Ateneo de Zamboanga University
School of Arts & Sciences
Philosophy Department
Course Code: Philosophy 133
Course Title: Health Care Ethics
Number of Units: 3
Pre-Requisite Subjects: Introduction to Philosophy and Logic (Philo 100) and Philosophy of Man (Philo 102)
Course Description:
This course will employ a case based learning approach. This approach will start will what they already know as they will be exposed to differrent cases in the clinical setting, specifically ethico-moral issues or problems in the health care practice. Through pre-formulated guide questions, the students initial analysis of the problem or issue at hand will yield a problem statement that will serve as a starting point for the investigation. It will be in this phase that the students will be analyzing the problem into components, discussing implications, entertaining possible explanations or solutions, and developing working hypotheses. Finally, the students will have to support their possible solutions or working hypotheses by validating it through the use of ethical theories or medical principles for validity, reliability and usefulness in applying to the problem.
The CBL approach will basically make use of group activity discussions and presentation. Moreover, this course will also have a reflective writing component. The students will be asked to think about the issues, problems and theories that will be studied and express their thoughts and feelings through writing reflection papers. It is important for that the moral framework is developed when there is the time to discuss and reflect upon it, rather than waiting until they are faced with the tough choices.
The course seeks to instill in the students the following values:
a. Critical Thinking
b. Intellectual Competence
c. Service
d. Dignity of the human person
e. Sanctity of the Human life
Course Objectives:
In health care professions as in other arenas of life, it is important to nurture moral wisdom and moral courage: wisdom to recognize when an ethical problem arises, as well as to make sound decisions in situations of moral conflict; and courage to know what is right even when there are strong pressures or incentives to do otherwise. Hence, the primary objectives of this course are:
1) to increase one’s awareness of a wide range of ethical challenges that can arise in the health care profession;
2) to enable one to test the strengths and weaknesses of various moral beliefs and ethical arguments relevant to health care practices; and apply relevant bioethical principles in nursing and health related situations;
3) to reinforce one’s personal sense of compassion and fairness in the context of current or future professional roles
COURSE SYLLABUS
Concepts, Theories and Principles of Bioethics in Nursing and Health
Chapter 1: Definition of Terms
I. Description
This chapter will gather information on student’s initial idea of what is ethics. Through a simple case presentation of several ethical issues, the students will share among themselves their own perceptions of what is ethics.
Further, this chapter will delve on the relevance of ethics into the health care practice, from ethics to bioethics and the related concepts of bioethics.
II. Objectives
At the end of this chapter, the students should be able to:
· Clarify and examine the factors contributing to the evolution of ethics and the foundations of ethics as a separate philosophical discipline.
· Express the distinction of the health care course from other ethics course or subject.
· Recognize the significance of the course in the practice of health care.
III. Outline of Content
A. Definition of Terms
1. Ethics
2. Biology
3. Bioethics
4. Health ethics
5. Professional Ethics
IV. Duration
6 hours
V. Resources
Bioethics for Contemporary Health Care, Ambong Fernandez, p. 1-14.
The other book on bioethics
VI. Methods
- Case Presentation
- Discussion/Assessment
- Synthesis
- Lecture
VII. Points to Ponder
1. State your reactions to the cases presented.
2. Are there any similarities and differences in the cases presented? What are these similarities? Differences?
3. On what grounds, would you say that they are similar or different?
4. Would you say that these are ethical situations? Why? How would you define ethics? What makes an action ethical or unethical in the first place?
5. Since this is a health care ethics/bioethics class, identify which of these cases is a bioethics situation? How is it different from other ethical situations?
Chapter 2: The Human Person
I. Description
This chapter will delve on the different dimensions of the moral experience. As such, this chapter will also explore on the ground and norm of morality by which the moral experience may arise.
II. Objectives
At the end of this chapter, the students should be able to:
· Understand the challenges poses to the concepts of “personhood” and human dignity.
· Examine the structure of the human act in relation to the different dimensions of the moral experience and its exigencies.
· Describe the nature, kinds and the dynamics in the formation of conscience.
III. Outline of Content
B. The Human Person
1. The Personhood
2. Human Acts & Acts of Man
a. knowledge
b. freedom
c. conscience
IV. Duration
V. Resources
Bioethics for Contemporary Health Care, Ambong Fernandez, p. 1-14.
Medical Ethics, Ethical Reasoning in Medical Practice, Gabriel Pastrana, University of Santo Tomas, Manila, p. 19-35.
VI. Methods
- Case Presentation
- Discussion/Assessment
- Synthesis
- Lecture
VII. Case Studies
Chapter 3. Ethical Theories
I. Description
This chapter concentrates on several types of ethical theory: utilitarianism, Kantianisn, natural law, Rawl’s theory of Justice and Ross Prima Facie duties. The different ethical theories will attempt to articulate and justify principles that can be employed as guides for making moral decisions and as standards for the evaluation of actions and policies.
Ethical theories also offer a means to explain and justify actions. If our actions are guided by a particular theory, then we can explain them by demonstrating that the principles of the theory required us to act as we did.
Further, these theories will serve as the basis for making moral decisions. As such, they will provide the framework in the ethical assessment of the ethical cases presented in this chapter.
Further, these theories will serve as the basis for making moral decisions. As such, they will provide the framework in the ethical assessment of the ethical cases presented in this chapter.
II. Objectives
At the end of this chapter, the students should be able to:
· Discuss intelligently the positions made by the different Ethical Theories.
· Articulate and justify ethical theories that can be employed as guides for making moral decisions and as standards for the evaluation of actions and policies.
· Demonstrate ability to discuss the “pros” and “cons” of different approaches to classis issues of abortion, euthanasia, truth-telling and resource allocation.
· Identify similar situations in the RLE where the ethical theory was either applied or violated.
III. Outline of Content
A. Ethical Theories
1. Kantian
2. Rawl’s Ethics
3. St. Thomas Aquinas’ Natural Law
· Principle of Double Effect
· Principle of Totality
4. Ross Ethics
§ actual/ prima-facie duty
§ duty of fidelity
§ duty of reparation
§ duty of gratitude
§ duty of justice
§ duty of beneficence
§ duty of improvement
§ duty of non-maleficence
IV. Duration
V. Resources
Bioethics for Contemporary Health Care, Ambong Fernandez, MS Lopez Printing and Publishing, Davao City, p. 1-14.
Intervention and Reflection, Basic Issues in Medical Ethics, 5th Ed., Ronal Munson, Wadsworth Publishing Company, Belmont, California. 1996, p.151.
Biomedical Ethics, 5th Ed. Thomas Mappes and David DeGrazia, McGraw Hill New York, 2001, p. 1-24
VI. Method
- Case Presentation
- Discussion/Assessment
- Synthesis
- Lecture
Chapter 4. Bioethical Principles
I. Description
This chapter will employ the different bioethical principles related to the practice of nursing.
II. Objectives
At the end of this chapter, the students should be able to:
· Express and provide a basis for evaluating actions or policies as well as for making individual moral decisions.
· Reach decisions that are reasoned, consistent and applicable.
· Reflect on the strengths and limitations of bioethical principles in relation to the nursing practice.
· Give a reasoned account of one’s decisions and actions by demonstrating the key facts of the case, one’s choice of appropriate means, and the principle or theories applied in reaching a decision.
III. Outline of Content
A. Bioethical Principles
· The Principle of Autonomy
· The Principle of Informed Consent
· The Principle of Beneficence
· The Principle of Nonmaleficence
· The Principle of Paternalism
· The Principle of Justice
· The Principle of Veracity (Truth Telling)
· The Principle of Confidentiality
IV. Duration
V. Resources
Bioethics for Contemporary Health Care, Ambong Fernandez, p. 1-14.
Biomedical Ethics, 5th Ed. Thomas Mappes and David DeGrazia, McGraw Hill New York, 2001.
VI. Methods
- Case Presentation
- Discussion/Assessment
- Synthesis
- Lecture
Chapter 5. Ethics of Care
I. Description
The ethical theories that were discussed previously are theories that can simply be applied to generate satisfactory solutions to concrete problems. However, in biomedical ethics, criticisms have increasingly been directed to this principle-based or deductivism ethical theories of Kant and the utilitarianist. In recent years, there has been a significant attention being given to a new approach of making moral decisions. The theory of Carol Gilligan provides feminist critiques of traditional ethical theories of rights and justice and for articulating the earliest descriptions of an ethic of care.
The ethics of care pays considerable attention to the affective components of the moral life, but with special emphasis on empathy and concern for the needs of others, that is, on caring. An ethic of care and responsibility develops from an individual's feeling of interconnectedness with others. It is contextual and arises from experience. It is characterized by nurturance and an emphasis on responsibilities to others. An ethic of justice, on the other hand, is an expression of autonomy. It is formulated in terms of universal, abstract principles and is characterized by rationality and an emphasis on individual rights. Some describe an ethic of caring as a "female" approach to morality and an ethic of rights and justice as a "male" approach.
It is in this context that this chapter will explore the possibility of providing an alternative mode of moral reasoning using the perspective of care.
It is in this context that this chapter will explore the possibility of providing an alternative mode of moral reasoning using the perspective of care.
II. Objectives
At the end of this chapter, the students should be able to:
· Appreciate the feminist perspective in making moral decisions.
· To explore the meaning of “care” and its relevance to understanding the ethics of care.
· Explain and illustrate with concrete examples to pay attention to the demands of specific cases.
· Relate similar experiences conducted in the RLE’s
III. Outline of Content
A. Relationship Based Accounts
B. Casuistry: Case-Based Reasoning
IV. Duration
V. Resources
Biomedical Ethics, 5th Ed. Thomas Mappes and David DeGrazia, McGraw Hill New York, 2001, p. 31.
VI. Methods
- Case Presentation
- Discussion/Assessment
- Synthesis
- Lecture
VII. Points to Ponder
