MODULE 1: Theories and

Principles of Health
Ethics
Introduction

This module is about Health Care Ethics applied to various professional health care fields. It is
also about the ethics of the health care consumers since the patient must make the most serious ethical
decisions of all.

Ethics is that branch of philosophy that seeks to determine how human actions may be judged
right or wrong. When the study of ethics is applied to a professional field, it becomes necessary to
discuss not only basic ethical positions, but also the nature of the profession and the conditions under
which that profession operates.

The study of ethics as a branch of philosophy implies that the human mind is the fundamental
means by which actions may be judged. The judgment itself may arise from the nature of or principles of
reason (as in Kant, 1984) or from experience. Ethics is not the same as moral theology or religious ethics,
sine common human experience as its point of departure. Ethics need not be taken as an attack on
religiously founded morality which for the believer has a superior validity.

Learning Objectives

● Integrate relevant principles of social, physical, natural and health sciences and humanities in a
given health and nursing situation.
● Apply the concepts of the different ethical theories in specific scenarios
● To gain understanding of the concepts of ethics
● Introduction to contrasting theoretical ethical approaches

At the start of the module, you are to take Pre - Assessment Test to see how much background
information and knowledge you have.

This module is self – instructional. You can read, analyze concepts and ideas presented and relied on
them. The Activities and Self – Check Questions will help you assess how you progress as you go through
the module.

Your answers to the Self – Check Questions and Activities may be self -evaluated by your facilitator if you
so desire. These will be part of your formative evaluation. Do not write your answers in this module. Your
answers should be written in a separate notebook.

This answer key to the Self – Quick Questions and Activities are found at the end of this module. The
post assessment will be given in a separate booklet upon completion of the module. It will serve as the
summative evaluation of your performance.

Remember, you are to work on this module independently. I shall not be around to supervise you as you
go through each lesson. It is expected that you will make the most of this module and grow
professionally in your desire to become a competent Nurse, determined to make a difference.

Pre – Assessment Test

Multiple Choice:

1. What is the teleological theory?

a. theory which suggests that patients needs are based upon the financial means
b. a theory that suggests older patients receive less competent care
 c. a theory wherein a nursing facilities overall morale will determine the level care patients
receive
d. a theory wherein the end or outcome justifies the means
2. Ethics is:
a. a formal process of making illogical and consistent decisions based upon one’s beliefs
b. a formal process of making logical and random decisions based upon moral beliefs
c. a formal process of making logical and consistent decisions based upon religious beliefs
d. a formal process of making logical and consistent decisions based upon moral beliefs
3. Florence Nightingale was a champion:
a. model for all nurses b. social reformer
b. nurse c. all of the above
4. Kant’s first form of the categorical imperative is derived from the nature of moral obligation as
universally binding
a. True b. False
5. According to Kant the shopkeeper who charges an equal price of all her customers because she
likes them is acting “out of duty”
a. True b. False
6. The reason why it is wrong to make a lying promise according to Kant is because this act cannot
be willed as a general practice without contradiction.
a. True b. False
7. Which writes was a major proponent of the theory of utilitarianism?
a. Jeremy Bentham c. Immanuel Kant
b. Karl Marx d. John Rawls
8. Utility can be defined as:
a. usefulness, in opposition to pleasure c. fulfillment of animalistic desires
b. pleasure and the absence of pain d. a constant state of rapturous excitement
9. Utilitarianism dictates that actions are morally good
a. when they promote the actor’s interests and well – being
b. when they are performed by a virtuous person
c. when they promote general happiness
d. when they reflect the following of a just principle regardless of the consequences
10. Which of the following is not teleological?
a. obeying moral laws regardless of the consequences
b. creationism
c. prayer
d. saving money
 Lesson 1:
Ethical
Theories

What is Ethics?

▪ Ethics is the concept of interpreting morality

✔ How should we behave?
✔ What choices should we make about how we live our lives?
✔ What do we consider acceptable in our society?

What Factors Affect How We Find Answers?

▪ Religions
▪ Intuitive Feelings
▪ Cultural Norms
▪ Laws and Policies
▪ Professional Codes of Conduct
▪ Coercion

“Ethics is the enterprise of disciplined reflection on the moral intuitions and moral choices that people
make”
(Veatch, 1989, p1)
DEONTOLOGICAL ETHICS
The second class of ethical theory, deontology, is very powerfully expressed in the work of
Immanuel Kant. Kant thought ethics should be as clear and firmly based as mathematical knowledge and
just as a mathematical truth (two plus two is four) is universally true, so is ethical truth.
Deontologists hold that lying is wrong even if a lie would accomplish great good for individuals and
society because lying involves disrespecting the person to whom you are lying.

● Immanuel Kant (1724 1804)

✔ A brilliant German thinker – study Deontologism
✔ Kant maintains that one acts morally (performs a moral act), if and only if one does
whatever one is obliged to do.

https://www.youtube.com/watch?v=8bIys6JoEDw&t=24s
 ▪ Derived from the Greek work “deon” meaning “duty”
▪ Deontology is a category of normative ethical theories that encompasses any theory which is
primarily concerned with adherence to certain rules or duties.
Types of Duties:
1. perfect – must always observe, irrespective of time, place or circumstances; should not harm or
inflict injury upon others.
2. Imperfect – must observe only on some occasions – should show love and compassion
occasionally to others based on our own choice.
In other words:
▪ Deontological theories hold that actions that are morally right are those in accordance with
certain rules, duties, rights or maxims.
▪ Actions can be morally good require, permitted or forbidden
Examples of Deontological Theories
✔ The Golden Rule”
✔ Kantian Ethics (Categorical Imperative)
● The Golden Rule
o Also knows an the ethic of reciprocity, this famous cross – cultural maxim states: “do to
others as you want them to do to you.”
● Agent Centered Deontology
o Theories focused on the duties of the moral agent (the person acting). Rather than the
rights of the person being acted upon (patient – centered theories).
o Agent centered theories can be further divided into those that focus on the mental state
of the agent and those that focus on the nature of the agent’s actions.
● Agent – Centered Theories: Mental States
o An action is wrong or right because of the intentions that motivated it.
o Catholic doctrine of double effect: We are categorically forbidden for intending to cause
evils) Such as killing the innocent, even in order to prevent other evils. However, it is
acceptable to cause evils unintentionally, even if we foresee them as effects of our
actions.
Case Example:
In a Deontological context, contraceptives look quite different. Sexual activity for the sake of pleasure
is both intensely individual (the pleasure) and not particularly in need of reasons. The partner is a
means to the end and need not be accorded the respect due a rational being. Thus, for a deontologist,
 it is possible to look at contraception as wrong because it violates the obligation to never use a person
simply as a means. if contraception is used in the context of marriage or at least an abiding
commitment to one;s partner, then it is possible that the partner is respected as a person as well as an
opportunity for pleasure. In which case contraception might be acceptable. This is a difficult analysis
for the society, since as we suggested above, the deontologist would find it difficult to talk of a
common good that would trump the discussion of the individual’s rights or personal dignity.

● Agent – Centered Theories: Actions

o We are categorically forbidden to cause evils (such as killing innocents) directly, but are
permitted to allow, enable or accelerate them under some circumstances.

Utilitarianism

The first class of ethical theories, consequentialism, see the rightness or wrongness of an action in terms
of the consequences brought about by that action. These consequences are generally evaluated
according to the extent to which they serve same intrinsic good – good in and of itself. The most
common, but not the only form of consequentialism is Utilitarianism. Utilitarianism or Social
Consequentialism holds that one should act so as to do the greatest good, for the greatest number.

https://www.youtube.com/watch?v=uvmz5E75ZIA&t=183s

Ethical Judgments

● Ethical philosophy differs from the sciences because it is normative or prescriptive, rather than
descriptive.
● In other words, ethics tell us how we ought to act or what we should do, while the sciences are
more likely to observe how things are in nature or society.

Making Ethical Judgments in Utilitarianism

● Utilitarianism says that the Result or the Consequence of an Act is the real measure of whether
it is good or bad.
● This theory emphasizes Ends over Means

Bentham’s Formulation of Utilitarianism

Man is under two great
masters, pain and pleasure
The great good that we
should seek is happiness
 Four Theses of Utilitarianism

● Consequentialism: the rightness of actions is determined solely by their consequences.

● Hedonism: Utility is the degree to which an act produces pleasure. Hedonism is the thesis
that pleasure or happiness is the good that we seek and that we should seek.
● Maximalism: a right action produces the greatest good consequences and the least bad.
● Universalism: The consequences to be considered are those of everyone affected, and
everyone equally.

John Stuart Mill’s (1806 – 1873)

Mill defines utilitarianism as a theory based on

the principle that "actions are right in proportion
as they tend to promote happiness, wrong as they
tend to produce the reverse of happiness." Mill
defines happiness as pleasure and the absence of
pain. ... The theory of utilitarianism has been
criticized for many reasons.
Mill had a lifelong goal of reforming the world in
the interest of human well - being

Mill argued that the lower pleasure were of

the mind and the higher of the body. He felt that, after the lower bodily needs were met we could
attend to the higher spiritual, moral, cultural pleasure. (Who decides? Only someone who’s experienced
both)

Two Types of Utilitarianism

Act: An Action is right if and only if it produces the greatest balance of pleasure over pain for the
greatest number. (Jeremy Bentham)

Rule: An Action is right if and only if it conforms to a set of rules the general acceptance of which would
produce the greatest balance of pleasure over pain for the greatest number. (John Stuart Mill)

Application of Utilitarian Theory

o You attempt to help an elderly man cross the street. He gets across safely.
Conclusion: the act was a good act.
o You attempt to help an elderly man cross the street. You stumble as you go, he is knocked into
the path of a car, and is hurt.
Conclusion: The Act was a bad act.

Case Example: Analysis of Contraception

The basic idea of contraception is to prevent a pregnancy arising from sexual intercourse. A utilitarian
will hold at contraception from the perspective of the concerns of the individual or the society. The
individual may want the pleasures of sexual activity without any commitments to carrying or raising a
child. Pleasure is understood as an appropriate end and thus contraception, as a means of preventing
contraception is a good to be chosen. A society may perceive population growth as a burden because,
for example, the added population is projected to exceed its capacity to house or feed the increase. On
the other hand, if the individual desires a child, or the society wants to encourage population growth,
contraception would be a bad choice. Contraception itself is neither good nor bad, rather it acquires its
value because of the larger end that is pursued.

Teleology Ethics

Teleology

o Teleology, from the Greek word telos, meaning “purpose” or “end,” is the study of goals, ends,
purposes, and destinies–if they exist, but few philosophers believe they do. Humans and other
organisms have purposes and goals that drive their behavior.
o Teleological ethics (also known as consequentialism) from the Greek world telos meaning
goal, claims that the “rightness or wrongness of an act is exclusively a function of the
goodness or badness of the consequences of that act.
o The notion of “consequence” refers to all the things that a specific action/behaviors on
behalf of an individual causes.

https://www.youtube.com/watch?v=6FzlBlifDYM&t=102s

● Teleology or
Consequentialism
is referred to as
results - oriented
ethics.
● It focuses on the
purpose of each action and whether there is an intention or meaning for the action.
● It deals with the consequences/utility of an action.
● it involves examining past experience in order to figure out the results of present actions.
● an example of teleology is utilitarianism which is also referred to as the greatest happiness
principle.
● While deontology is based on man’s absolute Duty towards mankind and how it is given
priority over results
● Teleology is based on the results of an action and on whether an action produces greater
happiness and less pain.
● Teleology examines past experiences in order to predict the results of a present action.

https://www.youtube.com/watch?
time_continue=26&v=Xa6c3OTr6yA&feature=emb_logo
A recurring them in the Star Trek film franchise, first voiced by the ever-logical Mr. Spock is that “the
needs of the many outweigh the needs of the few,” justifying a variety of heroic sacrifices and risks. This
idea embodies teleological ethics, or consequentialism, as discussed in section five. The end results of an
action—the salvation of many lives—justifies the sacrifice of one life in the present (first Spock’s, and
later Kirk’s).

Activity 1:
What does Kant mean by a
'categorical imperative'?
Why does Kant believe that the
imperatives of morality must be
categorical, in the sense in which he
uses the term?
Pre – Assessment Test
Multiple Choice:

1. What is the teleological theory?

a. theory which suggests that patients needs are based upon the financial means
b. a theory that suggests older patients receive less competent care
c. a theory wherein a nursing facilities overall morale will determine the level care patients
receive
d. a theory wherein the end or outcome justifies the means
2. Ethics is:
a. a formal process of making illogical and consistent decisions based upon one’s beliefs
b. a formal process of making logical and random decisions based upon moral beliefs
c. a formal process of making logical and consistent decisions based upon religious beliefs
d. a formal process of making logical and consistent decisions based upon moral beliefs
3. Florence Nightingale was a champion:
a. model for all nurses
b. nurse
c. social reformer
d. all of the above
4. Kant’s first form of the categorical imperative is derived from the nature of moral obligation as
universally binding
 a. True b. False
5. According to Kant the shopkeeper who charges an equal price of all her customers because she
likes them is acting “out of duty”
a. True b. False
6. The reason why it is wrong to make a lying promise according to Kant is because this act cannot
be willed as a general practice without contradiction.
a. True b. False
7. Which writes was a major proponent of the theory of utilitarianism?
a. Jeremy Bentham c. Immanuel Kant
b. Karl Marx d. John Rawls
8. Utility can be defined as:
a. usefulness, in opposition to pleasure c. fulfillment of animalistic desires
b. pleasure and the absence of pain d. a constant state of rapturous excitement
9. Utilitarianism dictates that actions are morally good
a. when they promote the actor’s interests and well – being
b. when they are performed by a virtuous person
c. when they promote general happiness
d. when they reflect the following of a just principle regardless of the consequences
10. Which of the following is not teleological?
a. obeying moral laws regardless of the consequences
b. creationism
c. prayer
d. saving money

I can do I can do this but I I am learning I can not

this very need to learn how to do do this yet
Competence well more and improve this (Novice)
(Expert) (Practitioner) (Apprentice)

Define Ethics

Define Consequentialism

Define Utilitarianism

Discuss Teleology Ethics

Differentiate Deontology vs
Utilitarianism

Resources:

1. Harold W. Baillie, John F. Mcceehan, Thomas M. Garrett, Rosellen M. Garrett 2018, Health Care
Ethics Sixth Edition, Mind Mover Publishing House, Inc. Manila
2. https://www.slideshare.net/clhendricksbc/js-mill-utilitarianism
3. https://www.youtube.com/watch?v=8bIys6JoEDw&t=24s
4. https://www.youtube.com/watch?v=uvmz5E75ZIA&t=183s
5. https://www.youtube.com/watch?v=6FzlBlifDYM&t=102s