Western Mindanao State University

COLLEGE OF NURSING
Baliwasan Normal Road,
Zamboanga City

REACTION PAPER
In
Bioethics

Samaco, Maria Ann Grace O

BSN II-D

September, 2014

Reaction:
The issue of Bioethics and the study of the principles it encompasses has become very
much prominent in the study of medicine and allied health. It is only imperative that students
under the academe would study and understand the entirety of the basic aspects of principles and
laws in which students are bound to follow through critical thinking and logical thought.
Moreover, knowing these Bioethical principles is vital in order for us to provide appropriate
provision of health care services that are acceptable to the norms of the society, to the client and
to ourselves or whichever the situation compels us to do.

I.

Clinical/Biological death and/or organ transplant

In determination of death and/or organ transplant, Im in the side of agreeing to the

donation/transplant of body organs to a person that is greatly in need of the said procedure. This
course of action is set to elongate the life of the patient by introducing a foreign organ to his
system for proper bodily functions. This route is in accordance to the principle of stewardship
and John Stuart Mills Utilitarianism. The principle of stewardship indicates that we have an
obligation and responsibility to take care of the life that a Higher being has established upon us.
We are to take it into account that it is our sole charge to do everything in our power to do whats
right. And as a ward of the medical profession, I believe that it is right to do all that it takes to
live a longer life as long as no individual gets undignified in the process. Utilitarianism also gets
in the picture since it tells us that the proper course of action is the one that maximizes utility and
maximizing total benefit and reducing the negative result. However, to some others, they may
not agree to this organ transplant methods since the principle of inviolability of life comes to
focus. Life shouldnt be destroyed in anyway, so the donation of body organs may deem
unethical since it may entail the degradation of bodily functions of the donor of the organ.

II.

Abortion

An abortion is when the pregnancy is ended so that it does not result in the birth of a
child. Sometimes this is called 'termination of pregnancy'. Abortion is also defined as a medical
procedure used to end a pregnancy and cause the death of the fetus.
As nurses, it is always our duty and responsibility to uphold the clients autonomy.
Autonomy is the personal rule of the self that is free from both controlling interferences by
others and from personal limitations that prevent meaningful choice. Autonomous individuals
act intentionally, with understanding, and without controlling influences.
Respect for autonomy is one of the fundamental guidelines of clinical ethics. Autonomy
in medicine is not simply allowing patients to make their own decisions. Physicians have an

obligation to create the conditions necessary for autonomous choice in others. For a physician,
respect for autonomy includes respecting an individuals right to self-determination as well as
creating the conditions necessary for autonomous choice.
Moreover, the principle of double effect says that if doing something morally
good has a morally bad side-effect it's ethically OK to do it providing the bad side-effect wasn't
intended. This is true even if you foresaw that the bad effect would probably happen. This
principle can be applied to cases of clients that should undergo abortion due to valid underlying
reason (e.g ectopic pregnancy).
In cases when saving the life of a pregnant woman causes the death of her unborn child for example, performing an abortion when continuing the pregnancy would risk killing the
mother - some people argue that this is a case of the doctrine of double effect. By this argument,
the death of the foetus is merely the side-effect of medical treatment to save the mother's life.
The principle of double effect is frequently cited in cases of pregnancy and abortion. A
doctor who believes abortion is always morally wrong may still remove the uterus or fallopian
tubes of a pregnant woman, knowing the procedure will cause the death of the embryo or fetus,
in cases in which the woman is certain to die without the procedure (examples cited include
aggressive uterine cancer and ectopic pregnancy). In these cases, the intended effect is to save
the woman's life, not to terminate the pregnancy, and the effect of not performing the procedure
would result in the greater evil of the death of both the mother and the fetus.
However, the conduct of abortion is also sensitive since the church and other religious
sectors does not approve of this in the grounds that abortion is murder of life. It goes against the
principle of inviolability of life and principle of stewardship. We are not in any status to stop the
potential of a fetus to become human and achieve its full capacity per se but in opposition if the
growth of the child in the mothers womb also put the life of the bearer in great risk then most
people would choose to abort the baby and choose to save the life of the mother.
The principle of stewardship can be utilized both in opposition and affirmative in this
case. It can be used to support abortion because cases of the growth of babies in the mothers
womb can be a health threat and risk for death if the baby was brought to full term and delivery.
We have to support the life of a mother because as part of our personhood and innate instinct, it
is our primordial course to save our lives before saving the life of another individual. The
aforementioned principle can also be used for supporting the opposition side because all life
comes from God or a Higher being so we have no right to suppress its growth and worse to stop
it from having life.

III.

Euthanasia

So, should Euthanasia or Assisted suicide be legalized? In my stand, I believe that

euthanasia should be legalized because a client wants it, a client needs it and the government can
control it. Supporters of euthanasia believe that allowing people to die with dignity is kinder
than forcing them to continue their lives with suffering. Some believe that every patient has a
right to choose when to die. Proponents believe that euthanasia can be safely regulated by
government legislation. These goes in accordance to the Right of an individual to liberty and the
protection to their right, Principle of autonomy and Principle of Integrity and totality. Every
individual has the entitlement to be self-directive and produce decisions without any
manipulations and coercion from external stimuli. Moreover, the principle of integrity and
totality entails that the well-being of the whole person should be taken account, always. The
whole is more important than the parts and parts only exist for the function of the whole.
However, Euthanasia goes against a couple of principles too. We have the Principle of
Stewardship, Principle of Inviolability of life, and right to life and preservation of life. There is
no right to be killed and there are real dangers of slippery slopes. Opening the doors to
voluntary euthanasia could lead to non-voluntary and involuntary euthanasia, by giving doctors
the power to decide when a patients life is not worth living. Alternative treatments are
available, such as palliative care and hospices. We do not have to kill the patient to kill the
symptoms. Nearly all pain can be relieved but the issue of financial availability and resources
comes to surface. Does everyone have the ability to afford such opportunity, such luxury?

IV.

Determination of death

Position One which is There Is No Sound Biological Justification for Today's

Neurological Standard does not insist that medicine or science can know that all or even some
patients with total brain failure are still living. Rather, Position One makes two assertions in light
of what we now know about the clinical presentation and the pathophysiology of total brain
failure. The first is that there are sufficient grounds for doubt as to whether the patient with this
condition has died. The second is that in the face of such persistent uncertainty, the only ethically
valid course is to consider and treat such a patient as a still living human being. Finally, such
respectful consideration and treatment does not preclude the ethical withdrawal or withholding of
life-sustaining interventions, based on the judgment that such interventions are futile.
On the other hand, If there are no signs of consciousness and if spontaneous breathing is
absent and if the best clinical judgment is that these neurophysiological facts cannot be reversed,
Position Two: There Is a Sound Biological Justification for Today's Neurological Standard
would lead us to conclude that a once-living patient has now died. Thus, on this account, total
brain failure can continue to serve as a criterion for declaring deathnot because it necessarily

indicates complete loss of integrated somatic functioning, but because it is a sign that this
organism can no longer engage in the essential work that defines living things.
The principles engaged in these issues are the Principles of double effect and the
Principle of autonomy. The latter means that if we do something moral and it has an immoral
side effect then, its acceptable so long as the immoral side effect was unintended. If a doctor
declares a client dead on the grounds that reviving it would be for vain and it has already lost its
consciousness, motor abilities and bodily functions then it would be alright so long as it was
done on a proper course through an acceptable standard of procedures. The principle of
autonomy also comes to surface in this issue. This entails that the client or the clients
Significant others are the ones to proclaim if the client is already on its death bed.
On my stand, I agree with Position two: There Is a Sound Biological Justification for
Today's Neurological Standard because so long as there is a proper standard for measure and
proof that the client has already flat lined and the client couldnt be revived anymore then, it
would just be right and appropriate to pronounce the client dead.

V.

In Vitro fertilization

Many individuals who are unmarried choose InVitro in order to have their own children.
Recently, many women are putting getting ahead in the workforce over marriage and starting a
family. This results in women being ready to have children too late and remaining unmarried. It
is also very common for this to happen among men as well. Without InVitro Fertilization, these
unmarried individuals would be unable to have their own children. InVitro allows couples who
are infertile a chance to have their own child. Sometimes there are male factor associated with
not having children. There are issues such as low sperm count, where the male is unable to get
the woman pregnant. InVitro helps the man by extracting his sperm and putting it inside the
woman. InVitro is the same as a naturally caused pregnancy; it just helps those couples who are
unable to on their own.
The principle and right engaged in this issue is the Right to happiness and the pursuit to
happiness. If bearing a child can make an individual/couple happy, then we shouldnt take that
opportunity to be happy from personas. Also, the principle of procreation comes to surface. All
couples have the right to bear and nurture children. If IVF allows this to be realized then, this
should be opened to the couple without apprehension.
On the other hand, Some people believe that if you cant have children, then you
shouldnt because God has a path for you. In addition, there are millions of orphans in the world
who can be the child any parent, single or a couple is seeking. To adopt a child would not only
be going along with the body you were given, but would also help to counteract the effects of
overpopulation while giving the parent the experience of having their own child. In-Vitro

Fertilization is incredibly expensive and to pay for it is not possible for many Americans. This
means that In-Vitro favors the wealthy and ignores the needs of those without insurance.
Most women who try In-Vitro already have had many emotionally draining failed
pregnancy attempts in the past. The pain of continually learning of a failed try to get pregnant
over and over again takes a toll on both parents. This causes many women who get IVF to
already suffer depression or be emotionally hurt. With the stress and anxiety of IVF studies have
shown depression to increase and hurt the parties involved. Also, Many scientific studies prove
there are more birth defects in children who are born from IVF than from natural reproduction.
These birth defects range from cardiac defects, to cleft lip to gastrointestinal defects to cancer of
the eye.

VI.

Stem Cell Technology

Opponents of embryonic stem cell research compare the destruction of an embryo to an

abortion. They believe that the embryo constitutes life because it has the potential to fully
develop into a human being. Those against embryonic stem cell use believe that is it immoral
and unethical to destroy one life to save another.
By using stem cells and discarding the embryo, it is thought that human life is ultimately
de-valued by this act and is paving a slippery slope for further scientific procedures that similarly
de-value life. In particular, many religious groups who are adamantly pro-life have condemned
embryonic stem cell research and all of its applications. Other arguments against embryonic stem
cells cite the fact that adult stem cells are the ones currently being used in therapies and thus,
there is no need to even venture into embryonic stem cell territory.
The principle that is related in this argument is the principle of inviolability of life. Since
it uses fetal embryo to create stem cells, then it would be unethical to devalue the life of a fetus
just to selfishly elongate ones life.
However, those who support embryonic stem cell research believe that an embryo is not
equivalent to human life because it is inside the womb. Supporters also contend that the societal
costs of many diseases and conditions, both in monetary and suffering aspects, means that the
ethical concerns regarding embryonic stem cell usage are not sufficient to warrant
discontinuation of this promising therapy.
The principles that are engaged in this issue are the Principle of Stewardship and
accountability. This entails that we are to take care of our body since it is our duty as creations of
God. We have no right to destroy it as such but we are to do to the best of our ability to elongate
life and improve life.

VII.

Suicide

With great power comes great responsibility

Indeed, we are given this power to live our own lives, to choose the path we want to
pursue, to have the liberty, all the independence to have our own set of values and morals to live
by. We are self-directive people capable of critical thought and logical reasoning. We are given
this great power to borrow a life we can live but do we have the responsibility to end it as well?
If an individual is giving up, who knows what might have been? Many of those around
you will be affected more than you think. The world will lose a positive contributor to society.
You lose your life. Not your right. The principles entailed in this argument are the Principles of
Inviolability of life, Principle of Stewardship and Right to life and Preservation of life.
For me, the only pro thing about suicide is a permanent escape from a miserable life, an
escape from shame. Some cultures honor suicide as a part of a noble ritual. Japan for example
practices hara-kiri or seppuku to retain honor if an individual will likely suffer physical or
emotional turmoil (e.g. prisoners of war, failing a college entrance exam, relationship affairs etc.)
But this pro argument goes against the abovementioned principles and the individual might lose
the chance to redeem him/herself, to rise from the ashes of failure. It was once said in an old
Chinese proverb to fall seven times, rise eight. So no matter how worse the situation is, we are to
stand up from the ashes and be reborn and renewed with a new strength, new hope and new
dreams to face the day.

CONCLUSION:
All the above mentioned bioethical issues are important in providing an effective and
moral health care service to clients. Understanding health policy and the legislative process is an
important part of delivering good health care in the modern world. However, all these issues as
well are Choices that each and every one of us has to make. We are given the autonomy to be
self-directing in choosing what kind of life we will live. We are given a brain to be critical
thinkers, to be reasoning, to get real and rational. These are also relative; speaking in such a way,
it means that whats right for me might not be right for you and whats wrong for you might be
right for me. So its just a matter of an individual perspective and judgment in the issues and
conditions our current world it taking in. We just have to be respectful and revential to whatever
decision someone else makes. We may influence them to what we think is right but it always
boils down to the facet that an individual has the autonomy to do whatever he likes so long as he
govern by the knowledge that he is under the divine law, natural law, human law and Eternal
law.

Samaco, 2014