Basic Bioethical Principles

• Bioethics - deals with the study of the morality of human conduct in relation to health in particular and to human life in general.
• Basic Bioethical Principles

  1. Stewardship Principle
  2. Totality Principle
  3. Double Effect Principle
  4. Principle of Cooperation
• Stewardship Principle - steward has the obligation to take good care and improve a thing or asset entrusted to him/her.
• Totality Principle - that the parts of the physical entity, as parts are ordained to the good of the physical whole.

  • classic criterion in dealing with concerns about mutilation, organ donation, and transplantation while preserving the sanctity of life.
• Teachings in Totality Principle:

  • The patient should have a serious need that can only be satisfied by organ donation.
  • Even if donation reduces “anatomical integrity, it should not diminish the functional integrity” of the person.
  • The risk in donation as “an act of Charity is [to be] proportionate to the good resulting for the recipient.
  • There should be ”free and informed consent” by the donor.
• Double Effect Principle - Contemplates that it is permissible to cause harm

  as a side effect (or “double effect”) of bringing about a good result

  • That the action in itself from its very object be good or at least indifferent.
  • That the good effect and not the evil effect be intended
  • That the good effect be not produced by means of the evil effect
  • That there be a proportionately grave reason for permitting the evil effect.
• Principle of Cooperation - concept that differentiates the action of

  the wrongdoer from the action of the cooperator
• Formal Cooperation - willing participation on the part of the cooperative agent in the sinful act of the principal agent.
• Material Cooperation - when the cooperator does not intend the object wrongdoer’s activity but actively participating in the deed by which the evil is performed.
• Principle of Respect for Autonomy - Entails that health-care professional should respect the autonomous decisions of competent adults.
• Types of Consent

  1. Informed Consent
  2. Parental Permission or Consent - for minor participants
• Health Legislations the mandates informed consent

  1. Philippine HIV and AIDS Policy Act
  2. Comprehensive Dangerous Drugs Act
  3. Newborn Screening Act
• Principles of Beneficence - the health care should aim TO DO GOOD.

  • The ethical obligation to maximize benefit and to minimize harm.
• Principle of Non-Maleficence - should do NO HARM.

  • to prevent undue and deliberate infliction of harm on persons.
• Non-maleficence is found in the instructions of the Hippocratic Oath, viz; “primum, non nocere” (first, do no harm)
• Principle of Justice - should act fairly when interests of different individuals or groups are in competition
• Types of Justice

  1. Comparative Justice - balancing the competing interest of individual and groups against one another
  2. Distributive Justice - the fair distribution of healthcare services to all
• Well-worn bioethical issues:

  1. Destruction of Life
  2. Abortion - most popular
  3. Euthanasia and assisted Suicide
  4. Sustaining Life
  5. Withholding life support
  6. Organ transplantation
• Article 2, in the Declaration of Principles and States that Section 12, “The State

  recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous institution.”

  • should equally protect the life of the mother and the life of the unborn
• Abortion - Refers to the termination of pregnancy before the viability of the fetus by removal or expulsion of an embryo or fetus
• Causes of Abortion:

  1. Natural Causes - spontaneous miscarriage
  2. Overt Acts - intentional or unintentional
  3. Performed or Personal Reasons - elective abortion
  4. Therapeutic Abortion - saving the life between a mother and a child
• Euthanasia - practice of painlessly putting to death a person suffering from an incurable disease

  • known as mercy killing
• Types of Euthanasia

  1. Positive or Active Euthanasia - Involves actions that speed up the process of dying; introduces a chemical agent
  2. Negative or Passive Euthanasia - no heroic measure taken to preserve life ; non-introduction of medical measures to preserve life.
• Passive euthanasia is implied or recognized in healthcare settings with the use of this code: DNR or no code order
• Withholding Treatment - decision of the patient or his/her representative to refrain from giving permission for treatment or care
• Withdrawing Treatment - decision of the patient or his/her representative to discontinue activities or remove forms of patient care
• Organ Transplantation - form of surgery wherein one body part is

  transferred from one site to another or from one individual to another.
• Types of Organ Transplantation

  1. Autograph or Autotransplant - Tissue transplanted from one part of the body to another in the same individual
  2. Allograph or homograph - Transplant of an organ or tissue from one individual to another
  3. Xenograph or heterography - surgical graft of tissue from animals to humans
• True


  (T or F) Organ transplantation is used as a form of medicine