Bioethics

• A discipline of applied ethics and comprises three main sub

  disciplines:

  medical ethics, animal ethics, and environmental ethics
• a compilation of ancient texts concerning the proper behaviour of physicians and the relationship between physician and patient

  HIPPOCRATIC OATH
• contains some binding ethical rules of utmost importance; doctor patient confidentiality and the prohibition on exploiting the patient, strict prohibition of euthanasia and abortion

  HIPPOCRATIC OATH
• IMPORTANT TRADITIONAL ISSUES IN MEDICAL ETHICS THAT STILL NEED TO BE SOLVED

  1. beginning- and end-of-life issues (notably abortion, euthanasia, and limiting therapeutic treatments)
  2. physician-patient relationship
  3. research on human beings (including research ethics and human genetics).
• More recent medical issues include:

  1. reproductive decision making
  2. organ transplantation
  3. just distribution of healthcare resources
  4. access to healthcare
  5. healthcare systems and (global) public health
• In the twentieth century, medical ethics was focused on-but not limited to- two main issues:

  1. the concept of personhood (for example, the Singer debate)
  2. the principle of autonomy (that is, individual informed consent).
• Theory by Kant (1785) and Ross (1930)

  DEONTOLOGICAL APPROACHES
• DEONTOLOGICAL APPROACHES provided by

  Kant (1785) and Ross (1930)
• Prime examples of applying moral rules:

  1. Religious approaches (Catholic Church)
  2. Non-religious deontological approaches (Kantian oriented theories)
• Four important core elements that all utilitarian approaches have in common:

  1. THE CONSEQUENCE PRINCIPLE
  2. THE UTILITY PRINCIPLE
  3. THE HEDONISTIC PRINCIPLE
  4. THE UNIVERSAL PRINCIPLE
• THE CONSEQUENCE PRINCIPLE:

  The consequences of a given action are the measure of its moral quality.
• The moral rightness and wrongness of actions are determined by the greatest possible utility for the greatest possible number of all sentient beings.

  THE UTILITY PRINCIPLE
• Maximize the total utility for all sentient beings affected.

  THE UNIVERSAL PRINCIPLE
• Utilitarian approaches in bioethics were spearheaded by:

  Singer (1979) and Harris (1975)
• Utilitarianism carried on by, among others,

  Savulescu (2001, 2002) and Schüklenk (2010)
• UTLTARIANISM Approaches in bioethics are less concerned with public welfare than other vital aspects, such as:

  1. debunking the traditional religious views on the sacredness of human beings, the prohibition of abortion, infanticide, and euthanasia;
• UTLTARIANISM Approaches in bioethics are less concerned with public welfare than other vital aspects, such as:

  (2) stressing the importance of non-rational sentient animals (animal ethics) and the preservation of nature (environmental ethics) against anthropocentric approaches such as Kantianism and religious approaches;
• UTLTARIANISM Approaches in bioethics are less concerned with public welfare than other vital aspects, such as:

  (3) arguing against the use of human rights and human dignity in bioethical discourses;
• UTILTARIANISM Approaches in bioethics are less concerned with public welfare than other vital aspects, such as:

  (4) maximizing the patient's well-being or best interests in medicine
• THE FOUR-PRINCIPLE APPROACH developed by

  Tom Beauchamp and James Childress
• UTILTARIANISM often simply called

  PRINCIPALISM
• four universal prima facie mid-level ethical principles:

  (1) autonomy (2) non-maleficence (3) beneficence (4) justice
• THE UNDERLYING PRINCIPLES OF ETHICAL PATIENT CARE include

  1. THE PRINCIPLE OF BENEFICENCE
  2. The Principle of Non-Maleficence
  3. The Principle of Respect for Autonomy
  4. The Principle of Respect for Dignity
  5. The Principle of Veracity
  6. The Principle of Distributive Justice
• Medical practitioners should act in the best interests of the patient.

  The Principle of Beneficence
• they should prevent harm, remove harm, and promote good for the patient

  The Principle of Beneficence
• When applying this principle, it must be determined whether a proposed medical treatment will prevent or remove harm, or promote good for the patient

  The Principle of Beneficence
• Medical practitioners must not harm the patient

  The Principle of Non-Maleficence
• Capable patients must be allowed to accept or refuse recommended medical interventions

  The Principle of Respect for Autonomy
• defined as the capacity for self-determination or the capacity to make one’s own decisions

  AUTONOMY
• requirement of voluntary informed consent

  AUTONOMY
• Patients, their families and surrogate decision makers, as well as health care providers,all have the right to dignity


  The Principle of Respect for Dignity
• The capable patient must be provided with the complete truth about his or her medi

  The Principle of Veracity
• Health care resources should be distributed in a fair way among the members of society


  The Principle of Distributive Justice
• Code of ethics

  As I enter into the practice of Medical Technology, I shall accept the responsibilities inherent to being a professional; I shall uphold the law and shall not engage in illegal work nor cooperate with anyone so engaged; I shall avoid associating or being identified with any enterprise of questionable character;
• Code of Ethics 2


  I shall work and act in a strict spirit of fairness to employer, clients, contractors, employees and in a spirit of personal helpfulness and fraternity toward other members of the profession;
• Code of Ethics 3

  I shall use only honourable means of competition for professional employment or services and shall refrain from unfairly injuring, directly or indirectly, the professional reputation, projects or business of a fellow medical technologist; I shall accept employment from more than one employer only when there in no conflict of interest;
• Code of Ethics 4


  I shall perform professional work in a manner that merits full confidence and trust carried out with absolute reliability, accuracy, fairness and honesty; I shall review the professional work of other medical technologists, when requested, fairly and in confidence whether they are subordinates or employees, authors of proposals for grants or contracts, authors of technical papers or other publications or involved in litigation;
• Code of Ethics 5


  I shall advance the profession by exchanging general information and experience with fellow medical technologists and other professionals and by contributing to the work of professional organizations;
• Code of Ethics 6


  I shall report any infractions of these principles of professional conduct to the authorities responsible of enforcement of applicable laws or regulations, or to the Ethics Committee of the Philippine Association of Medical Technologists as may be appropriate
• Code of Ethics 7


  To these principles, I hereby subscribe and pledge to conduct myself at all times in a manner befitting the dignity of my profession.