BIOETHICS

Types of Ethical Thoughts

1) Kantian Ethics
o Definition: Kantian ethics refers to a deontological ethical theory ascribed
to the German philosopher Immanuel Kant. The theory, developed as a
result of Enlightenment rationalism, is based on the view that the only
intrinsically good thing is a good will; an action can only be good if its
maxim the principle behind it is duty to the moral law.
o Example: In Kantian ethics helping an old lady across the street because
you feel pity for her is NOT a moral act. Likewise, helping an old lady
because your coworker will think highly of you is NOT a moral act. However,
helping an old lady because you have a sense of duty to help the elderly IS
a moral act.
2) Rawls Ethics
o Definition: Rawls's

ethics

revolves

around

the

adaptation

of

two

fundamental principles of justice which would, in turn, guarantee a just and

morally acceptable society. The first principle guarantees the right of each
person to have the most extensive basic liberty compatible with the liberty
of others. The second principle states that social and economic positions
are to be (a) to everyone's advantage and (b) open to all.
o Example: Person P is attempting to reach a conclusion as to whether or not
to do action A or which action (B,C or D) would be the morally correct thing
to do. Well, for Rawls a person would want to consider whether actions A B
C D would support or violate the principle of the moral GOOD which for
Rawls is the maxi-min principle:
- Maximize the liberty and freedoms of all involved. Do not restrict or deny
the freedom and choice of anyone involved in the situation.
- Minimize the harms or the plight of the least well off in the situation or
minimize the differences in the welfare of the least well off as compared to

those who are most well off. Do not make matters worse for those already
most disadvantaged in the situation.
3) St. Thomas Aquinas Ethics
o Definition: Metaethics is a branch of analytic philosophy that explores the
status, foundations, and scope of moral values, properties, and words.
Whereas the fields of applied ethics and normative theory focus on what is
moral, metaethics focuses on what morality itself is.
o Example: physician-assisted suicide, while nonetheless agreeing at the
more abstract level of a general normative theory such as Utilitarianism, so
too may people who disagree at the level of a general normative theory
nonetheless agree about the fundamental existence and status of morality
itself, or vice versa. In this way, metaethics may be thought of as a highly
abstract way of thinking philosophically about morality. For this reason,
metaethics is also occasionally referred to as second-order moral
theorizing, to distinguish it from the first-order level of normative theory.
4) Ross Ethics
4.1) Actual prima-facie duty
o Definition: An act is a prima facie duty when there is a moral reason in
favor of doing the act, but one that can be outweighed by other moral
reasons.
a) Fidelity and Reparation keeping promises made
b) Reparation - implied and compensating for wrongdoing
c) Gratitude returning favour for favour
d) Non-maleficence avoiding injury to others
e) Justice fair distribution of pleasure or happiness
f) Beneficence improving the condition of others
g) Self-improvement making ourselves better

o Example: If I have promised to meet a friend at a particular time for some

trivial purpose, I should certainly think myself justified in breaking my
engagement if by doing so I could prevent a serious accident or bring relief
to the victims of one. Ross
The Calling of the Health Care Provider
1) The Health Care Profession
- is an occupation requiring advanced, Specialized and systematic study and
training in the knowledge of health care designed to provide services to
society in that particular field.
2) The Client
- The one receiving the therapy has a health problem or need which must be
accurately identified through diagnostic procedures so that due health care
may be given. The therapeutic interaction is client-centered along with its
being a goal-oriented one.
The needs of the client and NOT of the health care practitioners that are being
served.
Responsibilities of the CLIENT/PATIENT
2.1) The client should be encouraged to take active role in the therapeutic
process
2.2) The patient should be open and amenable to the interaction along with
the competence of the health care provider and the effectiveness of
health care services.
2.3) The client should be the one to make a decision to give his full consent
manifested by his openness and responsiveness to pertinent questions.
2.4) The client should be cooperative in therapeutic activities and
submissive to health care instructions and suggestions.
3) The Health Care Provider
- Health care professional or practitioner is a person who has acquired an
advanced,
knowledge

specialized
of

health

and
care

systematic
along

training

with

its

and

various

experience
specific

in

the

scientific

specializations and techniques including those of medical doctors, nurses,

midwives, medical technologists and the like.
A nurse is highly esteemed among those in the medical profession, well-known
throughout the world for his/her contribution to medicine, and greatly admired
for the dedication of his/her life to the sick and afflicted, confided the
inspiration of his/her life. Nursing is a vocation just like priesthood and the
teaching profession, because the person who embraces the profession of a
nurse responds to the call of Christs charity: I am ill and you comforted me
I assure you, as often as you did it for one of my least brothers, you did it for
me (Matthew 25:36;40).
4) Health Care Provider-Client Relationship
- Since the HCP-client relationship is therapeutic, the interaction must also be
-

therapeutic.
This interaction is processive in nature and character.
Practice Standard Principles
The following principles set out the requirements for practice
1. Nurses

use

professional

judgment

in

determining

the

appropriate

boundaries of a therapeutic relationship with each client. The nurse - not the
client - is responsible for establishing and maintaining boundaries.
2. Nurses are responsible for beginning, maintaining and ending a relationship
with a client in a way that ensures the clients needs are first and foremost.
3. Nurses do not enter into a friendship or a romantic or sexual relationship
with clients.
4. Nurses are cautious in socializing with clients and former clients, especially
when the client or former client is vulnerable or may require ongoing care.

5. At times, a nurse may have to care for family or friends. When it is possible,
overall responsibility for care is transferred to another appropriate health
care provider.
6. At times, a nurse may want to care for family or friends. This situation
requires caution, discussion and careful consideration about the impact of
the dual role on everyone involved.
7. Nurses in a dual role make it clear to clients when they are interacting in a
professional capacity and when they are interacting in a personal capacity.
8. Nurses have access to privileged and confidential information, but never use
this access or information to the disadvantage of clients or others.
9. Nurses disclose personal information about themselves only after they
determine it may be helpful in meeting the therapeutic needs of the client.
10.

Supportive touching or hugging a client may be therapeutic in select

circumstances.
11.

Communicating with clients in ways that are perceived to be

demeaning, seductive, insulting, disrespectful, humiliating or otherwise

inappropriate is unacceptable.
12.

Unacceptable behaviour by the nurse includes neglect and/or verbal,

physical, sexual, emotional and financial abuse. Any action that results in
inappropriate financial or personal benefit to the nurse or loss to the client is
unacceptable.

13.

Nurses do not act as representatives for clients under powers of

attorney or representation agreements.

14.

Generally, it is not acceptable for nurses and clients to exchange gifts.

A group of nurses may give or receive a token gift in situations where it has
therapeutic intent. Any significant gift must be returned or redirected.
15.

Nurses maintain the same boundaries with the clients significant

others as with the client.

16.

Nurses help colleagues to maintain professional boundaries and report

evidence of boundary violations to the appropriate person.

-

It may develop even at a more meaningful level transcending what is merely

mechanical into commitment and accountability with love, trust, concern and
care for each other.