5. Registered Nurses are aware that their actions have professional, ethical, moral, and
legal dimensions. They strive to perform their work in the best interest of all concerned

a. perform their professional duties in conformity with existing laws, rules, regulations.
measures, and generally
accepted principles of moral conduct and proper decorum.
b. not allow themselves to be used in
advertisements that should demean the
image of the profession (i.e. indecent
exposure, violation of dress code,
seductive behavior, etc.).
c. decline any gift, favor or hospitality which
might be interpreted as capitalizing on
patients.
d. not demand and receive any
commission, fee or emolument for
recommending or referring a patient to a physician, a co-nurse or another PRC-BN
health care worker; not to pay any commission, fee or other compensations to the one
referring or recommending a patient to them for nursing care.
e. avoid any abuse of the privilege relationship which exists with patients and of the
privilege access allowed to their property, residence or workplace.
C. Registered Nurses and Co-workers
104
1. The Registered Nurse is in solidarity with other members of the healthcare team in
working for the patient’s best interest.
2. The Registered Nurse maintains a collegial and collaborative working relationship
with colleagues and other health care providers.

a. maintain their professional role/identity while
working with other members of the health team.
b. conform with group activities as those of a
health team should be based on acceptable,
ethico-legal standards.
c. contribute to the professional growth and
development of other members of the health
team.
d. actively participate in professional
organizations. e. not act in any manner prejudicial
to other professions.
f. honor and safeguard the reputation and dignity of the members of nursing and other
professions; refrain from making unfair and unwarranted comments or criticisms on their
competence, conduct, and procedures; or not do anything that will bring discredit to a
colleague and to any member of other professions.
g. respect the rights of their co-workers.
D. Registered Nurses, Society and Environment
1. The preservation of life, respect for human

rights, and promotion of a healthy environment
shall be a commitment of a Registered Nurse.
2. The establishment of linkages with the
public in promoting local, national, and
international efforts to meet health and social
needs of the people as a contributing member
of society is a noble concern of a Registered
Nurse.
"REGISTERED Nurses must:
105
a. be conscious of their obligations as citizens and, as such, be involved in community
concerns. PRC-BN
b. be equipped with knowledge of health resources within the community, and take
active roles in primary health care.
c. actively participate in programs, projects, and activities that respond to the problems
of society.
d. lead their lives in conformity with the principles of right conduct and proper decorum.
e. project an image that will uplift the nursing profession at all times.
E.Registered Nurses and the Profession
1. Maintenance of loyalty to the nursing profession and preservation of its integrity are
ideal.
2. Compliance with the by-laws of the accredited professional organization (PNA), and
other professional organizations of which the Registered Nurse is a member is a lofty
duty.
3. Commitment to continual learning and active participation in the development and
growth of the profession are commendable obligations.
4. Contribution to the improvement of the socio-economic conditions and general
welfare of nurses through appropriate legislation is a practice and a visionary mission."
"Registered Nurses must

a. be members of the Accredited Professional Organization (PNA).
b. strictly adhere to the nursing standards.
c. participate actively in the growth and development of the nursing profession
d.strive to secure equitable socio-economic and working conditions in nursing through
appropriate legislation and other means.
e.assert for the implementation of labor and work standards."
(Source: PRC-BN)
www.prc.gov.ph/uploaded/documents/Board of Nursing-CE.pdf · PDF file
Self- Check 2
List all that apply in the appropriate column what nurses are expected to manifest or
must do.
International Code of Ethics for Code of Ethics for Filipino Nurses
106
Nurses
1. Nurses and People 1. Registered Nurses and People
2. Nurses and Practice 2. Registered Nurses and Practice
3. Nurses and the Profession 3. Registered Nurses & Co-workers
4. Registered Nurses, Society and

4. Nurses as Co-workers
Environment
5. Registered Nurses and the Profession
Post Test
MATCHING TYPE: You have to match Column A with Column B and write your answer on the
space provided before each question.
COLUMN A COLUMN B
_____1. Nurses A. The nurse demonstrates professional values such as

As Practice respectfulness,responsiveness, compassion, trustworthiness
and integrity.
B. The nurse must know the definition and scope of nursing
_____2. Nurses practice which are in the provisions of R. A. No. 9173, known as
& Co-workers
the “Philippine Nursing Act of 2002” and Board Res. No. 425,
Series of 2003, the “Rules and Regulations Implementing the
_____3. Nurses Philippine Nursing Act. of 2002”, (the IRR).
& People C. The nurse assumes the major role in determining and
implementing acceptable standards of clinical nursing practice,
management, research and education.
_____4. D. The nurse must honor and safeguard the reputation and dignity
Nurses, Society of the members of nursing and other professions; refrain from making
& Environment unfair and unwarranted comments or criticisms on their competence,
conduct, and procedures; or not do anything that will bring discredit to
a colleague and to any member of other professions.
107
_____5. Nurses E. The nurse must lead their lives in conformity with the principles
& the of right conduct and proper decorum, project an image that will uplift
Profession the nursing profession at all times.
TRUE OR FALSE: Write True if the statement is correct and False if otherwise
_________1. Lobbying can be an activity in which ethically sensitive persons don’t take
pride.
_________2. One of the fundamental objectives of the healthcare management
profession
to create a more equitable,accessible,ineffective & efficient healthcare
system.
_________3. When we act as consumers, we seek to acquire what we want for
ourselves.
_________4. When we act as citizens, we seek to achieve what is right or best for
the
community.
_________5.A healthcare manager should assume that professional lobbyists have
the same ethical commitments that he or she does.
Final Requirement
For your final requirement, you just need to play the link and answer the questions
below.
_________________________play this link______________________________
https://drive.google.com/file/d/1IAz-
M9VHXwaTuZqXIbJfVLLDXs3S872u/view?usp=sharing
1. Presuming you as a nurse is Patch Adams in the film, would you do the same
actuations or decisions he did make?Expound your answer by citing 3 situations
and correlating it with nurses' code of ethics.
2. Cite situations in the movie where lobbying was portrayed or depicted and how
do you react to this.
108
3. In the movie, how was patient’s Bill of Rights portrayed? Was it in accordance
with the law or against it? Cite the situation from the movie and defend your
answer.
References
Weber M.D (1993). Healthcare Management of Ethics- A Positive View of Lobbying.

Retrieved from: https://www.chausa.org/publications/health-progress/article/november-
1993/healthcare-management-ethics---a-positive-view-of-
oBY8
International Code of Ethics for Nurses (2018) International Council of Nurses. ICN.ch.
Retrieved from: https://www.icn.ch/sites/default/files/inline-files/2012_ICN... · PDF file
Code of Ethics for Filpino Nurses (2018) Board of Nursing, Processional Regulation
Commission. Prc.gov.ph. Retrieved from: www.prc.gov.ph/uploaded/documents/Board
of Nursing-CE.pdf · PDF file
Tom Shadyac (1998) Patch Adams Film. Hollywood, USA. Retrieved at:
GLOSSARY
Assent:: a subject's certifiable consent to take an interest in research. Consent may

occur when the subject doesn't have the ability to give educated consent(e.g. the
subject is a youngster or intellectually impaired) however has the ability to definitively
consent.
Belmont Report: A report gave by the U.S. Public Commission for the Protection of
Human Subjects in Biomedical and Behavioral Research in 1979, which has had a huge
109
impact over human subjects research morals, guideline, and strategy. The report gave a
theoretical establishment to the Common Rule and verbalized three standards of
morals: regard for people, helpfulness, and equity.
Beneficence: the moral commitment to do great and abstain from causing hurt.
Cognitive: means knowledge or intellectual capacity of a living thing.
Conflict of interest (COI): a circumstance where an individual has a money related,

individual, political or other premium which is probably going to predisposition their
judgment or dynamic concerning the exhibition of their moral or lawful commitments or
obligations.
Conflict of interest, apparent or perceived: a circumstance where an individual has a

monetary, individual, political or other intrigue that isn't probably going to predisposition
their judgment or dynamic concerning the presentation of their moral or lawful
commitment or obligations yet which may appear to an external eyewitness to
inclination their judgment or dynamic.
Conflict of interest, institutional: a circumstance wherein a foundation, (for example,

a college) has monetary, political, or different interests which are probably going to
biasinstitutional dynamic concerning the presentation of institutional moral or lawful
obligations.
Conflict of interest, management: procedures for limiting the antagonistic effects of an

irreconcilable situation, for example, divulgence, oversight, or recusal/disallowance.
Contraception: These are the medically proven medication or devices that are against
or prevent the pregnancy
Divine: pertaining to the Creator; Higher Order; God
Decision-making capacity (DMC): the capacity to settle on quality choices. DMC is

frequently situational and comes in degrees: for instance, an individual might have the
option to arrange food from a menu yet not have the option to settle on a choice
concerning complex clinical treatment. Variables that can bargain DMC incorporate
psychological instability or handicap, extraordinary passionate pressure, medications,
age, or genuine physical disease. DMC isn't equivalent to lawful skill: an insane grown-
up might be legitimately able however need DMC.
Digital Health: Part of health services that are being operated by a wearable gadget.
110
De-identified data or samples: information or natural examples which have been
deprived of data, for example, name or clinical record number, which actually
distinguishes people.
Deontology: a way to deal with morals, for example, Kantianism, which stresses
adherence to rules or standards of direct.
Development: A constant change in behavior and knowledge over time.
Discrimination: treating individuals distinctively dependent on insignificant qualities, for

example, skin shading, identity, or sex.
Double-blinding: measures used to forestall human exploration subjects and analysts

from finding who is accepting a test treatment versus a fake treatment. Twofold blinding
is utilized to control for the misleading impact.
Ethics: moral philosophy; right and wrong behaviors are being analyzed, defending
with recommendations of principles.
Ethical dilemma: A circumstance where at least two potential activities seem, by all
accounts, to be similarly legitimate from a moral perspective, for example one must pick
between the lesser of two wrongs or the more prominent of two merchandise.
Ethical reasoning: Making a choice because of an ethical situation based a cautious

and careful evaluation of the various alternatives considering the realities and conditions
and moral contemplations.
Good clinical practices (GCPs): rules and systems for leading clinical trialssafely and
thoroughly.
Good laboratory practices (GLPs): rules and methods for planning and performing
trials or tests and recording and breaking down information thoroughly. A few kinds of
exploration are legally necessary to hold fast to GLPs.
Good manufacturing practices (GMPs): rules and methodology for assembling an

item, (for example, a medication) as indicated by norms of value and consistency.
Good record-keeping practices (GRKPs): rules and methodology for keeping

research records. Records ought to be intensive, exact, total, composed, marked and
dated, and supported up.
111
H
Helsinki Declaration: moral rules for leading clinical exploration including human
subjects research received by the World Medical Association.
Honesty: the moral commitment to come clean and abstain from misdirecting others. In
science, a few kinds of contemptibility incorporate information manufacture or
adulteration, and copyright infringement.
Informed consent: the way toward settling on a free and educated choice, (for
example, to partake in research). People who give educated assent must be legitimately
capable and have enough dynamic ability to agree to explore. Examination guidelines
indicate the sorts of data that must be uncovered to the subject.
Informed consent, blanket (general): an arrangement in an educated assent archive

that allows general to analysts to utilize the subject's information or tests for different
purposes and offer them with different scientists.
Informed consent, documentation: a record, (for example, a structure) used to report

the cycle of assent. Examination guidelines necessitate that assent be archived;
nonetheless, an institutional survey board may choose to defer documentation of assent
if the exploration is insignificant danger and 1) the standard danger of the investigation
is break of secrecy and the main record connecting the subject to the examination is the
assent structure or 2) the exploration includes strategies that ordinarily don't need
composed assent outside of the exploration setting.
Informed consent, specific: an arrangement in an educated assent report that expects

specialists to acquire explicit authorization from the subject preceding utilizing tests or
information for purposes other than those that are essential for the investigation or
offering them to different scientists.
Informed consent, tiered: arrangements in an educated assent report that give the
subject different choices concerning the utilization and sharing of tests or information.
Choices may incorporate cover assent, explicit assent, and different decisions.
Informed consent, waver: in human subjects research, the choice by an institutional

audit board to postpone (or put in a safe spot) a few or the entirety of the educated
assent prerequisites. Waivers are not typically conceded except if they are important to
lead the exploration and posture insignificant dangers to the subjects.
K
Kantianism: A moral hypothesis created by German logician Immanuel Kant (1724-
1804), which holds that the best activity is to play out one's obligation for the good of
duty. One's obligation is characterized by a moral standard known as the clear cut
112
objective (CI). As indicated by one form of the CI, one should act as per a saying that
could turn into a standard for all individuals. As per another rendition, one ought to
consistently regard individuals as having natural virtue (or pride) and never just as
articles or things to be utilized to accomplish some end.
Mismanagement of funds: spending research reserves inefficiently or illicitly; for

instance, utilizing award reserves dispensed for gear to pay for movement to a
gathering. A few sorts of botch may likewise establish extortion or theft.
Moral: It is an individual interpretations about the right or wrong based on the personal
experiences and existing standard of the society
Nuremberg Code: the primary global morals code for human subjects research,
embraced by the Nuremberg Council during the atrocities courts in 1947. The code was
utilized as a reason for sentencing Nazi doctors and researchers for atrocities identified
with their trials on inhumane imprisonment detainees.
Orthonasia: facing death naturally
Privacy: a condition liberated from undesirable interruption into one's very own space,
private data, or individual undertakings. See additionally Confidentiality.
Psychoanalytic: an analysis or interpretation of personalities.
Pyschosocial: an analysis or interpretation of behavior of each human stages to the

society
Subject selection: rules for including/barring human subjects in research. Subject

choice ought to be fair, for example subjects ought to be incorporated or rejected for
real logical or moral reasons. For instance, a clinical preliminary may prohibit subjects
who don't have the infection under scrutiny or are too wiped out to even think about
taking part in the investigation securely.
113
Telehealth: a new trend of healthcare that allows patient to have an access to health
information, treatment and advice from medical professionals with the use of online
technological means.
Telemedicine: A medical care being rendered by a physician from a distance with the
help of technology
Telenursing: A nursing care being rendered by a registered nurse from a distance with
the help of technology especially in terms in health education
Theory: Set of ideas that needs to be proven; or set of assumptions of the existing
phenomenon
Utilitarianism: A moral hypothesis which holds that the best activity is to create the
best parity of good/terrible ramifications for the best number of individuals. Act
utilitarians center around great coming about because of specific activities while rule
utilitarians center around joy coming about because of adhering to rules. Utilitarians
may liken the great with joy, fulfillment of inclinations, or some other attractive results.
See additionally Consequentialism, Ethical hypothesis.
Withdrawal: eliminating a human subjects research from an examination. Subjects may

willfully pull back or be pulled back by the specialist to shield them from hurt or
guarantee the uprightness of the examination. Subjects who pull back from an
investigation may demand to have their examples taken out from the examination
Answer to Quizzes
Unit 1. Theories of Health Ethics
Pre-Test
1)B 2)A 3)B 4)B 5)B 6)B 7)B 8)B 9)A 10)B
Post-Test
II.True or False 6. F
1. F 7. F
2. T 8. F
3. F 9. F
4. F 10. F
5. F
114
Unit 2. Principle of Ethics 5. a
6. b
II. Multiple Choice 7. a
1.a 8. c
2. c 9. d
3. b 10.b
4. d
Pre-test: 3. Principle of Justice

4. Principle of Autonomy and
1. Morality Justice
2. Ethics 5. Principle of Justice and
3. Health Care Ethics Stewardship
4. Veracity 6. Principle of Confidentiality
5. Autonomy 7. Principle of Veracity
6. Fidelity 8. Principle of Stewardship
7. Nonmaleficence 9. Principle of Ordinary Means
8. Beneficence 10. Principle of Justice and
9. Confidentiality Stewardship
10. Justice 11. Principle of Fidelity
Post-test: 12. Principle of Fidelity
13. Principle of Justice
1. Principle of Totality and Integrity 14. Principle of Justice
2. Principle of Autonomy 15. Principle of Fidelity and Justice
Unit 3. Bioethics and its Applications to Various Healthcare Situations
Pre-test.
1. Euthanasia 6. In-vitro fertilization

2. Family 7. Abortion
3. Contraception 8. Incomplete Abortion
4. Orthonasia 9. Missed Abortion
5. Suicide 10. Dysthanasia
Post-test.
115
1. D 9. B
2. A 10. C
3. C 11. B
4. B 12. A
5. B 13. C
6. C 14. B
7. B 15. C
8. B
Unit 4. Bioethics and Research
Pre-Test Post-Test
1. A 1. F
2. B 2. F
3. B 3. F
4. C 4. F
5. D 5. T
6. A 6. F
7. B 7. F
8. A 8. F
9. A 9. T
10. C 10. F
Unit 5. Ethical Consideration in Leadership and Management
Pre-Test Post-Test
1. B 11. 7
2. C 12. 2
3. A 13. 9
4. D 14. 3
5. A 15. 4
6. C 16. 10
7. D 17. 5
8. B 18. 8
9. C 19. 6
10. D 20. 1
116
Unit 6 Ethical Issues in Related to Technology in the Delivery of Healthcare.
Pre-Test
1. TRUE Post-Test
2. TRUE
3. FALSE
4. TRUE Identification:
5. FALSE
1. Data Privacy Act of 2012
6. TRUE
2. Telemedicine
7. TRUE
3. Personal Identification
8. FALSE
4. Telehealth
9. TRUE
5. Telenursing
10. TRUE
Enumeration:
1-5. Could either be any of these: Marital status, age, color, religious,
philosophical or political affiliations; Individuals health, education, gender, sexual
life, any offense committed or alleged to have been committed; Issued by
government agencies like SSS/GSIS number, previous or current health records,
licenses, suspension or revocation, tax returns.
6-8. Improved Patient Care; Better Education; Improved Treatment; Better kept record
9-11. Set Up & Internet Access; Malfunctioning Equipment; At the Mercy of the Server/
Power; Potential Lack of Attention to Detail
Unit 7 Continuing Education Programs on Ethico-Moral Practice in Nursing
Pre-test Post Test:

1. True A. Matching Type
2. True 1. B
3. False 2. D
4. True 3. A
5. True 4. E
6. True 5. C
7. False B. True or False
8. True 1. True
9. False 2. False
10. True 3. True
4. False
5. True
117
References
4 Advantages & 4 Disadvantages of Technology in Nursing (2019, January 29).

Healthcarepros.net. Retrieved from https://www.healthcarepros.net/4-advantages-4-
disadvantages-of-technology-in-nursing/
American Nurses Association (2016). Code of Ethics for Nurses. Retrieved

from:https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics/endoflife-
positionstatement.pdf
Board of Nursing (2020). Code of Ethics for Filpino Nurses.. Processional Regulation
Commission, Manila. Retrieved from: www.prc.gov.ph/uploaded/documents/Board of
Nursing-CE.pdf · PDF file
Canister Scandal, (2008 September 9). Youtube.com. Retrieved from:

118
Douglas, M. Summary of the Steps of Decision Making Process. University of
Kansas.Retrieved from:
https://research.ku.edu/sites/research.ku.edu/files/docs/EESE_EthicalDecisionmakingFr
amework.pdf
Grajek, S. 2019. Top 10 IT Issues, 2020: The Drive to Digital Transformation Begins.
Retrieved from https://er.educause.edu/articles/2020/1/top-10-it-issues-2020-the-drive-
to-digital-transformation-begins
International Council of Nurses ( 2020). International Code of Ethics for Nurses.
Retrieved from: https://www.icn.ch/sites/default/files/inline-files/2012_ICN... · PDF file
Mishra, R. 2019. Emerging Technology Trends Shaping the Healthcare Industry.

Retrived from https://blog.relecura.com/2019/02/emerging-technology-trends-shaping-
the-healthcare-industry/
Nambayan,A & Lu, H., (2015) Palliative care in the Philippines. Oxford University.
Retrieved
from:https://oxfordmedicine.com/view/10.1093/med/9780199332342.001.0001/med-
9780199332342-chapter-81
Code of Ethics for Nurses. (2004). prc.gov.ph. Retrieved from:

Republic Act 10173 – Data Privacy Act of 2012.(2012). Privacy.gov. Retrieved from:
Tom Shadyac (1998) Patch Adams Film. Hollywood, USA. Retrieved at:
Weber M.D (1993). Healthcare Management of Ethics- A Positive View of Lobbying.
Retrieved at: https://www.chausa.org/publications/health-progress/article/november-
1993/healthcare-management-ethics---a-positive-view-of-
oBY8
119
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Republic of the Philippines

Bulacan State University

Gil Benedict C. Llamelo, RN

Jane Marie M. Sumodlayon, RN, MAN

Maria Corazon De Guzman, RN, LPT, MSN

Course Syllabus ………………………………………………………………….5

UNIT 1 Theories of Health Ethics……………………………………..……….... 34

Lesson 1: Human Value Development …………………………………….37

Lesson 2: Theories of Human Development…..……………….…………38

Lesson 3: Ethical Theories…………………..…………………………..…...40

Lesson 4: Divine Command Ethics…………………………………………41

UNIT 2 Principles of Health Ethics…………..………………………..………...48

Lesson 1: Virtue Ethics………………………………………………………..50

Lesson 2: Ethical Principles…………………………………………..………51

Lesson 3: Other relevant Ethical Principles……………………………….53

Lesson 4: Other principles of Bioethics……………………………..…......53

UNIT 3 Bioethics and its Application in Various Health Care Situations...59

Lesson 1: Sexuality and Human Reproduction………………….………..61

Lesson 2: Dignity in Death and Dying……………..………………………...63

Lesson 3: Nursing Roles and Responsibilities

Lessson 4: Ethical Decision Making Process.……………………………66

UNIT 4 Bioethics and Research…………………………………………..…......71

Lesson 1:Principles of Ethics in Research…………..……………………..74

Lesson 2:Ethical issues in Evidence Based Practice………..…………...76

Lesson 3: Ethico-moral Obligations of the

Lesson 4: Introduction to Good Clinical

Lesson 1: Moral Decision Making……………………………………….…...84

Lesson 2: Strategies of Moral Decision Making Process……...………...86

Lesson 3:Meaning and Service

UNIT 6 Ethical Issues Related to Technology in

Lesson 1: Data Protection

Lesson 2:Benefits and Challenges of

Lesson 3: Current Technology: Issues and

UNIT 7Continuing Education Programs on

Lesson 1: Lobbying/ Advocating for Ethical Issues

Lesson 2: Code of Ethics for

Lesson 3: Registered Nurses and People………………………………….114

Lesson 4: Registered Nurses and Society and Environment.,………….116

Answer Keys…… ……………………………………………………………….117

Core Values: SOAR BulSU!

Service to God and Community

Program Educational Objectives (PEO)

Program Outcomes (PO)

Course Outcomes and Relationship to Program Outcomes

Course Outcomes Program Outcomes

University VMGO Online/ Recorded discussion

Bioethics and its

1.Data Privacy Act

FINAL COURSE OUTPUT:

Rubric for Oral Revalida

Criteria Exemplary Proficient Needs

5 pts 4 pts 3 pts

Organization · The information · Student presents · Sequence of

Language · Effectively uses · Maintains eye · Maintains eye

Question and · Demonstrates · Demonstrates · Demonstrates

Rubrics for Written Report Presentation

(applies to requirements such as homework/assignments, project

Criteria Exemplary Proficient Needs

5 pts 4 pts 3 pts

Organizatio · Struct · Struct · Organiz