ETHICS

-comes from the Greek word Ethos

-characteristic way of acting -Latin word mos -Morrs meaning of acting -Study of human acts or conduct from a moral perspective as to weather they are good Or bad. -customs,morals & etiquette -concern putting these principle in action. CUSTOMS -are acts approved by a group or society ETIQUETTE -social observance required by good breeding PARTS OF ETHICS 1.GENERAL ETHICS-deals with the basic principle which are the morality of human acts. 2.SOCIAL ETHICS- tackles the basic principle in life of man as a member of society. OBJECTIVES OF ETHICS 1.To make clear to us why one act is better than another. 2.To live an orderly social life. 3.To appraise and criticize intelligently the noral conduct and ethical system. 4.To seek the true value of life. CONCLUSION; ETHICS & GOOD HEALTH -ethics is like nutrition. -one studies bodily health,the other moral health. -significant disagreement in both fields -still there is a significant common ground. DO WHAT THE BIBLE TELL YOU DIVINE COMMAND THEORIES -being good is equivalent to doing whatever the Bible or the Quran or some other sacred text or source of revolution tells you to do. -what is right equals what God tells me to do FOLLOW YOUR CONSCIENCE THE ETHICS OF OUR INNER VOICE -conscience tell us what is right or wrong -often has a religous sources

-may be founded in a notion of human nature -is often negative in character,telling us what is not right. ETHICAL EGOISM -the only person to look out for is yourself. DO THE RIGHT THING THE ETHICS OF DUTY : DEONTOLOGY -ethics is about doing what is right,about doing your duty. -duty may be determined by: REASON: -KANT: do what any rational human being should do. PROFESSIONAL ROLE -A Physicians duty to care for the sick. SOCIAL ROLE -a parent duty to care for his/her children -A person behavior can be wrong even if it results in the best possible outcome. -An act can be right even if it results in a negative outcome. DONT DO DIS me THE ETHICS OF RESPECT -the human interactions should be governed bu rules of respect -what counts as respect can vary from one culture to another EXAMPLES; -spitting in the sand -showing the soles of ones shoes-RICHARDSON ALL MEN ARE CREATED....WITH CERTAIN UNALIENABLE RIGHTS THE ETHICS OF RIGHT -the most influential moral notion of the past two centuries -established minimal conditions of human decency -make the world a better place -seek to reduce a suffering and incomplete pleasure or happiness -seek to demand a high degree of self-sacrifice.we must consider the consequences for everyone. -utilitarians claim the purpose of morality is to make the world a better place -daddy,thats not fair THE ETHICS OF JUSTICE -begins early in the family with fairness to all members of the family.

-seek to develop individual character -assumes good persons will make good decisions. BIOLOGY -is natural science concerned with the study of life and living organisms,including their structure,function,growth,origin,evolution,,distribution,and taxonomy.. WHAT IS BIOETHICS? Bio + ethics = life of acting BIOETHICS -is the term used to describe the application of ethics to biological sciences,medicine and related fields. -it is philosophical study of the ethical contro versies brought about by advances in biology and medicine. -it is systemic study of moral conduct in life sciences and medicine. -for M.T. Reich,it is systemic study of human behavior,specifically,in the field of life science and health care,as examined in the light of moral values and principles. -to a special focus on challenges arising from medern technology. BIOTECHNOLOGY -is any technology using micro-organism or biological materials for technological purposes.example (cloning) SCOPE OF BIOETHICS -in initial stages bioethics was concerned with ethical problems associated to medical practices but later,the subjects matter was broadened to include all biosciences. -bioethics does not deal only but solely to the doctor-patient of relationship from a moral stand point,but it expanded to social issue related to health,animal welfare,environmental concerns,however,biomedical ethics remains central to this paradigmatic discipline. -has something to do to the challenge posted by the biotechnological advances and its power over life and death. THREE DIFFERENT POINTS 1.The beginning of life (contraception and family planning) 2.In the midst of life (Genetic Eng and Abortion) 3.After end of life (Death Penalty and Euthanasia)

IMPORTANCE OR SIGNIFICANCE OF BIOETHIOCS 1.To provide awareness to health team or workers of the dos and dont of medical practice. 2.To enrich ones competence by understanding that the patient is a person and a holistic Individual.

-this field of study was developed in countries that had to face many ethical challanges due to the bioscientific developments,but the same moral problem challanges us even in the Phil. -it is vital for every member of the health profession to be acquanted to ethical principle Involved in the biomedical procedure. -biomedical science will continue to grow,as it will,there is a great need for us to take moral stand on these development. NEED FOR BIOETHICS The following changes gave rise to the need of Bioethics 1.Scientific advances 2.Inequalities in socio-economic,educational and political position 3.Finitude of resources 4. Pluralistic communities 5.Changes in the doctor-patient relationships 6.Rampant unethical behavior GOAL OF BIOETHICS 1.Aims to help one recognize the ethical component and implications of every actions in order To arrive at a justifiable decision. 2.Aims to have one committed to Bioethics, and integrated it into ones daily living. 3.Aims to correct the disequilibrium between technological possibilty ang moral energy. PROFESSIONAL ETHICS -it is a branch of moral science which treats of the obligations which a member of a Profession owes to the public,to his/her clients. -A professional medical ethics expresses responsibility in medical codes ang ethical treatises.All socially authorized professional power requires a public accountability and this is especially true of medical or community health professional power. MALPRACTICE AND NEGLIGENCE MALPRACTICE-any professional misconduct or any unreasonable lack of skill or fidelity in the perfomance of professional or fiduciary duties. PROFIT NEGLIGENCE-doing failure to do that action which a reasonably prudent person would Have done or would have not done in like or similar circumstances. ELEMENTS OF NEGLIGENCE 1.Existence of duty-there must be a moral obligation incumbent upon the person of doing or ommiting something as mandated by his/her profession. 2.Failure to perform the duty-one fails to respond the call of his/her profession.

3.Injury resulting from failure-there was a grave harm that results from not doing his/her duty or from doing the wrong thing due to lack of knowledge. SIX ELEMENTS THAT MUST BE PRESENT FOR A CASE OF NURSING MALPRACTICE TO BE PROVEN 1.DUTY The nurse must have a relationship with the client that involves providing care and Following an acceptable standard of care.. 2.BREACH OF DUTY There must be a standard of care that is expected in the specific situation,but that the Nurse did not observe. 3.FORESEABILITY A link must exist between the nurses act and the injury suffered 4.CAUSATION It must be proved that the harm occured as a direct result of the nurses failure to follow The standard of care and the nurse could have known that failure to follow the standard Of care could result in such harm. 5.HARM OR INJURY The client or plaintiff must demonstrate some type of harm or injury as a result of the Breach of duty owed the client. 6.DAMAGES If malpractice caused the injury,the nurse is held liable for damages that may be Compensated.The goal of awarding damages is to assist the injured party to his/her Original position so far as financially as possible.

PHILIPPINE NURSING ACT OF 1992 -defines the scope of nursing practice -nurses employed in any agencies are directly responsible to their immediate supervisor. -nurses are held responsible and accountable for the quality of performance of their Duties. -PDN are held to a standard of conduct that is expected of reasonably prudent nurses. PATIENTS BILL OF RIGHT -Nurses have the right of practice in any manner that fulfills their obligations to society And to those who receive nursing care. -Nurses have the right to practice in environments that allow them to act in accordance With professional standards and legally authorized scopes of practice. -Nurses have the right to a work environment that supports and facilitates ethical Practice,in accordance with the CODE OF ETHICS for NURSES and its imperative Managements.

-Nurses have the right freely and openly advocate for themselves and their patient, Without fear of retribution. -Nurses have the right to fair compensation for their work,consistent with their Knowledge,experience,and professional responsibilities. -Nurses have the right to a work environment that is safe for themselves and their Patients. -Nurses have the right to negotiate the conditions of their employment,either as Individuals or collectively,in all practice settings.

NURSING ETHICS -Is the examination of all kinds of ethical and bioethical issues from the perspective Of nursing theory and practice (Johnson 1999)

THE ICN CODE OF ETHICS FOR NURSES HAS FOUR PRINCIPLE ELEMENTS THAT OUTLINE THE STANDARDS OF ETHICAL CONDUCT. ELEMENTS OF THE CODE 1.NURSES AND PEOPLE -The nurse primary professional responsibility is to people requiring nursing care. -In providing care,the nurse promotes an environment in which the human rights, Values,customs and spiritual beliefs of the individual,family and community are Respected. -The nurse ensures that the individual receives sufficient information on which to Base consent for care and related treatment. -The nurse holds in confidence personal information and uses judgement in sharing This information. -The nurse shares with society the responsibility for initiating and supporting action to Meet the health and social needs of the public,in particularthose of vulnerable Populations. -The nurse also shares responsibility to sustain and protect the natural environment From deplation,pollution,degradation,and destruction. 2.NURSES AND PRACTICE -The nurse carries personal responsibilty and accountability for nursing practice, And for maintaining competence by continual learning. -The nurse maintains astandard of personal health such that the ability to provide Care is not compromised. -The nurse uses judgement regarding individual competence when accepting and

Deligating responsibility. -The nurse at all times maintains standards of personal conduct which reflect Well on the profession and enhance public confidence. -The nurse,in providing care,ensures that the use of technology and scientific advances Are compatible with the safety,dignity,and rights of people. 3.NURSES AND THE PROFESSION -The nurse assumes the major role in determing ang implementing and implementing Acceptable standards of clinical nursing practice,management,research and education. -The nurse is active in developing a core of research-based professional knowledge. -The nurse,acting through the professional organization,participates in creating and Maintaining safe,equitable social and economic working conditions in nursing. 4.NURSES AND CO-WORKERS -The nurse sustains a co-operative relationship with co-workers in nursing and other Fields. -The nurse takes appropriate action to safeguard individuals,families and communities When their health is endangared by a co-worker. CODE OF ETHICS FOR REGISTERED NURSES (PHILIPPINES) REGISTERED NURSES AND PEOPLE ETHICAL PRINCIPLES 1.Values,customs,and spiritual beliefs held by individuals shalll be respected. 2.Individual freedom to make rational and unconstrained decisions shall be respected. 3.Personal information acquired in the process of giving nursing care shall be held in Strict confidence.

GUIDELINES TO BE OBSERVED; REGISTERED NURSES MUST; a.consider the individuality and totality of patients when they administer care. b.respect the spiritual beliefs and practices of patients regarding diet and treatment. c.uphold the rights of individuals. d.take into consideration the culture and values of patients in providing nursing care. However,in the event of conflicts,their welfare and sefety must take pregedence.

REGISTERED NURSES AND PRACTICE ETHICAL PRINCIPLES 1.Human life is inviolable. 2.Quality and excellence in the care of the patients are the goals of nursing practice. 3.Accurate documentation of actions and outcomes of delivered care is the hallmark Of nursing accountability. GUIDELINES TO BE OBSERVED; REGISTERED NURSES MUST; A.know the definition and scope of nursing practice which are in the provisions of R.A. No. 9173,known as the PHILIPPINE NURSING ACT OF 2002 and board Res. No. 425,series of 2003,the RULES AND REGULATION IMPLEMENTING THE PHILIPPINE NURSING ACT OF 2002(the IRR) B.be aware of their duties and responsibilties in the in practice of their profession as defined in the Philippine Nursing act of 2002 and the IRR C.acquire and develop the necessary competence in knowledge,skills,and attitudes to effectively render appropriate nursing services through varied learning situations. D.if they are administrators,be responsible in prviding favorable environment for the growth And development of registered nurses in their charge. E.be congizant that professional programs for specialty certification by the BON are accredited through the Nursing Specialty Certification Council (NSCC). F.see to it that quality nursing care and practice meet the optimum standard of safe nursing practice. G.insecure that modification of practice shall consider the principles of safe nursing practice. H.if in position of authority in a work environment ,be normally and legally responsible for devising a system of minimizing occurances of ineffective and unlawful nursing practice. I.ensure that patients records shall be available only if they are to be issue to those who are Professionaly and directly involved in their care and when they are required by law. ETHICAL PRINCIPLE 4.Registered nurses are the advocates of the patients;they shall take appropriate steps to safeguard their rights and priviledges. GUIDELINES TO BE OBSERVED

REGISTERED NURSES MUST;

a.respect the PATIENTS BILL OF RIGHTS in the delivery of nursing care. b.provide the patients or their families with all pertinent information except those which may be deemed harmful to their well-being. c.uphold the patients rights when conflict arises regarding management of their care. ETHICAL PRINCIPLE 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. GUIDELINES TO BE OBSERVED; REGISTERED NURSES MUST; a.perform their professional duties in conformity with existing laws,rules & regulations,measures,and generally accepted principles of moral conduct and proper decorum. b.not allow themselves to be used in advertisement that should demean the image of the profession(i.e. indecent exposure,violation of dress code,seductive behavior,etc.) c.decline any gift,favor or hospitality which might be interpreted as capitilizing on patients. d.not demand and receive any commision,fee or emolument for recommending or reffering or recommending an patient to them for nursing care. e.avoid any abuse of the privilege relationship which exists with patients and the privilage access allowed to their property,residence or workplace. REGISTERED NURSES AND CO-WORKERS ETHICAL PRINCIPLES 1.The Registered Nurses is in soliditary with other members of the healthcare team in working for the patients best interest. 2.The Regustered Nurses maintains collegial and collaborative working relationship with colleagues and other health care providors. GUIDELINES TO BE OBSERVED; REGISTERED NURSES MUST

a.maintain their professional role/identity while working with other members of the health team. b.conform with group activities as those of a health team should be based on acceptable,ethico-legal standards. c.contribute to the professional growth and development of other members of the health teams. d.actively participate in professional organizations. e.not act in any manner prejudicial to other professions. f.honor and safeguard the reputation and dignity of the members of nursing and other professions;refrain from making unfair and unwarranted comments or critisism on their competence,conduct,and procedures;or not to do anything that will bring discredit to a colleague and to any member of other professions. g.respect the rights of their co-workers.

REGISTERED NURSES,SOCIETY,AND ENVIRONMENT ETHICAL PRINCIPLES 1.The preservation of life,respect for human rights,and promotion of healthy environment shall be a commitment of a Registered Nurse. 2.The establishment of linkages with the public in promoting local,national,and international efforts to meet health and sosial needs of the people as a contributing member of society is a noble concern of a Registered Nurse. GUIDELINES TO BE OBSERVED; REGISTERED NURSES MUST; a.be conscious of their obligation as citizen and,as such,be involved in community concerns. b.be equipped with knowledge of health resources within the community,and take active roles in primary health care. c.actively participate in programs,projects,and activities that respond to the problems of society. d.lead their lives in conformity with the principles of right conduct and proper decorum. e.project an image that will uplift the nursing profession at all times. REGISTERED NURSES AND THE PROFESSION ETHICAL PRINCIPLES; 1.maintainance of loyalty to the nursing professionand 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 Registered nurse 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 a visionary mission. GUIDELINES TO BE OBSERVED; REGISTERED NURSES MUST; a.be members of the ACCREDITED PROFESSIONAL ORGANIZATION(PNA) b.strictly adhere to the nursing standards. c.participate actively in the growth and development of the nursing profession. d.strive to secure equitable socio-economic and work conditions in nursing through appropriate legislation and other means. e.assert for the implementation of labor and work standards. THE HUMAN PERSON -Biologically,possess the genetic code of Homo-sapiens with the potentially to be the human person from the beginning of life. -In christian perspective,person are created by God in His image and likeness and redeemed by his son -Possess superior intelligence and freewill -Is the subject of healthcare and his helath is our common goal. A PERSON 1.Has an inherent dignity which must be respected a.A person cannot be destroyed or denatured b.A person must be an end aand not a means to an end c.A person can and should decide what is best for one without constrain from others. d.All persons are of equal worth regardless of race,color,age,past history,socioeconomic,political or cultural status. e.A person must be related to in a respectful courteous manner.One must be acknowledged and listened to 2.Has an ultimate destiny,a single and final end (eternal happiness in union with the Creator) a.A person has needs that must be met b.A person has rights

c.Must have stewardship. 3.Lives with other persons in the community a.Individual community members are in a reciprocal relationship of give and take with the community. b.Individual members relate to each other in peaceful pluralism 4.Reflects his Creator a.A person possessess an inherent goodness,no matter how poor,ignorant and dirty. b.A person is called sainthood. c.A personwho is a healthcare provider must continue Christs healing love for the suffering in ones service and love for Christ in the sick person.

HUMAN ACTS -Applied to acts when they are proper to man as performed by a human being -An act (thought, word, desire, omission) performed by a human being when he is responsible,when he knows what he is doing and wills to do it -Human act is actus humanus,an act of man is actus humilis-act done bu human being but Without knowledge and consent -Every human act is willed act.A human act is a moral act. -Are the outward expression of a persons choice. -The morality of human act depends on 3 factors: 1.The object;the specific action,the means,what the person chooses to do now,the Proximate end of the act of willing. 2.The end; the purpose of the agent,the motive,the ulterior end for the whose sake one Chooses to do this here and now 3.The circumstances; who,where, by whom,when,the context of the action -An acts is morally good only if these factors are morally good or in conformity with the order of Reason -Both the proximate and ulterior end must be good and the circumstances must be appropriate -a persons responsibility for a human act is proportionate to ones capacity to make a correct Judgement and his freedom to act upon it. -Ignorance and misinformation may cause failure of understanding.

ELEMENTS OF HUMAN ACT 1.KNOWLEDGE- a person is not responsible for an act done in ignorance 2.FREEDOM- a person is not responsible for an act over which he has no control 3.ACTUAL CHOICE OR VOLUNTARINESS- a person is not responsible for an act which he does not will,unless he will to give up his self control -The more complete this elements are,the greater is the persons responsibility to the act

THE MODIFIERS OF HUMAN ACT 1.IGNORANCE a.vincible diligence or culpable ignorance-ignorance that may e overcome by due diligence. b. Invicible diligence or inculpable ignorance- ignorance that cannot be expelled by due diligence. 2.CONCUPISCENCE- any of the human impulses or tendency technically called passions (hatred, grief, desire, anger, fear, courage, hope, aversion,love)

3.VIOLENCE- co-action or violence is external force applied by a free cause 4.HABIT- is a readiness,born of repeated acts,for doing a certain thing.

NORMS OF HUMAN ACTS -These are directives or guides in making decision s on what we ought to do or to be a.LAW- an ordinance of reason,promulgated for the common good by one who has legitimate authority.It is an authoritative order that should be just honest,possible or fullfilmment,useful, to a certain degrees of permanency and promulgated or made known to the subject b. CONSCIENCE- the practical judgement of reason upon an individual act as good and to be performed or as eviland to be avoided. IMPORTANT CLASSES OF LAWS a.ETERNAL LAW -It is Gods eternal plan and providence for the universe.It is the diverse reason or will commanding the preservation of the natural order of the things and forbidding its disturbance.

According to St.Thomas,it is the plan flowing from Gods wisdom directing all acts and movements. b.NATURAL LAW -It is the eternal law as known to human through reason.It is nothing than the rational creatures participation in the eternal law of God and Human comes to the knowledge of this law by natural light his/her reason.. -The reason why it is called NATURAL is because it is neither communicated in a supernatural way,nor a result of a command of a legislative or authority.The precept of natural law is found derived for the very nature of human beings.

PROPERTIES OF NATURAL LAW a. UNIVERSALITY The natural moral law binds every person at all times and in all places or its basis is the very nature of human.One cannot remain ignorant of the natural law,atleast not of its basic precepts.However,human beings do not possess the knowledge of this law,in a fully developed form from the beginning.She or He must developed it just as the development of other form of knowledge.example (respect for life) b. IMMUTABILITY As soon as the human being has the capacity of using his/her reason,certain fundamental norms are imprinted in human nature,so that they exist as long as human nature exists.The genuine commands and prohibition of natural law cannot be changed. c. INDISPENSABILITY No one is depended or excused in the observance of the natural law.Why? Because,the origin of the natural law is God.Natural law is identical to Gods will.Evidently,human has no authority over a law of this status.This means that if there is dispensation of this law,there is a violation in Gods law.

TYPES OF NATURAL LAW AS PRESENTED OR FORBID AN ACT 1.AFFIRMATIVE Laws which bind always,but not at very moment.It states that human is morally obliged adopt all ordinary means of preserving health and life,except if the point is not spiritually prepared for death.Humans may adopt extraordinary means to conserve health and life.If it appears to be useful,desirable and prudent thing to do.

2.NEGATIVE Laws that are prohibitory.These are laws of the natural order,which bind always and at Every moment.It states that noa ct (+) or (-).Maybe directly,deliberately willed as a means of destroying health or life. At point,it is good that we identify the ordinary from extraordinary means of preserving Life,from the standpoints of physicians and moralists. 3.HUMAN POSITIVE LAW Law enchanced by the church or state. An ordinance of reason derived from the natural law,promulgated for the common good by a human institution in charge of society. NOTE; Whenever we perform actions that are in conformity to the law,it is good.We are talking now of laws that are also morally sounds,this will guide us not only become citizens who abide to certain rules but also develop us to become moral individuals.The mare careful in following the norms to fulfill our duty in the preservation of human life.

FUNCTIONS OF THE LAW IN NURSING 1.Provides a framework for establishing which nursing actions in the care of the clients are legal 2.Differentiates the nurses responsibilty from those of other health professional 3.Helps establish the boundaries of independent nursing action 4.Assists in maintaining a standard of nursing practice by making nurses accountable under the law.

THE CALLING OF THE HEALTH CARE PROFESSION 1.Health is the optimum human functioning of a person to meet biological,physiological social and spiritual needs in an integrated manner.It is multifactorial.Health is wholeness a.biological refers to mans having all the correct structure in the proper places and in a proper sizes,biochemically and physiologically functioning optimally to grow, mature,maintain and continue ones species.Dysfunction is DISEASE,SICKNESS,AND DEATH. b.Psychological refers to mans manifesting appropriate mental and emotional behavior. Dysfunction are MENTAL DISORDER.

c.Social refers to mans making rational and correct moral choices,the ability to choose and control self,and assume responsibility for choices made.Dysfunction are ANTI-SOCIAL BEHAVIOR d.Spiritual refers to mans creativity and commitment.It is the ability to self actualize,plan, set goals,unite to and connect with God and all of creation. 2.Many healthcare providers are concerned almost exclusively witj physiological and psychological functions. 3.They must be cognizant of the social and spiritual functions of their patients and help then lead A better life.

CHAPTER 3 ETHICAL SCHOOLS OF THOUGHT

KANTS ETHICS -a brilliant German thinker of great renown -maintains that one acts morally -if and only if one does whatever one is obliged to do.but what is that act which an Individual is obliged to do? ACT DONE IS ACCORD WITH DUTY AND ACT DONE FROM A SENSE OF DUTY -Kants makes a distinction between these two acts. CATEGORICAL IMPERATIVE -Imperative mandates an action without regard to the consequences that such an action may yield. HYPOTHETICAL IMPERATIVE -Command with corresponding condition or limitation FORMULATIONS OF THE CATEGORICAL IMPERATIVE 1.Act only on the maxim which you can at the same time will to become a universal law. 2.Always act so as to treat humanity either ypurself or other as an end and never as only a means.

TWO TYPES OF DUTIES 1.PERFECT DUTY -the former is one which we must always observe,irrespective of time and place or circumstances. -that I should not harm or inflict injury upon others is a perfect duty. 2.IMPERFECT DUTY -the latter is one which we must observe only on some occasions. -that I should show love and compassion occasionally to others,based on my own choice,is an imperfect duty. AUTONOMOUS,SELF-REGULATING WILL -Kants concept of the will as autonomous and self-regulating has contributed A great deal to our understanding of autonomous as freedom of action. -Autonomy means governing,regulating,restraining oneself ,including ones own and Which are binding on everyone.

IN THE MEDICAL CONTEXT -in dealing with issues in medical practice and research. KANTS ETHICAL PRINCIPAL ARE; 1.For Kant it is always wrong to lie,no matter what the consequences may be medical investigators/researchers should not lie to their patients. 2.We must always treat people as ends and not only as means.. -Based on Kants principles,we also have a duty to treat ourselves as ends,and to preserve Our dignity and worth as human being. 3.An action is right and ligitimate in so far as it satisfies the categoral imperative.Good results never make an action morally right. 4.Kants distinction between perfect and imperfect duties suggest that same rights should be recognized. DIFFICULTIES 1.That I promise to keep a secret,but then someone else asks me about the thing I am supposed to keep secret.

2.That the cathegorical imperative fails to establish duties in cases involving maxim that cannot be willed to become a universal law for subjective reason. 3.An autonomous self-regulating will.

ROSS ETHICS WILLIAM DAVID ROSS -A British Aristotelian scholar and moral philosopher,presented a rule-deontological theory in his book. -rejected the utilitarian precept that an action is validated as right by its consequences. -He percieved that only do such principles fail to demonstrate sensitivity with regard to the complexities of actual situations,but they also conflict with one another in some instances. RULES AND MORAL PROPERTIES -Has percieved the ethical significance of rules in medical context,althought more rules should not be so absolute and inflexible that there are no exceptions whatsoever. - Moral rules serve as moral guidelines in such a way that they must be adjusted or modified,if not set aside in some situations,depending upon our perception of what is right and good.

Actual duty and Prima Facie duty -Ross makes a distinction between an actual duty and prima facie duty. -The former is ones real duty in a given situation.It is the action one ought to choose from among many other action. -The latter ( which means at first view or so far as it appears) is one that direct or commands what one ought to perform when other relevant factors are not taken into account. SIR DAVID ROSS OFFERS TWO PRINCIPLES 1.Act in accordance with the prima facei duty which has a greater balance of rightness over wrongness compared to other prima facei duties. ROSS HOLDS THAT a.one and only one of these two prima facei duties is my actual duty. b.I know each of them to be a prima facei duty c.I can have only an opinion about which is more of a duty and therefore my actual duty. 2.Act in accordance with the stronger,more stringent or more severe prima facei duty.

ROSS SEVEN TYPES OF PRIMA FACEI DUTIES 1.Duty of fidelity 2.Duty of reperation 3.Duty of gratitude 4.Duty of justice 5.Duty of beneficence 6.Duty of self-improvement 7.Duty of non-maleficence DUTY OF FIDELITY -We should be faithful to our duties,obligation,vows or pledge -Refers to ones loyalty to a worthy cause,telling the truth as thesituation demands it,keeping actual implicit promises,and not representing fiction as truth. DUTY OF REPERATION -Saying underscores the great significance of this duty kung nakagawa ka nang masama,gumawa ka naman ng mabuti. -We have a duty of make amends for injury that we have inflicted on others. DUTY OF GRATITUDE -We have a duty to appreciate and recognize the services other have done for us,which may be either a favor,kindness,good fortune,a great help,or saving ones life. DUTY OF JUSTICE -Ross stresses the proper distribution of social benifits and burdens. -The duty of justice demand fairness for everyone. DUTY OF BENEFICENCE -Do good (+) -Duty enjoins us not only to bring about what good for others but also to help them better their conditions with respect to virtue,intellegence,or comfort. DUTY OF IMPROVEMENT -We have duty to help others better themselves

-We also have duty to improve and develop ourselves with respect to virtue,intelligence,and hapiness. -hand-hand with other duties. -You will notice here that the effective and fruitful fulfillment of our other duties revolves,to a large extent,around out dutyof self-improving merit. DUTY OF NON-MALEFICENCE -Do know harm (-) -Ross views not injuring others -We ought to avoid inflicting evil,injury or harm upon others as we avoid doing so to ourselves. -We ought to prevent evil or harm,which encompasses pain,suffering,disability and death. IN MEDICAL CONTEXT -Ross ethics encourages us to show discernment and sensitivity with regard to the unique aspects of varying situation before making a moral desicion. -Our moral guide should be not what is useful,but what is right. DIFFICULTIES -Contrary to what Ross seems to suggest,it is practically impossible for all individuals to be able to discern the same moral principle and prima facei duties. -Ones perceptionof what is right and wrong as well as of ones duties,is the by-product,so to speak,of ones education,training and experience. -Ross,after giving us a two fold principle by which to resolve conflicting prima facei duties does not tell us how to determine which duty,between two prima facei. RAWLS THEORY OF JUSTICE -Theory of justice -John Rawls,a noted Harvard philosopher,has attempted a brilliant synthesis of the strenght of utilitarianisms and of the deontological views of Kants and Ross. -talks of a hypothetical situation which he calls THE ORIGINAL POSITION in trying to elucidate his concept of justice. -A community of individuals living in the original position UNDER THE VEIL OF IGNORANCE -They dont know their sex,race,natural abilities,social status,or their economic conditions. -justice is FAIRNESS -Some individuals in the original position would introduce and promote principles that would support INEQUALITIES in their society. -Supposes that rational people would choose a strategy by which they could select from many alternatives the one whose worst possible result would be better than those of the other alternative.

THEORY OF JUSTICE -Every individual is inviolable -This inviolable which is founded on justice,is so sacrosanct that not even the general welfare,of society can override and superside it.

PRINCIPLES OF JUSTICE RAWLS SPEAK OF TWO FOLD PRINCIPLE OF JUSTICE a.Equal access to the basic human rights and liberties this principle defines and secure equal liberties citezenship. -basic rights and liberties include the right to vote and to be eligible for public office,freedom of speech and peaceable assembly,liberty of conscience,freedom of thought,right of ownership,and freedom from a from arbitiary arrest and seizure as defined by the concept of the rule of law,and not or man. b. fair equality of opportunity and the equal distribution of socio-economics inequalities. JUSTICE IN HUMAN RELATIONS -Aware of the need for principles that bind and guide individuals in making moral decisions.

RAWLS FOUR TYPES OF DUTIES 1.fairness in our dealing with others 2.fidelity 3.respect for persons 4.beneficence RAWLS NATURAL DUTIES 1.The duty of justice 2.The duty of helping others in need or in jeopardy 3.The duty not to harm or injure other 4.The duty to keep our premises IN THE MEDICAL CONTEXT -Rawls recommends the legitimacy of paternalism which others should act or decidein our behalf whenever we are unable to make the decision by and for ourselves.

DIFFICULTIES -His account of a hypothetical community under the evil of ignorance. -Rawls does not permit the people in the original position to know their goals,plans,interest,and purposes,but only their self-respect,wealth and rationality. NATURAL LAW ETHICS -Ethical doctrine assumes many names by virtue of its historical development. ST.THOMAS AQUINAS (1225-1274) -A profound Italian Philosopher and Theologian,who gave the doctrine its most influential formulation and articulation in the 13th century. VOICE OF RIGHT REASON OR VOICE OF CONSCIENCE -Interpreters of St. Tomas moral doctrine regard right reason or the voice of reason as the moral norm,insofar as an individuals natural capacity to determine what is right from what is wrong is no less than the manifestation of moral law. MORAL LAW -Is the dictate of the voice of reason. -dictate is expressed in the moral principle THE GOOD MUST BE DONE,AND EVIL AVOIDED

MANS THREEFOLD NATURAL INCLINATION -What is good? -St. Tomas asserts that human good is that which is suitable to or proper for human nature. -St.Tomas views,the good is bulit into human nature,and it is that which we are directed bu our natural inclination as both physical and rational creatures. THREE NATURAL INCLINATIONS 1.self-preservance 2.just dealings with others 3.propagation of our species. THREE DETERMINANTS OF MORAL ACTIONS -St.Tomas ethical problem,there are three factors which determine the rightness or wrongness of a individual human act.

1.the object 2.the circumstances 3.the end of the agent

OBJECT -that which the will intends directly and primarily is the object of the moral act.It be either a thing. CIRCUMSTANCES -there are conditions which,when super added to the nature of moral act,will affect its morality WHO? -has something to do with special quality,prestige,rank or execllence of the person involved in moral act. WHAT? -refers to the quality or the quality of the moral object. WHERE? -denotes the place where the act occur. -It makes a big difference BY WHAT MEANS? -refers to the means used in carrying out the act. WHY? -The end or purpose is considered as a circumstances affecting the goodness or badness of the action. HOW? -Indicates the manner in which the action is done. WHEN? -refers to the time element involved in the performance of an action,not only with regard to quantity but to quality as well. THE END OF PURPOSE -We take end in the sense of end or purpose of the doer or agent. -also affects the goodness or badness of an action or decision in a number of important way. -the end or purpose may be taken either as a circumstance or as the end of the agent,for it is an integral part of every moral act in either case.

NATURAL OF MORAL ISSUES AND MORAL REASONING -Bioethics is an applied ethical study dealing with moral issues. MORAL ISSUES -It is a case problem,situation,or subject matter of great interest and crucial significance that demands a moral decisions. -It may also be understood as that which involves the rightness or wrongness of action.

CHAPTER 4 THE MORAL ISSUES OF ABORTION -The practice of abortion is as old as mankind itself.It is a method of birth control in which contraception is terminated rather than prevented. -In the Philippine abortion is illegal. MEANING AND TYPE OF ABORTION ABORTION -means the expulsion of a living fetus from the mothers womb before it is viable. -termination of pregnancy,spontaneously or by induction,prior to viability. DELIVERY -Termination of pregnancy FIVE TYPES OF ABORTION 1.NATURAL ABORTION -or the expulsion of the fetus through natural or accidental causes. 2.SPONTANEOUS OR ACCIDENTAL ABORTION -laymans term miscarriage -unintentional and involuntary -devoid of moral significance 3.DIRECT OR INTENTIONAL ABORTION -refers to the deliberately induced expulsion of a living fetus before it has become viable.

4.THERAPEUTIC ABORTION -which is deliberately induced expulsion of a living fetus in order to save the mother from the danger of death brought on by pregnancy. 5.EUGENIC ABORTION -recommended in cases where certain defects are discovered in the developing fetus. 6.INDIRECT ABORTION -The removal of the fetus occur as a secondary effects of a ligitimate or licit action,which is the direct and primary object of the intention.

THE MORAL ISSUES -Moralists point to the difficult question regarding the beginning of human life as the moral issue of this practice. IMMEDIATE HOMONIZATION -contends that a new human person exist immediately upon conception. DELAYED ANIMATION -the theory of delayed animation upholds that ensoulment occurs at a later time but not from the moment of conception. IMPLANTATION -First,ensoulment occur at implantation -Geneticists state that nidation or implantation take place six to seven days after conception. UNITY AND UNIQUENESS -ensoulment occurs when the unity and uniqueness of the fetus are definitly established -this happen between two and four weeks after conception. LOOKS HUMAN -ensoulment occur when the fetus already looks human. -even the four-week old embryo does not look human where as the six-week old one is beginning to. ELECTRICAL ACTIVITY -ensoulment occur when electrical impulses or activities are first detectable from the brain,around the eight weeks of pregnancy.

-electrical activity indicates that the brain starts functioning. QUICKENING -ensoulment take place when the mother can feel the spontaneous mevements of the fetus during the 10th to 12th week of pregnancy. VIABILITY -ensoulment occur at viability that is,when the fetus is considered viable during the 28th or 7th months of pregnancy. BIRTH -ensoulment occur at birth when the child has become biologically independent of his mother. FERTILIZATION PROCESS -from all views of animation that have been discussed let us take the safest one as our point of reflection. -the theory of immediate hominization which claims that ensoulment occur from conception. -conception is said to occur when the male sperm and the female egg or ovum combine or unite in the oviduct or fallopian tube. -otherwise known as the process of fertilization. PRE-IMPLANTATION -Modern geneticists and embryologists give us a rather detailed andaccurate account of the preimplantation period, or the period before the zygote burrow itself in the endometrium. -In sexual intercourse,about 300-500 million sperms are deposited in the vagina. -In the time of ejaculation,the sperms are not yet capable of immediately fertilizing an ovum they must undergo a chemical change known as CAPACITATION without which they cannot fertilize the ovum. -there will be a period of several hours within which interference with reproduction or prevention of conception can be undertaken if one so desire. -after six-eight hours following action.fertilization or conception may occur. CELL DIVISION PROCESS -Embryologists explain that the one-celled conceptus divides into two cells,then four,then eight,then sixteen. At a rate of one division per day. -six to eight days of this cell division process,the next critical stage of fetal development starts. -the opposite pole of this sphere will become the fetus.The part which becomes the placenta produces hormones.the material blood stream which serves a critical function in preventing the mother from menstruating. -fetus grows and develops about 280 days from the time of conception

CURETTAGE -It is very crucial for rape and/or incest victims..If within the 8th day period following the sexual assults the lining of the uterus can be scaraped or rasped of by CURETTAGE. -implantation can be prevented and pregnancy will not continue. THINGS TO TAKE INTO CONSIDERATION ABOUT THE 1ST eight days of fetus in the Fallopian tube are: 1.the pills and intrauterine devices may act during the 8th days. 2.this stage precedes the period when a diagnose of pregnancy can be made. 3.it is the stage when the morning-after-pill may act. 4.it is not covered under current abortion laws, in as much as it precede the stage when a woman knows She is pregnant. THREE GENERAL VIEWPOINTS OF ABORTION 1.the conservative 2.the liberal 3.the moderate or intermediate CONSERVATIVE POSITION -Declares that abortion is never permissible,or at most,is permissible if and only if it is required to save the pregnant womans life,as in the case of the removal of a cancerous uterus or the removal of the fallopian tube,or a part of it,because of ectopic pregnancy. LIBERAL POSITION -States that abortion is always permissible,whatever the state of fetal development may be. MODERATE POSITION -holds that abortion is morally permissible up to a certain stage of fetal development,or some limited set of reasons sufficient to justify the taking of life in this or that special circumstances.

PRO-LIFE MOVEMENT -holds that abortion is the DISAPPROVING VIEW of abortion. -from the movement of conception,the life of every human being is to be respected in an absolute way becauseman is the only creature on earth that God has WISHED FOR HIMSELF and the spiritual soul of each man is immediately created GOD.

EFFECTS OF ABORTION -These are physical and psychological effects of abortion on the women concerned. -The physical effects,for instance,include habitual miscarriage,ectopic pregnancy,menstrual disturbances or discomfort,stillbirths,bleeding,shock,coma,perforated uterus,fever,cold ,sweat,intense pain,loss of other organs,insomia,loss of appetite,weight loss,frigidity. PSYCHOLOGICAL EFFECTS 1.guilt 2.suicidal tendencies 3.loss of sense of fulfillment 4.mourning 5.loss of confidence 6.lower self-esteem 7.hostility 8.self-destructive behavior 9.anger 10.rage 11.helplessness 12.lost interest in sex 13.inability to forgive oneself 14.nightmares and frustration 15.thwarted maternal instinct 16.intense interest in baby PRO-CHOICE MOVEMENT THE JUSTIFICATION FOR THE EXPULSION OF THE FETUS; 1.personal 2.social 3.fetal PERSONAL OR FAMILIAL REASONS 1.Underscores freedomof choice,giving centrality to the sovereignty of the individuals conscience,specially in grey areas of morality. 2.liberates procreation decision from the control of the church,even as it realizes that a religously directed choice against abortion is not fully free at all. 3.safeguard the mother from a pregnancy that would threated her life by ppossibly resulting in cancerous uterus,therapeutic abortion or ectopic pregnancy. 4.protects the reputation of the woman in cases of pregnancy due to rape and incest.

SOCIAL REASON 1.pro-choice position helps provide an adaption to a world that no longer needs nor can afford unlimited childbearing. 2.it alleviates economic,sociological,or demographic problems. 3.it anticipate the social costs involved in the care,support,and education of a severely handicapped individual during his/her lifetime. 4.it makes an important contribution to building a society in which there is no bias against the poor in favor of afferent and the powerful. 5.it checks overpopulation and reduces unwanted pregnancy,child abuse,or prostitution,maternal death,through illegal or dangerous abortion,poverty and illness. FETAL REASONS 1.It prevents the births of terribly malformed or defective children. 2.Child deformity will cause the family to in our staggering financial and psychological costs. AMNIOCENTESIS -The malformation of the fetus in utero can be detected as early as the 5th month or 16th week of pregnancy. 3.Abortion is a post natal method of eliminating a couples affsring if its sex is found to be undesirable.

CHAPTER 5 THE MORAL ISSUES OF EUTHANASIA -There is no freedom to be born -There is no freedom to die -Modern technology and embryology haved paved the way of pregnancy by design rather than by accident,by choice and not by chance. EUTHANASIA -means easy death -from the Greek eu- easy - thanatosdeath -painless,peaceful death -it is the deliberating putting to death,in an easy,painless way of an individual suffering from an incurable and agonizing disease. -mercy killing -prolonged suffering

-some call it the art or practice of painlessly putting to death a person suffering from a marked deformity or from an unbearable and distressing disease. THE LATTER MAY BE CLASSIFIED IN FOUR WAYS; 1.Active and Voluntary Euthanasia 2.Passive and Voluntary Euthanasia 3.Active and Non-Voluntary Euthanasia 4.Passive and Non-Voluntary Euthanasia Different views T.GARY WILLIAMS -considers euthanasia to be morally wrong,because it is intentional killing and opposes the natural moral law,or the natural inclination to preserve life.

JAMES RACHELS -opposite for Euthanasia,believing it to be humane insofar as it suffering to be brought to a speedy end. PHILIPPINE FACT -endorses bothactive and passive Euthanasia,in which the patient explicity gives consent. RICHARD BRANT -applies Rosss notion of prima facei duty not to injure other in this analysis of the issue at hand.

CHAPTER 6 THE MORAL ISSUE OF SUICIDE

-Ancient Greeks and Romans both defended and condemned suicide,depending on the circumstances under which it is was committed. -Socrates as recounted by Plato,for instance.taught that an individual was a property of the Gods,so that self-killing would bring about their anger.

-The permission of the God could be made manifest by a visible necessity of dying as had been imposed by Socrates himself.

PLATO CITED THREE OTHER EXCEPTION TO THE PROHIBITION OF SUICIDE 1.any shame of extreme distress and improvement 2.affliction by any extraordinary sorrow 3.inevitable turn of fortune. -Epicurus in his way,held that if life ceases to be a pleasure or a pleasant one,the recourse for free individual was to terminate it. MEANING AND CAUSES OF SUICIDE -suicide is the direct ,willful destruction of ones own life.It is direct insofar as the primary object of the ac itself it is the killing of oneself.It is willful insofar as it is deliberate,voluntary and intentional,and it is destructive insofar as the means of terminating ones own life,more often than not,violent,brutal or very harsh. -suicide as an act of self-destruction indicates that an individual for various reason.no longer regards life as worth life.

RELIGIOUS OR CULTURAL CAUSES OF SUICIDE,WE MAY CITE PERSONAL,FINANCIAL & SOCIAL REASONS: PERSONAL REASONS; 1.misfortune and three overlap frustration in love or marriage making one a victim of a broken home or marriage. 2.parental indifferenceor apathy toward ones boyfriend or girlfriend. 3.in-laws problems,specially if victim live with their parents-in-law. 4.failure in examination 5.loss of honor and integrity. 6.nervous breakdown due to ones inability to cope with life problems. FINANCIAL CAUSES 1.poverty nad impoverishment 2.great loss of money or collapse in business venture. SOCIAL AND POLITICAL CAUSES 1.failed coup detat 2.protest against mans inhumanity to man

THE CONS OF SUICIDE FLAVIUS JOSEPHUS -A famous soldier -Statesman and historian who has the commander of a defeated army. JOSEPHUS ARGUED; 1.suicide is a crime which is contrary to the common nature of all animals 2.the soul is depositum ST.AUGUSTINE LIKEWISE CONTENDED 1.suicide is itself a greater sin than any all sins that could be allegedly avoided by committing 2.self-murder is against the 5th commandment 3.suicide deprives one os the opportunity to repent 4.it is ignoble act through which one attempts to escape the ills of life. ST.TOMAS AQUINAS 1.suicide is against the natural law 2.being a member of a society;a person who kills himself will deprive the community 3.suicide is usurpation of Gods function THE PROS OF SUICIDE MICHAEL DE MONTAIGNE (1533-1592) -A French Essayist and Skeptical Philosopher -was the first to explicity question the viewsof Augustine and Aquinas -if and when an individual reaches a point where all that he feels is terrible pain,agony and misery. JOHN DANNE (1573-1631) -British clergyman and a religous writer -critized the Christian prohibition of suicide as self-serving for capitalists and Christian Authorities who exploit and appress their laborers. BARON DE MONTESQUIEU(1689-1755) -A Philosopher and political theorist 1.it is unjust to compel a person to labor for a society he no longer consent to be a member of this justifies the act of terminating ones own life. 2.the act of suicide does not disturb the order of providence,nor does any other human act alter the modification of matter. 3.though the soul is separated from the body,the order or regularity in the universe never Changes.

DAVID HUME (1711-1776) -A Scotish Philosopher,defended suicide; 1.The removal of misery makes suicide morally justifiable and permisible to bear unbearable pain is no way part of a natural inclination. 2.Moral duties is reciprocal-while alive and healthy,it is my bounded duty of render service to Society as it protects me in return but when my life becomes a liability and a burden to society My withdrawal is not only innocent but laudable. 3.There is no such thing as order designed by God;mans life is as disposable as that of an oyster.

CHAPTER 7

THE MORAL ISSUES OF BIRTH DEFORMITIES

-A mother who gave birth to a horribly deformed baby whose lrft side is malformed will certainly draw various reactions,depending upon ones own Philosophical worldview or religous outlook. -The fatalistic and religous mother will leave everything to Gods will KUNG ANO ANG KALOOB NG DIYOS -but for the concerned parents,some kind of moral decision must be made for and behalf of the newborn baby.

MEANING AND COMMON CAUSES OF BIRTH DEFORMITIES BIRTH DEFORMITIES ARE; 1.defect 2.malformation 3.abnormalities of a child which are present at birth TWO KINDS OF DEFORMITIES; 1.genetic deformities 2.congenital deformities GENETIC DEFORMITIES -defects or abnormalities that are present in the genetic materials -are hereditary,they are the outcome of the genetic information of the child

SEVERAL CAUSES OF CONGENITAL DEFORMITIES; 1.radation (X-ray) 2.drugs (thalidomide) 3.chemical (mercury) 4.nutritional deficiencies (undernourishment) 5.bilogical disease agents (certain viruses or spirochettes) TYPES OF DEFORMITIES 1.Trisomy-21 2.Spina bifida 3.Hydrocephaly 4.Anencephaly 5.Esophageal Atresia 6.Duodenal Atresia TRISOMY-21 -DOWN SYNDROME -is a genetic disease which result from the presence of an extra chromosomes in the Genetic formation. -the affected newborn has a 21 triple rather tha a 21 pairs of chromosomes -it born retarded and with various physical deformities -IQ of 50-80 PHYSICAL DEFORMITIES OF DOWN SYNDROME 1.broad skull (big-headed newborn) 2.a large tongue 3.an upward slant of the eyelids SPINA BIFIDA a.an opening of the spine b.a bulging sac resulting from the protrusion of the membrane covering of the spinal cord c.spinal fluid and nerve tissue contained in the swelling protrubance d.paralysis below the waist e.no control of bladder and bowel movement HYDROCEPHALY -Etymologically,this term hydro (water) Kephale (head)......WATER IN THE HEAD OR IN BRAIN -defective condition characterized by the accumulation of fluid within the ventricles or between the membranes of the brain,especially in very young children.

-surgical treatment is required by inserting a thin tube (shunt) to drain the fluid from the Brain to the heart or abdomen where it can be absorbed. ANENCEPHALY -Greek an without Enkephalesbrain....WITHOUT BRAIN -this deformity,the brain is partially or totally absent -some bones or skull are not completly formed -death is a virtual certainly ESOPHAGEAL ATRESIA -an atresia is the closing or blockage of a normal canal or opening -refers to the closing of the esophagus -surgery is required DUODENAL ATRESIA -the duodenum the upper part of the small intestine is closed-off -food cannot pass through and be digested -surgical operation is highly successful RETROSPECT -regard to the moral issue under consideration,the parents moral desicion is very crucial.information -deformed baby is obviously unable to make such decision. -physical who are supposed to know better tha parents regarding the nature of particular birth deformity should brief them about all pertinent -informed consent must be observed as much as possible. APPLICATION OF ETHICAL THEORIES -Roman Catholic stand on this matter is that even the most terribly malformed baby is a human person,so its right to life must be respected and safeguarded. -Kantian principle,if the malformed baby is a person,then it possesses an inherent dignity and worth. Aside from being defective,ot takes the capacity to reason (rationality) and to express its will..(autonomous and self-regulating will) which,for Kant,are the bases of HUMAN DIGNITY. -Joseph Fletcher does not only favor the expulsion of a terribly malformed fetus and the decision to terminate a SUBHUMAN LIFE IS EXTREMIS -A ulitarian may justify any act of communication to put an end tothe miserable life of a newborn with severe deformities with the following reasons;

1.PERSONAL a.the suffering of the infant b.the anguish of the parents c.the discomfort it brings to the family members 2.SOCIAL a.the monetary cost to society b.the deformed babys being liabilty rather than an asset to the community PRAGMATISTS MORAL PRINCIPLES OF; a.usefulness b.practically c.workability d.benificialitys

CHAPTER 8 REDEFINITION AND DETERMINATION OF DEATH -all living human being only man knows that he will die sometime,somehow,somewhere. -an advantage over other living organisms insofar as an individual is aware of his impending death and can prepare himself for it. -a disadvantage or a curse,on the other hand,precisely because,since he is aware of his imminenth death,man realizes the fertility of human existance,which make him anxious. a.no person can die by proxy b.we die our own death THE NEED TO REDEFINE DEATH -to redifine here means to know or to be able to determine the exact point in time where or when a person is dead. TWO IMPORTANT REASONS; 1.There is a widespread and increasing use of new devices for prolonging life. 2.There is a great demand for cadaver organ for transplantation. THREE OBVIOUS REASONS FOR DYING PERSONS; 1.To avoid paying the numerous expenses to be incurred. 2.To eliminate the suffering of the dying individual-to prolonged ones suffering in this context seems to do more harm than good,which is contrary to the principle of beneficence or non-malficence.

3.To be able to use the life-support machines for the patients who have better chances of survival,most specially if the demand to use them is greater than the supply. SEVERAL DEFINITION OF DEATH 1.PHYSIOLOGICAL DEFINITION -A person is dead when the heart has stopped beating.This is often called the traditional understandingof death. 2.RELIGOUS OR PHILOSOPHICAL DEFINITION -death means the separation of soul and body.People are said to be composed of body & soul. -the soul is viewed as the principle of life;it animates and gives from to the body;it makes distinctly human with rationality and freedom.when the soul departs from the body,the person ceases to be human. 3.BRAIN DEATH DEFINITION -A condition in which the brain is completely destroyed,and in which the cessation of function of all other organs are imment and inevilable. 4.CELLULAR DEFINITION -Refers to the desintegration and breakdown of the metabolic processes of the body substance. -considers the irreversible loss of no-cortical activity as the only significant criterion,because its eliminate all capabilities for consciousness and all social integration impossible. -EEG is needed for this definition. IN THE METHOD CONTEXT -brain death definition is very significant.Most suitable donor organs come from patient who die from injuries or disease of the brain. -in such patient,blood circulation may be artificially maintained after death,so that the organs needed can be extracted with the minimal ischemic damage. ATTITUDES TOWARD DEATH DEATH ARE CLASSIFIED INTO; 1.cognitive 2.affective 3.behavioral attitudes COGNITIVE ATTITUDES -which indicate how dying individual thinks about death include acceptable and denial.

AFFECTIVE ATTITUDES -which bear out the dying individual may include; a.depression b.sense of loss c.fear BEHAVIORAL ATTITUDES -Include anger or irritabilty,barganing,resentment,and fear.The dying person may become irratable,or may easily become emotionally upset without reason or cause. SEVERAL VIEWS OF DEATH NIKOLAI BERDYAW -A Russian Theologism,states only death can give meaning to life without death,life would be meaningless.meaning is bound up with the end. a.our last hope lies in death b.immortality can be attained only through death EPICURUS -The Athenean thinker,argus;either there is immortality or there is none. -then we should be glad there is death,for once we are dead we shall become immortal;if there is none,then death is our final liberation from pain and suffering. MARTIN HEIDEGGER -A German existentialist -views death as the completion of life,for unless and until one dies,ones life is not yet complete;hence his concept of man as being towards death. -sa kabaong at libingan anf lahat ay pantay-pantay;dukhat kardinal magkaparis kung mamatay. APPLICATION OF ETHICAL THEORIES -natural law ethics regards death as a part of nature,it declares that a person is dead once the soul leaves the body. -when all vital functions of the brain completely disappear or stop,extraordinary medical measure may not be necessary,but,infact,useless.it is morally wrong to prolong the suffering of the dying individual by means of life-sustaining machines in such circumstances. -Rawls concept of justice may also justify the unplugging of life-sustaining machine if and when they are no longer useful to the dying person.

CHAPTER 9 THE MORAL ISSUES OF PATERNALISM AND TRUTH-TELLING -In Ancient China.a Confucianist thinker named MENG TZE OR MENCIUS THERE ARE four beginning THAT DIFFERENTIATE MAN FROM THE BEASTS. 1.Thefeeling of helpfulness and commiseration,which is the beginning of human heartedness. 2.The feeling of shame and dislike,which is the beginning of righteousness. 3.The feeling of modesty and yielding,which is the beginning of propriety. 4.The sense of right and wrong,which is the beginning of wisdom. DEFINITION AND TYPES OF PATERNALISM -Latin pater father or paternus fatherly paternalism means the act of being fatherly to someone,as if the latter were ones own offspring. SEVERAL TYPES THAT DEFINE THE GENERAL IDEA OF PATERNALISM,AND INDICATE THEIR DIFFERENT ASPECTS. 1.with regard to the recipients welfare,paternalism may be either pure or impure.pure paternalism justifies intervention into a persons life for the sole welfare of that person. 2.with regard to the recipients defect and safety,paternalism may be either restricted or extended.Restricted paternalism support intervention which overrides an individuals action because of some defect or weakness in that individual. 3.with regard to the promotion of good and prevention of harm,paternalism may be either positive or negative. 4.with regard to the patient sense of values ,paternalism may be either soft or hard.In a sift paternalism act,the patient values are used to justify the intervention with his possible action or decision. 5.with regard to the recipient of the benifit,paternalism may be either direct or indirect.In the case of the former,the individual who should receive the supposed benefit is the one whose values overridden or disregarded for his own GOD. IN THE MEDICAL CONTEXT -We can speak of personal and state paternalism in its appliaction in the medical context; a.personal paternalism is one in which an individual decedes on the basis of ones best knowledge of what is good for another person. b.state paternalism,on the other hand,refer to the control exerted by the legislature,an agency,or governmental bodies over particular kinds of practices and procedures in medicine.

JUSTIFICATIONS FOR PERSONAL PATERNALISM 1.The recipient of the paternalistic act is sick and consults the physician seeking medical expertise and assistance. 2.The recipient of the paternalistic act has some incapacity which prevent him/her from making a decision. 3.To the best of ones knowledge and training,there is the probability of harm unless a paternal decision is made here one needs to determine if all harms are equal. 4.The probable benefit of paternal intervention outweight the probable risk of human from noninterference. 5.The physician ha san obligation to act in the best interest of the patient. 6.The patient,upon consulting the physician,voluntary transfer part of his/her autonomy to the latter based on faith in the physician. JUSTIFICATION FOR STATE PATERNALISM 1.To improve the good quality of medical education. 2.To upgrade a high standards of medical care. 3.To control drug addiction,other drug abuse,or the spread of AIDS and other sex-related disease. APPLICATION OF ETHICAL THEORIES -natural law ethics endorses both kinds of paternalism in the medical context;personal and state paternalism. -individuals are just moved by momentary passions and unforeseen circumstances to make happen.hazard decisions. -Kants concept of a person as a rational and autonomous agent,it seems that he might be against paternalism. -Rawls theory of social and political morality is compatible with state paternalism. -Utilitarianism endorses paternalism insofar as state laws and policies are justified by the principle of utility.Restricted individual liberty may promote the greatest benefit for the greatest number.. TRUTH-TELLING -When a patient agrees to place himself under the care of a doctor;the virtue of the fact the former.consults the latter for medical care,the power of the physician over the patient cannot be absolute. TWO APPROACHES TO THE TRUTH-TELLING ISSUE 1.person-centered 2.problem-centered

PERSON-CENTERED -The former lends importance to the patient as a person,while the latter stresses the nature of the problem,or the degree and severity of the patient illness. -The problem-oriented approach,on the other hand,considers the patient problem,illness or condition. TWO TYPE OF RELATIONSHIP 1. I- it and the 2. I-thou I-IT -relationship describes a persons relationship with things,object or its -man object,subject-object relationship -this kind of relationship is determined by ourattitude to what is other than ourselves. I-THOU RELATIONSHIP -on the other hand,delineates our relationship with other person,like ourselves,other subject. JUSTIFICATION FOR TRUTH-TELLING 1.It isargued that our human and moral qualities as persons is taken away from us if we are denied whatever knowledge is available about our condition as patient;as the case may be. 2.As patients,we have entrusted to the physician any knowlwdge he has about oueselves,so the facts are ours ano not his.hence to deny them to us is to steal from us. 3.The highest conception of the physicisn-patient relationship is personalistic one which is based on mutual confidence and respect for each others right. 4.To deny a patient pertinent knowledge about himself,especially in a life-and-death situation,to deprive him the sample time to prepare for his own death or to carry out responsibilities that are based solely on his decision or action. CONFIDENTIALITY -from the Latin confidence TO TRUST -refers here to medical or professional service in which certain information. -the moral issues of confidentiality arise if and when there is conflict between individual interest. FOUR CONDITIONS MAY BE CITED TO JUSTIFY THE VIOLATION OF CONFIDENTIALITY; 1.when keeping the secret would be detrimental to the common good. 2.when the subject of the secret intends to inflict grave injury upon an innocent third party. 3.when it is necessary for the subject of the secret to avert grave injury. 4.when it is necessary for the one keeping the secret to avoid grave injury.

CHAPTER 10 THE MORAL ISSUES OF PATIENTS RIGHT -Rights are necessary because every individual lives in a community of persons in relation NO MAN IS AN ISLAND MEANING OF PATIENTS RIGHT -In the medical context, a patient right means the moral and inviolable power vested in him as a person to do,hold,or demand something as his own. TYPES OF PATIENTS RIGHT 1.RIGHT TO INFORMED CONSENT -The patient has the right to recive all necessary information concerning diagnosis and treatment in order to be able to give consent based on his/her value system.informed consent refers to the knowledge or information about and the consent to a particular form a medical treatment,before the treatment is administered.the in formation should include the risks and advantages of any medical treatment that concerns the patient. 2.RIGHT TO INFORMED DECISION -Information and understanding are necessary for genuine deliberation.The patient cannot make a moral decision unless these two important elements are present. -INFORMED DECISION refers to the necessary INFORMATION OF AND DECISION ON a medical treatment before the latter is carried ouINFORMED DECISION refers to the necessary INFORMATION OF AND DECISION ON a medical treatment before the latter is carried out.The patient must be informed about the whole process and must understand what this information pertains to so that anappropriate moral decision can be arrived at. 3.RIGHT TO INFORMED CHOICE -INFORMED CHOICE refers to the necessary information a patient should know about a medical treatment or experiment so that a moral choice can be made.The patient has the right to be informed about all possible alternative courses of action to be taken,together with the possible consequences. -in short,as the patient consents to undergo treatment,he/she decides on it;as the patient makes a decision. FOUR MAJOR ELEMENTS OF INFORMED CONSENT 1.competence 2.disclosure 3.comprehension 4.voluntarines

4.RIGHT TO REFUSAL OF TREATMENT -In conjunction with the STATEMENT ON A PATIENTS BILL OF RIGHTS presented by the American Hospital Association,the patient has the right to refuse treatment to the extend permitted by law and to be informed of the medical consequences of his action LIMITATION OF A PATIENTS RIGHTS 1.Patients right do not include the right to be allowed to die. 2.A patients in a moribund condition does not possess the necessary mental or emotional stability to make an informed choice. 3.Patients rights are not absolute. IN THE MEDICAL CONTEXT -In actual medical practice in the Philippines,there are two methods of obtaining INFORMED CONSENT; 1. WRITTEN CONSENT -which is a consent form to be filled up and sugned by a patient as he/she chexks in for admission in a hospital 2.VERBAL CONSENT -whenever the patient verbally signifies his/her willingness to undergo medical treatment,informed consent is met.

TYPES OF PATIENTS NEED NOT REQUIRE INFORMED CONSENT; 1.comatose or obtunded patients 2.blind or illiterate patients 3.underaged patients or those unable to understand the circumstances 4.language-barrier patients THE RIGHTS OF PATIENTS 1.The patients has the right to considerate and respectful care. 2.The patient has the right to obtain from his physician complete current information concerning his diagnosis,treatment,and prognosis in terms that the patient can be reasonably expected to understand. 3.The patient has the right to recieve from his physician information consent prior to the start of any Procedure and/or treatment. 4.The patients has the right to refuse treatment to the extent permitted by law and to be informed of The medical consequences of his action. 5.The patients has the right to every consideration of his privacy concerning his own medical care Program.

6.The patients has the right to expect that all communications and records pertaining to his care should be treated as confidential. 7.The patients has the right to expect that,within its capacity,the hospital must provide a reasonable response to his/her request for services. 8.The patients has the right to obtain information regarding any relationship of his hospital to other health care and educational institutions insofar as his care is concerned. 9.The patients has the right to be advised if the hospital proposses to engage in or perform human experimentaional affecting his/her care or treatment.The patient has the right to refuse to participate in such research projects. 10.The patients has the right to expect reasonable continuity of care. 11.The patients has the right to examine and receive an explanation of the hospital bill,regardless of source of payment. 12.The patient has the right to know what hospital rules and regulation apply to his/her conduct as a patient. APPLICATION OF ETHICAL THEORIES -Natural law ethics regards the right to informed consent as morally legitimate.Should a patient decide to give his/her consent,it must be given freely and not the consequence of intimidation,deception,or coercion. -With Kants ethical principal that we must always be treated as ends and never only as means.patients must not be decieved by their physician,no matter how good their intentions may be. -Utilitarianisms principle of utility requires health care professional to design medical treatment in a way that minimizes suffering and harm. -Rawls principle of justice do not allow medical treatment or experiments that violate freedom which a patient is entitled to by virtue of being a member of society.

CHAPTER 11

THE MORAL ISSUES OF CONTRACEPTION AND STERILIZATION -The expression of the conjugal will of a man and a woman to parenthood is commonly called sexual intercourse,or coitus,the celebration of physical,mental,and spiritual intimacy.

MEANING OF CONTRACEPTION -The moral issue of contraception is concerned with the rightness or wrongness of the use of various methods by which CONCEPTION can be PREVENTED in the conjugal union. -contraception is thus defined as the voluntary prevention and conception by the positive used of artificial means which hinder the generative cells from uniting during the sexual act.

DEFINITION OF STERILIZATION -sterilization is also a form of contraception insofar as its purpose is the prevention of conception-not by the positive use of artificial methods but by cutting off the sexual capacity in a man or woman.Sterilization is thus defined as the mutilation of sexual power in a man or woman si as to render conception impossibel. -a sterilization permits coitus,but hinders conjugal act and can attain orgasm but cannot procreate. TYPE OF STERILIZATION 1.VOLUNTARY STERILIZATION -Is that in which a person will and requests that the procedure be done on himself or herself. 2.INVOLUNTARY STERILIZATION -Is that which is done by order of the public authority of the state. STERILIZATION IS EITHER; 1.therapeutic 2.eugenic or social 3.punitive 4.contraception THERAPEUTIC -means the removal of a reproductive organ or a portion thereof in order to save ones life or to promote bodily i ntegrity. -this is governed by the principle of totality which declares that an individual has a right to dispose of his organs or to destroy their capacity to function only to the extent that the general well being of the whole body demands.

CONTRACEPTIVE -is the intentional prevention of conception through sterilization.advocates of this type of sterilization cite the following justification. a.first,is serious illnessof either husband or eife-who may. Example; 1.be tubercular 2.epileptic 3.syphilitics 4.lepers b.second,is the probability of genetic abnormality.an individual for instance,who is contempleting marriage and who has been diagnosed to be a carrier of defectives genes may avail of contraceptive sterilization so that the birth ofmalformed can be prevented c.third,is severe financial burden d.fourth,is when child-bearing puts ones health in danger. EUGENIC AND SOCIAL -performed for the purpose of hindering the conception of undesirable and physically or mentally unfit offspring. PUNITIVE -on the other hand,is done as punishment for crime or anti-social behavior,particularly rape and other sex-related offenses. JUSTIFICATION OF CONTRACEPTION -proponents of family planning present the following reasons to justify; 1.Parenthood and birth are matters of moral responsibility and intellegent choice.Parenthood as a matter of personal and moral responsibility seeks to promote the condition for the maximum enjoyment of the good and happy life. 2.An individual should be the one to determine his/her fertility.and should be able to control his/her fecundity.Ones procreativity should not be left to fate or to the blind forces of nature. 3.One should be able to decide how many children one is able to bear and support. 4.Contraception technology makes men and women persons of will and decision,and not met merely inert and powerless bodies subject to church proscription or to the divine will. 5.Contraceptive checks the transmission of recessive disorders or genetically-linked disease.Procreation should be a responsible human activity. METHODS OF CONTRACEPTIVE OR FAMILY PLANNING A.FOLK METHODS -these methods have long been used for contraceptive purposes by the common tao-hence the nema.

a.PRECOITAL/POSTCOITAL DOUCHE -Vinegar and brine are prescribe as precoital douche.both substance are Highly spermical,although some people experience a burning sensation in the sensitive membranes of the genitals. b.PROLONGED LACTATION -An ancient method contraception is prolonged breastfeeding of babies.It is believed that the prolongation of milk secretion or production in the mother mammary glands will delay ovulation. c.WITHDRAWAL -One of the most frequently used methods pf contraception throughtout history in all parts of the world-even among fairly well-educated societies where more sophisticated method are available-is that of withdrawal or coitus interruptus.

MECHANICAL METHODS a.CONDOM -popularly known as the rubber the condom is a sheath of latex rubber which is put on the penis during intercourse to prevent the sperm from entering the uterus. b.DIAPHRAGM -A dome-shaped latex rubber membrane,the diaphragm is placed in the vagina to clesed the opening of the cervix to prevent entrance of the sperm. c.SPONGE -another variation of the diaphragm is the sponge.It is rectangular object with the string attached for easy removal.

CHEMICAL METHODS a.VAGINAL SUPPOSITORIES AND TABLETS -a small,bullet-shaped substance similar to paraffin or a piece of candle,a suppository contains chemicals capable of killing sperms. b.VAGINAL JELLIES,CREAMS,AND FOAMS -contraceptive jellies and creams are also inserted into the vagina shortly before copulation.Sold with a plastic applicator,vaginal foams are packaged with the butane propellant in the bottle. HORMONAL METHODS a.CONTRACEPTIVE PILLS -The pills is a combination of synthetic hormones,usually estrogen and progestin.It is taken daily for about 20-21 days each monthe starting on the day five after the beginning of the menstrual cycle.

b.INJECTIONS AND IMPLANTS -A biodegradable pill implant,which is one centimeter long and can be injected through a large-bore needle right through the mans skin,is a combination of hormones and cholesterol which works for up to three years and does not require surgery for insertion. ABORTIFACIENTS a.INTRAUTERINE DEVICE (IUD) -placed inside the uterus,the IUD is a small made of plastic or stainless does not prevent ovulation,nor does it prevent conception.;but it acn discontinue pregnancy. b.DIETHYLSTILBESTROL (DES) -Also known as morning.after pill,DES is the powerful hormone that forces the endometrium or uterine lining to shed. c.PROSTAGLANDIS -This is also a powerful hormone drug.When taken by mouth,injection or as a vaginal suppository,it causes a violent contraction of the uterus,pushing out whatever is inside it. d.ANTI-PREGNANCY VACCINE -This vaccine makes the woman produce antibodies that nuetralize human chorionic ganadotropin (HCG).HCG is the mechanism which is used to shut off the mothers menstrual period after conception. e.LOW DOSE TYPE OF CONTRACEPTIVE PILLS -To prevent ovulation,400 meg of ethinylestradiol.No contraceptive pill has such amounts of estrogen. SURGICAL METHODS a.TUBAL LIGATION -This is the cutting and tying of both Fallopian tubes,thus preventing the ovum from passing through the uterus,thus preventing the ovum from passing through the uterus. b.VASECTOMY -vas duct; ectomy to cut out -Male sterilization is called VASECTOMY,in which the vas deferans (spermatic cords) are cut off and tied so that the sperm coming from the testicle cannot pass through. c.HYSTERECTOMY -(hystero uterus ; ectomy to cut out -This refers to the complete removal of the uterus.Sometimes it is used as a method of sterilization rather than as a surgical operation for uterine pathology or malfunctioning. NATURAL OR BEHAVIORAL METHODS a.RHYTHM OR CALENDAR METHOD -This basedon the biological fact that a women experiences recurring cycles of fertility and nonfertility during each of her menstrual months. b.TEMPERATURE METHOD -This method (also Known as BASAL BODY TEMPERATURE)

-is used to indicate the time of ovulation. c.OVULATION (MUCUS) METHOD -known also as the billing method,in honor of Dr. John and Lyn Billings who developed it,this technique is based on the mucous discharge from the vagina as a sign of impending ovulation. d.SYMPTO-THERMAL METHOD -This is a combination of the temperature method and the mucus method with the other symptoms of pain or cervical changes.symptoms which may accompany ovulation include; a.pain in the right or left lower abdomen which may occur in some women at the time of ovulation. b.prior to ovulation,the cervix feels firm like the tip of the nose;toward ovulation,it becomes soft like the lips,opens,and rises. e.SEX RELATION DURING MENSTRUATION. -some consider copulation when a women is having her period as a NATURAL method of contraception,insofar as this is the time when the ovum is gone,and conception will not occur. APPLICATION OF ETHICAL THEORIES -Natural law moralists are divided on the issue of contraception.The neo-scholastic ethicians consider the natural order as designed by God,hence it is reality preceding man and any interference with this order is forbidden.. -majority of the members of the same commision,on the other hand,took the position that contraception does not conflict with human nature and the natural law if it is practiced to promote responsible parenthood. -it is argued that inasmuch as the rhythm or safe method is allowed by the encyclinical,it necessary follows that it. -Roman Catholic Church veiws voluntary sterilization as intrinsically wrong,insofar as it involves the frustration of natural power and function,hence is contrary to natural law. -Utilitarianism,with its principle of utility,may justify contraception and sterilization in terms of the great hapiness and benefits that they will ultimately bring forth.Pragmatism may likewise consider the practically,usefulness,and benifiality that the practice of contraception can provide for couples who want to limit the number of children that they can support and educate,wiyhout sacrificing the unitive element of their marriage. -according to Fletcher,to be artificial or against nature is often the highest good,in terms of moral values.All medicine and art and science,he argues,in an Interference with brute nature,using it or outwitting it,for the sake of HUMANLY CHOSEN ENDS.

CHAPTER 12 THE MORAL ISSUE OF ARTIFICIAL INSEMINATION -Both naturally and traditionally,procreation has been understood as human conception resulting from the sexual union of a man and a woman.Procreation always presupposes sex and vice-versa.This traditional,naturalistic outlook has also molded our thinking and moral values. -Thus,if morality is to be discovered in the bilogical nature of sexuality,the purpose of sex is much more intercourse for the sake of love than for conception.In other words,if there are more INFERTILE DAYS than FERTILE DAY in the menstrual cycle,then NATURE must have intended that sex is more for love making than for baby making,more for recreation than for procreation.It is more for UNITIVE element than for the PROCREATIVE element of marriage. -Another naturalistic view which has left a lasting grip on our moral attitude towards sex is that procreation is inseparable from sex.Modern biomedical science and technology:however,have made this naturalistic thingking absolute.We may now have BaBY MAKING WITHOUT LOVE MAKING.This is the moral issue of artificial insemination.

DEFINITION AND TYPES OF ARTIFICIAL INSEMENATION (AI) -Artificial insemination consists of depositing a man,s semen in the vagina,cervical canal or uterus,through the use of instruments (like syringe) to bring about conception unattained or unattainable by sexual intercourse.As the definition suggest,the process may be either INTRAVAGINAL(placing the semen in the vaginal vault),INTRACERVICAL (in the cervical cavity),or INTRAUTERINE (inside the uterud itself).Some AI specialists prefer fresh semen,oyher frozen,and still others use a mixture of both. THERE ARE SEVERAL METHODS OF EXTRACTING SEMEN FOR AI PURPOSES; 1.masturbation,after a short period of abstinence from ejaculation (3-12 days)-----the quality improved by a short of abstinence 2.condomistic intercourse 3.coitus interruptus 4.anal massage of the prostate gland 5.direct puncture of the epididymis(excretory duct of the testicle). -A Scottish Anatomist and Surgeon,John Hunter,carried out the first recorded successful human.AI,using a husbands semen,in London in 1785.

THERE ARE TWO BASIC TYPES OF AI 1.HOMOLOGOUS insemination (often called AIH),in which the semen is obtained from the husband himself.Artificial insemination by the husband. 2.HETEROLOGOUS insemination (AID), a technique in which the semen is acquired from a donor other than the husband.Artificial insemination by the donor. AID CAN BE CARRIED OUT THROUGH TWO DIFFERENT METHODS: 1.HOMOLOGOUS ARTIFICIAL INSEMINATION -A technique used to facilitate human conception through the transfer into a human vagina of the sperm previously extracted from her husband. 2.HOMOLOGOUS IVF and ET(in vitro fertilization and enbryo transfer) -a technique used to facilitate a human conception through in vitro fertilization of the generative cells(sperm and ovum) of a couple---the newly conceived embryo is transferred into the wifes uterus for gestation. JUSTIFICATION FOR AIH 1.husband impotence,the husband is incapable of erection,hence ejaculation which is necessary for fertilization is not possible. 2.anatomival defects of husbands urethra,the tube from the bladder conveying both urine and semen. 3.deficient sperm count or OLIGOSPERMIA,a defect in the quality of the sperm. 4.some types of spinal injury,and certain physical and psychological problems that hinder normal intercourse. 5.some husband who undergo vasectomy for contraceptive purposes have their semen stored for eventual use in the future,if for some unforeseen reason they decide ta have a child. 6.physiological obstructions in the genital apparatus of the wife. AID CAN BE CONDUCTED BY MEANS OF EITHER OF THE FOLLOWING METHODS; 1.HETEROLOGOUS artificial insemination -the technique used to obtain a human conception through the transfer into the genital tracts of the wife of the sperm previously extracted from a donor other than the husband. 2.HETEROLOGOUS IVF AND ET -the technique used to obtain a human conception through invitro fertilization of the generative cells(sperm & egg) taken from atleast one donor other than the two spouse in marriage.

JUSTIFICATION FOR AID 1.The husband is sterile(azoospermia) 2.The husband is a carrier of a hereditary disease. 3.The wifes oocyte are defective,or she may also ba a carrier of certain genetically-linked disorders;and 4.The wifes fallopian tubes are severely damaged by gonorrhea.

APPLICATION OF ETHICAL THEORIES -Natural law ethics,whose chief exponent is Roman Catholicism,consider AI to be immoral,insofar as tha AI child is not the fruit of the conjugal act as an expression of personal love.AI splits the sex unity of husband and wife in marriage as it transfer procreation into a biological laboratory where the UNITIVE MEANING of conjugal love is completly lost. -Natural law moralists claim that fertilization is licit only when it is the result of cinjugal act which is PER SE suitable for the generation of children to which marriage is ordered by its very nature and by which the couple have become one flesh. -be fruitful,and multiply,and replenish the earth,and subdue itbe fruitful but one cannot be fruitful with natural defects.