Midwife Licensure Exam Bioethics & Professional Conduct — Bioethics & Ethical Principles in NursingExam Answer Templates

Marks

1

Topic

Core Ethical Principles — Autonomy

Difficulty

easy

Template Id

T1

Examiner Tip

The word 'competent' is critical — examiners specifically check whether you limit autonomy to patients with decision-making capacity. Without it, the definition is incomplete.

Model Answer

Autonomy is the ethical principle that recognizes a competent patient's right to self-determination — the right to make informed decisions about their own body and care without coercion.

Question Type

very_short_answer

Answer Structure

• Line 1: State the definition clearly, including the key element of self-determination and competent patient [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing only 'patient choice' without mentioning competence or informed decision-making
• Defining autonomy as 'the nurse's decision-making' — autonomy belongs to the patient
• Using vague language like 'patient freedom' without linking to self-determination

Key Phrases To Include

• self-determination
• competent patient
• informed decision
• without coercion
• right to make decisions

Marks

2

Topic

Core Ethical Principles — Beneficence and Non-maleficence

Difficulty

easy

Template Id

T2

Examiner Tip

Examiners reward answers that show you know beneficence is active (do something good) while non-maleficence is a restraint (stop or avoid harm). The Latin phrase 'primum non nocere' (first, do no harm) for non-maleficence signals deeper knowledge.

Model Answer

Beneficence is the duty to actively do good and promote the patient's well-being (e.g., the nurse repositions a bedridden patient to prevent pressure injuries). Non-maleficence is the duty to do no harm and avoid injurious actions (e.g., the nurse verifies the 10 rights of medication administration before giving a drug to prevent medication errors).

Question Type

short_answer

Answer Structure

• Line 1: Define beneficence and provide one clear clinical nursing example [1 mark]
• Line 2: Define non-maleficence and provide one clear clinical nursing example [1 mark]

Scoring Breakdown

Common Mark Deductions

• Using the same example for both principles — each needs a distinct clinical illustration
• Reversing the definitions (writing non-maleficence definition for beneficence and vice versa)
• Giving a non-nursing example (e.g., a physician's act) when a nursing example is required

Key Phrases To Include

• duty to do good
• promote welfare
• do no harm
• primum non nocere
• prevent harm
• avoid injurious actions

Marks

2

Topic

Core Ethical Principles — Veracity

Difficulty

easy

Template Id

T3

Examiner Tip

Always link veracity to informed consent in your second line — this connection is almost always what earns the second mark.

Model Answer

Veracity is the ethical duty to tell the truth and to refrain from deceiving the patient. It is important because it is the foundation of the therapeutic nurse-patient relationship — patients can only make truly informed decisions (autonomy) and give valid consent when they receive accurate, complete information from their nurse. Without veracity, trust collapses and the process of informed consent becomes invalid.

Question Type

short_answer

Answer Structure

• Line 1: Clear definition of veracity as the duty to truth-tell and avoid deception [1 mark]
• Line 2: Explain its importance — link to informed consent, autonomy, or the therapeutic relationship [1 mark]

Scoring Breakdown

Common Mark Deductions

• Defining veracity as 'honesty' only without connecting to deception or the nurse's professional duty
• Giving importance without linking back to another principle (informed consent or autonomy)
• Confusing veracity with confidentiality

Key Phrases To Include

• duty to tell the truth
• avoid deception
• informed consent
• therapeutic relationship
• trust
• autonomy

Marks

3

Topic

Ethical Decision-Making — Dilemma vs. Moral Distress

Difficulty

medium

Template Id

T4

Examiner Tip

The distinction mark is the hardest to earn here. Write it as a direct contrast sentence: 'In a dilemma, the right action is unclear; in moral distress, the right action is clear but blocked.' This single sentence earns the third mark.

Model Answer

An ethical dilemma occurs when two or more ethical principles conflict and any choice requires sacrificing at least one of them, with no fully 'right' answer available. Example: A competent patient refuses a blood transfusion (autonomy) while the nurse recognizes that the refusal will cause death (beneficence) — both principles are legitimate, and a choice must be made. Moral distress, on the other hand, occurs when the nurse knows what the ethically correct action is but is prevented from carrying it out by institutional, hierarchical, or systemic barriers. Example: A nurse knows a physician's medication order is dangerously wrong but feels pressured not to question it because of the hospital's hierarchical culture. The key distinction is that a dilemma involves genuine uncertainty about what is right, whereas moral distress involves certainty about the right action but an inability to act on it.

Question Type

short_answer

Answer Structure

• Line 1: Define ethical dilemma — conflict between principles, no fully right answer [1 mark]
• Line 2: Give one clinical nursing example of an ethical dilemma [0.5 mark — usually bundled with next point]
• Line 3: Define moral distress — knows the right action but is blocked from performing it [1 mark]
• Line 4: Give one clinical nursing example of moral distress [0.5 mark — usually bundled]
• Line 5: State the key distinction between the two concepts [1 mark]

Scoring Breakdown

Common Mark Deductions

• Using the terms interchangeably without stating a clear distinction — loses the distinction mark
• Giving a dilemma example for moral distress or vice versa
• Failing to mention that in a dilemma the nurse is unsure what is right (not just unable to act)

Key Phrases To Include

• conflict between ethical principles
• no fully right answer
• moral distress
• knows the right action
• constrained from acting
• institutional or hierarchical barriers
• genuine uncertainty

Marks

3

Topic

Informed Consent

Difficulty

medium

Template Id

T5

Examiner Tip

The most-tested point here is the division of responsibility: the physician obtains consent, the nurse witnesses and confirms understanding. Write this explicitly — it is a common NLE trap.

Model Answer

Valid informed consent requires four elements: (1) Disclosure — the patient is given accurate information about the procedure, its purpose, expected benefits, material risks, and alternatives; (2) Comprehension — the information is given in language the patient understands, using an interpreter if needed; (3) Capacity/Competence — the patient can understand, reason, and communicate a decision; and (4) Voluntariness — the decision is free from coercion, manipulation, or undue influence. The nurse's role in the consent process is to witness the patient's signature, verify that the patient understands the information already given by the physician, and notify the physician if the patient appears confused, has unanswered questions, or seems to be under pressure. It is the physician performing the procedure who is responsible for obtaining consent; the nurse's role is to confirm comprehension, witness, and document.

Question Type

short_answer

Answer Structure

• Lines 1–2: List and briefly describe all four elements of valid informed consent [2 marks — 0.5 per element, typically awarded as 2 marks for all four]
• Line 3: State the nurse's specific role — witness, confirm understanding, notify physician if needed [1 mark]

Scoring Breakdown

Common Mark Deductions

• Stating that the nurse obtains informed consent for surgical or medical procedures — this is the physician's responsibility
• Listing only three of the four elements
• Confusing the nurse's witnessing role with the physician's obtaining-consent role

Key Phrases To Include

• disclosure
• comprehension
• capacity
• voluntariness
• witness the signature
• verify understanding
• notify the physician
• physician is responsible for obtaining consent

Marks

3

Topic

Core Ethical Principles — Justice

Difficulty

medium

Template Id

T6

Examiner Tip

Using the term 'distributive justice' instead of just 'justice' signals higher-order knowledge and almost always earns the definition mark. Filipino NLE scenarios frequently involve disaster triage or limited government resources — practice this application.

Model Answer

Justice is the ethical principle of fairness in the distribution of benefits, burdens, and scarce resources. It requires that patients receive care based on clinical need and established criteria, not on personal wealth, social status, political connections, religion, or ethnicity. In a Filipino government hospital with only one available ICU bed and two critically ill patients, the principle of distributive justice requires that the allocation decision be made transparently using objective clinical criteria — such as severity of illness, likelihood of benefit, and urgency of need — rather than on the basis of who the patient knows or can pay. The nurse's role is to advocate for fair allocation, participate in triage according to established protocols, and report any discriminatory practices that violate justice.

Question Type

short_answer

Answer Structure

• Line 1: Define justice — fairness in distribution, based on need not status [1 mark]
• Line 2: Apply to the Philippine context — describe the scenario and the fair allocation criteria [1 mark]
• Line 3: State the nurse's specific role in upholding justice in this context [1 mark]

Scoring Breakdown

Common Mark Deductions

• Defining justice only as 'fairness' without linking to distribution of resources or non-discrimination
• Not applying the principle to a specific clinical or Philippine context
• Omitting the nurse's role, which costs the third mark

Key Phrases To Include

• distributive justice
• fairness
• based on clinical need
• not on wealth or status
• transparent allocation
• triage
• objective criteria
• non-discrimination

Marks

1

Topic

Informed Consent — Implied and Emergency Consent

Difficulty

easy

Template Id

T7

Examiner Tip

Mention 'doctrine of emergency' to signal you know the legal basis, not just the concept. One correct circumstance earns full marks for a 1-mark item.

Model Answer

Implied consent is a form of consent inferred from the patient's actions or from the circumstances of a genuine emergency. It applies in two situations: (1) when a patient extends an arm for a routine procedure (e.g., blood pressure measurement), signaling non-verbally that they agree; and (2) in life-threatening emergencies where the patient is unconscious or incapacitated, no surrogate is available, and immediate treatment is necessary to preserve life — governed by the doctrine of emergency.

Question Type

very_short_answer

Answer Structure

• Line 1: Define implied consent and state the two circumstances where it applies [1 mark — any one circumstance earns the mark; both earns full credit]

Scoring Breakdown

Common Mark Deductions

• Confusing implied consent with verbal (express) consent
• Stating that implied consent always applies in any situation the nurse deems necessary — it is specifically for emergencies or routine non-invasive acts

Key Phrases To Include

• inferred from actions
• non-verbal agreement
• emergency
• unconscious
• no surrogate available
• doctrine of emergency
• life-threatening

Marks

3

Topic

Autonomy — Competent Refusal of Treatment

Difficulty

medium

Template Id

T8

Examiner Tip

The NLE frequently tests whether you know that respecting autonomy does not mean abandoning the patient. Always state that care continues even after a refusal — this distinguishes a competent ethical response from simple non-interference.

Model Answer

The guiding ethical principle is autonomy — the right of a competent adult to make informed decisions about his own body and care, including the right to refuse treatment. The nurse should respond by: (1) Assessing whether the refusal is truly informed — ensuring the patient has received and understood complete information about his diagnosis, the purpose of chemotherapy, expected benefits, risks, and the consequences of refusing treatment; (2) Respecting the decision once it is confirmed to be informed and made without coercion — the nurse does not attempt to override or emotionally manipulate the patient into accepting treatment; and (3) Documenting the refusal, notifying the physician and health team, and ensuring the patient signs an 'Against Medical Advice' (AMA) form if applicable. The nurse continues to provide supportive care, advocate for the patient's comfort, and ensure he has access to alternative or palliative options. Respect for autonomy does not mean abandonment — it means honoring the patient's choice while continuing compassionate care.

Question Type

case_study

Answer Structure

• Line 1: Identify the governing ethical principle — autonomy [1 mark]
• Line 2: Describe nursing actions — assess informed refusal, respect the decision, do not coerce [1 mark]
• Line 3: Address documentation, notification, and continuing care obligations [1 mark]

Scoring Breakdown

Common Mark Deductions

• Saying the nurse should 'convince' or 'persuade' the patient to accept chemotherapy — this violates autonomy
• Not mentioning documentation or physician notification — these are mandatory nursing obligations
• Failing to identify the ethical principle by name

Key Phrases To Include

• autonomy
• competent adult
• right to refuse treatment
• informed refusal
• assess comprehension
• no coercion
• document the refusal
• notify the physician
• AMA form
• continue supportive care

Marks

2

Topic

Non-maleficence — Principle of Double Effect

Difficulty

medium

Template Id

T9

Examiner Tip

Use a palliative care example (high-dose morphine for pain in terminal illness) — it is the most recognized and accepted example in Philippine nursing ethics texts and always earns the example mark.

Model Answer

The principle of double effect states that an action intended to produce a good outcome may be ethically permissible even if it also causes a foreseen but unintended harmful side effect, provided four conditions are met: the action itself is good or morally neutral, the good effect is intended (not the harm), the harm is not the means by which the good is achieved, and the benefit outweighs the harm. Clinical example: Administering high-dose opioid analgesia to a terminally ill patient to relieve severe pain is ethically justified even though it may hasten respiratory depression, because the intent is pain relief (good effect), not to cause death (harm), and the patient's dignity and comfort outweigh the risk.

Question Type

short_answer

Answer Structure

• Line 1: Define the principle of double effect — include the key condition that harm is foreseen but unintended, and benefit outweighs harm [1 mark]
• Line 2: Provide a clear, relevant clinical nursing example with the intended good and foreseen harm both named [1 mark]

Scoring Breakdown

Common Mark Deductions

• Describing double effect without stating that the harm is unintended (foreseen but not desired)
• Using an example where harm is the means to the good — this violates double effect
• Confusing double effect with euthanasia — they are legally and ethically distinct

Key Phrases To Include

• foreseen but unintended harm
• intended good effect
• benefit outweighs harm
• harm is not the means
• palliative sedation
• opioid analgesia
• ethically permissible

Marks

2

Topic

Core Ethical Principles — Fidelity

Difficulty

easy

Template Id

T10

Examiner Tip

Examiners look for the word 'promise' or 'commitment' in fidelity answers — always use at least one of these in your definition to signal you know the core concept.

Model Answer

Fidelity is the ethical principle of faithfulness — keeping promises, honoring commitments, and maintaining loyalty to the patient and to the professional nurse-patient relationship. Two examples: (1) A nurse promises a post-operative patient that she will return in 30 minutes with pain medication and follows through on that promise; (2) A nurse maintains strict confidentiality of a patient's HIV status, sharing information only with the care team on a need-to-know basis, thereby honoring the trust the patient placed in the therapeutic relationship.

Question Type

short_answer

Answer Structure

• Line 1: Define fidelity — faithfulness, promise-keeping, honoring commitments [1 mark]
• Line 2: State two distinct nursing examples that illustrate fidelity in practice [1 mark — both examples needed for full credit]

Scoring Breakdown

Common Mark Deductions

• Defining fidelity as 'being a good nurse' without the specific concept of promise-keeping or loyalty
• Giving only one example when two are asked
• Confusing fidelity entirely with confidentiality — confidentiality is one expression of fidelity, not synonymous with it

Key Phrases To Include

• faithfulness
• keeping promises
• honoring commitments
• loyalty
• therapeutic relationship
• maintaining confidentiality
• following through

Marks

5

Topic

Ethical Decision-Making Process

Difficulty

hard

Template Id

T11

Examiner Tip

For a 5-mark answer, you need approximately one paragraph per two steps, plus an introduction and conclusion. Use the exact step names (Assess, Identify, Explore, Apply, Act, Evaluate) — these are markers the examiner scans for. Mentioning RA 9173 and the ethics committee in Step 4 almost always earns the application mark.

Model Answer

When a nurse encounters an ethical dilemma — a conflict between two or more ethical principles where any choice requires sacrificing at least one — a structured decision-making process ensures a reasoned, defensible, and patient-centered resolution. The six-step process is as follows: Step 1 — Assess: Gather all relevant information — the medical facts, the patient's clinical condition, the patient's own values and expressed wishes, the legal context, and the perspectives of the family and interdisciplinary team. Incomplete information leads to poor ethical decisions, so this step must be thorough. Step 2 — Identify: Clearly name the ethical problem and the principles in conflict. For example: 'The conflict is between the patient's autonomy (right to refuse dialysis) and the nurse's beneficence (duty to preserve life). This step prevents the nurse from acting on assumption rather than principle. Step 3 — Explore Options: List all possible courses of action — do not eliminate options prematurely. For each option, analyze the potential consequences for the patient, family, team, and institution. Consider what each ethical principle (autonomy, beneficence, non-maleficence, justice) would support. Step 4 — Apply: Apply relevant ethical principles, the PRC Code of Ethics for Registered Nurses, and applicable Philippine law (e.g., RA 9173, RA 10173). Consult the hospital ethics committee if the case involves end-of-life decisions, DNR orders, or withdrawal of life support. The nurse contributes clinical and psychosocial information and advocates for the patient's expressed wishes. Step 5 — Act: Implement the chosen course of action. Document the decision-making process, the rationale, the parties consulted, and the action taken. Communication with the patient, family, and health team must be clear, respectful, and transparent. Step 6 — Evaluate: Assess the outcome for the patient. Reflect on what went well and what could be improved. Use the experience to guide future ethical practice and professional development. Ethical reflection is a mark of a morally mature practitioner. Throughout this process, the nurse's primary obligation is to the patient as advocate — ensuring that the patient's rights, dignity, and expressed wishes are represented even in the most complex clinical and institutional environments.

Question Type

long_answer

Answer Structure

• Introduction (2-3 lines): Define ethical dilemma and state that a structured process is needed [context marks]
• Steps 1–6: Each step named, briefly defined, and applied with a clinical illustration — 1 mark for every 1–2 correctly described steps
• Conclusion (1-2 lines): Summarize the nurse's advocacy role throughout the process

Scoring Breakdown

Common Mark Deductions

• Listing the steps without describing what each involves — names alone earn minimal marks
• Omitting the documentation aspect of Step 5 (Act) — documentation is a legally required nursing obligation
• Not mentioning the ethics committee or professional code in Step 4
• Writing the steps out of order or skipping evaluation entirely
• Failing to mention the nurse as patient advocate at any point in the answer

Key Phrases To Include

• assess
• identify the ethical problem
• explore options
• apply ethical principles
• act and document
• evaluate and reflect
• ethics committee
• PRC Code of Ethics
• patient advocate
• RA 9173
• principles in conflict

Marks

5

Topic

Veracity, Autonomy, and Cultural Considerations in Filipino Nursing

Difficulty

hard

Template Id

T12

Examiner Tip

This is a high-frequency NLE scenario. The winning answer acknowledges Filipino culture without surrendering patient rights. The phrase 'How much would you like to know about your condition?' directed at the patient is the key clinical action that demonstrates both cultural sensitivity and ethical soundness — always include it.

Model Answer

This situation presents a conflict between the patient's right to veracity and autonomy and the family's culturally motivated request for non-disclosure. Understanding the Filipino healthcare context is essential: cultural values such as pakikisama (maintaining harmony), utang na loob, and the family-centered decision-making tradition are deeply embedded in Filipino health behavior and must be respected without compromising the patient's rights. Step 1 — Assess the situation: The nurse must first determine the patient's competence — whether he or she is a mentally competent adult capable of understanding and processing the information. The nurse also assesses what the patient already knows or suspects about the condition, and explores the family's specific concerns and reasoning. Step 2 — Identify the ethical conflict: The principles in tension are veracity (the patient's right to truthful information), autonomy (the patient's right to make informed decisions, including those about end-of-life care), and beneficence as interpreted by the family (protecting the patient from emotional harm). There is also a risk of violating the patient's right to plan for death, say goodbyes, and resolve unfinished life matters. Step 3 — Explore options: The nurse considers whether a family meeting can be arranged to discuss concerns respectfully; whether the patient can be gently asked what information they wish to receive (giving them control over the disclosure process); and whether a palliative care team or social worker can mediate. Step 4 — Apply principles and professional standards: Under the PRC Code of Ethics for Registered Nurses and the principle of veracity, the nurse's primary duty is to the competent patient. A competent adult has the right to receive his or her diagnosis. However, the nurse can honor both family and patient by first asking the patient: 'How much would you like to know about your condition?' This patient-centered approach respects autonomy while accommodating cultural sensitivities. The physician should be involved immediately as disclosure of diagnosis is primarily the physician's responsibility; the nurse supports the process and advocates for the patient. Step 5 — Act: The nurse facilitates a family-physician-patient meeting, advocates for truthful communication delivered compassionately and at the patient's preferred pace, ensures the patient is not deceived, and provides emotional support throughout. The nurse does not personally withhold the truth from the patient if the patient directly asks. Step 6 — Evaluate: The nurse monitors the patient's and family's emotional response, ensures ongoing support is available, and documents the process including the family's concerns, the actions taken, and the patient's response. The key ethical principle is that a competent patient's autonomy and right to truthful information supersede family wishes, but the manner of delivering truth should be culturally sensitive, compassionate, and guided by the patient's own expressed preferences about information.

Question Type

case_study

Answer Structure

• Opening paragraph: Identify the ethical conflict — veracity/autonomy vs. family's non-disclosure request in Filipino cultural context [1 mark]
• Body paragraphs: Apply the structured ethical decision-making process — assess competence, identify principles, explore options [1 mark]
• Application of professional standards: Reference PRC Code of Ethics, patient-centered questioning approach, physician involvement [1 mark]
• Action plan: Family meeting, advocacy, compassionate disclosure, nurse's role boundaries [1 mark]
• Cultural sensitivity + conclusion: Acknowledge Filipino values without compromising patient rights; patient autonomy is primary [1 mark]

Scoring Breakdown

Common Mark Deductions

• Siding entirely with the family and recommending non-disclosure — this violates veracity and autonomy and loses multiple marks
• Ignoring Filipino cultural context entirely — the answer must show cultural competence
• Not involving the physician — disclosure of diagnosis is primarily the physician's responsibility
• Failing to mention asking the patient about their own information preferences — this is the highest-scoring clinical action

Key Phrases To Include

• veracity
• autonomy
• competent patient
• right to know
• Filipino cultural values
• pakikisama
• family-centered decision-making
• patient-centered approach
• PRC Code of Ethics
• physician's responsibility
• nurse as advocate
• patient preference for information

Marks

2

Topic

Confidentiality and Privacy — RA 10173

Difficulty

medium

Template Id

T13

Examiner Tip

Citing RA 10173 by name and number is mandatory for full marks on any question about patient data privacy. Mentioning social media as a common violation context is a contemporary addition examiners reward.

Model Answer

Under RA 10173 (Data Privacy Act of 2012), health information is classified as sensitive personal information and is afforded the highest level of protection. The nurse's obligations are: (1) to collect, use, and share patient health data only for legitimate care purposes and only to those who need the information to provide care (need-to-know basis); and (2) to obtain the patient's consent before sharing information except in legally mandated situations such as mandatory reporting of notifiable communicable diseases to the Department of Health. Unauthorized disclosure of patient information — including posting clinical details on social media or sharing with unauthorized individuals — constitutes a violation of the Data Privacy Act and may result in professional and criminal liability.

Question Type

short_answer

Answer Structure

• Line 1: Identify health data as sensitive personal information under RA 10173 and state the need-to-know principle [1 mark]
• Line 2: State exceptions (mandatory reporting, legal obligation) and consequences of unauthorized disclosure [1 mark]

Scoring Breakdown

Common Mark Deductions

• Not citing RA 10173 by name — generic statements about 'patient privacy' without the legal reference lose the mark
• Stating that confidentiality is absolute without acknowledging legally mandated exceptions
• Not mentioning consequences of violation

Key Phrases To Include

• RA 10173
• Data Privacy Act of 2012
• sensitive personal information
• need-to-know basis
• consent
• mandatory reporting
• unauthorized disclosure
• professional and criminal liability

Marks

3

Topic

Advocacy and Ethical Principles

Difficulty

medium

Template Id

T14

Examiner Tip

Structure your answer so each principle gets its own clause or sentence — examiners scan for the three names (autonomy, beneficence, fidelity) and mark each individually. Using the word 'operationalizes' signals conceptual mastery and typically impresses examiners.

Model Answer

The nurse as patient advocate is the professional positioned closest to the patient and charged with voicing and protecting the patient's interests within the healthcare system. The nurse advocates by informing patients of their rights, supporting informed decisions, protecting patients from incompetent or unethical practice, and speaking up when care is unsafe. Advocacy operationalizes three core ethical principles simultaneously: It upholds autonomy by ensuring that the patient's own wishes — not the physician's or family's preferences alone — drive care decisions. It expresses beneficence by actively working toward the patient's well-being and removing barriers to receiving quality care. It demonstrates fidelity by honoring the commitment and loyalty owed within the therapeutic nurse-patient relationship — the nurse remains trustworthy and follows through on promises to represent the patient's interests.

Question Type

short_answer

Answer Structure

• Line 1: Define the nurse's advocacy role — protecting patient interests, informing rights, speaking up for safety [1 mark]
• Line 2: Link advocacy to autonomy — patient's wishes are protected, not overridden [0.5 mark] and to beneficence — active promotion of well-being [0.5 mark]
• Line 3: Link advocacy to fidelity — loyalty and commitment of the therapeutic relationship [1 mark]

Scoring Breakdown

Common Mark Deductions

• Defining advocacy only as 'helping the patient' without linking to specific ethical principles
• Linking advocacy to only one principle when the question asks for all three
• Confusing the nurse's advocacy role with the physician's role or the family's role

Key Phrases To Include

• patient advocate
• informing patients of their rights
• speaking up for safety
• autonomy — patient's wishes
• beneficence — promoting well-being
• fidelity — loyalty and commitment
• therapeutic relationship
• protecting from incompetent practice

Marks

2

Topic

End-of-Life Bioethical Issues — Euthanasia and DNR

Difficulty

medium

Template Id

T15

Examiner Tip

The phrase 'allowing natural death' for DNR vs. 'intentionally causing death' for euthanasia is the core distinction examiners test. Write these as a direct contrast sentence to maximize clarity and marks.

Model Answer

Active euthanasia — the deliberate act of causing a patient's death to end suffering — is not legal in the Philippines and is ethically prohibited under the nursing Code of Ethics and Philippine law. A Do-Not-Resuscitate (DNR) order, by contrast, is a legally and ethically permissible decision, made by the patient or authorized surrogate in consultation with the physician, to withhold cardiopulmonary resuscitation in the event of cardiac or respiratory arrest. DNR does not mean withdrawing all care — the patient continues to receive comfort, pain management, and dignified nursing care. The fundamental difference is intent: active euthanasia involves an intentional act to end life, while a DNR order allows natural death to occur without artificial prolongation.

Question Type

short_answer

Answer Structure

• Line 1: State the legal and ethical status of active euthanasia in the Philippines — not legal, prohibited [1 mark]
• Line 2: Define DNR and state the key distinction — allowing natural death vs. actively causing death [1 mark]

Scoring Breakdown

Common Mark Deductions

• Stating that DNR means 'stopping all care' — a serious error; only CPR is withheld, other care continues
• Confusing passive euthanasia with a DNR order
• Not specifying that active euthanasia is illegal in the Philippines specifically

Key Phrases To Include

• active euthanasia is not legal in the Philippines
• deliberately causing death
• DNR — Do-Not-Resuscitate
• allowing natural death
• withhold CPR
• comfort care continues
• intent
• artificial prolongation