Patient Rights and Autonomy

 Should patients have the absolute right to refuse life-saving medical

treatment?

https://web.senate.gov.ph/lisdata/2577422144!.pdf
- Senate Bill NO. 1402
AN ACT PROCLAIMING THE RIGHTS AND OBLIGATIONS OF PATIENTS,
PROVIDING A GRIEVANCE MECHANISM THEREOF AND FOR OTHER
PURPOSES EXPLANATORY NOTE
Every person shall be given appropriate health care based on their
needs and must not be deprived of their right without discrimination
regardless of their social status. Thus, this bill seeks to ensure the
rights of Filipino people to proper healthcare, protect their wellbeing,
and instill health consciousness among them. As part of the society, it
is only just to provide them with a decent quality health care they
deserve without prejudice. All patients must be treated fairly and
equally, human dignity, convictions, integrity, individual needs and
culture shall be respected, especially to those who are underprivileged
who doesn't have the means to afford one. Patients' needs to be
informed as well insofar their rights and moral obligations are
concerned, through the Department of Health, upon the enactment of
this act, it is their duty to conduct a nationwide campaign to raise
awareness of the people's right as patients.

Section 4. Right to Good Quality Health Care and Humane

Treatment –
Every person has a right to a continuity of good quality Health
Care without discrimination and within the limits of the
resources, manpower and competence available for health and
medical care. In the course of such care, his human dignity,
convictions, integrity, individual needs and culture shall be
respected. If a Patient cannot immediately be given treatment
that is medically necessary, he shall be informed of the reason
for the delay and be treated in accordance with his best
interests: Provided, that the treatment applied shall be in
accordance with generally accepted medical principles.
Emergency Patients shall be extended immediate medical care
and treatment without requiring, as a prerequisite thereof, any
pecuniary consideration.
c. Right to be Informed of His Rights and Obligations as a
Patient –
Every person has the right to be informed of his rights and
obligations as a Patient. In line with this, the Department of
Health, in coordination with Health Care Providers, professional
and civic groups, the media, health insurance corporations,
people's organizations and local government organizations, shall
launch and sustain a nationwide information and education
campaign to make known to the people their rights as Patients,
as provided in this Act. It shall also be the duty of Health Care
Institutions to inform Patients of their rights as well as of the
institution's rules and regulations that apply to the conduct of
the Patient while in the care of such institution. These rights and
rules and regulations shall be posted in a bulletin board
conspicuously placed in a Health Care Institution.

d. Right to Choose His Physician / Health Institution –

The Patient is free to choose the sei-vices of a physician or
health institution of his choice except when he chooses to be
confined in a charity ward. In this case, the attending physician
shall be the consultant under whose sei-vice the patient was
admitted as appearing in the Doctor's Order Sheet of the Medical
Record, the Patient shall have the right to seek a second opinion
and subsequent opinions, if necessary, from another physician or
health institution, and to change his physician or health
institution.

e. Right to Informed Consent –

The Patient has a right to self-determination and to make free
decisions regarding himself/herself, however, the attending
physician shall inform the Patient of the I consequences of
his/her decisions. A Patient who is mentally competent and is of
legal age, or in his incapacity or age of minority, his legal
representative, has a right to a clear explanation, in layman's
terms, of all proposed or contemplated procedures, whether
diagnostic or therapeutic, including the identity and professional
circumstances of the person or persons who will perform the said
procedure or procedures. The explanation shall include the
amount of information necessary and indispensable for him to
intelligently give his consent, including, but not limited to, the
benefits, risk, side effects and the probability of success or
failure, as a possible consequence of said proposed procedure or
procedures, including the implications of withholding consent. In
the explanation, the comprehensive ability of the patient shall
also be considered, taking into account his level of education,
the dialect or language that he speaks and understands, and if
possible, with the use of anatomic sketch or any materials or
visual aids that may aid the Patient, or his legal representative,
in fully understanding the proposed procedure or procedures.

The right to informed consent shall likewise consider the

voluntariness in which the Patient or his/her legal representative
has given his/her consent, seeing to it that the Patient or his
legal representative was allowed to ask questions, or that he/she
is given the chance to consult his/her kin, or to seek another
expert opinion. If the Patient is unconscious or is unable to
express his/her will, informed consent must be obtained
whenever possible from a legal representative; Provided
however, that when medical intervention is urgently needed, the
consent of the patient may be presumed; Provided further, that a
physician should always try to save the life of a Patient who is
unconscious due to suicide attempt. In the case of a Patient who
is legally incompetent or is a minor, the consent of a legal
representative is required; Provided however, that the Patient
must be involved in the decision-making process to the fullest
extent allowed by his mental capacity. If the legally incompetent
Patient can make rational decisions, his/her decisions must be
respected, and he/she has the right to forbid disclosure of such
information to his/her legal representative. If the patient's legal
representative forbids treatment, but, in the opinion of the
physician, it is contrary to the patient's best interest, the
physician may challenge this decision in court; Provided however
, that in emergency cases, the physician shall act in the patient's
best interest; Provided further, that in emergency cases where
there is no one who can give consent on the patient's behalf, the
physician can perform any emergency diagnostic or treatment
procedure in the best interest of the patient.

f. Right to Refuse Diagnostic and Medical Treatment –

 The Patient has the right to refuse diagnostic and medical
treatment procedures, provided that the following conditions are
satisfied; 1. The Patient is of legal age and is mentally
competent; 2. The Patient is informed of the medical
consequences of his/her refusal; 3. The Patient releases those
involved in his care from any obligation relative to the
consequences of his/her decision; and 4. The Patient's' refusal
will not jeopardize public health and safety.

 Should individuals have the right to access assisted suicide or

euthanasia?

https://www.jpmer.com/abstractArticleContentBrowse/JPMER/23986/
JPJ/fullText
The term euthanasia originated in Greece and meant a good death.
The medical definition is “the act or practice of causing or permitting
the death of hopelessly sick or injured individuals in a relatively
painless way for reasons of mercy”. The British House of Lords Select
Committee on Medical Ethics defines euthanasia as “a deliberate
intervention undertaken with the express intention of ending a life, to
relieve intractable suffering”. In the Netherlands and Belgium,
euthanasia as “termination of life by a doctor at the request of a
patient”. The Dutch law, however, does not use the term “euthanasia”
but includes it under the broader definition of “assisted suicide and
termination of life on request”. (You can use the senate bill No.1402)

Legalizing Voluntary & Non-Voluntary Euthanasia in the Philippines:

A Utilitarian Perspective
Keywords:
Rule-Utilitarianism, Act-Utilitarianism, Divine Command Theory, Voluntary
Euthanasia, Non-voluntary Euthanasia & Life-support System
Introduction
Decisions regarding euthanasia are especially difficult in bioethics because it
is
interacting with a hard fact that all humans will eventually face, and
sometimes not willingly:
death (Nathan, 2015). Doctors have been using this method (euthanasia) for
the ill-patient
who wishes to end the suffering due to heavy medication. Patients who’ve
been kept in a
life-support, (Danao, 2014) states that it stresses a patient’s directive
against prolonging his or
her life through artificial means. Life-support system defines a technological
system which
helps an individual to prolong the individual’s existence and regularly
function in an
environment.
By definition, euthanasia is inducing the painless death of a person who is
severely
debilitated for reasons assumed to be merciful, either through voluntary,
non-voluntary,
involuntary means (Hendin, 2004). There are three types of euthanasia,
which are voluntary,
non-voluntary, and involuntary; however, the research won’t emphasize on
regarding the
definition of invonlutary euthanasia. Voluntary euthanasia is given consent
from the person
who wishes to die. Non-voluntary euthanasia is when the person is
unconscious or unable to
decide whether one is in a coma or if one is a baby with congenital
disabilities.
Legalizing Voluntary & Non-Voluntary Euthanasia in the Philippines:
A Utilitarian Perspective
Keywords:
Rule-Utilitarianism, Act-Utilitarianism, Divine Command Theory, Voluntary
Euthanasia, Non-voluntary Euthanasia & Life-support System
Introduction
Decisions regarding euthanasia are especially difficult in bioethics because it
is
interacting with a hard fact that all humans will eventually face, and
sometimes not willingly:
death (Nathan, 2015). Doctors have been using this method (euthanasia) for
the ill-patient
who wishes to end the suffering due to heavy medication. Patients who’ve
been kept in a
life-support, (Danao, 2014) states that it stresses a patient’s directive
against prolonging his or
her life through artificial means. Life-support system defines a technological
system which
helps an individual to prolong the individual’s existence and regularly
function in an
environment.
By definition, euthanasia is inducing the painless death of a person who is
severely
debilitated for reasons assumed to be merciful, either through voluntary,
non-voluntary,
involuntary means (Hendin, 2004). There are three types of euthanasia,
which are voluntary,
non-voluntary, and involuntary; however, the research won’t emphasize on
regarding the
definition of invonlutary euthanasia. Voluntary euthanasia is given consent
from the person
who wishes to die. Non-voluntary euthanasia is when the person is
unconscious or unable to
decide whether one is in a coma or if one is a baby with congenital
disabilities.
Utilitarianism is an ethical theory that determines right from wrong by
focusing on outcomes. It is a form of consequentialism. Utilitarianism holds
that the most ethical choice is the one that will produce the greatest good
for the greatest number.

Resource Allocation and Access

 Is it ethical to prioritize younger patients over older ones in organ

transplantation?

https://journals.lww.com/co-transplantation/fulltext/2023/06000/
ethics_of_allocation_of_donor_organs.9.aspx

Thus understood, treating patients equally can be considered to serve as a

‘guardrail’ [11] or a sine qua non for any fair allocation system. Thus, the
ethical discussion converges on the two remaining principles of ‘favoring the
worst-off’ and ‘maximizing total benefits’, which are often at odds.

Favouring the worst-off implies that patients who run the greatest risk of
dying when left untreated, should be treated first (‘sickest first’). It is
assumed that other patients, who are less acutely ill, can wait, and be
treated later.

The latter fits with the principle of maximizing total benefits, which follows
from utilitarianism, or the notion that ‘doing good’ implies acting in such a
way as to bring about as much utility (e.g. health) as possible for all patients,
‘the greatest good for the greatest number’. It aims at saving the most lives
(or life-years or quality-adjusted life years). The principle of maximizing total
benefits thus points in the opposite direction: patients who have the best
chances of living a long and healthy life after transplantation should be
prioritized for transplantation, and patients with the worst prognosis should
be passed over. Tapos ipasok ung part na younger people are more resilient
and can live up to many years.

Emerging Technologies and Research

 Is it ethical to use animals for medical testing and research?

https://paws.org.ph/downloads/awa_ao40-
rules_and_regulations_on_the_conduct_of_scientific_procedures_usi
ng_animals.pdf

Administrative Order No. 40 Series of 1999

 Animals are biologically very similar to humans. In fact, mice share

more than 98% DNA with us!
 Animals are susceptible to many of the same health problems as
humans – cancer, diabetes, heart disease, etc.
 With a shorter life cycle than humans, animal models can be studied
throughout their whole life span and across several generations, a
critical element in understanding how a disease processes and how it
interacts with a whole, living biological system.

Through AO 40, the Institutional Animal Care and Use Committee

or IACUC evaluates or reviews how animals are used or cared for
in laboratory settings, for consumer and biomedical research.

The three Rs
The three Rs are a set of principles that scientists are encouraged to follow in
order to reduce the impact of research on animals.

The three Rs are: Reduction, Refinement, Replacement.

 Reduction:
 Reducing the number of animals used in experiments by:
 Improving experimental techniques
 Improving techniques of data analysis
 Sharing information with other researchers
 Refinement:
  Refining the experiment or the way the animals are cared for so as to
reduce their suffering by:
 Using less invasive techniques
 Better medical care
 Better living conditions
 Replacement:
 Replacing experiments on animals with alternative techniques such as:
 Experimenting on cell cultures instead of whole animals
 Using computer models
 Studying human volunteers
 Using epidemiological studies

 Are genetic modifications of embryos ethical in preventing

hereditary diseases?

Gamitin mona lang yung nasa taas, wala ako mahanap na magandang
argument dine.

Reproductive Ethics

 Is it ethical to limit access to abortion services based on gestational

age?

Yes kasi Pro tayo so meaning based on its gestational age of the baby for
example full term na yung mommy, hindi na pwede bigyan ng rights sa
abortion because full term na and buhay na yung baby. Pero pag sinabi na
illegal ang abortion sa phillipines is pwede sabihin na ang tanong is limit
access based on gestational age so meaning pewede sya magpaabort early
tyerm pa lang which is di pa nagdedevelop ung baby. Pwede din siya
isupport ng Senate bill no.1402 which is right ng patient kung anong
treatment ang gusto niya.
  Should surrogacy be regulated or banned to prevent exploitation?

https://lawphil.net/statutes/repacts/ra1992/ra_7610_1992.html

So meaning dahil pro tayo regulated ang idedefend natin. Surrogacy - A

process in which a woman carries and delivers a child for a couple or
individual. Surrogate mothers are impregnated through the use of in vitro
fertilization (IVF). A legal contract is required for intended parents and their
carrier before medical treatment begins. In the Philippines, there is no law on
surrogacy; whether traditional or gestational. But the Philippines have
become the best gestational surrogacy destination for many patients. Dapat
yung mga taong exploiters ang pinarurusahan hindi ung part ng surrogacy
kasi surrogacy is the alternatives ng mga couple kapag may mga
circumstances sila na hindi sila magkakababy.

Republic Act No. 7610: AN ACT PROVIDING FOR STRONGER

DETERRENCE AND SPECIAL PROTECTION AGAINST CHILD ABUSE,
EXPLOITATION AND DISCRIMINATION, AND FOR OTHER PURPOSES

It is hereby declared to be the policy of the State to provide special

protection to children from all firms of abuse, neglect, cruelty exploitation
and discrimination and other conditions, prejudicial their development;
provide sanctions for their commission and carry out a program for
prevention and deterrence of and crisis intervention in situations of child
abuse, exploitation and discrimination. The State shall intervene on behalf of
the child when the parent, guardian, teacher or person having care or
custody of the child fails or is unable to protect the child against abuse,
exploitation and discrimination or when such acts against the child are
committed by the said parent, guardian, teacher or person having care and
custody of the same.

It shall be the policy of the State to protect and rehabilitate children gravely
threatened or endangered by circumstances which affect or will affect their
survival and normal development and over which they have no control.

The best interests of children shall be the paramount consideration in all

actions concerning them, whether undertaken by public or private social
welfare institutions, courts of law, administrative authorities, and legislative
bodies, consistent with the principle of First Call for Children as enunciated in
the United Nations Convention of the Rights of the Child. Every effort shall be
exerted to promote the welfare of children and enhance their opportunities
for a useful and happy life.