File 112

HEALTH CARE ETHICS
Module 3.1: Ethical Decision-making in Various

Bioethical Issues
Health Care Ethics Team
Learning Objective:
• Identify and reflect on the ethical dilemma nurses are
facing in the practice of their profession.
• Explain how nurses can manage these ethical dilemmas
• Enumerate the individual and situational factors that
influence the ethical decision-making process.
• Determine possible outcomes of ethical decision-
making and unethical behaviors.
• Integrate ethical decision-making process in the nursing
process.
• Reflect on the application of ethical principles in various
health care situations discussed.
Proposed Strategy:
• Video presentations (30 minutes)

• Lecture discussion: 60 minutes with catch up
every 20 minutes
• Open Forum: (60 minutes) with the class
divided into small groups so they can initially
discuss their insights.
What are these moral or ethical problems that nurses are facing?
Jameton (1984) described 3 different types of moral

problems:
• Moral uncertainty
• The nurse identifies a moral problem but is unsure of the morally correct
action.
• Jameton (1984) described 3 different types of moral problems:
•
• Moral uncertainty
• The nurse identifies a moral problem but is unsure of the morally correct
action.
• Moral outrage
• The nurse knows the morally correct action and feels a responsibility to the
patient, but institutional or other restraints make it nearly impossible to
follow through with appropriate action.
How do the nurse handle those moral or ethical
concerns/problems?
• Nurses are able to deal with the mentioned concerns if she has
moral courage and has a well-developed ethical decision making
skills.
ON MORAL COURAGE
• Moral courage can be defined as taking action to do what is right in
spite of possible repercussions.
• Moral courage is easily practiced if the individual has personal
integrity (adherence to moral principles or values) and moral
imagination (a sense of the variety of possibilities and moral
consequences of their decisions, the ability to imagine a wide range
of possible issues, consequences, and solutions” ), a heightened
sense of moral integrity. (Werhane, 1998:76)
concerns/problems?
ON MORAL INTEGRITY
• This heightened sense of moral integrity is facilitated through moral
discernment and conscience formation.
Principle of Moral Discernment

To make a conscientious ethical decision one must do the following:
1. Proceed on the basis of a fundamental commitment to God and to human
persons (including oneself) according to their God-given and graced
human nature
2. exclude any that are contradictory to it (or those that are intrinsically evil)
3. Consider how one’s own motives and other circumstances may contribute
to or nullify the effectiveness of these other possible actions as means to
fulfill one’s fundamental commitment.
4. Among the possible means not excluded or nullified, select one by which
one is most likely to fulfill that commitment and act on it.
concerns/problems?
ON DECISION- MAKING
• The process follows a similar pattern in most circumstances, including
gathering data, comparing options, using some criteria for weighing the
merit of each option, and making a choice. Also, the evaluation of
outcomes provides more data regarding the rightness of the choice.
• Ethical decision-making particularly is imperative to arrive at an ethical

action or intervention.
• Ethical decision-making would require an ethical judgment and such

judgment needs a basis. A specific reference point, criteria or. condition so
we can examine, evaluate then judge and consequently act ethically.
concerns/problems?
ON ETHICAL DECISION MAKING
• The Ethical Decision-making Process is the process of choosing the best

alternative for achieving the best results or outcomes in compliance with
individual and social values, morals, and regulations.
• Making good ethical decisions to solve Ethical Dilemmas requires a trained

sensitivity to ethical issues and a practiced method for exploring the ethical
aspects of a decision.
• Having a method for ethical decision-making is absolutely essential.
• The ethical decision-making process provides a method for nurses to

answer key questions about ethical dilemmas and to organize their thinking
in a more logical and sequential manner just like the nursing process.
concerns/problems?
The process of making ethical decisions requires:
• Commitment: The desire to do the right thing regardless of the cost

• Consciousness: The awareness to act consistently and apply moral
convictions to daily behavior
• Competency: The ability to collect and evaluate information,
develop alternatives, and foresee potential consequences and risks
concerns/problems?
Possible outcomes:
• Good decisions are both ethical and effective:

• Ethical decisions generate and sustain trust; demonstrate respect,
responsibility, fairness and caring; and are consistent with good
citizenship.
• Effective decisions are effective if they accomplish what we want to
be accomplished and if they advance our purposes.
• Consequences of unethical behaviors: Criminal charges and/or
fines; Lawsuits; Ruined careers; Injured organization reputation;
Wasted time; Low morale; Recruiting difficulties; Oppressive
legislation; Fraud and scandal
What influence ethical decision-making?
Oxford University (2005) identified individual and situational influences which
eventually help a nurse become more self-aware as to the influences that
shape his or her moral stand, ethical judgment, and ethical decisions.
Individual Influence on Ethical decision making

• Age and gender
• National and cultural characteristics
• Education and Employment
• Psychological factors:
• Cognitive moral development
• Locus of control
• Personal integrity
• Moral imagination
What influence ethical decision-making?
Oxford University (2005) identified individual and situational influences which
eventually help a nurse become more self-aware as to the influences that
shape his or her moral stand, ethical judgment, and ethical decisions.
Situational Influence on Ethical decision making

• Issue-related - Moral intensity, Moral framing
• Context-related – Rewards, Authority, Bureaucracy, Work roles,
Organizational culture, National context
Integrating Ethical Decision-Making Process in the Nursing Process
NURSING ETHICAL DECISION-MAKING: PROCESS
PROCESS
Assess Assess the situation and gather all information relevant to the case ;
Ask what are the relevant facts of the case?
Clarify issues and Gather Data on the elements of the issue (Act itself, The intent, The
Circumstances), the keyplayers in the issues
Diagnosis Diagnose the moral problem _ morally acceptable or morally unacceptable, Morally licit or
morally illicit.
Analyze the elements of the issue (Act, intention, Circumstances) if good or bad and if there
are violation and non-violations of ethical principles code of ethics then come up with a,
ethical judgment if acceptable or not.
Ask what is the nature of the problem in this case?
Plan Make a decision based on the ethical judgment Set moral goals and plan of course of action
aimed at achieving a morally just outcome;
Ask – How best can the client’s best interests(wellbeing &welfare) be maximized in this
case?
Implement Act on it, participate on initiatives and advocacy if needed

This could involve range of actions –reporting the matter to the supervisor
/manager/involvement of an institutional ethics committee for advice
Evaluate Evaluate the outcome of the plan of action implemented.

Ask –Has the desired moral outcome been achieved in this case.
Health Care Ethica and Its Application
in Various Health Care Situations
Sexuality and Human Reproduction
1. Human Sexuality and its Moral Evaluation
2. Marriage
● Fundamentals of Marriage
● Issues on Sex Outside Marriage and Homosexuality
● Issues on Contraception, its Morality, and Ethico-moral
Responsibility of Nurses
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 other Problems Related to
Destruction of Life
•
Health Care Ethics and Its Application
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
On Sexuality and Human Reproduction
Nurses are trained in the areas of human sexuality,

maternal and child nursing, and family health nursing to
assist individual patients and the family to thrive and
manage health concerns.
However, some concerns may put the nurse in a much

challenging situation as the patient and the family face
issues with ethical dimension.
Human Sexuality and its’ Ethical Evaluation
• Human sexuality is defined as the totality of experiences, systems,

attributes, and behavior that characterize the sexual sensation,
reproduction, and intimacy of Homo sapiens (Grebe and Drea,
2018).
• To be able to ethically evaluate sufficiently and appropriately the
issues concerning human sexuality, there is a need for the students
of health care ethics to understand different perspectives on
sexuality and related concepts such as marriage and procreation.
Anthropological Perspective of Sexuality and Procreation
● In sexual ethics, it is useful to understand the relationship

between the person and sex that mirrors the relationship
between the person and the body.
● The differentiation and complementarity of the sexes is
discerned in the biological design of the body.
● The body is contained in an essentially uniform structure
that exhibits a series of differentiating factors imprinted on
the entire basic personality.

● These differentiating factors are:
o The chromosomal factors (presence of X or Y in the last chromosome
pair)
o The neuroendocrine factors are linked to the last chromosomal pair of
X or Y and are marked by major differences in the gonads. (ovaries for
women- internal, and testicles for men – external)
o Differentiation continues with the ducts (Wolffian ducts in men,
Mullerian ducts in women)
o This is followed by the emergence of phenotypic sex characteristics or
the so-called primary and secondary sex characteristics.
o The human body is then marked as a whole in its morphology, the
voice, movement, sensorial and perceptive traits by sexual
differentiation in its fundamentally identical and homogenous structure.

● being sexed differently is therefore an original fact with men endowed with
masculinity and women endowed with femininity by virtue of the sex differentiation
described.
● Being sexed enables man and woman to acquire a unique personality in a different
dimension expressed “in and by” the design of their bodies. This expression of the
body carries the richness and vitality of the entire being – the spirit that animates the
body – which is believed to have been created in the image and likeness of the
Creator.
● Sexuality marks the entire person. That the person does not merely have a given sex
but is truly a complete man and a complete woman who are sexually differentiated
by design but whose endowments of complimentary traits can harmoniously fulfill
coexistence in the world –the man and the woman, though diversified or not
identical, but the complementarity and capacity for reciprocity reveal an equal nature
of personal dignity.

● This does not mean however that the corporality is only sexuality since the body also
has other functions and dimensions. But a person is more than one’s body, more
than the sum of its parts, more than one’s sex.
● Human sexuality, therefore, cannot be reduced to a thing or an object. The mentality
of “sexuality without risks and without regrets” sums up the philosophy of sexuality
as consumption.
● Human sexuality, rather, is the structural conformation of the person that expresses a
unique personality, hence, such structural expression warrants respect and
acceptance.
● Sexuality has a role in how a person reveals himself to others.
● Treating sexuality as a mere object and thing to be manipulated and changed will
have a profound effect on the whole person and others to which he is revealing
himself.
Other Perspectives on Sexuality
1. Catholic Morality on Sexual Ethics can be summarized in the

following:
▪ Sexuality must be used in keeping with its human teleology.
▪ The conjugal act has inseparable and integrated unitive, and
procreative dimensions.
▪ Unitive – love-giving: signifies, expresses and incarnates the
mutual love between husband and wife; authentic total self-
giving.
▪ Procreative – life-giving; inherent orientation to the
transmission of life.
● On the contribution of Sigmund Freud to the concept of Sexuality:

o The contributions of Sigmund Freud were fundamental in affirming
sexuality as a dimension of the whole person and its importance in the
individual’s process of maturation and socialization.
o It can be deduced from Freud’s theory that sexuality expresses itself
and by its dynamics is linked to the depths of the subconscious, and
structures personality.
o Freud proposed sublimation as a mechanism that inhibits instinctual
forces. Nonetheless, the pansexualitys and deterministic understanding
of the person took its cue from Freud which includes: Sex is everything,
sex takes orders from no one, and psychological disturbances and
sufferings of the person are due to sexual repression.
•
● Other contributions to the liberalization of sexuality and its detachment

from the procreative responsibilities
o Sexological Therapy by the American sexologists William Masters and
Virginia Johnson whose theories were taken up by Helen Singer Kaplan
and Robin Skynner.
o They conducted a study of the neurophysiological reactions in men and
women during sexual intercourse which apparently reduced the unitive
gesture of sex- of authentic self-giving- into a complex network of
recordable reactions. Measurements of these reactions were provided
using scientific instruments, filmed recordings of them were distributed,
and viewing them in the laboratory was suggested as a method of
“treatment”
•
Phenomenology of Sexual Life
A phenomenology of the sexual inclinations and a correct interpretation

of its significance are requisites for the metaphysical analysis of love
which affirms the value of the person and the communion of the
persons.
In animal species, the sexual impulse acts as a strong, irrational

instinct. In human beings, the sexual impulse has the natural
tendency to be transformed into love.
The playful components of sexual life that are associated with the
sexual impulse, rise to the level of the dignity of the person when the
sexual impulse is closely connected with love.
Freedom, Responsibility and Sex
● Beyond psychological and cultural dynamics lies the spirituality of

man which is his freedom and responsibility. Sexuality cannot be
deprived of this spiritual vitality, cannot be devoid of freedom and
responsibility.
● Freedom and responsibility enrich sexuality, expressing it in an
interpersonal relationship, and consequently in the overall process
of personal growth.
● Sexuality is also not just mere psychological mechanisms or cultural
constructs.
● All of sexual life is accompanied by responsibility.
● Responsibility also means accepting sexuality for what it is and
what it involves in terms of meaning and consequences.
The sexual revolution
● The ideologies of sexual revolution according to Screggia (1992)
○ Libertinism: posits that sexuality is one of the fundamental instincts that
govern life hence it must be exempted from moral control. There is one
sexuality oriented to pleasure and another sexuality oriented to
procreation.
○ Post-Freudian interpretation: asserts it is necessary to satisfy every
impulse since sexuality is the fundamental driving force and all of its
expression (pansexualism). Failing to do so or repressing those
impulses will lead to neuroses.
○ Feminism of Simone Beauvoir: This posits that a woman must be made
capable of planning her own life autonomously and of freeing herself
from the trappings of motherhood.
How nurses should respond ethically to sexuality issues?

- It is important that sexual counseling is structured according to the
needs of the individuals.
- Nurses are responsible for strengthening the sexual health of the
individuals they care for, encouraging them to express their sexual
problems, identifying the causes of these problems, making
appropriate initiatives to resolve these identified problems, and
raising their quality of life. (vcili, Funda & Demirel, Gulbahtiyar. (2019). Patient’s Sexual Health and Nursing: A
Neglected Area.)
- Nurses do not impose their own beliefs on sexuality on the patients,

instead, a nonjudgmental attitude towards caring is necessary.
- When a patient requests counseling, the nurse must facilitate this
taking into consideration the patient’s autonomy, beliefs, and
preferences.
On Marriage
Fundamentals of Marriage
- Article 1 of the Family Code of the Philippines defined marriage as:

“a special contract of permanent union between a man and a
woman entered into in accordance with law for the establishment of
conjugal and family life. It is the foundation of the family and an
inviolable social institution whose nature, consequences, and
incidents are governed by law and not subject to stipulation, except
that marriage settlements may fix the property relations during the
marriage within the limits provided by this Code.” (Executive Order
No. 209, s. 1987 | Official Gazette of the Republic of the Philippines,
n.d.)
- What does this definition imply?
Issues on Sex Outside Marriage and Homosexuality
● Chapter 3 of the Family Code of the Philippines stipulates the

reasons that renders marriage void from the beginning, as if the
marriage did not take place and hence is annulled.
● Under Article 35.4, those bigamous or polygamous marriages not
failing under article 41 is one of the reasons that a marriage is void
from the beginning.
● Article 45 of the Family Code further stipulates that a marriage may
be annulled for any of causes mentioned below that are existing at
the time of the marriage:
● Article 45 of the Family Code further stipulates that a marriage may

be annulled for any of the causes mentioned below that are existing
at the time of the marriage:
1. Marriage for those18 years of age or over but below 21 and the marriage was solemnized
without the consent of the parents, guardian or person having the parental authority
over those who are married unless such arty freely cohabited with the other and both
lived together as husband and wife
2. Either party was of unsound mind, unless after coming to reason, freely cohabited with
the other as husband and wife.
3. Consent was obtained by fraud, unless afterwards, with full knowledge of the facts
constituting the fraud, freely cohabited with the other as husband and wife.
4. Consent was obtained by force, intimidation, or undue influence.
5. Physically incapable of consummating the marriage with the other, and such incapacity
continues and appears to be incurable
6. Either party was afflicted with a sexually-transmissible disease found to be serious and
appears to be incurable.

● Meanwhile, Article 55 of the family code stipulates that a petition for legal separation
may be filed under these circumstances:
○ Repeated physical violence or grossly abusive conduct
○ Physical violence or moral pressure to compel the petitioner to change religious or
political affiliation.
○ Corruption or inducement to engage in prostitution, or connivance in the
corruption and inducement.
○ Imprisonment of more than six years, even if pardoned.
○ Drug addiction or habitual alcoholism
○ Lesbianism or homosexuality
○ Bigamous marriage, whether in the Philippines or abroad
○ Sexual infidelity or perversion
○ Attempt against the life of the petitioner
○ Abandonment of petitioner by respondent without justifiable cause for more than
one year.
○ Note: Please read related articles in the family code to further understand related
matters regarding the legal separation
On Homosexuality
● Semantically, homosexuality (a noun) is the condition or the quality
of being homosexual. A homosexual (adjective) is either a male or a
female. (Homosexual | Etymology, Origin and Meaning of Homosexual
by Etymonline, n.d.)
● Sexual inversion was a term used in 1883 to refer to homosexuality
which later became inversion in 1895; unnatural love was used
between 18th-19th century. It is said to have originated in Italian
psychology. (Homosexual, Adj. and n. : Oxford English Dictionary,
n.d.)
● In the field of Psychology ad Psychoanalysis, homosexuality is
characterized by sexual or romantic , desire, attraction or sexual
activity with people of the same sex. (Homosexual, Adj. and n. : Oxford
English Dictionary, n.d.)
On Homosexuality
● In the present context, homesexuality has evolved to the LGBT

movement. LGBT stands for the collective of lesbian, gay, bisexual,
and transgender people.
● Other initialism emerged such as LGBTIAQ which refers to lesbian,
gay, bisexual, transgender, intersex, asexual, aromantic and queer
people). LGBTIAQ is sometimes replaced with LGBT+ to explicitly
refer to other groups. (Medina-Martínez et al., 2021)
How do healthcare providers ethically respond to issues of
marriage and homosexuality?
● Healthcare practitioners guided by the ethical principle of respect for

persons, are to carry out without judgment the case-and-age-
appropriate interventions to address the health disparities
identified.
● Supportive, non-judgmental, and respectful dealing with people
going through those issues is imperative as they navigate through
the challenges of their personhood and be given their inherent right
to authentic human dignity and respect.
● As much as a society protects the integrity of marriage as the
foundation of the family, there is also a need to assist every person
who faces and experiences these threatening issues of marriage and
family life like homosexuality.
Issues on Contraception and its Morality
In the past decades, people believed that the population or the number of
people cohabiting the earth is out of control resulting in poverty and suffering
of the human species. Hence, efforts to control the population were sought.
Methods to control conception are:
● Methods of Contraception
o Folk methods - Pre-coital/ post-coital douche using vinegar, Prolonged
lactation, Coitus interruptus, and coitus reservatus
o Mechanical methods – condom and diaphragm
o Chemical Methods – Vaginal suppository, vaginal tablets, vaginal jellies,
creams and foams
o Hormonal Methods- Contraceptive pills, injections, and implants
Morality of Contraception
• Central to the morality of contraception is the answer to the

profound question-“when does life begin”- which is often the topic of
ethical debates.
• In answering the question of when life begins, comes to mind the question
whether the terms “zygote”, “pre-embryo”, “embryo” and “fetus” really indicate
biological successive stages of the development of a human being or not.
• If one rejects recognition of such terms as stages in the development of the

human being, one is bound to accept any acts that do not render respect to such
biological stages of human development.
• When one accepts a zygote, embryo, or fetus as biological stages of human

development, then one is bound to render respect to such stages the way respect
for the dignity of persons is rendered to a grown human person.
Issues on Artificial Reproduction and its Morality
1. Artificial Insemination is a less radical and sophisticated procedure

to facilitate conception in an unnatural way.
a. Artificial insemination is the introduction of sperm from a man

into a woman by laboratory methods in the attempt to bring
about a conception in the woman’s womb, thus making the
marital act of husband and wife insignificant causally in the
bringing about of the conception.
2. In-vitro fertilization: In vitro (in glass) human fertilization is facilitating

conception of a human person outside the body of a woman.
a. This conception takes place in a laboratory container—a glass
vessel or suchlike—using eggs taken from a woman’s body and
sperm from a man’s.
b. The living human embryo of the conception is then transferred
from the laboratory container into the body of a woman for
gestation until normal birth.
c. All techniques of in vitro fertilization proceed as if the human
embryo were a mass of cells to be used, selected and
discarded.
3. Surrogate Motherhood - is to facilitate conception through a

third-party reproduction in which a woman consents to carry a
pregnancy for intended parent(s) who cannot conceive for medical
reasons or those who are a gay couple.
a. There are two forms of surrogacy: traditional surrogacy and
gestational surrogacy.
i. Traditional surrogacy uses the surrogate mother’s egg for
conception.
ii.Gestational surrogacy is performed by transferring embryos
made through IVF with eggs from the intended mother or a
donor.

third-party reproduction
a. The advent of IVF has assisted gestational surrogacy. However,

pregnancy and gestation involve psychological burdens and
health risks for the surrogate mother.
b. The legal procedures for parenthood following surrogacy are
complicated due to the typical legal assumption that a woman
giving birth to a child is the legitimate mother of the child.
c. Therefore, a surrogate mother is required to formally abandon
parental authority, and the intended parent(s) then adopt the
child born. (Ishii, 2018)

third-party reproduction
a. The advent of IVF has assisted gestational surrogacy. However,

pregnancy and gestation involve psychological burdens and
health risks for the surrogate mother.
b. The legal procedures for parenthood following surrogacy are
complicated due to the typical legal assumption that a woman
giving birth to a child is the legitimate mother of the child.
c. Therefore, a surrogate mother is required to formally abandon
parental authority, and the intended parent(s) then adopt the
child born. (Ishii, 2018)
How do healthcare providers ethically respond to issues on

Artificial Reproduction?
The ethicality of artificial insemination, IVF, and surrogacy can be

discerned by analyzing the applicable ethical principle such as respect
for the dignity of the person, beneficence, non-maleficence, justice, and
autonomy.
Healthcare practitioners, the nurse most importantly, is to assist the

person who is facing issues with artificial reproduction in a non-
judgmental manner, offering information when necessary and
facilitating decision-making on the part of the patient through such
information. Moreover, the nurse is to highly advocate for the
autonomy or freedom of choice of the patient as a manifestation of
respecting his dignity as a person.
Abortion, Rape and other Problems Related to Destruction of Life

ABORTION
• Abortion is the expulsion from the uterus of the products of conception before
the fetus is viable. It is the premature stoppage of a natural or a pathological
process.
o TYPES OF ABORTION:
1. Complete Abortion - one in which all the products of conception are expelled
from the uterus and identified.
2. Habitual Abortion - spontaneous abortion occurring in three or more successive
pregnancies, at about the same level of development.
3. Incomplete Abortion - that with retention of parts of the products of
conception.
4. Induced Abortion - that brought on intentionally by medication or
instrumentation
5. Inevitable abortion - a condition in which vaginal bleeding has been profuse and
the cervix has become dilated, and abortion will invariably occur.

ABORTION
the fetus is viable. It is the premature stoppage of a natural or pathological process.
o TYPES OF ABORTION:
6. Infected abortion - associated with infection of the genital tract.
7. Missed abortion - retention in the uterus of an abortus that has been
dead for at least eight weeks.
8. Septic abortion - associated with a serious infection of the uterus
leading to generalized infection.
9. Spontaneous abortion - occurring naturally.
10. Therapeutic abortion - induced for medical considerations.
11. Threatened abortion - a condition in which vaginal bleeding is less
than inevitable abortion and the cervix is not dilated, and abortion may or
may not occur.

ABORTION
the fetus is viable. It is the premature stoppage of a natural or pathological process.
o Induced Abortion Techniques:

1. Abortion by dilatation and curettage (7- 12wks AOG)
2. Abortion by CS or abdominal Hysterectomy
3. Abortion by Suction (before 3-4months or 12-16wks)
4. Via Intra- amniotic infiltration (before 3-4months or 12-16weeks)
5. Via injection of Prostaglandin RU 486 –Contraceptive pill
associated with Prostaglandin
o LEGAL, MORAL & ETHICAL CONSIDERATIONS
o Article II, Section 12 of the 1986 Constitution provides that “The

state recognizes the sanctity of life and shall protect and strengthen
the family as the basic autonomous social institution. It shall equally
protect the life of the mother and the life of the unborn from
conception.”
Abortion, Rape, and other Problems Related to Destruction of Life

o LEGAL, MORAL & ETHICAL CONSIDERATIONS
- ARGUMENTS: CONTRA-ABORTION
- Not firmly a choice between a mother only or the child only but must
center on saving both lives.
- The ethical choice can be guided by the principle of Double Effect,
- Unselfish love and solitude to an innocent creature are upheld
- Recognition of the complementary roles between men and women

- The offspring has a genetic code totally different from the cells of the
parents
- ARGUMENTS: PRO-ABORTION
- To safeguard the life of the mother
- Abortion as a woman’s right
- Abortion is an expression of a woman’s sexual freedom
- The fetus is not a human person
•
• Rape
• Rape is an unlawful activity with sexual intercourse carried out
forcibly or under threat of injury against a person’s will or with a
person who is beneath a certain age or incapable of valid consent
because of mental illness, mental deficiency, intoxication,
unconsciousness, or deception. (Rape Definition & Meaning -
Merriam-Webster, n.d.)
Other Related Problems to the Destruction of Life

• 1.Human Population Control: Eugenics
- The term eugenics was coined by the Scientist Francis Galton (1822
- 1911). It literally means (eu)good (genos)birth.
- Francis Galton was the cousin of Charles Darwin who wrote the
evolutionary books Origin of the Species and The Descent of Man.
Galton coined the phrase from studying Darwin's works.

Human Population Control: Eugenics
There are two sides to Eugenics

- Negative Eugenics-the study of or belief in the possibility of improving the
qualities of the human species or a human population, especially by such
means as discouraging reproduction by persons having genetic defects or
presumed to have inheritable undesirable traits.
- Positive Eugenics-encouraging reproduction by persons presumed to have
inheritable desirable traits.

How Eugenics has Manifested Itself Throughout History

- Abortion: This form of human population control is at an all-time high now since the
1973 court decision of Roe v. Wade.
- 50 million babies have been murdered since then. As one looks closer at this
issue, it is startling to see how the largest abortion provider in the US has
targeted poor and minority groups.
- Most abortion clinics are found in poor, black or hispanic areas. Planned
Parenthood's agenda (an organization founded by a supporter of eugenics) is an
agenda of genocide.


Genocide: There are some graphic and disturbing examples of Genocide that
have occurred in the 20th century alone.
- This Nazi war devoured millions of mentally and physically handicapped people,
homosexuals, Jews, Slavs, Gypsies and so many other groups of people all
because they were considered undesirables who were taking up space and food
from the superior white race who were deemed to be those deserving of life.
- Under Communism, 158 million (approx.) people were murdered. Communism
is an atheistic worldview that wants to further the great experiment of causing
one great race of mankind to dominate the world and bring the human race to
its glorious heights. Communists idealize the strong and independent worker.


- Euthanasia: This is assisted suicide (predominantly) of people who are
suffering usually from a long terminal illness and want to expedite
inevitable death. A more exhaustive discussion is shared under issues on
death and dying.
- Sterilization: Many people who have had undesirable traits like mental
illness, alcoholism, mental or physical defects and genetic disorders were
sterilized in the 20th century. Against their will. This was completely legal in
the States for a time.


- Anti-miscegenation: The Darwinists and the eugenicists pushed for the
banning of interracial marriage and got it into law. It was illegal in the USA
to marry or have sexual relations with someone of a different ethnicity from
the 17th century until as recently as 1967.
- Negative eugenicists on Evolution: Evolution is an ideology based on
'survival of the fittest.' Negative eugenicists (possibly the positive ones as
well) believe that helping the poor and feeding the hungry and providing
health care for the sick and treating mental illness is setting back the
'natural' process of survival of the fittest. They dislike these acts of mercy
since it is sustaining the lives of the poor and sick.
•

The phenomenon of DEMOGRAPHIC WINTER:

Demographic winter was called the plague of the century - (Demographic
Winter: The Plague of the Century - Washington Times, n.d.)
- The rise of the graying population, often called by the name demographic
winter, is a cause of manifold social and economic concerns.
- Men and women are delaying marriage, making it less likely to have more
than one or two children. In the West, almost one in two marriages end in
divorce. The children of divorce are less likely to marry and form families
themselves.
- More married women are putting off having children for careers. After 35, it
becomes progressively harder for women to conceive.

The phenomenon of DEMOGRAPHIC WINTER:

Demographic winter was called the plague of the century - (Demographic
Winter: The Plague of the Century - Washington Times, n.d.)
o ALFI (ALLiance for the FAMILY Foundation Philippines, Inc. (ALFI) elaborated on this through the
following explanations:
o The fall in fertility is an observed phenomenon in both rich and poor countries and in the
majority of cases fertility has fallen below the accepted 2.1 replacement rate indicative of
the inability of the population to replace itself.
o When developed countries imposed their population control programs on poor countries,
they also fell prey to the lures of enjoying a “safe and satisfying sex life” free from the
responsibilities of children.
o Global trends indicate that fertility reduction accompanied by increased life expectancy
have produced aging populations all over the world. This is evidenced by the increase in the
percentage of 60 years and over in the latest UN projections.
• How do nurses respond to issues about life?

– Nurses are advocates of patients and hence are
advocates of human life.
– Nurses ascribe to the universal ethical principles in
dealing with ethical issues concerning the beginning
of life while at the same time focusing on the unique
needs and concerns of the patients with a
nonjudgmental attitude.
– As needed, the nurse must be able to discern and
ethically evaluate the intent, the action itself, and the
circumstances and effects of the action in question.
THANK YOU!
My Dear Students J

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HEALTH CARE ETHICS

Module 3.1: Ethical Decision-making in Various

• Video presentations (30 minutes)

Jameton (1984) described 3 different types of moral

Principle of Moral Discernment

• Ethical decision-making particularly is imperative to arrive at an ethical

• Ethical decision-making would require an ethical judgment and such

• The Ethical Decision-making Process is the process of choosing the best

• Making good ethical decisions to solve Ethical Dilemmas requires a trained

• Having a method for ethical decision-making is absolutely essential.

• The ethical decision-making process provides a method for nurses to

• Commitment: The desire to do the right thing regardless of the cost

• Good decisions are both ethical and effective:

Individual Influence on Ethical decision making

Situational Influence on Ethical decision making

Implement Act on it, participate on initiatives and advocacy if needed

Evaluate Evaluate the outcome of the plan of action implemented.

1. Euthanasia and Prolongation of Life

On Sexuality and Human Reproduction

Nurses are trained in the areas of human sexuality,

However, some concerns may put the nurse in a much

Human Sexuality and its’ Ethical Evaluation

• Human sexuality is defined as the totality of experiences, systems,

Anthropological Perspective of Sexuality and Procreation

● In sexual ethics, it is useful to understand the relationship

Anthropological Perspective of Sexuality and Procreation

Anthropological Perspective of Sexuality and Procreation

Anthropological Perspective of Sexuality and Procreation

Other Perspectives on Sexuality

1. Catholic Morality on Sexual Ethics can be summarized in the

Other Perspectives on Sexuality

● On the contribution of Sigmund Freud to the concept of Sexuality:

Other Perspectives on Sexuality

● Other contributions to the liberalization of sexuality and its detachment

A phenomenology of the sexual inclinations and a correct interpretation

In animal species, the sexual impulse acts as a strong, irrational

Freedom, Responsibility and Sex

● Beyond psychological and cultural dynamics lies the spirituality of

How nurses should respond ethically to sexuality issues?

- Nurses do not impose their own beliefs on sexuality on the patients,

- Article 1 of the Family Code of the Philippines defined marriage as:

Issues on Sex Outside Marriage and Homosexuality

● Chapter 3 of the Family Code of the Philippines stipulates the

Issues on Sex Outside Marriage and Homosexuality

● Article 45 of the Family Code further stipulates that a marriage may

Issues on Sex Outside Marriage and Homosexuality

● In the present context, homesexuality has evolved to the LGBT

● Healthcare practitioners guided by the ethical principle of respect for

Issues on Contraception and its Morality

• Central to the morality of contraception is the answer to the

• If one rejects recognition of such terms as stages in the development of the

• When one accepts a zygote, embryo, or fetus as biological stages of human

Issues on Artificial Reproduction and its Morality

1. Artificial Insemination is a less radical and sophisticated procedure

a. Artificial insemination is the introduction of sperm from a man

Issues on Artificial Reproduction and its Morality

2. In-vitro fertilization: In vitro (in glass) human fertilization is facilitating

Issues on Artificial Reproduction and its Morality

3. Surrogate Motherhood - is to facilitate conception through a