BIOETHICS

1. APPLICATION OF BIOETHICAL PRINCIPLES
TO THE CARE OF THE SICK
INFORMED CONSENT
 refers to the patient's deliberate
and voluntary acceptance of a
health care procedure which
presupposes sufficient disclosure
of the nature and goal of the
procedure, its possible side-
effects, risks, benefits and the
available medical options.
Form of Consent
1. Consent by Presumption
 this is reasonably presumed to be
present in the subsequent
employment and series of
procedures as they are aligned
with the primary procedure to
which explicit consent is express.
Example: Through it is not utterly
expressed consent to perineal flushing is
reasonably presumed that is done after
the patient is medically assisted for
delivery to which she gives explicit
consent.
2. Consent by Proxy
 this is done when the patient is
not capable of informed consent
and is legitimately represented
by a competent surrogate who
acts in his behalf
 The patient may be unconscious,
insane or minor /child who is out
of reason or not in the age of
reason.
Example: A febrile baby is given an
antipyretic injection at the consent of his
mother
THE PRINCIPLE OF AUTONOMY
 refers to one's moral power or
right to self governance and
determination to make decisions
in directing one's own life
 exercise of freedom
Implications of the Patient's Autonomy
1. The patient is responsible for his
choices and decisions
2. His human dignity is upheld and
recognized
3. His personal value and worth are
affirmed
4. His patient's rights are protected and
are not unduly interfered with
5. He cannot be constrained or forced
to make decisions and perform actions
against his will
PATIENT'S RIGTHS
 refer to the moral power
incumbent upon the dignity of
the patient as a human person
which is enjoined by both natural
law and positive law requiring
that what is due must be
rendered to the patient as justice
demands.
FILIPINO PATIENT'S BILL OF RIGHTS
1. The patient has the right to
considerate and respectful care,
irrespective of socio-economic status
2. The patient has the right to obtain from
his physician complete current
information concerning his diagnosis,
treatment, and prognosis in terms the

2. patient can reasonably be expected to
understand
3. The patient has the right to receive
from his physician information necessary
to give informed consent prior to the start
of any procedure and or treatment.
Except in emergencies, such information
for informed consent should include but
not necessarily limited to specific
procedure and or treatment, the
medically significant risks involved, and
probable duration of incapacitation.
The patient has also the right to know
the name of the person responsible for
the procedures and/ or treatment.
4. The patient has the right to refuse
treatment/ life-giving measures, to the
extend permitted by the law, and to be
of the medical consequences of his
action.
5. The patient has the right to every
consideration of his privacy concerning
his own medical care program
 Case discussion, consultation,
examination and treatment are
confidential and should be
conducted discreetly
 Those not directly involved in his
care must have the permission of
the patient to be present.
6. The patient has the right to expect that
all communication and records
pertaining to his care should be treated
as confidential
7. The patient has the right that within his
capacity, a hospital must make
reasonable response to the request of
patient for services.
 The hospital must provide
evaluation, service and/or
referral as indicated by the
urgency of care
8. The patient has the right to obtain
information as to any relationship of the
hospital to other health care and
educational institutions in so far as his
care is concerned.
9. The patient has the right to be advised
if the hospital proposed to engage in or
perform human experimentation
affecting his care or treatment.
 The patient has the right to refuse
or participate in such research
project.
10. The patient has the night to expect
reasonable continuity of care;
 he has the right to know in
advance what appointment
times the physicians are available
and where.
 The patient has the right to expect
that the hospital will provide a
mechanism whereby he is
informed by his physician or a
delegate of the physician of the
patient's continuing health care
requirements following discharge.
11. The patient has the right to examine
and receive an explanation of his bill
regardless of source of payment.
12. The patient has the right to know
what hospital rules and regulations apply
to his conduct as a patient.

3. Nursing Code of Ethics
Code of Ethics for Filipino Nurses
- The professional code of ethics for
Filipino nurses strongly emphasizes the
four-fold responsibility of the nurse, the
universality of nursing practice, the
scope of their responsibilities
 to the people they serve,
 to their co-workers
 to society and environment, and
 to their profession
- The Code of Ethics used by Filipino
nurses prior to 1984, was the code
promulgated by the International
Council for Nurses. In 1982, the PNA
Special Committee developed a Code
of Ethics for Filipino Nurses but was not
implemented.
- In 1984, the Board of Nursing adopted
the Code of Ethics of the ICN, adding
"promotion of spiritual environment" as
the fifth-fold responsibility of the nurse.
- In 1989 the Code of Ethics promulgated
by the PNA was approved by the
Professional Regulation Commission and
was recommended for use.
- This was approved In October 25, 1990
by the general assembly of the PNA.
- In July 14, 2004, a new Code of Ethics for
Filipino Nurse was adopted under RA
9173 and was promulgated by the BON.
The Code of Ethics for Filipino Nurses
embodies ethical principles and
guidelines to be observed, stipulated
under seven (7) articles.
Article 1-Preamble
1. Health is a fundamental right. The
Filipino RN, believing in the worth and
dignity of each human being, recognizes
the primary responsibility to preserve
health at all costs. This responsibility
encompasses promotion of health,
prevention of illness, alleviation of
suffering, and restoration of health
However, when the foregoing are not
possible, assistance towards a peaceful
death shall be his/her obligation.
2. To assume this responsibility, RNs have
to gain knowledge and understanding of
man's cultural, social, spiritual,
psychological, and ecological aspects
of illness, utilizing the therapeutic
process.
 Cultural diversity and political
and socio- economic status
are inherent factors to
effective nursing care.
3. The desire for the respect and
confidence of clientele, colleagues, co-
workers, and the members of the
community provides the incentive to
attain and maintain the highest possible
degree of ethical conduct.
Article II-Registered Nurses and People
1. Values, customs, and spiritual beliefs
held by individual shall be represented
2. Individual freedom to make rational
and unconstrained decisions shall be
respected

4. 3. Personal information acquired in the
process of giving nursing care shall be
held in strict confidence.
Article Ill-Registered Nurses and Practice
1.Human life is inviolable
2.Quality and excellence in the care of
patients are the goals of nursing practice
3. Accurate documentation of actions
and outcomes of delivered care is the
hallmark of nursing accountability
4. Registered nurses are the advocates of
the Jog patients they shall take
appropriate steps to safeguard their
rights and privileges.
5. Registered Nurses are aware that their
actions have professional ethical, moral
and legal dimensions They strive to
perform their work in the best interest of
all concerned.
Article IV-Registered Nurses and Co-
workers
1. The RN is in solidarity with other
members of the health care team in
working for the patient's best interest.
2. The RN maintains collegial and
collaborative working relationship with
colleagues and other health care
providers.
Article V-Registered Nurses, Society, and
Environment
1. The preservation of life, respect for
human rights, and promotion of healthy
environment shall be a commitment of a
RN.
2. The establishment of linkages with the
public in promoting local, national, and
international efforts to meet health and
social needs of the people as a
contributing member of society is a
noble concern of a RN
Article VI-Registered Nurses and the
Profession
1. Maintenance of loyally to the nursing
profession and preservation of its integrity
are ideal.
2. Compliance with the by-laws of the
accredited professional organization
(PNA) and other professional
organizations of which the RN is a
member is a lofty duty.
3. Commitment to continual learning
and active participation in the
development and growth of the
profession are commendable
obligations.
4. Contribution to the improvement of
the socio- economic conditions and
general welfare of nurses through
appropriate legislation is a practice and
visionary mission.
Article VII-Administrative Penalties,
Repealing Clause and Effectivity
The certificate of registration of the RN
shall either be revoked or suspended for
violation of any provisions of this Code
pursuant to Sec 23 (f), Art IV of RA No
9173 and Sec 23 (f), rule III of Board Res.
No 425, Series of 2003, the IRR.

5. "Art IV of RA 9173-Examination and
Registration Sec 23 Revocation and
Suspension of Certificate of
Registration/Professional License and
Cancellation of Special/Temporary
Permit -The Board shall have the power
to revoke or suspend the certificate of
registration/professional license or
cancel the special/temporary permit of
a nurse upon any of the following
grounds/
 (a)For any of the causes
mentioned in the preceding
section,
 (b)For unprofessional and
unethical conduct,
 (c) For gross incompetence or
serious ignorance
 (d) For malpractice or
negligence in the practice of
nursing
 (e)For the use of fraud, deceit,
or false statements in
obtaining a certificate of
registration/professional
license or a
temporary/special permit
 (f) For violation of this Act,
then rules and regulations,
Code of Ethics for nurses and
technical standards for
nursing practice, policies of
the Board and the
Commission, or the conditions
and limitations for the
issuance of the
temporary/special permit, or
 (g)For practicing his/her
profession during his/her
suspension from such practice
Provided, however, That the suspension
of the certificate of
registration/professional license shall be
for a period not to exceed four (4) years