ETHICAL PRINCIPLES

ETHICAL PRINCIPLES PRINCIPLE OF CONFIDENTIALITY

● Ethical principles do not provide a straightforward ● Confidentiality- information can be restricted to
guide that guarantees the making of an ethically those authorized to have access to it.
correct decision, nor can they offer guidance about ● is an important aspect of the trust that patients place
ranking when the principles appear to conflict with in health care professionals.
one another ● it refers to the medical or professional secrecy in
● Instead, they point only to considerations that should which certain information is committed to a physician
be weighed when making decision in his official capacity for the sake of medical
● “Deliberation” assistance.
● It is mandatory for the health care provider to protect
PRINCIPLE OF AUTONOMY the information provided by the client/patient.
● means self-governing ● Basic ethical arguments in favor of confidentiality:
● denotes having the freedom to make choices about ○ The individual’s right to control personal
issues that affects one’s life information and protect privacy
● frequently used as a contrast to undesirable states ■ What are the limitations of the patient in
such as dependency, coercion, paternalism, providing information?
thoughtlessness and habit ■ Every individual has the right to protect their
● Autonomy is the opposite of thoughtlessness privacy
● Being autonomous means being capable of ■ It depends on the patient whether they
determining what is best for themselves disclose such information, but they should
be aware that if the healthcare provider is
ELEMENTS OF AUTONOMY unaware of their health status, they could
● A person should be respected: not come up with a good intervention and
○ He should be able to determine his personal treatment plan for them
goals ○ Utility - if patients suspect that healthcare
○ He should have the ability to decide on plans of providers would reveal sensitive and personal
actions information they may be reluctant to seek care
○ He should have the freedom to act upon his ■ When the healthcare provider carry
choice themselves in a way that shows
trustworthiness, then the patient would not
be reluctant to disclose information with
VIOLATION TO AUTONOMY
them
● Paternalism
○ From Latin word “pater or paternos” which LIMITS OF CONFIDENTIALITY
means being fatherly ● Principle of harm - applied when professionals
○ The act of being fatherly to someone as if the recognize that maintaining confidentiality will result
latter was one’s offspring in preventable wrongful harm to innocent others
○ It violates the principle of autonomy - unable of ○ When there is a possibility of harm, even if they
determining what is best for themselves have rights to confidentiality, then we have the
○ This happens when someone makes a decision ability to divulge information to the right ear with
in behalf of the other person and is still right the only reason: to prevent harm.
since it benefits the other person who cannot ● Principle of vulnerability - the duty to protect others
make the decision from harm is stronger when the third party is
■ Has two conditions: dependent on others or someway vulnerable
– When there is no one close to the kin or ○ Ex. When you know that there is domestic
kin of patient who can make the abuse happening inside the household, then we
decision have the ability to divulge information to the right
– When the person cannot make the ear with the reason: to protect the vulnerable.
decision such as mentally ill clients,
unconscious etc. PRINCIPLE OF VERACITY
– The one making the decision knows ● Veracity - relates to the practice of telling the truth
better than the one making the decision ● Truth Telling
itself ex. children cannot determine if - will bring about respect, open communication,
their decisions are right or wrong trust, and shared responsibility
therefore the parents will be the one to - telling the truth will enable the health care
make the decision worker to plan out the concrete management for
○ PATERNALISM IN HEALTHCARE the patient
■ Practices wherein providers confer - if nurses tell the truth, it will enable the patients
treatment upon a person or persons without to trust them
their consent, maybe due to reason of their ● Right information
limited autonomy and diminished capacity - patients have the right to obtain complete,
– Limited autonomy and freedom current information concerning diagnosis,
Ex. confined mentally-ill patients treatment, and prognosis in terms that can easily
understand
TYPES OF PATIENT’S RIGHTS - Healthcare providers are expected to tell the
● The moral and inviolable power vested in a person truth to their patients
to do, hold, or demand something as his own
1. Right to informed consent JUSTIFICATIONS OF TRUTH TELLING
2. Right to informed decision ● It is argued that our human and moral quality as
3. Right to informed choice persons is taken away from us if we are denied
4. Right to refuse treatment whatever knowledge is available about our condition
5. Right to self-determination as a patient.

NCM 208 Health Care Ethics (Bioethics)

by: [Apellanes, Glemao, Vidoy]
 ○ Whatever information that we do not disclose to
the patient, is just like denying them the right to
information
● As patients, we have entrusted to the physician any
knowledge he has about ourselves, so the facts
(findings) are not ours and not his, hence to deny
them to us is to steal from us.
○ Common
○ Ex. When patient undergoes lab testings, the
doctor must interpret the results to the patient
because if not it is like stealing information that
is due to the patient
● The highest conception of the physician-patient
relationship is a personalistic one which is based on
mutual confidence and respect for each other’s
rights
○ Nurse-patient relationship is based on mutual
confidence
○ When you are a nurse, trustworthiness is
essential because if a patient entrusts you with
details of their life, they should not be afraid,
anxious after sharing it.
● To deny a patient pertinent knowledge about himself,
especially in a life and death situation, is to deprive
him the ample time to prepare for his own death or
to carry out responsibilities that are based solely on
his decisions or actions

TWO APPROACHES OF TRUTH TELLING

● Person - centered - considers patient as a person
with a problem, but not as a problem himself/herself
○ Depends on the patient’s state
○ Tell the truth based on the person; you can
choose not to inform the patient the truth for
now, but as the patient gets better, you need to
tell the patient the truth
○ If information can cause anxiety or decrement to
the health of the patient, then we withhold the
information for a time.
● Problem - centered - considers the patient’s
condition, illness or diseases
○ When the problem needs to be addressed right
away, then we need to center our decision
making of telling the truth on the problem itself
○ Ex. If the patient has hypertension, before we
disclose any information that could elevate his
blood pressure, we could give him medications
to control his blood pressure.

VIOLATION OF THE PRINCIPLE OF VERACITY

● Benevolent deception
○ Practitioner is allowed to intentionally withhold
information based on his/her “sound medical
judgment” that to divulge the information might
potentially harm the depressed and unstable
patient for an unpleasant fact
○ This is where the act of the nurses or healthcare
providers revolve of not telling the truth first for a
period of time
○ Making white lies since that lie cannot stay there
forever, it should be divulged or shared to the
person concerned to know about the information

PRINCIPLES OF FIDELITY
● Refers to the concept of faithfulness to our duties,
obligations, vows, or pledges
● Refers to one’s loyalty to a worthy cause
● Telling the truth as the situation demands it
● Keeping actual and implicit promises, and not
representing fiction as truth
○ Ex. Patient: “Nurse, may I know my lab results”
Nurse replies “I'll get back to you ma'am”
But the shift of the nurse has passed and she
did not get back…
○ The nurse may have forgotten to do it because
she had several patients or she did not do it.

NCM 208 Health Care Ethics (Bioethics)

by: [Apellanes, Glemao, Vidoy]