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Ethics Bioethics Christian Bioethics Professional SIGNIFICANCE OF BIOETHICS IN MEDICAL / LIFE

Bioethics SCIENCE PRACTICE
ETHICS - Medicine (or health care) is a moral enterprise
- The ought or ethical dimension is an integral part of the
- Greek term Ethos medical decision
- Latin term Mores moral - The duty to help others in need
-I i a ema ic d of h man righ ne or - If there is no element of goodness or rightness (without
wrongness humanity), you are not a physician but a scientist
- Science of what a man ought to be by reason of what he - A tragic person is a meaningless person
is (moral being) - Gi e direc ion, g ide, meaning; can relie e people
- Kind of character; pattern of behavior; developed pain and suffering whose only is in our hands
- A doctor without ethics is a mere technician. But with
Character begins with what we think ethics, s/he is properly called a physician
1. Thought Greek ord fisica nature; full of life
2. Acts
Expert of human life
3. Habit repetition of acts
- Good virtue
- Bad vice PROFESSION
4. Character a result of a long process
- Etymologically from latin professo or profiteor
BIOETHICS - Does not come from profit or profitere gain money
- To profe i o make a p blic declara ion i h a
- Ethics of life sciences; rightness or wrongness of a commi men or promi e o er e
procedure towards life especially to issues, dilemmas, - Usually practiced with a group that shares the common
and problems brought by science and biotechnology in skill, knowledge, and code
relation to human life and dignity - Presented as a socially-benefiting undertaking and the
- Both normative and practical science society accepts it, expecting it to serve some important
- Mix of theory and practice in which biomedical facts and social goals
ethical principles are mutually connected and enriched
Amateur Professional
CHRISTIAN BIOETHICS - Traditionally initiated - Should always be at the
into the trade or craft height of knowledge
- Applying the principle of ethics in life sciences (health - More erratic, panicky, - More skills, knowledge,
sciences, research, and the environment clumsy and experience
- Supreme confidence
PROFESSIONAL BIOETHICS
CORE VALUES OF PROFESSIONALISM
- Very limiting
- Codes concretized in the practice of medicine 1. Commitment to excellence and competence
- Spring for h a a na ral concep in he prac ice of one
skill Competence
Try to practice skill that will benefit others; - Specialized body of knowledge and skill necessary to
humanize the well-being of yourself and other practice the profession
people - Makes the professional analytic and practical in dealing
- Without a natural moral line, the best profession is with his trade
always bad - Result of continuing education and training
He m , herefore, ac according o hi na re and
cho en profe ion Commitment of excellence
- Always have a space for charity - Refers to lifelong learning in order to keep at the cutting
Do what you love, money will follow 😉 edge of the trade
Provide quality medicine affordable, efficient,
TOWARDS A GLOBAL ETHICS moral
- Pursuing more
- Basic condition: Every human being must be treated in
a human way
2. Adhere to code of conduct
- Requirements:
- Ethically nature
1. A cultural respect for human life
- Aside from knowledge, temper it with conduct
2. A culture of solidarity with fellow humans o be one
- Promote notions of duty, honor, and integrity
3. A culture of tolerance and a coherent life style
- Delineates provisions that bind the professional to
4. A culture of equality of all persons nobody is lesser
practice moral values, especially justice and fairness
because we have the same value
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- Moral compass that keeps us on the straight and narrow 3. Circumstances

way - Particulars, events, or occasions that surround the act
- Guide to action where primacy of least harm and - Severity depends on (a) who, (b) what, (c) whom, (d)
maximum benefit is to good professional behavior why (e) how (f) where and (g) when
- Affects responsibility but not the nature of morality
3. Altruism - Ex. Robin hood
- Al er others The bad can never be good. However,
- Simply doing good for others, putting their interests responsibility is lesser because of nobility of the act
before the person of the professional, sometimes at But for example, he stole from the poor,
great personal sacrifice responsibility is higher
- Unselfish regard - Worse crime: Poor widow w/ P100 > Henry Sy w/
P20,000
4. Society must give you authority to do it
NORMS OF MORALITY
Imprimatur of the society
- Latin for To le i be prin ed or Go ahead, o are clear 1. Natural Law (Objective norm)
EXAMPLE:
You are not doing any harm to anybody 2. Conscience (Subjective norm)
Norm in Driving
- Socie a hori o gi e licen e or en i lemen o - Evaluation; voice inside
Philippines right
people to practice their profession Britain - left

CONSTITUENTS OF HUMAN ACTS

Natural Moral Law natural law applied to behavior
- Subjected to right or wrong/good or bad Law (1)ordinance of (2)reason (3)promulgated by a duly
- Human act deserves a constituted (4)authority for the (5)common good of the
Merit/reward or society
Punishment
KINDS OF LAW
- More knowledge, freedom, and/or voluntariness, more
responsible 1. Eternal Law
- Divine will/wisdom directing all actions and movements
1. Knowledge - Commands that the nature of things be preserved and
- Advertence of what the moral agent is doing, thinking, forbids that it be disturbed
willing - Ex. Sun rises in the east; unbalance ecology
- Knowledge of ends and means to do the act flashflood
- Knowledge of the implication and conditions of the act
2. Natural Law
2. Freedom - Man hare in he e ernal la
- Power to choose from among the alternatives - Law of human conduct arising from human nature as
ordered to the natural ultimate end which is recognized
3. Voluntariness by the nature light of reason (Natural Moral Law)
- Any action or omission that results from an internal - Understanding the natural law will lead us to the solution
principle within the agent and eventually ends in an if there is a problem
actual act - Man is included in this universal plan. As an intelligent
being, he is able to recognize the laws designed for him
SOURCES / DETERMINANTS OF MORALITY which is called Natural Law.
1. Object of the Act
a. The act performed CONTENTS OF THE NATURAL LAW
b. The end of the act Golden r le: Do n o o her a o o ld ha e hen do
c. The effect of which an action primarily and directly no o
causes a. Fundamental principles of action
- Ex. Studying regularly diligence/studiousness as the b. General principles that sustain relationship with self,
specific act others and God
- Giving help to the needy alms-giving c. Application of the general principles to specific
situations
2. Motive/Intention of the Agent d. Remote conclusions
- The end of the agent, the motive which the agent wants
to achieve 3. Positive Law
- Ex. If you want to be a doctor, you need to continuously - Enacted by authorities
study, go on duties, see patient, etc.
- Sometimes, object is the same as motive
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CONSCIENCE PRINCIPLE OF HUMAN DIGNITIY

- con to be together All ethical decisions aim at human dignity and human
- science knowledge needs
- The quality of practical judgment by which one
determines that an act is good (therefore to be done) or Ab aha A. Ma l Hie a ch f Need The
bad (there to be avoided) 1. Physiological food, water
- Must be accompanied by knowledge 2. Safety/security
3. Belongingness
PRINCIPLE OF A WELL-FORMED CONSCIENCE 4. Self-esteem
5. Self-actualization
To attain the true goals of human life by responsible
actions, in every free decision involving an ethical question, PRINCIPLE OF STEWARDSHIP AND CREATIVITY
people are usually obliged to do the following:
- Steward - caretaker
1. Inform themselves as fully as practically possible about - Gifts of multidimensional nature and natural
the facts and the ethical norms environment must be used
2. Physical examination, diagnosis, epidemiology - With profound respect
3. Recognize signs and symptoms The person is an end to itself and a means to an
E hical norm of Jeho ah i ne e : canno be end
transfused with blood - Nature Intrinsic purpose
2. Form a morally certain judgment of conscience on the Must be conscious and respectful for intrinsic
basis of information teleology
3. Act according to this well-formed conscience - Human creativity develop the environment within the
4. Accept responsibility for actions made bounds of actual knowledge
CASE Attitude
A nurse who does not want to participate in an There is always truth in research
abortion procedure CASE
Conscientious objection - cannot be something that A couple planned/conceived a baby to get BM for
violate himself their 18 year old daughter
The child is an end in itself, never a means to an end.
HIERARCHY OF BEINGS WALANG GAMITAN!
Inferior beings are ordained to superior beings PRINCIPLE OF TOTALITY
1. God
2. Man PURPOSE:
3. Animals To promote human dignity and integrity
4. Plants - o celebra e holene
5. Minerals
To promote human dignity or integrity in community, every
HUMAN DIGNITIY
person must develop, use, care for, and preserve all of his
- La in erm digna worth natural physical and psychic functions in such a way that:
- The state of being respected or honored to the essential 1. Lower functions are never sacrificed except for the
or intrinsic worth or value of the human person better functioning of the whole person and even then
- Human life starts during fertilization with an effort to compensate that define human
- Such value cannot be quantified nor reduced into personhood.
monetary terms, but is always inestimable or Diabetic foot has to be sacrificed to have a better
incalculable function
Nose lift and liposuction is okay because social life
BASES OF HUMAN DIGNITIY is an ethical function
Botox is not okay because it destroys nerve/s
1. Image and likeness of God 2. Basic capacities that define human personhood are
2. Redeemed by Christ never sacrificed unless this is necessary to preserve
3. Man has ultimate destiny life.
4. Man is a moral being
It boils down to MOTIVATION promotes sanctity and
What lies at the heart of all ethical thinking is the issue of majesty of the human body (integrity)
our capacity and our willingness to recognize others and a. Necessity
their uniqueness. Bit, it cannot be denied that there is a b. Vanity obsession of a person to make himself in
moment when the mind makes summons of this so-called order to be admired
o her . Thi i he fer ili ed o m in its primitive state.
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c. Insanity try to do anything to the body within the CASE

borders of insanity Pregnant woman has tumor, AOG 24 weeks
1. Wait for another 1 month, do C section to save the
Beauty splendor of order and proportion baby, then medicate the mother
CASE 2. Patients have autonomy right to refuse or accept
Ligation of women having the gene for hemophilia 3. Surgery if the baby dies, apply the principle of
- It is unethical for the government to intervene with double effect
personal lives
- It is against the principle of totality to sacrifice PRINCIPLE OF LEGITIMATE COOPERATION
healthy body parts
- There are other measures to manage hemophilia - Purpose: to achieve well-formed conscience
- Cooperation participation in a particular act
1. Formal cooperation
CASE 😐 2. Material
Sex change
Ethical issues Formal identified at the purpose of evil act
- Removed a body part 1. Do it yourself
- Want to be loved as a woman 2. Agree
Womanhood is not only physical but also mental 3. Advice CASE
4. Trivialize/Condone Terminate pregnancy
PRINCIPLE OF DOUBLE EFFECT 5. Provoke Mother formal
6. Reinforce Ob-gyn formal
- One procedure, two effects Cardiologist - depends
May be beneficial and harmful at the same time Ex. Bank robbery
- To form a good conscience (purpose) when an act is
foreseen to have both ethically beneficial and physically CASE
harmful effects, the following conditions should be met: Bank robbery
- Mastermind formal
1. The directly intended object of the act must not be - Cohort formal
in rin icall con radic or o one f ndamen al - Taxi driver material
commitment to God and neighbor (including oneself). - Security guard, teller, manager formal if inside
Ex. If you take a tablet, it makes you comfortable job; material if they did not participate
The object of the act must be good or indifferent
neither good or bad; not fundamentally
contradicting CASE
Unmarried woman was rushed to the hospital
2. The intention of the agent (sources of morality) must because of induced abortion
be to achieve the beneficial effects and as far as - If the baby is still alive, it is unethical to complete
possible to avoid the effect (that is, must only indirectly the procedure
intend the harm) - If the mother is profusely bleeding and the baby
Intention of the act good (direct), bad (indirect) dies in the process, the doctor is a material
Ex. Allergy tablet cooperator
- Good: relieves discomfort
- Bad: drowsiness
CASE
General hospital 30 abortions/ mo. vs. Abortion
3. The foreseen beneficial effects must be equal to or
greater than the foreseen harmful effects clinic 300/mo.
In the abortion clinic, all of them are abortionists
Beneficial > harmful
including the plumber, electrician, accountant, etc
Principle of proportionality
while in the general hospital, all of them are not.
4. Order of time
Benefit must come first before harm

CASE
Ectopic pregnancy
- Object of the act: surgery
- To relieve the mother from harmful effects, fix the
fallopian tube (directed to good intention) but the
baby will be lost (indirect bad effect)
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ORGAN DONATION 3. Risk taken by donor as an act of charity is

proportionate to the good resulting for the recipient
- A person may will to dispose of his body and to destine - Minus good result = risk
it to ends that are useful, morally irreproachable and - Kidney transplantation
even noble, among them the desire to air the sick and - Donation must be significant enough so that he may
suffering live a long life
- One may make a decision of this nature with respect to - Give it to the one with optimum good: 30 years old >
his own body with full realization of the reverence which 100 years old
is due it Good result must prevail proportionate to the
- This decision should not be condemned but positively risk
justified
- Our body is a sacred entity, temple of the holy spirit 4. D c e i f ee a d i f ed
- Desire to donate must be free and should not be be
DIFFERENT TYPES OF ORGAN DONATION based on fear, threat, or pressure
- Only you can make a decision over your body; not
1. Homologous Transplantation your own skin-graft
absolute decision but still has the authority
to another part of your body
- Unethical conduct among institutionalized
2. Heterologous Transplantation other person
Prisoners, mentally-ill people no one can
3. Xenotransplantation e.g. p a a
harvest an organ without free or informed
consent
In addition, transplanting organs from one living person to
another is also ethically acceptable provided that the
5. Recipients for the scarce organs are selected justly
following criteria are met:
- Principle of Queuing- wait for your turn
1. Serious need (to improve quality of life) of the
- No one should use position for the privilege
eci ie ha ca be f fi ed i a he a
- Transplant of pinna or ear to depressed daughter
6. Donation is by nature, an act of charity
(could be a serious need no ethical problems;
- Not a monetary act
mother could give her pinna)
- If the recipient is unable to live his life normally/ Donor must be helped through the procedure. If
weakened/ill/unproductive an illness may come, the recipient must help the
- Ex. A person who has a kidney failure under dialysis donor
- Charity act act of free will; does not expect
Weakening/fatal/temporary treatment
something in return
Best treatment: transplantation
- Our organs are not subject of trade
- Transplantation because you want a blue eye not
Immoral to sell body parts selling of blood has
serious enough
been outlawed
2. Functional integrity of donor as a human person Slavery inhumane to buy a human being
will not be impaired, even though anatomical Flesh trade is immoral as in prostitution
integrity may suffer
- Organ donation is generally acceptable even if 7. The transplantation should not change the
a c ;b c a integrity personality of the recipient
,
- Functional integrity complete ability/capacity of a CASE
person to use his body Uterus transplant
2 hands, 10 fingers tells you the capacity to - Functional integrity of the donor is impaired (if in the
do things; must be able to grasp things normally productive age)
10 fingers but cannot grasp things there is - If the donor is menopausal, it can be done
physical integrity but do not function well - If a woman will not get married or have a child, it is
- If you have to donate/transplant, functional integrity of still unjustified because (1) she may change her
the donor must not be impaired mind in the future and (2) you cannot just remove a
healthy organ by virtue of Principle of Totality
Donation of one kidney functional integrity is
- The procedure is still new, know the facts and ethical
not impaired
questions
- Anatomical integrity physical complete
acc ca a b
- Integrity wholeness/completeness of physical
accounting of the body
- Ethical question: If you donate one of your eyes, there
will be one deficiency
Gray matter, e.g. father donated one of his eyes
to his son (but at least, both of them can be able
to see (functional)
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CASE - The doctor will treat his patient because he is sick and
29 years old fell down the pavement, broken skull, the patient will entrust himself to the doctor
coma (irreversible condition); Hospital harvested
his kidneys and liver B. The doctor promises to treat his patient
- Ethical issue: Harvesting without free and informed acc di g hi be j dg e
consent - Even if there is no money involved
- The doctors based their decision to harvest the - Judgment must be scientific or evidence-based
organs as provided for in the Philippine Organ - Sometime, the best judgment is referring the patient
Donations Act 7170 of 1991 to another doctor
- Pa a c a
because it already followed the legal guideline C. The doctor, although he believes he knows best,
should fully inform his patient and defer to the
Philippine Organ Donation Act RA 7170 in 1991 a e i acce ejec he ed
1. A man is dead if he is clinically dead plans of management
- CNS the brain, when damage is irreversible, is
clinically dead D. When the patient is incompetent, proxy consent
2. The one who will make a declaration that a person is should be sought
clinically dead is an independent neurologist a. Minors below 18 years old
3. The hospital must be able to advertise to tri-media (TV, - Parents will make decisions
newspaper, radio) to inform relatives that this patient is - US: emancipated minors can make decisions
in the hospital, clinically dead, within 3 days (72 hrs) for themselves economically stable aged
4. If after 3 days, no relative comes to claim the body, <18 yo
harvest of the organ can proceed b. Comatose
*The state assumes authority, it gives the consent c. Mentally impaired
*Heaven does not need our organs, we need them here
- Proxy consent exhaust the vertical relationship
before the lateral
CASE 1. Parents 5. Uncles and aunts
Father needs kidney transplant, two sons did not 2. Siblings 6. Cousins of major age
agree and a son with Down Syndrome had no 3. Grandparents 7. Grandparents of uncles
response, mother volunteered the son saying it is 4. Great grandparents or aunts
useful for the father
- If the 2 other sons agreed ethical because organ - But if there have advanced directives which are not
donation is charity constitutively evil, follow them
-T a a a a a
than it actually is (even if 25 yo) so the mother can Single, major age try to look if he has:
still decide; but human beings are ends in 1. Durable power of attorney (DPA) designation of
themselves. If the decisions were made by the someone to make decisions if he is incompetent, e.g. a
mother, the benefits must lead to the Down friend
Syndrome child (It is not! The attitude of the mother 2. Next of kin
is unethical)
- Every person is useful from the time he was born Married, major age
- Volunteering is not ethically right - Next of kin: (1) spouse (2) children of major age (3)
grandparents, great grandparents
PRINCIPLE OF AUTONOMY
E. he a ie igh decide i ca ed a a d
- S - a c ;G should be respected unless his actions constitute
auto self an evil act
nomus nomy - law - Ex. A patient want to abort a child
- The right of the patient to accept or refuse the o Evil act
ca a o Doctor should not agree to it
o The patient is the most important person in the oN a , ab
hospital
o The doctor does not decide CASE
- His option to choose is based on respect of his free will Man becomes comatose, 2nd wife brought him to the
Respect for free will = respect for dignity hospital, 1st wife (separated for 7 years) came
- The right to make a decision 1st wife, legal wife
ESSENTIAL ELEMENTS - Both are there for the sake of the patient
- Doctor must say his decision for the sake of the
A. The relationship of the physician and patient is patient; let the wives fight in the court since it is not
governed by a moral contract/unwritten the turf of the doctor
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CASE 3. Prognosis
12-year-old boy, hit-and-run case in need of blood - Doctors owe information to the patients
a f i , Jeh ah i e - What is the prospect/result expected out of the
-J a believes blood transfusion is procedure
abomination to God/ evil - Answers to the patient must be evidence-based
- Some doctors talk to the parents privately because - How many are able to recover from the procedure
their community can ostracize them
- But in the case, parents are not there 4. Financial implications
- Bases: (a) Loco parentis in place of the parents, - One of the bases a patient will give a consent
the doctor can make the decision because it is better - Patient must be provided with at least an estimate of
do something than nothing, (b) Legal basis the how much they are going to pay
child has not yet reached 18 yo, therefore, he has
not chosen his own religion, (c) No court will convict PRINCIPLE OF TRUTHFUL/PROFESSIONAL
and send you to jail for saving a life COMMUNICATION

- To fulfill their obligation to serve the patient, health care

PRINCIPLE OF FREE AND INFORMED CONSENT professionals have the responsibility to do the following:

-G a , a a c A. To strive to establish and preserve trust at both the

autonomy to make decisions for his/her health interests. emotional and rational levels
Appropriate and necessary information are required so - We do not communicate with patients with jargons
that medical protocols and management may be done - Explain/discuss things in a language they understand
for his interest. - Try to have psychological knowledge of the patient; (1)
- Informed must be provided with necessary empathize with his emotions/fears/agitations and other
information negative emotions low level of communication makes
- Consent agree; based in the given information and you the person trust you, (2) Higher level of reason once
are willing to do it freely you make him comfortable, explain the state of illness
- Purpose: To protect the basic need of every human
a ca a a B. To share information as they possess which is
responsibility for his or her own health provided legitimately needed by others in order to have an
1. No physical or psychological therapy maybe informed conscience
administered without free and informed consent of - Problem: Family would intervene family requests to
the patient or give them time
2. I a c , a - We have to tell the patient no matter what happens
a a ( ) ac a b - Patient must not be deprived of the truth
and, as far as possible, in accordance with the - W ca a b ca b a
a a b - As an art: look for the best time a good doctor must
-D c a a a ab gradually tell the patient what ails him
wishes or advanced directives are (e.g. written
documents, things he had said to someone who can C. To refrain from lying or giving misinformation
attest to it) - Ex. Cancer. Tell the diagnosis gradually to prepare the
Ex. If I fall into coma, no more CPR/surgeries patient (1) Bukol (2) 3 bukol (3) tumor (4) cancerous
cells (final) Malignant, 3rd stage CA [gradual artistic
BASIC MINIMUM INFORMATION REQUIRED TO information]
MAKE A VALID FREE AND INFORMED CONSENT - If the patient does not want to know
(AUTONOMY) Principle of Autonomy
Usually because of fear (neutralizing fear is a crucial
1. Diagnosis (including the AMD, etc) role of the doctor)
- Inform the family and the patient what e.g. stage of CA
- In some cases, the family would not want the patient D. To keep secret information which is not
to know legitimately needed by others and that if revealed
- Also tell the people (doctors) who will be going to do might harm the patient or destroy trust
the procedures - Privacy and confidentiality
- Some hospitals have ghost surgeons (resident - There are information that might be sensitive, might give
surgeons) psychological trauma
-I a a a a a
2. Therapeutic process implies sense of shame so keep it confidential
- Options to the patients for the therapy
- Risks and benefits
- Financial implications
- A good doctor gives many options
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TIPS TO DELIVER BAD NEWS WELL 2. Public Safety

- Reportable cases, surveillance
1. S a ab a b - Ex. DOH can say there is an epidemic, barangay will
discussed face to face in a quiet, comfortable, private be quarantined (SARS, AH1N1, meningococcemia,
place, not in the hall, on the phone or in the middle of ebola, MERS CoV)
the ground rounds with half a dozen of strangers 3. Medico-legal cases
listening. - DNA, blood samples
- Ex. There are some diseases with social stigma (HIV) - Crimes (knife wound, gunshot)
2. Ideally, a caring relative or friend should be present to - In order to prove paternity
provide emotional support and assist in gathering - Report to RITM, San Lazaro
critical information. d. Court Summons
3. When imparting bad news the physician should allow - Expert witness, etc
an open-minded amount of time free of interruption, sit
CASE
close to the patient at eye level, look directly to the
Wife has conjunctivitis (C. trachomatis) before her
patient and, if appropriate, touch the patient.
OFW husband returns. The husband secretly asked
4. Patients should be given as much information as
the doctor about it.
needed to understand the condition, its treatment and
- He has no right to be given an answer but he can
the likelihood that treatment will cure the illness or
ask the doctor
control its symptoms
- The husband should not be told about the sickness
5. Treatment options and the reasons for more tests
- A caring doctor can call both of them and tell the wife
should be clearly described along with their likely or
that the husband wants to know about (but it is not
possible side effects so that people (patients) can make
c b )
intelligent choice.
PRINCIPLE OF CONFIDENTIALITY CASE
24-year-old male, Jeff, treated for genital herpes,
- Privacy things associated with the person are the mother of his fiancée saw him leaving the clinic
physical, psychological person (e.g. gender, age); - Principle of Confidentiality the doctor should not tell
attached to your person or anything you see when you - The doctor can call Jeff and tell him that his future
do physical diagnosis (e.g. tattoo) mother-in-law is asking
- Confidentiality subject is records (medical), - Prevention and Control of HIV/AIDS Law a section
something outside you (e.g. chart, summary of health) obliges that a person with HIV must disclose the
Sometimes not taken cared of disease to his would-be sexual partner; the doctor
Ex. Picture of a patient the patient agree to take his must encourage Jeff to tell it
picture but do not post it on social media
- The medical records of the patient is characteristically
PRINCIPLE OF JUSTICE
personal and individual in nature and should never be
revealed to anyone by anyone. The revelation of which Justice
when called for must always be under utmost restrictive - A virtue which inclines man to give others what is due
care them
SUBJECTS OF CONFIDENTIALITY Virtue is practiced
o Quality in us which is a repeated operative habit
- Should not be revealed to anyone except for graver o Habit of diligence studying
causes o Virtue of charity
1. Private secrets (Personal information) o Virtue of Justice: Fair
- Age, name, gender, birthday Give to the patients what is due to them help, care
b. Contractual secrets (Sensitive information) even without pay
- Diagnosis, treatment, prognosis - Is a respect given to a rightful claim that belongs to
- Informing the public can harm the patient others
psychologically and put him to trauma - Effect of this virtue is respect or recognition of a right that
c. Professional secrets (Privilege information) belongs to others, either to God or to fellow men and, by
- Information between a doctor and patient, client and extension, to the environment
professional - Healthcare is a right
- Data Privacy Act RA 10173, 2012
PRINCIPLE OF JUSTICE IN THE ALLOCATION OF
CONFIDENTIALITY CAN BE BROKEN IN THE FF: HEALTHCARE RESOURCES

- Not a violation of confidentiality because it has to serve - Rational distribution of scarce healthcare resources
a higher or noble purpose - In order to serve the people/citizens based on equity and
1. Principle of Autonomy real needs
- If patient permits you to tell it to the public
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- Meant to give access to every citizen as a matter if PRINCIPLE OF SUBSIDIARITY

his/her right
- Subsidiarity stems from the demands of the virtue of
Abraham Maslow needs of humans Justice
The 5M ( e ce ): - Recognizes that no individual is self sufficient
1. Money - cash, receivables When he is unable to help himself, a stronger or
2. Materials - supplies, physical support higher entity in the society is called to assist him
3. Manpower - human resources, skill - Well reflected in the Christian commitment to concretize
4. Machine - instruments, gadgets C a W a the least of my
5. Methodology - preventive, curative, and rehabilitative b , M
- Public hospitals are there to help the less fortunate
Kinds of Allocation: Privatization makes it difficult for to poor to get quality
a. Giga - transnational/multinational; global treatment
- WHO send doctors to places with calamities
- Allocation of resources: doctors, medicine CASE
- Ex. Bubonic plague control it at an early stage to Reservation of incubator
prevent spread - The one who reserved and paid for it already has the
b. Macro national; how many allocated to the citizens right but
c. Meso institutional - The hospital must implement that life-saving
d. Micro - individual equipment must not be reserved

Filipinos Expense Priority CASE

1. Food An inmate set to be out of prison in a month fell ill
2. Shelter and was worried she will not be treated for free
3. Education - Unethical to stay in prison; she does not belong there
4. Entertainment anymore
5. Health - She can petition the government (PCSO)
PARADIGMS OF JUSTICE IN THE ALLOCATION OF
HEALTHCARE
RESOURCES RIGHTS
1. Utilitarianism - greatest good for the greatest number
- Majority must be able to access sacrificing the few - Rightful claim(s) of a person (moral)
2. Egalitarianism - equal access to healthcare, universal Senior citizen card entitlement only not a right
access
Right to lie cannot be waived
- Equal: rich and poor
Understand when to use
- Paradigm of communism
- Based on:
- Not realistic not all government have resources for
a. Divine Law
all
- Right to honor father and mother
- Poor universal access (0 balance) 0 not for those
- Exercise religion
who can afford; therefore, not really universal
- Make holy Sabbath day
3. Libertarianism - free enterprise
b. Natural Law
- Medicine is a commodity
- Right to life
- Good for rich countries
- Right to self-defense
4. Distributive Justice - equitable allocation of both
c. Constitutional Law
benefits and risks
- Due process
- Ex. 2 patients need 10 each, they will be given 5 each
- Cannot be put in prison or lose a property right away
and let them pay for the other half
d. Human Positive Laws
5. Social justice - more benefits to those who have less
- Laws enacted by the congress
in life; poor does not have to pay
- Ex. Minimum wage earners should not be taxed
6. Pragmatic/Popular Model - Machiavellian, political
e. Privilege and Entitlement duly given (grants)
- Political harms the citizen
- According to intention
- Bagyong Yolanda resources are wasted
- Given by a particular institution for a particular
7. Natural Law Model equitable; give to those in need
purpose
8. Minor Models:
- Ex. 20% discount, you may avail of it
a. First come first serve
b. Social standing HUMAN RIGHTS
c. Triage servable vs. unservable; survivable vs.
survivable - Rightful claim to basic needs by humans as humans (St.
Thomas and Maslow)
 Page |6

- Persons have a relationship toward a good which is - Ex. Use of supplies 4 out of 12 gloves are used
fundamental, that toward a good which is essentially the hospital must be efficient in storing those which
connected with leading a good and fulfilled life are not used so the patient will only pay for the
- R connotes a relationship to a good which is not supplies he had used
fundamental 7. The right to obtain information concerning any
Owning a car is not right because you can still live relationship of his hospital to other health services
with dignity and decency (not human right but as far as his care is concerned, and to the existence
probably human wants or delights) of any professional relationships among
- H a implies relationship or natural individuals who are treating him
orientation to a fundamental good, a good that without - Ex. Prescribing a drug which is more expensive even
which, one cannot live or survive as a human being if there is an equally effective, less expensive
substitute (some doctors also work in a
IMPLICATION OF HUMAN RIGHTS pharmaceutical company)
8. The right to be advised if the hospital proposes to
1. That human beings strive to acquire these fundamental
engage in human experimentation affecting his
goods
care and to refuse to participate in such research
2. That persons should not be impeded by other in their
9. The right to reasonable continuity of care including
quest for these goods
post-discharge following
3. That if one cannot strive to achieve these fundamental
10. The right to examine and receive explanation of
goods through personal efforts, then the community of
his/her bill, including itemized charges. This
persons should help in this endeavor
information should be readily available regardless
Principle of Subsidiarity f he a ie ce f a e .
PATIENT RIGHTS 11. The right to know hospital rules and regulation
that apply to his/her conduct as a patient
- Rightful claim to basic health needs - No smoking, drinking
- ER: Must be given medical attention even if you do not - Behavior and conduct inside the hospital or
have the money yet institution
- If stabilized already, you have to pay
- Cannot be detained by the hospital make a promissory RIGHT OF THE PHYSICIAN/HEALTH
note that he is a charity patient PROFESSIONALS
PARTICULAR PATIENT RIGHTS 1. To practice the medical profession, referrals and
anything attendant to his medical skill and
1. The right to considerate and respectful care
knowledge
- Interpret, translate to whoever need it
- Lose license because of medical malpractice
- Honor the person (Principle of Privacy and
2. To accept or refuse patients (except in emergency
Confidentiality)
cases). He has the rights over patients as an
2. The igh b ai hi h icia c ee
admitting physician
current information concerning his diagnosis, in a
- All doctors must know how to manage all patients
language he can understand
- Ex. Inside the plane
- Be persevering and patient to your patients
3. To therapeutic privileges according to his acquired
- If the patient is not compliant, explain well
training and accredited by his workplace
3. The right to obtain from his physician information
- Accredited in the hospital as a surgeon, etc
for free and informed consent
4. Do clinical and scientific research, with prior
- Diagnosis, treatment, prognosis, financial
informed consent of subjects
implications
5. To practice his profession according to his
4. The right to decide on proposed treatment
religious and moral beliefs
- Explain risks and dangers, prognosis, benefits
-I a J a , a a a b
5. The right to every consideration to his privacy
concerned in which blood transfusion is not allowed,
concerning medical care
you can withdraw the case (conscientious objection)
6. The right to the best possible economical care and
6. To professional fees (except those which are
hospital management that operates efficiently and
prohibited by virtue of outstanding policies, like those of
eliminates wastes, such as unnecessary services
colleagues in the profession or of his children and
and duplication of facilities or procedures
spouses)
- Equally effective but affordable
7. To legal representation in the courts of law when
- Indicators of quality care/good health care:
his expert opinion is sought in order to serve the
Effective demands of justice
Efficient
Affordable
Accessible
Moral
 Page |7

CASE Which one is true? Right to life or right to die

Euthanize burned patient, extremely in pain - A right is always positive no such thing as right to
- Direct killing can never be ethical die
- What you can do is only palliative give a pain killer - To assist in order that life is promoted a right
- Suicide will never be justified rejection for the - When it comes to right, there is a responsibility of
value of life other people to respect that right
- So there is no right to die because there is no
corresponding respect in death

PRO-ABORTION ARGUMENTS CONTRA-ABORTION ARGUMENTS

1. Not a flimsy choice between a mother or child but must
1. To safeguard the life of the mother
center on saving both lives
- Maternal-fetal conflict
- There are many advances in medicine
- Ectopic pregnancy, cancer
- If it cannot be avoided, Principle of Double Effect
2. Unselfish love and solicitude to an innocent creature
- It is not your body only, there is a tissue being formed
inside
2. Ab a a a - There is another body growing and growth is a sign of
- 70 : F men and women are equal life
- Usual argument: Woman says it is her body, she has - The uterus is the proper home of the fetus
a control - Innocent creature must be protected
- Every creature is depending on someone/something
else (air, water, etc)
- Principle of stewardship your body is not yours
3. Complimentary roles between a man and a woman
- Equal dignity but different roles, there is nothing to be
equal with, only dignity
3. Ab a a a a
- Roles based on biology: (1) Woman has uterus for
- They want to act like how men act
pregnancy (2) Man has genitals that fertilize that eggs
- Pregnancy is inconvenient
of woman
- Freedom: freely functioning in the role of being a
mother or father
4. It has a genetic code totally different from the cells of the
woman (or of the father)
4. The fetus is not a human - Ontological origin: you came from a human, you are
- Indicator that you are human and not an animal a human also
rational thinking - Functional man knows how to distinguish between
- Argument: Fetus cannot think right or wrong, think, rationalize, analyze
- The argument that a fetus is not human is a bad
biology
5. W a a c b ab a a
5. The unwanted child syndrome
ca b a a ca b / worth living
- Products of incest, violence, rape, unplanned sex
- There is no unplanned sex, not accidental
6. To stave off the birth of a potentially deformed child
6. Life can be enjoyed by all people being them normal or
- Down Syndrome, physically deformed pitiable human
handicapped
being
7. Abortion as a means of improving the quality of life 7. There are many alternatives to eliminate poverty
- Fast multiplication, multiplying poverty - Educate the youth, improve health care services
8. Abortion as a means of controlling the population
8. There are many ways to control population growth; not
- They made us believe food, space, energy is limited,
killing of organisms
imperative to control the population
9. The right to privacy
- Roe and Wade: the court who granted the petition has 9. Right to life > right to privacy
the very basis that a fetus is no a human
 Page |8

MALTHUSIAN THEORY Clinics run in chains because it is profitable

- What way is the woman deceived?
- Thomas R. Malthus Englishman, demographer, Woman has 2 questions (1) Is it a baby? (2) Does it
political economist hurt?
- Malthusian Theory Ab a N a a woman to
Growth of food provisions is arithmetical slow treat the baby as a glob of tissue or only a product of
o Mango trees can only bear fruit annually, conception
consumed in 3 months - Did you do counselling in the clinics?
Growth of human population is exponential W c , ab
- How did you dispose of an aborted baby?
POPULATION ISSUES (Premises and assumptions) Put in garbage disposal
1. A larger population worsens poverty 2nd and 3rd Trimester babies have strong muscles
2. Higher population density means lower personal have to be thrown in trash shoots
incomes 20TH CENTURY
3. Higher population growth leads to lower economic
growth 1. Simon Smith Kuznets
4. Larger population means more hungry and - Russian American Economist
malnourished people - Nobel Laureate
5. Larger population means less funds for education - As economy grows, mass education provides
6. Food will run out when population is not controlled opportunities that decrease inequalities
7. Space will run out when population is not controlled
8. Energy will run out when population is not contributed 2. Pope Paul VI
- Humanae Vitae
INFLUENCES OF THOMAS MALTHUS - Zeroed in on Contraception and Abortion as modern
day menace population control is anti-human; must
understand family planning
1. Charges Darwin Prophecy Fulfilled
2. Karl Marx 1. General lowering of moral standards throughout
3. Mao Zedong society
4. Paul R. Erlich protégé of Malthus (1970s pop. Bomb, 2. A rise in infidelity
millions will die due to starvation) 3. A lessening of respect for women by men
5. Julian Simon won a wager against Erlich to disprove 4. The coercive use of reproductive technologies by
the a c governments
- Basic crops, after 10 years, have the same price 5. Contraception increases so will abortion increase
- Debunked Malthusian theory Malthus did not know
about the preservation of food 3. Henry Kissinger (Nixon Administration)
6. Margaret Sanger activist, social reformer, sexual - 1969 1974 National Security Study Memo 200
revolutionist and eugenicist, racist, geneticist - Agenda that began the legalization of RH bill
- Forerunner of Planned Parenthood - Comprehensive guide to overpopulation, feminism,
- Advocate of abortion to control population movement Humanae Vitae, Pastoral plan for pro-life
- S b
- O a Conclusions of Agenda:
7. Carol Everett modern day protégé of Sanger - All activities decided as national security issues
- Owner of abortion clinic - Large population in Asia is not for interest of USA
- W a a a , ab ? It was - Provisions of NSSM200 must be promoted in all
ca ca government of the world
- Break down their natural modesty, separate them - Means: control population (contraception and abortion
from their parents and their values and they become as parts of RH as declared by Sec. Hillary Clinton)
the sex experts in their lives Results:
- Goal was 3-5 abortions from girls between age 13 - Donors are Global Foundations
18 Packard Foundation
- Get them young, get them sexually active, get them Gates Foundation
coming back for 3-5 more abortions Starbucks
- A signer of Anti Strauss Abortion and Planned - Population Control: EUPHEMISMS
Parenthood Statistics Birth control
Family Planning
Interview with Carol Everett Reproductive Health
- What is the governing force behind abortion industry?
Responsible parenthood
Money as a lucrative business - Population Issues:
Largest unregulated industry in our nation Food
 Page |9

Space - Sensuality
Energy Devotion to pleasure, sense of appetite,
consummation of sex
FOOD Hedonism/Shankara (?) philosophy
- 1945: Food production increased by 53% GENESIS:
Machineries are developed FUNDAMENTAL AND ANTHROPOLOGICAL TRUTH
There is nothing in history that there are lack of food ABOUT SEXUALITY
production or provision
Problem of distribution happened only during wars - God created man in his own image, male and female
- Hydrophonics - Man is the highpoint of the whole order of creation in the
visible world
- Both man and woman are human beings to an equal
SPACE
degree as both are images of God
- Population densities: 39/km2 - Man and woman are rational and are able to dominate
- Land around the world is only 25% planted to productive the other creatures of the visible world
crops - Ma a a a a , c ,
Space is not a problem marriage arose and is an indispensable condition for the
Even deserts can be panted on transmission of life to which conjugal love is naturally
- Overpopulation cannot be true because there is no ordered
standard BASIC CONCEPTS/VALUES RECOGNIZED IN SEXUALITY
May not equate to poor country
1. Personally - sex is a search for sensual pleasure and
ENERGY satisfaction, releasing physical and psychic tensions
2. Humanly
- Has not been optimally tapped: fossil fuels, wind, water, - Sex is a search for the completion of the human
etc person through an intimate personal union of love
expressed by bodily union (completes humanity)
- Ordinarily, it is also conceived as the
Total Fertility Rate: Birth Rate complementation of male and female by one another
- Minimum: 2.2+ children per productive woman so that each achieves a more complete humanity
- Product of completion: offspring
Population growth because there is life expectancy growth 3. Interpersonally
not because of new lives! - Sex is a social necessity for the procreation of
children and their education in the family so as to
SEX, SEXUALITY AND GENDER expand the human community and guarantee its
future beyond the death of individual members
- Sex - refers to nature and implies two possibilities (man 4. Symbiotically
and woman) - Sex is symbolic (sacramental) mystery, revealing the
- Sexuality cosmic order
Attribute that defines the essence, function and - God of love and fertility
purpose of sex
It is a characteristic attribute of man and woman not SEX, A NATURAL AND SUPERNATURAL DESIRE
only in the physical level but also on the psychological FOR INTIMACY
and spiritual, making its mark on each of the
expressions in the mode of being, communicating - Men and women are naturally attracted to one another
with others, of feeling, of expression and of living and engage in sexual activities
human love Due to the pleasure that they can derive from it
- Gender Also, it is a natural attribute that they can engage in
Comes form the field of linguistics and culture and c a a g
includes three varieties: - The pleasure is not limited to the physical realm; it
o Masculine extends to the psychological and even the spiritual
o Feminine dimension
o Neuter - I ca a a c a
Sex, which is the biological principle and Gender, the intimacy under right conditions, timing and mutuality
cultural expression are not identical, but neither are - Each sexual act is always a learning experience that
they completely independent may lead a couple to new discoveries and thinking
- Genitality - It can always transcend the mere concupiscence
towards spiritual fulfillment
To breed, reproductive structure refers to sexual
- This is because God made sex not only as something
organ, to carry on the sexual act
that belongs to the animal nature of man and woman,
 P a g e | 10

but also to their spiritual nature especially when done for - Examples of Artificial Methods:
a noble purpose IUD Diaphragm
- On a profane level, sexual love involves the elements of Condom (M/F) Withdrawal
romance, desire and concupiscence Vasectomy (M/F) Heating
Kamasutra- desiring and engaging in sex Spermicides or Gels Patch (norplants)
- Sex takes a plurality of understanding and satisfaction:
PASSION Self-surrender Issue in the Beginning of Life
- Self-abandonment, ecstasy, intimacy, understanding Fertilization vs. Implantation (against science)
and feeling Contraceptives
I ac b a
- Catholic morals CARE OF THE TERMINALLY-ILL
Locus of sex is marriage because this symbolic
element is deeply grounded ISSUES
- Is it ethical to remove LSD or other interventions when
PRINCIPLE OF HUMAN AND CREATIVE SEXUALITY these are the only means to keep him alive?
-U a, a ; ?
- The gift of sexuality must be used in keeping with its - If interventions just prolong the dying process, is it
intrinsic, indivisible, specifically human teleology ethical to continue applying them?
Teleology means: the explanation of phenomena by - Can the family ask the AMD to withhold or remove LSD
the purpose they serve rather than by postulated on a terminally-ill patient?
causes; the doctrine of design and purpose in the - When are interventions considered ordinary or
material world extraordinary?
- Open to fruition in perpetuation and expansion of this - When the decision to remove LSD has been agreed
personal communion through the family they beget and upon, who will do it?
educate - Who should give consent?
- Should health care givers honor advanced directive of
CONJUGAL LOVE
patients? (Wills, Living Wills, DPA)
- Highest expression of union between man and woman
IMPORTANT THINGS TO CONSIDER
- Originates from supreme origin, God, who is Love
- Divine Love- generous, giving of self 1. Cultural and religious values
- Baptized persons, represent union of Christ and of 2. Marital and familial issues
Church - The one who is going to put the bill, follow him or her
- Being a doctor, try to have a family counsel
CHARACTERISTICS OF CONJUGAL LOVE
3. View of life: Young, adult, old age
1. Human 4. View of medicine has limits, not a solution for all
- It belongs to both Senses and Spirit 5. View of pain and suffering
- Not only to instinct and sentiment but also to an act 6. View of death we must not be afraid of death
of free will intended to endure and grow GOALS ASSIGNED TO MEDICINE
2. Total
- It is a very special form of personal friendship - Preserving life, preventing disease, maintaining health,
- Husband and wife generously share everything, and relieving pain and suffering
without undue reservations or selfish calculations - In addition, the duty to seek, within moral means to a
3. Faithful and Exclusive decent, peaceful death, which is an aspect of the duty to
- Lasting relationship until death try to relieve suffering
- Bond between the man and woman
4. Fecund Preserve life because it is VALUABLE and SACRED
- Destined to come together - It is a gift from God who is a generous giver
- Fecund means ability to produce offspring - By the Principle of Stewardship, we are given a
shared, not an absolute domino over our life
- Sacred
Artificial Contraceptive Methods It comes from a holy God and goes back to a holy
- They are means to make impossible the union of sperm God
and egg before or after sexual act so that it does not Because its source is divine and end is divine
result to pregnancy Life is not only a physical body but also a spiritual soul
- Assault to the gift of sexuality Human life is the only creature in this world with
- They may be: dignity
Mechanical Chemical
Pharmacological Thermal
Surgical
- May either be Temporary or Permanent
 P a g e | 11

CATEGORIES OF TERMINALLY-ILL PATIENTS T ac

individually and socially
- Patients with terminal illness whose death is imminent - If the treatment to cure/alleviate pathology is
(probably within one month) Effective and does not impose grave burden, it must
- Patients with terminal illness whose death is not be utilized
imminent but who are faced with a current acute life Ineffective or non-beneficial, it must not be used
threatening crisis (massive stroke, cardiogenic shock, Effective but imposes grave burden, it may be
septicemic shock) withheld or withdrawn
- Patients on a PVS whose condition is irreversible (no
cerebral cortical function) IMPLICATIONS OF DISCONNECTING LIFE SAVING
DEVICE (LSD)
WHY DOES MAN SUFFER?
1. When LSD is disconnected and the patient dies
- Philosophically, because his nature is limited, implication of LSD is useless
imperfect, and weak 2. When LSD is disconnected and the patient survives
- Suffering a state of a person undergoing painful or implication of LSD is useless
distressing feeling; a sign of human helplessness
- In either case, there is moral justification in the
VALUE TO SUFFERING disconnection of LSD
- In such circumstance, the intention is not to kill the
- To remind him of his self-insufficiency and dependence patient but simply to avoid doing something (a medical
on the power of His Creator intervention) that is useless or futile (This is good
1. Realizes sinfulness and its consequences medicine!)
2. Sees the real value of things
3. Makes one empathetic to others LOEB S LAW IN MEDICAL CARE
4. Realizes the temporality of the world
5. Makes one prayerful - If what you do works, continue doing it
6. Highlights frailty of human being -I a , stop doing it
7. Develops noble virtues of man (compassion, empathy, -I a ,d anything
justice) at all
8. Distinguishes the temporary from the permanent - Remember the two eminent duties of the physician,
values namely:
9. Draws interest to the true God The Principle of Beneficence always do good
The Principle of Non-Maleficence do no harm
PRINCIPLE OF GROWTH THROUGH HUMAN SUFFERING
Misunderstanding
- As bodily pleasures should be sought as the fruits of - Certain issues: Killing/allowing to die
the satisfaction of some basic need of the total human - Withholding/withdrawing life support
person, so suffering and even bodily death when - Ordinary or Extraordinary means of life preservation
endured with courage can and should be used to
promote personal and social growth, maturity and even PRINCIPLE IN THE USE OF ORDINARY AND
as means to freedo A &OR EXTRAORDINARY MEANS

FATAL PATHOLOGY 1. Extraordinary

- Refers to interventions that does not offer any
- Any disease, illness or injury which will cause death if reasonable hope of recovery, or that which makes
allowed to run its course care unreasonably burdensome
- In the presence of Fatal Pathology, the duty to preserve 2. Ordinary
life is assessed: - Refers not only to nutrition, hydration or respiration
Will the intervention be effective? but also to ay treatment or intervention that offers
Will the intervention cause serious/excessive reasonable hope of recover, or that does not make
burdens? care unreasonably burdensome
o Suffering (Pain) - Food and water becomes extraordinary when organs
o Effort that process food and water are not functioning
o Psychological, emotional burden anymore
o Financial burden - Respiration is always ordinary
- No one deserves to suffer excessively, LSD can be 3. Ethical Duty
stopped - We are not normally bound to use extraordinary
- If there is too much effort but there is nothing much to a ba a avoid
hope for, it is ethical to withdraw the interventions a a b a
Ex. Nasogastric tubes
 P a g e | 12

Distinction of the following: WHY DOES A MAN DIE?

A) Euthanasia - Obviously because man is not omnipotent
- Good death, intentionally ending a life to relieve pain and - He has Limitations, Imperfections and Weaknesses
suffering) - Theologically,
Active deliberately doing something to cause the He is not meant for this world, though he is in this
patient to die (poison, overdoses) world
Passive withhold treatment of the patient (intention: He is meant for something greater, fit for his higher
to kill by doing nothing) spiritual nature (bang bang)
- Unethical because of intention He is therefore destined for a place beyond this world
- Positive before but became polluted/abused this is what makes life meaningful, for life is not
merely earthly but heavenly
B) Dysthanasia It is not only to perfect him in his human form but
- Bad death much more so in his divine form
- Dysfunctional death - Medically,
- Prolonging the dying process when there is no hope for
When disease or illness overcome the human
recovery organism
When vital organs necessary for life cease to function
(C) Orthonasia
permanently (e.g. entire brain including brainstem)
- Right death
Irreversible loss of cardiorespiratory function
- Dying at the right time, but with comfort
- Philosophically,
- Let the nature take its course by removing unnecessary
intervention It is the stoppage of self-motion
When the physical body reaches its final subjection to
Hippocratic oath physical corruption and decay
- Good medical care STAGES IN THE DYING PROCESS
Cures sometimes there cures that are unnecessary
Relieves often - Stages of Grief
Comforts always 1. Denial
- Never allows euthanasia and abortion 2. Anger
- Should never charge children, wife, and fellow 3. Bargaining
4. Depression
NOTES TO PONDER 5. Acceptance or Hope
- We are not obliged to keep everyone alive Theologically,
- Death of a patient is not a failure of medicine nor the - It is a rite of passage
doctor (unless proven that negligence is present) - It has a beautiful message pain and suffering ends
- Death can occur even in the best of hands or best - It is a great heritage so that we can live forever
medicine Life is meant for beatitude with the Creator
Medicine is not a cure for all, it helps
-W a a a b of CASE
the patient (whether he dies or not) 72 year old grandmother on cardiac arrest,
- Who disconnects the respirator/ventilator? irreversible, the doctor asks the family who will pull
ung nagkabit yung magtatanggal dapat the ventilator, 4 year old granddaughter was
instructed to pull it
Further Notes to Remember - Pulling out the ventilator is ethical because there is
- When medical care fails, not everything ends or fails no need for any other intervention since it is useless
- There is PALLIATIVE CARE, that is still available - The doctor asking is unethical he is afraid about
To reduce the violence of a disease being blamed if he will pull it, afraid of the guilt and
To ease symptoms without curing the underlying passing it on others
disease - A medical procedure can only be done by medical
Drugs to palliate the pain personnel, passing it to the family is also unfair
Basically the focus is on improving the quality of life;
hopeless to survive so you just want the patient to live
a comfy life
- There is COMFORT CARE, that everyone can do References:
-F.J Ma a c
- What is important is, never abandon the patient in his - ACD B2022 notes
most crucial moments - D2021 transcript
- Ca a ca G b H ca
St. Peter