Major Bio Ethical Principles, Pt's Rights

BIOETHICS REVIEWER Page |1 Major Bioethical Principles 4: much in common with W.D Ross’s Prima Facie Duties 1.) Principle of Autonomy(Respect): Requires Health-Care Professionals not to interfere with the effective exercise patient’s autonomy 2.) Nonmaleficence: Not to act in ways that entail harm or injury to the patient 3.) Beneficence: … to act in ways that promote the welfare of the patient 4.) Justice: requires that social benefits (e.g. healthcare services) and social burden (e.g. taxes) be distributed in accordance to demands of justice. AUTONOMY: -self-governance

Human person as: -Bodily Subject -Knowingly Subject -Social Subject -Self transcendent Religion// image & like of God Body-Spirit Integrated dimensions Secular 4. Sufficiently free of internal constraints Ex. Schizo-delusions, visuals & hallucinations, alcoholic AUTONOMY- interfere, effective exercise, patient’s atunomy -morally blame worthy- reprimanded -charges of battery

-right to self-determination RIGHTS ARE NOT ABSOLUTE Autonomous action: 1. Intention 2. Understanding (sufficient) Insufficient understanding

Oneself Other

AUTONOMY IS NOT ABSOLUTE •Understanding- a matter of degree Perfect? Threshold/cut-off Decision- informed consent autonomous -not Informed consent becomes a problem 3. Sufficiently free of external constraints Physical Barriers (objects)

Forms of Coercion (persons) Occurent: Force

Disposition: threat of harm

*LIBERTY-CONSISTING PRINCIPLES* 1.) Harm Principle -widely used -the person can be justifiably restricted to prevent harm to others •nonmaleficince to patients 2.) Offense Principle -to prevent offensing others -offensive behavior can Shame be Embarrassment cultural Discomfort •PDA (ill-ness, dis-ease) 3.) Patternalism 4.) Extreme Paternalism

Read Timbreza

BIOETHICS REVIEWER Page |2 Patternalism Father: to act like a father Doer/Agent Recipient Moderate paternalism: prevent from harm weak Extreme paternalism: benefit strong Benefit Weak: ·diminished autonomy ·mentally challenge( severely) retardates ·severely depressed ·psychotics Strong: Full autonomy : miss out act against our long term interest Personal: Individual State: Institutions -laws against drugs TYPES of Patternalism 1. With regard to recipients welfare justifications diminished autonomy •Sick full autonomy 1. Sick 2. Probable harm 3. Probable benefit (intention) outweighs probable harm 4. Voluntary trust →Pure Paternalism: interventions for a person’s life for the sole welfare of that person (Ex: the child is told by his parents

to eat vegetables because it is good for his health) →Impure Paternalism: interference with another person not only for that person’s welfare but also for the welfare of another (Ex: A Jehovah’s Witness must have a blood transfusion not only for his own good but also for the good of his children) 1. With regard to the recipient’s defect and safety →Restricted Paternalism: supports intervention which overrides an individual’s action because of some defect or weakness in that individual (Ex. One may prohibit a child from doing something because of chronological or psychological incompetence) →Extended Paternalism: is one on which an individual is restrained from doing something because it is too risky or dangerous (Ex. Riding motorcycles without wearing helmets is not encourage because of the imminent danger it incurs) 2. With regard to the promotion of good and prevention of harm →Positive: Ex. When a patient is forced into a rehabilitation program to promote his/her own good →Negative: Ex. When cigarettes or weapons are taken away to prevent an Individual from any harm or violence 3. With regard to the patient’s sense of values →Soft Paternalism Act: patient’s values are used to justify the intervention with his possible action or decision (Ex. “kapag ako’y nag-aagaw buhay na, huwag na ninyo akong ikabit sa artificial respirator.”) →Hard Paternalism Act: patient’s values are not the ones used to justify a paternalistic act (Ex. “Doc, mabuti pa

BIOETHICS REVIEWER Page |3 kaya’y gawin nang Caesarean ang panganganak ng misis ko.”) 4. With regard to the recipient of the benefit →Direct Paternalism: the individual who should receive the supposed benefit is the one whose values are overridden or disregarded for his own good (Ex. The motorcyclist who is forced by law to wear helmet is the one who will benefit in case of an accident. →Indirect Paternalism: a particular individual will be benefited, if one person is restrained from doing something (Ex. Child abuse, in which parents are restrained by law in some way to protect the child) 5.) Legal Moralism- immorality/ immoral behavior. Ex suicide 6.) Social Welfare- to BENEFIT others HYPOCRATIC OATH Kindness Nonmaleficence safe guard the patient

Skills

Action Deficient At risk Harm

Patient’s Right (Informed Consent) •Justice: rendering what’s due to the person deserved Plato: Giving what is due Context: relations Rights Duty

Corp Corp Nation Nation Jus/ ius: right “iustitia” INRI- Jesus Nazarenus Rex Judeorum IHS- Jesus _______ Salvator

Beneficence

Correlated Binary

Charity Care of pt.

KINDS OF JUSTICE General legal Common good

Common legal Moral law, +civil law

Do good First ethical principle:

Avoid Evil Malevolence

N.M M

Benevolence: Human-heartedness William Frankena 4 elements 1. One ought not to inflict harm or evil 2. One ought to prevent harm or evil 3. One ought to remove harm or evil 4. One ought to do or promote good N.M-nonmaleficence M-Maleficence

Equity civil law

JUSTICE Commutative fairness of exchange ParticularPrivate good Personal Distributive: sharing the goods that benefits/right belong to the burden/duty community

BIOETHICS REVIEWER Page |4 “It is wrong to base equality to justice” “Human beings will never be equal” “The Equality is not the same w/ Equity” ? Due 1.) To each person equal share 2.) To each person according. to individual needs 3.) To each person according. to acquisition in the free market 4.) To each person according. to merit Qualification

Patient’s Rights - inviolable Nos duties po Respect the rights Autonomy- not to interfere with effective exercise of the patient’s autonomy Timbreza: Right to self-determination Informed consent •information •agreement/disagreement •consent/non-consent Informed decision •information + understanding Informed choice •choices/options Right to refuse of treatment *Perfunctory- automatic Elements of Informed Consent 1. Competence- able to decide Incompetent-paternalism 2. Disclosure- content or information 3. Comprehension- jargon avoid

4. Voluntariness- given out of the freewill of the patient Controversial: euthanasia (emergency Patient’s Right is suspended) Right to die- limitation against the patient’s right “There are rights that are not written” READ: TIMBREZA for Patient’s Rights FINALS: Basic ethical principles Major bioethical principles Patient’s Right (informed consent)

“If any of you lacks wisdom, he should ask God, who gives generously to all without finding fault, and it will be given to him.” James 1:5