Introduction | Definition | Foundation & Principles of Bioethics in

Nursing
Blaise B. Nieve | Edgardo Lupo, Jr.
Master of Arts in Nursing, Davao Doctors College
Lecture Notes
Objectives
At the end of this report, the learners will be able to:
1.
2.
3.
4.

Discuss ideas that serve as the foundation of bioethics;

Discuss the relevance and meaning of bioethics in our lives;
Analyze bioethical issues and dilemmas in nursing; and
Conceptualize the implications of bioethics in the practice of nursing.
Origin and History of Ethics

Beginning of many world literatures: Mesopotamian Epic of Gilgamesh,

Homer's Iliad and the Icelandic Eddas: Valour and success are the principal
qualities of a hero, and are generally not constrained by moral
considerations.

The Sumerian Farmer's Almanac and the Egyptian Instruction of

Amenhotep: farmers to leave some grain for poor gleaners, and promise
favours from the gods for doing so.

A number of ancient religions and ethical thinkers, including Ancient

Judaism and Christianity, also put forward some version of the golden rule,
at least in its negative version: do not do to others what you do not
want done to yourself.

More than 2000 years later, Greek civilization flourished and Socrates, Plato,
and Aristotles philosophy became widely known and The Well Known
Hippocrates of Cos (a tiny island in the Mediterranean) appeared (~460 to
~375 B.C.).

Socrates, as portrayed in Plato's Republic, articulates the greatest good

as the transcendent "form of good itself". The pursuit of and love of the
good itself (rather than any particular good thing) Socrates thought was the
chief aim of education and (especially) of philosophy.

However, Plato's ethical ideal, as expressed also in the Republic, still has
much in common with the Homeric conception of the leader of a tribe or city:
the successful running of the city and the internal harmony of the citizen who
runs it is the main ethical aim, and there is little mention in Plato of any
strictly moral obligations the ruler may be under.

Aristotle's ethics builds upon Plato's with important variations. Aristotle's

highest good was not the good itself but goodness embodied in a
flourishing human life. His ethics are based on eudaimonia, variously
translated as "happiness," "prosperity," "flourishing," or "success." A "greatsouled" citizen who lives a life of virtue can expect to achieve eudaimonia,
which Aristotle argues is the highest good for man

Later Greek schools of philosophy, such as the Epicureans and Stoics,

debated the conditions of the good life. Epicurus taught that the greatest
good was pleasure and freedom from pain. The Epicureans emphasized
the quiet enjoyment of pleasures, especially mental pleasure, free of fear and
anxiety. The Stoics thought the greatest good not pleasure but reason
and everything in accord with reason, even if painful. Hence they
praised the life of reason lived in accordance with nature.

Hippocrates, on the other hand, had also been a pioneering figure in the
field of medicine and medical ethics during his time. In fact, his Oath is still
stated in most medical schools all over the world by those who are starting
their medical career.

Six centuries later, the Roman Empire had already taken over the GrecoHellenic civilization. There, appeared Galen (131201 A.D.). He wrote many
books describing diseases and prognoses as well as modifications to the
Hippocratic views in medicine.

With the introduction of Christianity, moreover, ethics had become widely

based on the teachings written in the Bible. A passage of the Torah, "Love
your neighbour as yourself" was taken up by the writers of the New
Testament and made part of the theological centerpiece of Christian ethical
stance. The New Testament lets Jesus teach that all the commandments of

Jewish religious law could be summarized in the two rules, "Love God and
love your neighbor" (Mark 12:28-31).

Thomas Aquinas, a prominent religious figure during the Middle Ages,

developed a synthesis of Biblical and Aristotelian ethics called natural law
theory, according to which the nature of humans determines what is right
and wrong.

Immanuel Kant, in the 18th century, argued that right and wrong are
founded on duty, which issues a Categorical Imperative to us, a command
that, of its nature, ought to be obeyed. An action is only truly moral if done
from a sense of duty, and the most valuable thing is a human will that has
decided to act rightly. To decide what duty requires, Kant proposes the
principle of universalizability: correct moral rules are those we could will
everyone to adopt.

In 19th century Britain, Jeremy Bentham and John Stuart Mill advocated
utilitarianism, the view that right actions are those that are likely to result
in the greatest happiness of the greatest number. Utilitarianism remains
popular in the twenty-first century.

Nuremberg Code:

Thalidomide:

Declaration of Helsinki: In 1964, the World Medical Association established

recommendations guiding medical doctors in biomedical research involving
human participants. The Declaration governs international research ethics
and defines rules for "research combined with clinical care" and "nontherapeutic research." The Declaration of Helsinki was revised in 1975, 1983,
1989 and 1996 and is the basis for Good Clinical Practices used today.

Issues addressed in the Declaration of Helsinki:

Research with humans should be based on the results from laboratory and animal
experimentation
Research protocols should be reviewed by an independent committee prior to
initiation
Informed consent from research participants is necessary
Research should be conducted by medically/scientifically qualified individuals
Risks should not exceed benefits

Tuskegee Syphilis Study (1932-1972):

National Research Act (1974):

Radiation Experimentation and Human Participant Abuses

Belmont Report:

Foundations and Principles of Bioethics in Nursing

Foundation of Bioethics | Definition of Terms

Bioethics a living study of the conduct of human life; derived from morality
principles and ethics.
Ethics practical and normative science, based on reason, which studies human
acts and provides norms for their goodness or badness; a generic term for various
ways of understanding and examining the moral life of a person;

Being normative, ethics of actions are based on standards of society

and acts are judged by standards of what is accepted as right or good

action;
Being descriptive, ethics of actions are based on what people believe

and how people act are phenomenologically described;

Being analytic, people analyze the concepts and methods of ethics in
the light of what they observe, believe, and practice.

Morality addresses the question of what is right and what is wrong.

Common morality Comprises of socially approved norms of human conduct.
Ethical theory and moral philosophy philosophical reflection or when we
speak of moralitys nature and function; the purpose of a theory is to enhance
clarity, systematic order and precision of argument in our thinking about morality.
Metaethics involves analysis of these three: language, concepts and methods
of reasoning; a branch of analytic philosophy that explores the status, foundations,
and scope of moral values, properties, and words. Whereas the fields of applied
ethics and normative theory focus on what is moral, metaethics focuses on what
morality itself is.
End of Written Report