Ethical, moral and legal considerations In the
practice healthcare profession
Morality VS. ethics
MORALITY
 Greek word: “Mos” = Customs
 Latin Word: “Moralitas” = Beliefs
 Morality is a system of beliefs
about what is right and wrong thing to
do.
 Its relies on an authority such a Divine
Being, or it can be politically or
personally driven.
 Its what the majority perceives right
and wrong.
“The ideas we believe about being right and
wrong”
ASSOSCIATED TERMS FOR MORALITY
 Customs – long established practices
common to a particular group of people
 Habit – applies to an individual and
implies the repetition of the same action
as to develop a natural, spontaneous or
rooted tendency or inclination to
perform it.
 Etiquette – means observance of social
norms as required by good breeding
WHAT IS ETHICS?
 Is a branch of philosophy
dealing with values
relating to
human, with respect to the rightness
and wrongness of certain actions and t
o the
goodness and
badness of the motives and
ends of such actions.
 It’s a system of moral principles that is
based on values and reasoning.
“The laws, rules, principles and codes that
governs doing right and wrong”
OBJECTIVES OF ETHICS
1. Make clear to us why one act is better
than other
2. Enable us to live and have an orderly
social way of life.
3. Appraise, criticize and evaluate
intelligently the moral conduct and
ethical system
4. Explore and aspire to the true value of
life.
Medical ethics
 The code of behavior considered to be
correct for members of the medical profession
 Examines the questions of rights and
wrongs in the practice of medical
profession.
 Medical ethics involves examining a
specific problem, usually a clinical case,
and using values, facts, and logic to
decide what the best course of action
should be.
 Ethical decisions should respect the
values and attitudes of patients.
PILLARS OF MEDICAL ETHICS
Autonomy
Beneficence
Confidentiality
Do not harm/ non-malificence
Equity or justice
 Code of ethics of the MEDICAL
TECHNOLOGY profession
1. Accept the responsibilities of being a
professional
2. Uphold the law at all times
3. Equality to all
4. Camaraderie among the profession
5. Respect to the employer
6. Work integrity
7. Sharing of expertise
8. Contribute to the advancement of the
profession
9. Respect for others
10. Stick to the law of confidentiality
11. Uphold the dignity of the profession
12. Promote life and protect human dignity
ISSUES IN MEDICAL ETHICS
THE SANCTITY OF HUMAN LIFE
“Is human life sacred?”
 RELIGIOUS/THEISTIC APPROACH
 Human life has dignity and it is sacred
because it is a gift from God.
 God is the source and ultimate
guarantor of the sanctity of life.
 RATIONAL/ HUMANISTIC APPROACH
Sacredness of life is generated of being alive
and experiencing elemental fear of its extinction
• 3 STAGES OF HUMAN LIFE THAT MUST
BE PROTECTED
1. The Beginning of Life
 Contraception, Family planning,
Conception & Abortion
2. The Middle Life
 Genetic Testing, Treatment of diseases
3. The End of Life
 Death and Euthanasia
CONTRACEPTION & FAMILY PLANNING
 Classified into two forms: Artificial
contraception & Natural Family
Planning.
 Artificial Contraception is the most
effective way of family planning.
 This involves the use of contraceptives:
Pills, Condoms, IUD, injectable
 Natural Family Planning/Contraception
does not involves external materials and
factors but depends on the natural cycle
of fertility in women, respect and
commitment.
 This involves: Calendar method, Coitus
Interuptus
ETHICAL AND MORAL ISSUES
 Religious groups considers
contraception as ethical accepted but
immoral according to church teaching.
 They believe that sex is sacred and is
done for conception.
 Health practitioners promotes artificial
way of contraception and believes that
those are both moral and ethical.
 Efficiency of contraception is achieved
by using the contraceptives.
CONCEPTION AND ABORTION
 Theistics believes that conception and
procreation begins in the sexual union
of man and woman.
 Scientists describes conception
happens when an egg and sperm has
united and is developed and deposited
in the uterus.
 There are many ways of artificial
conception that is being utilized and
advised medically.
 Baby-making, Rent-a-womb,
Insemination & In-Vitro Fertilization,
Sperm, Egg and Embryo Banking
 Sperm, Egg & Embryo Banking
 Freezing and preservation
of sperm cells, egg cells and
zygote at low temperature,
technically known as
“Cryopreservation”
 Moral Justifications
1. Overcoming infertility
2. Serves as fertility insurance for males
undergoing vasectomy.
3. Used for research on genetic diseases
and reproductive processes
4. Further studies about sex selection for
eugenic reasons
 INSEMINATION & IN-VITRO
FERTILIZATION
 INSEMINATION is an artificial
introduction of sperm to the
vagina. Sperm donor collects
the sperm and is given to either
wife or surrogate mother.
IN-VITRO FERTILIZATION is as the laboratory
fertilization of two generative cells inside a test
tube and the zygote is then deposited back to
the mother. This is controversial because one or
more embryo are produced and only one is
deposited to the mother.
 SURROGACY involves a biomedical
technique whereby a fertilized embryo
is implanted into the uterus of another
woman who will carry the baby to term
either as a favor or for a fee.
 It is precisely a financial ag-
reement between the
surrogate and the couple.
 It is referred to as
“ Rent-a-womb”
 Some of these end up in
wrangling and heartbreak
on both sides.
 CHILD SEX DETERMINATION
 The primary justification for
selecting the sex of a child is
in the control of sex-linked
and sex-influenced diseases.
 Secondary justification because is
contemplated reduction of birth rate
and accumulation of scientific
knowledge about human production.
 Third and most important of all is the
happiness of the parents.
 Pre-sexual determination usually ends
up in abortion
 ABORTION is the expulsion of
a living fetus from mother’s
womb before it is viable.
 In medical parlance “it is the
termination of pregnancy
 spontaneously or by induction prior to
viability.
 Spontaneous abortion is a natural
process that happens due to problems
on genes and hormonal imbalance.
 Induced abortion occurs as a result of
artificial or mechanical interruption or
due to voluntary and effective human
intervention
GENETIC ENGINEERING & INTERVENTIONS
• Genetic Engineering refers to the
biochemical studies or chromosomal
analysis for purposes of detecting
genetically caused diseases.
• This includes genetic testing, genetic
control, genetic therapy, genetic
surgery and cloning.
• GENETIC SCREENING & TESTING
 is another procedure whose main
purpose is to screen, choose or select
the genes for proper detection of any
genetic diseases and other
chromosomal activities or
malformation.
 If a fetus is seen with these
abnormalities these ends up usually
with abortion.
• GENETIC THERAPY
 Treatment of diseases that involves
genetic modifications and redesigning
to produce a healthy offspring or
product
CLONING
 this is derived from the
word “twig” in Greek
 Denotes asexual reproduction,
or replication of an organism.
 Cells maybe cloned by growing
them in the culture under
conditions that promote cell
reproduction.
 Moral Justifications & Issues:
1. It can prevent genetic diseases
2. It can provide immortality
3. It can create super-organism
TRANSFUSION, TRANSPLANTATION AND
TISSUE CULTURE
 BLOOD TRANSFUSION is a common
medical procedure performed which is
an introduction of an allogenic or
autogenic blood to a patient to answer
a medical problem.
 Not all people gives full agreement on
blood transfusion. Some sect and
groups declines blood transfusion
because for them “blood is sacred and
cannot be transferred from one person
to another”
 ORGAN DONATION & TRANSPLANT it
is the replacement of an organ which is
damaged or dysfunctional
 The organs that are commonly
transplanted are kidneys, cornea and
skin.
 KINDS OF TRANSPLANTATION
1. Autograft– transplantation to own self
2. Homograft – transplantation of an
organ from one individual to another
individual in one specie
3. Heterograft/Xenograft –
transplantation of an organ from one
specie to another specie
4. Isograft – transplantation of compatible
tissues between two genetically
identical persons
 MORAL AND ETHICAL PROBLEMS FOR
SELECTION OF DONORS
 The consent of the donor and his
voluntarily submission as the organ
donor
  The determination of the exact moment
of death of the donor, before
proceeding to the extraction of organs
 The legal nature of the cadaver, e.g.,
who has the responsibility, authority or
power over it, who can decide its use
for therapeutic purposes
 TISSUE CULTURES
 Geneticists can do tissue culture to
study genes and growth of
microorganisms.
 This is commonly employed specially
when cells are tested against drugs and
other therapeutic processes.
 Most controversial of all tissue
culture cells are the HeLa Cells
which was taken from a
Black American woman
(Henrietta Lacks) who
was suffering from cervical
cancer.
 The cells were taken, propagated and
experimented without her consent or
even he family.
DEATH AND EUTHANASIA
 Death is the end stage of life. It is the
passing form this world.
 Death is determined as lifeless which is
shown as no signs of breathing and
voluntary movement.
 When will we consider someone as
dead?
1. Breathing is not observed for more than
an hour
2. No voluntary responses
3. Brain and heart activity stops fully
 Who pronounces someone as dead?
 Physicians or medical practitioners are
considered and has the right to
pronounce death to patients or
someone that is non-responsive or
considered as clinically dead.
 EUTHANASIA
 is defined as the intentional killing of a
dependent human being, by act or
omission, for his or her alleged legal
benefit.
 Derived from Greek word eu = good &
thanathos = death
 This word was used in 1623 by a man
named Francis Bacon.
 The word is used today to signify that
procedure which facilitates death and
liberates one from all types of pain,
provoking death of the hopeless patient
and suppressing “useless” human lives.
 Who are subjected to euthanasia?
1. Elderly 3.
Patients that has
2. Terminally-ill patients hopeless cases
 CLASSIFICATIONS OF EUTHANASIA
1. Suicidal euthanasia – it is called as such
when the subject himself (alone or with
the help of others) resorts to lethal
means to end such life.
2. Homicidal Euthanasia
a. Pious Euthanasia
b. Social or Eugenic Euthanasia
3. Orthanasia – The subject is left to die by
omitting any medical assistance.
4.Painless Death
5. Voluntary and Non-voluntary Euthanasia
6. Euthanasia by action – lethal injection
7. Euthanasia by omission – intentional death
by not providing basic necessities such as food
& water
Moral evaluation of euthanasia
 Gravely illicit because it implies
homicide
 Gaudium et Spes, no 2 : “ Anything
that goes against life itself ; homicide,
euthanasia, genocide, abortion is evil
and undermines human civilization,
degrade those who practice it more
than those who suffer from it”
 “The right of life is a fundamental
right”
 “Euthanasia with patient consent is
suicide and without his/her consent is
homicide” – Pope Paul VI
Legal issues in HEALTHCARE PROFESSION
LAWS GOVERNING PATIENT RIGHTS
1. Article III, Section 1 of the 1987
Constitution
“No person shall be deprived of life, liberty, or
property without due process of law, nor shall
any person be denied the equal protection of
the laws.”
2. Universal Healthcare Bill
“All Filipinos will automatically be enrolled into
the National Health Insurance Program”
3. Magna Carta of Patient’s Rights and
Obligations Act of 2017
“It is hereby declared that the policy of the state
to promote right to health of the people and
instill health consciousness among them and it
shall likewise protect and enhance right of all
people to human dignity”
4. Data Privacy Act of 2012
CHAPTER 5, SEC 20
“The personal information controller must
implement reasonable and appropriate
organizational, physical and technical measures
intended for the protection of personal
information against any accidental or unlawful
destruction, alteration and disclosure, as well
as against any other unlawful processing.”
PATIENT RIGHTS
1. Right to good quality health care,
humane treatment and dignity
2. Right to be informed of his rights and
obligations as a patient.
3. Right to choose healthcare provider and
facility
4. Right to informed consent
5. Right to refuse diagnostic and medical
treatment
6. Right to refuse participation in Medical
research
7. 9. Right to Privacy and Confidentiality
8. 10. Right to Leave
9. 11. Right to correspondence and to
visitors
10. 12. Right to express grievances
11. 13. Right to Information and records
12. 14. Right to safety and healthy safe
workplace
13. 15. Right to an Equitable and
Economical use of resources
RIGHT TO INFORMED CONSENT
 Informed consent should be clear,
truthful and contains substantial
explanation, in a manner and language
understandable to the patient.
 It should comprise all proposed
procedures whether diagnostic,
 preventive, curative, rehabilitative or
therapeutic.
 It also includes the name and the
credentials of the person who will
perform the procedure.
 All information such as possibilities of
any risk of mortality or serious side
effects, problems related to
recuperation, and probability of
success and reasonable risks involved.
 Consent doesn’t go out of date
GUIDELINES OF THE INFORMED CONSENT
1. Informed consent shall be obtained
from a patient concerned if he is of
legal age and of sound mind.
2. In cases when the patient is, mentally
incapable and minor, a third party is
required:
a. Spouse
b. Son or daughter of legal age
c. Either parent
d. Brother or sister of legal age
e. Guardian
f. Court (in cases of litigation)
3. Cases that does not require patient consent:
a. Emergency cases
b. When the health population is
dependent on the adoption of a mass
health program to control epidemic
c. When the law submits everyone to
undergo a procedure
d. When disclosure of material
information to the patient will
jeopardize success of treatment
e. When the patient waives his right in
writing
Patient privacy & confidentiality
 Privacy of the patient must be assured
always at all stages of the laboratory
procedures.
 The right of privacy shall include right
not to be subjected to exposure,
private or public, either by
photography, publications,
videotaping, discussion or by any
means that reveals sensitive
information about the patient.
 All identifiable information about
patients health status, laboratory
results, diagnosis, prognosis and
treatment must be kept confidential
even after death.
WHEN CAN CONFIDENTIALITY BE BREACHED?
 The patient who is in sound mind and of
legal age is only allowed to obtain those
information personally.
 Disclosure of the patient information
can be without his consent is allowed in
following situations:
a. When the patient’s medical or physical
condition is in controversy in a court
litigation
b. When public safety so demands
c. When the patients medical condition is
discussed in scientific forum for the
benefit and advancement of science
and medicine; provided that his/her
identity should not be revealed
d. When it is otherwise required by law
Patient privacy & confidentiality
e. When the patient or in his capacity, his/her
legal representative or the patient wives his
right.
 Who are allowed to be patient’s legal
representatives?
 1. Spouse 4. Do not violate patients privacy and
2. Son or daughter of legal age confidentiality.
3. Either parent
4. Brother or sister of legal age 5. Maintain blood collection area with
5. Guardian (close family kin/relative) appropriate supplies, especially for safety
6. Presiding Judge (in cases of litigation) concerns.

MALPRACTICE & NEGLIGENCE 6. Exhibit good listening and critical thinking

skills.
• NEGLIGENCE
7. Report and document the incident
 When the healthcare worker who is on immediately.
duty of care, has failed in that duty and
as a consequence injury or death arisen. 8. Act professionally at all times.
 Violation of duty to exercise reasonable
skill and care performing tasks

• MALPRACTICE

 Improper or unskillful care of a patient

by an healthcare worker, or any
unreasonable lack of skill or
professional misconduct

Cases resulting from negligence and

malpractice in phlebotomy

1. Patient misidentification
2. Hematomas
3. Infection to the puncture site
4. Patient injury from fall
5. Fainting
6. Nerve damage
7. Emotional distress
8. Professional misconduct

How to minimize law suit

1. Perform the proper standards according to

the laboratory protocol.

2. Perform the collection procedures according

to national standards.

3. Obtain informed consent in a proper manner.