Midwife Licensure Exam Bioethics & Professional Conduct — Bioethics & Ethical Principles in NursingConcept Map

Concept

Core Ethical Principles

Sub Concepts

• Autonomy (Self-determination)
• Beneficence (Do good)
• Non-maleficence (Do no harm)
• Justice (Fairness)
• Veracity (Truth-telling)
• Fidelity (Faithfulness)

Relationship To Central

Foundation of all ethical decision-making in nursing

Concept

Ethical Frameworks & Theories

Sub Concepts

• Deontology (Duty-based)
• Teleology/Utilitarianism (Consequence-based)
• Principlism (Four-principle framework)
• Double Effect Principle

Relationship To Central

Philosophical approaches to resolving dilemmas

Concept

Informed Consent

Sub Concepts

• Disclosure
• Comprehension
• Capacity/Competence
• Voluntariness
• Express Consent
• Implied Consent
• Emergency Doctrine

Relationship To Central

Process operationalizing autonomy and veracity

Concept

Confidentiality & Privacy

Sub Concepts

• Need-to-know basis sharing
• RA 10173 Data Privacy Act
• Legal exceptions to confidentiality
• Duty to warn vs. confidentiality

Relationship To Central

Protects patient autonomy and trust

Concept

Patient Advocacy

Sub Concepts

• Informing patients of rights
• Supporting patient decisions
• Protecting from unsafe practice
• Speaking up against unethical care

Relationship To Central

Nurse's professional duty to protect patient interests

Concept

Ethical Dilemmas & Moral Distress

Sub Concepts

• Ethical dilemma definition
• Moral distress definition
• Conflict between principles
• Structured resolution process

Relationship To Central

Common challenges in clinical practice requiring resolution

Concept

Common Bioethical Issues

Sub Concepts

• End-of-life care & DNR orders
• Reproductive & beginning-of-life ethics
• Truth-telling & cultural mediation
• Resource allocation & triage
• Whistleblowing

Relationship To Central

Real-world applications of ethical principles

Concept

Cultural Context in Philippine Nursing

Sub Concepts

• Family-centered decision-making
• Pakikisama (smooth relations)
• Utang na loob (gratitude debt)
• Deference to authority figures
• Respect for patient autonomy within culture

Relationship To Central

Shapes how ethics are applied in Filipino healthcare

Concept

Professional & Legal Framework

Sub Concepts

• RA 9173 (Nursing Practice Act)
• Code of Ethics for Nurses
• Professional accountability
• Scope of nursing practice

Relationship To Central

Grounds ethical practice in nursing law

To

Informed Consent

From

Autonomy

Strength

strong

Relationship

Autonomy is operationalized through the informed consent process; consent requires respect for the patient's right to self-determination

To

Non-maleficence

From

Beneficence

Strength

strong

Relationship

Both are duty-based principles; beneficence promotes good while non-maleficence prevents harm; both guide clinical judgment

To

Informed Consent

From

Veracity

Strength

strong

Relationship

Truthful disclosure is essential to valid informed consent; without veracity, comprehension and voluntariness cannot be assured

To

Patient Advocacy

From

Fidelity

Strength

strong

Relationship

Fidelity (faithfulness and trust) is the foundation of the therapeutic relationship; it motivates advocacy for patient interests

To

RA 10173 Data Privacy Act

From

Confidentiality

Strength

strong

Relationship

RA 10173 legally codifies the nursing ethical duty of confidentiality; it establishes compliance requirements for health data protection

To

Resource Allocation

From

Justice

Strength

strong

Relationship

Justice principles guide fair distribution of limited healthcare resources, especially critical in triage and disaster settings

To

Structured Decision-Making

From

Ethical Dilemma

Strength

strong

Relationship

When ethical principles conflict, a systematic assess-identify-explore-apply-act-evaluate process resolves dilemmas

To

Patient Advocacy

From

Moral Distress

Strength

strong

Relationship

Moral distress arises when institutional barriers prevent the nurse from acting ethically; advocacy and escalation resolve the constraint

To

Non-maleficence

From

Double Effect Principle

Strength

moderate

Relationship

Double effect justifies a foreseen harmful side effect when the primary intent is good and benefit outweighs harm; applied in palliative sedation

To

Autonomy

From

End-of-Life Ethics

Strength

strong

Relationship

Patient autonomy (choice of DNR, palliative care, or full code) is central to ethical end-of-life decision-making

To

Non-maleficence

From

DNR Orders

Strength

moderate

Relationship

DNR respects the patient's refusal of potentially harmful or futile resuscitation; it prevents unnecessary suffering

To

Cultural Context

From

Family-Centered Decision-Making

Strength

strong

Relationship

Filipino culture emphasizes family involvement; ethical nursing balances family-centered practice with patient autonomy protection

To

Cultural Context

From

Pakikisama & Utang na Loob

Strength

moderate

Relationship

These cultural values (smooth relations, gratitude debt) influence how Filipino patients and families engage with healthcare decisions

To

Professional Accountability

From

RA 9173 Nursing Practice Act

Strength

strong

Relationship

RA 9173 defines the scope of nursing practice and grounds professional accountability; violations are a breach of the nurse's legal duty

To

All Ethical Principles

From

Code of Ethics for Nurses

Strength

strong

Relationship

The professional Code of Ethics incorporates all ethical principles; it serves as the standard for judging ethical conduct

To

Non-maleficence

From

Deontology

Strength

moderate

Relationship

Deontological ethics emphasizes duty; non-maleficence (do no harm) is a fundamental duty in nursing

To

Justice

From

Teleology/Utilitarianism

Strength

moderate

Relationship

Utilitarian thinking seeks greatest good for greatest number; justice distributes benefits and burdens fairly to maximize overall good

To

Informed Consent

From

Consent for Minors

Strength

moderate

Relationship

Parents/guardians provide consent for minors; however, adolescents' developing autonomy may be respected through assent

To

Implied Consent

From

Emergency Doctrine

Strength

moderate

Relationship

When patient cannot consent and no surrogate is available, emergency doctrine permits life-saving treatment based on implied consent

To

Patient Advocacy

From

Whistleblowing

Strength

strong

Relationship

Whistleblowing is a form of advocacy; it protects patients from unsafe or unethical practice when internal reporting fails

To

Confidentiality

From

Duty to Warn

Strength

strong

Relationship

Duty to warn identifiable third parties at serious risk can override confidentiality when the threat is imminent and specific

To

Confidentiality

From

Mandatory Reporting

Strength

strong

Relationship

Legal duty to report abuse, communicable diseases overrides confidentiality; nurse must balance patient privacy with public safety

To

Ethical Dilemma

From

Ethics Committee

Strength

moderate

Relationship

Ethics committees provide structured consultation and deliberation for complex dilemmas; they support nurse decision-making

To

Cultural Context

From

Reproductive Ethics

Strength

moderate

Relationship

Filipino reproductive decisions are heavily influenced by religion and family values; nurses navigate ethical issues within this context

To

Justice

From

Triage in Disaster

Strength

strong

Relationship

Fair allocation of scarce resources (beds, ventilators, personnel) during disasters is guided by justice principles and transparent criteria