CAHS BSN 2 C 01 Nur 104

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Bioethics
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Sessions 8,9,10 and 11

Session 8
1. ANSWER: B
Rights in moral philosophy and political theory are thought as justified claims. In this sense, If you have a moral or legal right to personal property, then others have an obligation to respect your claim to that property.

2. ANSWER: A
Self-determination is a process by which a person controls their own life and this is closely associated with autonomy where you have your personal liberty and you have the ability to decide on your own.

3. ANSWER: D
Informed consent is derived from the principle of autonomy, which generally contain the elements of disclosure, understanding, voluntariness, competence, and permission giving.

4. ANSWER: B
Paternalism is the intentional limitation of the autonomy of one person by another, in which the person who limits autonomy appeals exclusively to grounds of benefit to the other.

5. ANSWER: D
Justice deals with concepts of fairness, just deserts, and entitlement.

6. ANSWER: B
Veracity is being truthful. This binds the health practitioner and the patient. The patient must tell the truth so that appropriate care can be provided. The practitioner needs to disclose information so that the patient can exercise personal autonomy.

7. ANSWER: A
All patients have their right to privacy, we cannot disclose their information to the public as part of ethical principle of confidentiality. With this important aspect the patient places his or her trust to the health care professional.

8. ANSWER: A
If you make use of a placebo you are engaging yourself in a nondisclosure and deception for your practice of work even if it is for ther**eutic purposes, you are still deceiving the patient or lying to the patient which makes it a conflict with one of the universal principles which is veracity.


9. ANSWER: D
Non maleficence means ought not to inflict evil or harm to one person

10. ANSWER: C
Role fidelity is to do your role within your scope of practice. E.g. Role of nurse is to provide competent care to patients and to do it in a way that is honest, responsible and fair.

Session 9
1. ANSWER: C
It is a commonly held view that rights imply correlative obligations. That is, if someone has a right to x, then someone else (some person, group of people, institutions, etc.) bears some obligation, or duty with respect to that right. Sorting out the nature of obligations implied by rights, however, turns out to be a contentious matter.

2. ANSWER: C
Perhaps a more useful contractarian model for the development of justified claims for individual rights is the moralized initial situation as described by John Rawls. Rawls offers a kinder and gentler arrangement of the context for the social contract and envisions an initial situation known as the original position.

3. ANSWER: B
Natural rights were generally equated to the law of God and found their most succinct expressions in forms such as the Golden Rule.

4. Answer: A
Golden Rule across Religion
Islam-No one of you is a believer until he desires for his brother that which he desires for himself.
Judaism- What is hateful to you, do not to your fellow man.
Buddhism- Hurt not others which you would find hurtful.
Brahmanism- Do naught unto others which would cause you pain if done to you.
Confucianism- Do not unto others that which you would not have them unto you.
Taoism- Regard your neighbor’s gain as your gain, and your neighbor’s loss as your own loss.
Christianity- All things whatsoever ye would that men should do to you, do ye even to them.

5. ANSWER: D
Thomas Hobbes is known for his Hobbesian model, For Hobbes, nature did not teach lessons to innate human rights, but rather that human nature itself created the need for something with sufficient power to crush individual will and bring about acceptable behavior of chaos.

6. ANSWER: C
Perfect obligation which has inherent within them assigned correlative rights. The basis of perfect obligations was the realm of required duty.

7. ANSWER: A
In Contractarian Theory, the driving force or mechanism for the selection of correct principles is the agreement or bargain reached by initial agents, within the tradition, moral agents come to the situation and the bargain to a choice.

8. ANSWER: C
Please refer to number 4

9. ANSWER: B
Mill subdivided duties into two sets one of which was an imperfect obligation which did not give birth to any right. The basis of imperfect obligation was those in which act was obligatory but the particular occasions of performing them are left to our choice.

10. ANSWER: C
Original position is designed to promote rational choice and fairness. In this position all individuals are free and equal.

Session 10
1. ANSWER:C
List of negative legal rights that have been afforded by the sanction of law.
- Equal opportunity in employment
- Freedom of Religion
- Right to bear arms
- Right to personal property
- No taxation without representation
- Right to an abortion

2. ANSWER: D
Only legal persons can receive legal rights. The characteristics commonly attributed to a legal person include that.
- Person can be injured
- Person can be thought to have interest
- Person can be benefitted

3. ANSWER: A
Positive rights or also known as welfare rights is about provision of goods and services.

4. ANSWER: A
Legal Rights are clearly, rights which exist under the rules of legal systems or by virtue of decisions suitably authoritative bodies within them. Legal rights are created through constitutional guarantees, legislative statutes, judicial review and government agencies.

5. ANSWER: B
Positive rights examples (US based)
Indigent right to health care
Licensed drivers right to use of public roads
Right to a public education
American veterans right to health care
Citizen of Ballwin, Michigan, to garbage collection

Session 11
1. ANSWER: A
The two basic principles that to be in conflict in the Tarasoff case is confidentiality and beneficence. Because the health care practitioner strictly maintains a patient confidentiality despite there is a potential danger to another person (Tatiana) because of his patient (Prosenjit) statement/ threat and also the health care practitioner instead of giving warning to Tatiana for him to prevent his patient to do harm or evil, he did not do a single effort that’s why Tatiana died.

2. ANSWER: C
Harm principle requires that healthcare providers refrain from acts of omissions that foreseeably result in harm to others, especially in cases in which the individuals are particularly vulnerable to the risk. Harm principle is modified by the level of vulnerability.

3. ANSWER: C
Misappropriation usually deals with the unpermitted use of other person’s identity or name for another’s benefit.

4. ANSWER: C
Intrusion is the act of intruding or act of wrongfully entering upon, seizing, or talking possession of the property of another.

5. ANSWER: D
Common legal reporting requirements in most American Jurisdiction are mention above and includes
Communicable diseases, births and deaths, Injuries with guns and knives, poison and industrial accidents, misadministration of radioactive materials.

6. ANSWER: A
In Sissela Bok on the ethics of concealment and revelation book, she cites several instances in which confidentiality is overridden by more compelling obligations.

7. ANSWER: A
The patient’s record is not only accessible to physician but also readily available to technical and administrative staff who generate and handle patient data. During an average five days of inpatient care within a teaching hospital as many as 150 staff—from nursing, respiratory care, radiology, and billing clerks—have legitimate access to a patient’s record to provide both direct and/ or supportive services.

8. ANSWER: D
Presenting someone in a false light to the public usually involves the publication of information that leads to the public regarding the plaintiff falsely. An example would be the use of a stock photo of a surgical team in an article about Medicare fraud. The intent was to show a generic picture of practitioners: however, the implication of associating them with the article would place them in a false light.

9. ANSWER: C
Invading a patient's privacy will result in breach of confidentiality. It can create distrust between patient and practitioner.

10. ANSWER: B
Utilization review is the use of managed care techniques such as prior authorization that allow payers, particular health insurance companies to manage cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria

P1 WEEK 4 CASE STUDY📌
TOPIC: Basic Principles of Health Care and the Nature of Rights in Ethical Discourse

comments from Facebook and Instagram showing how a nurse attending her good-looking, 16-year-old son, confined with a communicable disease, shared images/selfies, confidential information, his medical condition, the treatment he has been undergoing and other care-related scenarios they had online. Alleged social media updates didn’t display the name of the patient but still bothers his guardian for possible harm, such action may damage his son’s reputation. In an initial inquiry, the nurse clarified that there is no intention to expose her patient. She claimed that her only purpose is to post personal updates on what she’s been doing to her family and friends since she is not in her province in the Philippines. However, withholding a patient name on an online post like hers is insufficient and is never an excuse. Posting pictures and updates about patients are intolerable activities in a healthcare environment. This is considered a serious breach of the patient’s privacy and confidentiality.
What could be the possible action that the nurse will face in such a situation? Site some possible solution ( Negotiation, Disciplinary Action or Agreement )

P1 WEEK 4 CFU SAS 8-11 📌

CFU_BIO ETHICS 8,9,10,11 15 MINUTES

📌P1 WEEK 4 ATTENDANCE

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Ms. Lara’s option is to abandon the notion that the well-being of the patient always takes priority over the public welfare. That would permit her to take into account the impact of her decision on the welfare of others—the state agency, taxpayers, and her other clients. She might, from this perspective, try to produce the greatest good by taking the welfare of all into account. She could strive for the greatest good for the greatest number, to use the classical utilitarian phrase.

There may be other options open to Ms. Lara, options that would permit her to take into account certain benefits to society, but not others, when she decides whether morally she should put the care of her patient above all other considerations. The balancing of the two kinds of interests might depend, for instance, on whether promises have been made either to her patient or to the state agency. It might depend upon how she, her profession, and society see the role of the nurse. It might depend upon the relative urgency of her patient’s needs and the needs of others who might be helped with the funds. Any of these factors might be seen by the nurse, the profession, patients, or others in society as morally relevant, in addition to the amount of benefit and harm involved. The problem of how benefits to the patient relate to benefits to others is the first major moral issue confronted in many ethical situations in nursing.

FEEDBACK
BIOETHICS
SESSION 3

ANSWER: D
Important part of human motivation comes from our values and what we need in certain situations.

ANSWER: B
Food falls under physiologic needs together with air, water, shelter, sleep, reproduction

ANSWER: A
Conventional stage is within 7-12 years old which is usually the age who respect rules and more of pleasing others.

ANSWER:C
Carol Gilligan argued Kohlberg’s research methods were flawed and gender biased that’s why she did a research to describe a separate value development pathway for females (personal responsibility) and (legalistic equality)
for males.

ANSWER: A
Pre conventional fall under ages 3-7 under Kohlberg’s theory of moral reasoning and one of their characteristics is egotism which means they are self-centered and they just want to satisfy their own desire, they also think that they are superior to others.

ANSWER: B
In Maslow’s Hierarchy of needs self-actualization is the highest point of development in the pyramid, followed by prestige and esteem needs going down to belongingness and love needs, safety needs and physiologic needs which is the most important.

ANSWER: B
Because Carol Gilligan believes that Kohlberg’s research for value development is gender biased. Gilligan describes a separate value development pathway in her research where she describes values for each s*x—“personal responsibility “for females and” legalistic equality” for males.

ANSWER: B
Abraham Maslow was an American psychologist who was best known for creating Maslow’s Hierarchy of Needs, a theory of psychological health predicated on fulfilling innate human needs in priority, culminating in self-actualization.

ANSWER: C
The foremost theorists of value development are Kohlberg and Piaget. According to their models individuals can be seen to grow through several stages of ever- increasing complex, value orientation from infant to adult.

ANSWER: D
Kohlberg’s orientation of stages:
Preconventional-3-7 years of age; Punishment/Obedience, Egotism
Conventional- 7-12 years of age; Respect rules, Please others
Postconventional- 12 and above; Social contract, Personal conscience

FEEDBACK
BIOETHICS
SESSION 4

ANSWER: B
Morris Massey is known for his phrase “who you are is where you were when” is his popular generational theory during 1970-1980, in this theory it holds that the historical time period in which an individual is born shapes the development of their world view.

ANSWER: A
Great Depression and World War 2 were trying times, when fiscal and personal survival required that all participate, all work together, and all do their duty. As a result, they are conservative and serious with an ethic of hard work and are comfortable with rules, order, and social structures.

ANSWER: D
Baby Boomers had declared themselves the brightest and best generation and as a result, the next generation, Generation X, was initially underrated by them and labeled by some the “slacker generation”.

ANSWER: A
Value Cohorts are construct from generational theory, which holds that generations occupy a 20-year span of time during which individuals in their youth are value programmed as a group by historical events.

ANSWER: B
Generation Z are known to be techno savvy multitaskers because they grew up with advanced technologies like computers, cellphones etc., they are master of multitasking; they can text, talk, read and eat at the same time which amazes previous generation. They have adopted and mastered advances in technology faster than any previous group. As a result of their techno savvy, some have suggested generation names such as iGeneration, Gen Tech, Net Gen and Digitarians.

ANSWER: B
Generation Z are known to be born from late 90’s to around 2025, they grew up with advanced technologies like computers, cellphones etc., they are master of multitasking; they can text, talk, read and eat at the same time which amazes previous generation.

ANSWER: C
Cusp is the point at which two parts of a curve meet. In generational theory, individuals who fall into the overlap between two generations are born in time between eras and are influenced by both eras.

ANSWER: D
Morris Massey is known for his popular generational theory during 1970-1980, in this theory it holds that the historical time period in which an individual is born shapes the development of their world view.

ANSWER: C
Millennials are defined by vents immediately following the cold war. They were born mid- 1980’s-2000. Some of their values and characteristics are Ethical consumption, Media overload, Confidence, Positive reinforcement, networkers etc.

ANSWER: B
Baby boomers are born during 1946-1960 following world war II.

FEEDBACK
BIOETHICS
SESSION 5

ANSWER: C
Nihilism is a philosophy that there are no moral truths, no moral rules, no moral knowledge or responsibilities. For those that hold this position, nothing can truly be wrong or right in moral sense. For a moral nihilist, morality, like religion, is a mere illusion.

ANSWER: B
Private law deals with the relationship between citizen to citizen or that is concerned with the definition, regulation and enforcement of rights in cases where both parties involved are private citizens.

ANSWER: A
All the above mention except letter A are included in Unethical Acts according to most culture together and to include torture and slavery.

ANSWER: C
Standpoint theory holds that in ethical decision making one should always try to take into account or listen to the standpoint of the most marginalized and vulnerable persons involved.

ANSWERT: B
Misdemeanor is a crime punishable by less than a year in a jail or house of correction. Examples of common misdemeanor are the theft of a small amount of money, disorderly conduct or breaking into an automobile. Felony is far more serious breach of law and is punishable by death or imprisonment in a state or federal penitentiary and these include kidnapping and r**e.

ANSWER: B
Public Law deals with relationships between private parties and the government; concerned with the state in its political or sovereign capacity. It consists of constitutional, administrative, criminal and international law while Private law consists of tort and contract law.

ANSWER: C
Sexism is a prejudice or discrimination based on a person’s s*x or gender but it primarily affects women and girls. It is linked to gender roles and may include the belief that in s*x or gender is intrinsically superior to another.

ANSWER: B
Slavery is a formed of human bo***ge; exhausting someone in labor.

ANSWER: B
Ethical relativism is the theory hold morality is relative to the norms of one’s culture. Whether action is right or wrong depends on the moral norms of the society.
ANSWER: A
World view is a system of thoughts, feelings, opinions, and beliefs with which we screen events occurring around us. It is the subjective screen, based on our culture and life experiences, that we judge the rightness and wrongness of actions as they pertain to what a person should do in a given situation.

FEEDBACK
BIOETHICS
SESSION 6

1.ANSWER: C
Utilitarianism is the most common form of consequence-oriented reasoning, to a utilitarian good resides in the promotion of happiness or the greatest net increase of pleasure over pain.

2.ANSWER: B
Kant based his moral philosophy on the crucial fact that we are rational beings, and a central feature of this rationality was that principles derived from reason are universal.

3. ANSWER: A
Utilitarianism is the most common form of consequence-oriented reasoning, to a utilitarian good resides in the promotion of happiness or the greatest net increase of pleasure over pain.

4. ANSWER: B
Duty oriented ethicists feel the basic rightness and wrongness of act depends on its intrinsic nature rather than on the situation or the consequences. This position is often called deontological theory, taken the Greek word for duty.

5. ANSWER: B
Rule utilitarianism seeks to avoid the hedonic calculus of act of utilitarianism in which each option must by measured by the principle of utility. Rule utilitarianism holds that action can be right if it conforms to a rule that has been previously validated by the principle of utility.

6. ANSWER: A
Categorical imperative is an action could be known to be right when ii was in accordance with rule that satisfied a principle and this is a part of duty oriented reasoning.

7. ANSWER: A
In the classic work of Kant “Groundwork of the Metaphysic of Morals” he held that consequences of action were essentially irrelevant.

8. ANSWER: C
Golden rule is not a part of categorical imperative; this is the famous rule that states “Don’t do unto others what others don’t want to do unto you.”

9. ANSWER: B
The above mention was the admonition of J.M Barrie and it is wise to follow this admonition when you are trying to come to mutual understanding regarding value agreements.

10. ANSWER: A
Bentham and Mill are considered the fathers of utilitarianism, which is the most common form of consequence oriented reasoning.

FEEDBACK
BIOETHICS
SESSION 7

1. ANSWER: C
Virtue ethics is primarily about personal character and moral habit development rather than a particular action.

2. ANSWER: A
One of the elements of a torte is the existence of a legal duty owing from defendant to plaintiff not from plaintiff
to defendant

3. ANSWER: D

4. ANSWER: A
Libel is known as written defamation, Harming others reputation

5. ANSWER: B
Respondeat superior means let the master answer. Liability assessment against employer for negligent act
committed by their employees during the course of their work.

6. ANSWER: D
All of the above mention are forms of intentional torts that have implication to health care setting, Libel and slander are part of the defamation of character, invasion of privacy, false imprisonment, assault and battery.

7. ANSWER: C
Negligence is charge when something just happens, when there is no intent, when the outcome is unexpected, but injury occurs.

8. ANSWER: A
One of the forms of negligence is malfeasance it’s the ex*****on of an unlawful or improper act. E.g. In healthcare, malfeasance occurs when people are injured or die because of poor treatment or negligent care. Also known as medical malpractice.

9. ANSWER: C
In divine theory a divine being sets down finite rule, example is the rules known as the Ten Commandments taken from Judeo- Christian traditions. It includes key moral prohibitions common to most culture, as well as some specific rules set down to exact adherence of a particular religion.

10. ANSWER: D
All of the traits mention above includes in Aristotle’s traits of virtuous character

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📌WEEK 3 CASE STUDY:📌
TOPIC:👇
The Nurse and Cost Containment: The Duty to Society (Benefit to the Patient vs Benefit to Others)

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A 45-year-old farmer Jesus De Leon with a history of hypertension, had been experiencing headaches for 2 weeks on a daily basis. Disturbed by the persistent and severe nature of the headaches, he visited the barangay health clinic. Ms. Lara, the barangay health nurse and sole staff member of the clinic, listened as Mr. De Leon described his headaches. Upon initial examination, revealed good general health with the exception of an elevated blood pressure of 190/108mmHg. Since Mr. De Leon had described some dizziness and visual disturbances during his headaches, Ms. Lara also completed a neurologic assessment. Everything seemed within normal limits except for Mr. De Leon’s peripheral vision. Ms. Lara assessment demonstrated that he had some difficulty seeing objects in the visual field on his left side. Ms. Lara realized that this disturbance was probably a manifestation of his present headache in combination with his known visual deficit. Since no other abnormalities were demonstrated, the possibility of a more serious problem seemed remote, according to Ms.Lara’s judgment. Yet Mr. De Leon was very distressed by his headaches. He asked the nurse what he could do to prevent the headaches or, at least, what could be done to lessen the pain he was experiencing.

Ms. Lara would not have hesitated to refer Mr. De Leon for an examination by a specialist for his neurologic evaluation of his headaches. She would have done this for no other reason than to relieve the patient of his worry and to confirm the absence of a more serious problem. She still believed that, on balance, the referral would be of some help. In recent weeks, however, the state agency that funds the rural health clinics had urged all health clinic personnel to be careful in referring patients for costly laboratory or evaluative testing and in incurring the added expenses. But Ms. Lara could not overlook the fact that Mr. De Leon was distressed by his headaches, and there was always the possibility that he was presenting with early signs of impending cerebrovascular disease, the effects of which could seriously affect him and his family. She was uncertain about what choice to make. If Mr. De Leon was your patient, which action(s) would you take? What factors would be important to you in making decisions about Mr. De Leon’s care?