REVIEW OF MIDWIFERY ETHICS

ETHICS - came from the Greekword, ethos which means a characteristic way of acting. - suitably employed to designate the science of human act and of human conduct

Importance of ethics

Ethics teaches us to distinguish what is right from what is wrong. help us to make the right judgments and decisions and actions in different situations.

It

Ethical Theories

Are based on the previously explained ethical principles. Emphasize different dilemma and lead to the most ethically correct resolution according to the guidelines within the ethical theory itself. People usually base their individual choice of ethical theory upon their experiences

Natural Law

The system of natural law holds that man should live according to an inherent human nature

e.g. -ability to procreate, think, love, Bill of Rights

Deontology
Deontological theory states that people should adhere to their obligations and duties when analyzing an ethical dilemma Holds that the most important aspects of our lives are governed by certain unbreakable moral rules A person must follow his/her obligations to another individual/society because upholding ones duty is what is considered

Example: A midwife routinely assess and record the vital signs of the postpartum woman and the newborn.

A person who follows this theory will produce very consistent decisions since they will be based on individuals set duties.

Utilitarianism
This theory promotes good or valued ends. Instructs adherents to work for those outcomes the will give the most advantage to the majority of those affected in the most impartial way possible.

To a utilitarian, it is ethically correct if the choice that yields the greatest benefit to the most people

Types: 1. Act Utilitarianism - adheres exactly to the definition of utilitarianism - a person performs the act that benefit the most people, regardless of personal feelings or the societal constraints such as laws. Example: A midwife performs handwashing before and after performing internal examination.

2. Rule Utilitarianism - this takes into account the law and is concerned with fairness - a rule utilitarian seeks to benefit the most people but through the fairest and most just means available
Ex. The Midwife maintains confidentiality during the conduct of family planning counseling of a woman with HIV infection.

Virtue Theory

Ethical theory that judges a person by its character rather than by an action that may deviate from his normal behavior. It takes the persons morals, reputation and motivation into account when rating an unusual and irregular behavior that is considered unethical.

Rights
Rights ethical theory - rights set forth by a society that are protected and given the highest priority. Considered to be ethically correct and valid since a large or ruling population endorses them Individuals may also bestow rights upon others if they have the ability and sources to do so. Example: The Pregnant women refuses to undergo chemotherapy because she believes it can harm her baby.

Casuist Ethical Theory

One that compares a current ethical dilemma with examples of similar ethical dilemma and their outcome.

This allows one to determine the severity of the situation and to create the best possible solution according to others experiences.

Division of Ethics
General Ethics
refers to all diverse formulations of general and universal concepts and principles which serve as the foundation on morality. Deals with :
The ultimate end of man Human acts Morality of human acts Law of conscience Virtue in general

Determinants of Moral Quality of Actions

1. The OBJECT is the thing with which the action is essentially concerned. For example,: - lying, praying the rosary, stealing, helping a blind person across the street. For a morally good act, the object of it must be good, the is, the thing with which the action is concerned must conform to the law of God.

2. The CIRCUMSTANCES ARE SUCH THING AS THE PERSON INVOLVED, THE TIME, the place, the occasion, which are distinct from the object, but can change or completely after its moral tone. - Circumstances can make an otherwise good action as evil, as when a soldier on guard duty deliberately goes to sleep. Example: - A midw

3. The intention or END OR PURPOSE. For a human act to be morally good the agent or doer must have a good intention he must want to accomplish something that is good on one way or another. - The morality of many things that we do is determined by the intention such as walking,, talking, reading and so forth. Many such activities are said to be indifferent morally in them.

Law of Conscience or Natural Law

Law - ordinance of reason, promulgated for the common good by the one who has charge of a society.

- practical judgment of reason upon an individual act as good, or as evil and to be avoided.

Conscience - is a practical judgment of reason upon an individual act as good, or as evil and to be avoided.
Law of Conscience ensures that people cannot be forced to facilitate practices or procedures to which they object for reasons of conscience. They may include abortion, capital punishment, contraception, sterilization, artificial reproduction, euthanasia, assisted suicide, human experimentation, torture. etc

Virtue
Is a good habit that enables us to act accordingly to right reason, enlightened by faith It is a firm disposition to act according to Gods will and disregard the contrary impulse of our own will.

Four Cardinal Values: 1. Prudence able to judge b/w actions with regard to appropriate actions at a given time. 2. Justice proper moderation b/w selfinterest and the rights and needs of others. 3. Restraint/Temperance-practicing self-control, abstention and moderation 4. Courage or Fortitude- forbearance, endurance and ability to confront fear and uncertainty or intimidation.

Capital Virtues:
HUMILITY - virtue that counters pride. -as pride leads to other sin, true humility clears path for holiness -about modest behavior, selflessness and the giving of respect GENEROSITY - virtue of liberality is focused not merely on appropriate concern regarding ones earthly goods, but also on generosity and a willingness to give, freely and without request for commendation

CHASTITY -embraces moral wholesomeness and purity, and in both thought and action treats Gods gift of sexuality with due reverence and respect MEEKNESS -virtue of meekness focuses on patiently seeking appropriate resolution to conflicts, and on the ability to forgive and show mercy TEMPERANCE -virtue of temperance is centered on selfcontrol and moderation

KINDNESS -kindness, or love for ones neighbor in manifest in the unprejudiced, compassionate and charitable concern for others. DILIGENCE -manifest the appropriately zealous attitudes toward living and sharing the faith

APPLIED ETHICS - Applies the general concepts and principles but also specifies the particular situation in life in which they are valid and legitimate moral - Also called the special ethics
Deals with: Individual ethics - deals with duties to God; duties to one self and others Social ethics deals with right life, right to property and the right to marriage Political Ethics - deals with the state; the political authority and the international authority Professional Ethics branch of moral science which treats the obligations which a member of a profession owes to the public, to the profession, to his colleagues and client.

Ethical Framework for Decision Making

1.
2. 3. 4. 5.

Ethical System and Principles Patient Bill of Rights Professional Code of Ethic Institutional Policies Laws

Principles that will guide the Midwife in her Practice

1. THE GOLDEN RULE - Do unto others what you would like others to do unto you.

2. THE TWO-FOLD EFFECT - aims to provide specific guidelines for determining when it is ethically permissible foe a human being to engage in conduit of a good end with full knowledge that the conduct will also bring about bad results.

3. PRINCIPLE OF TOTALITY - an individual may not dispose of the organs or destroy their capacity to function, except to the extent that this is necessary for the general well-being of the whole body. 4. EPIKIA - Exception to the Rule