REASON AND

IMPARTIALITY
 Exercise

to discuss “The New Found Use of the Placebo Effect”

to discuss “To Let Go or to Let live”

to discuss “ For a Worthy Cause”

 Guide Questions for Case Discussion

● 1. Gather the facts.

● 2. Determine the Ethical Issues.

● 3. What Principles have a bearing on the case?

● 4. List the Alternatives
● 5. Compare the alternatives with the Principles.
● 6. Weigh the Consequences.

● 7. Make a decision.
The New Found Use of the Placebo Effect

● To keep patients from being addicted to certain

pain medications like morphine, most doctors
would prescribe alternate dosage of morphine
and plain normal saline solution. Both will create
a cessation of pain sensation, morphine exerting
its pharmacotherapeutic effect and the normal
saline creating a psychological effect to the
patient thinking that it was morphine being
injected.

● In a surgical unit of a certain hospital, a nurse

found a new application of the “Placebo Effect.”
● Nurse Lucky was a newly hired
registered nurse in the surgical unit of a
hospital. He was hired immediately
because of his brother who is a nurse
supervisor for five years of that hospital.

● He was being oriented on the floor by his senior

nurse. His senior nurse told him that some of the
patients in their floor will ask for pain
medications a lot but pain medications are not
given liberally because of its addictive properties.
They sometimes administer Nss solutions as
placebo for morphine. The senior nurse
demonstrated how placebo is carried out and
administered to their patients. He was instructed
to do it under the prescription of a doctor.
● One of his duty days one night, Lucky decided
to do an extra effort of cleaning the nurses station
in line with the 5s program of the hospital. As he
begun his task he found vials of pain relievers ad
IV antibiotics under the sink. The medicines were
not expired, so he wondered why it was kept
under the sink. He also found out that these
medicines cost P2,000 per vial. He decided to
place it back under the sink and decided to ask his
senior nurse later about it.
● One day, a patient’s relative approached him and
asked where he can find Lucky’s brother. Lucky
asked him why and introduced himself as his brother.
The patients relative then said “Good that he is your
brother. Will you kindly hand him over these three
vials of medicines I bought from him at half the price.
My sister who is in the surgical unit would no longer
use it because she died this morning. Kindly ask him
if I could get refund because I really need the money
to arrange interment.
● Lucky was in shock when he heard the patient’s
relative. He remember the medicines he found the
other night. He looked for it under the sink and it
was no longer there. When he asked his senior
nurse about it he replied: “Just pretend you did not
see it. Everybody is doing it anyway. Welcome to
the club.” Lucky could not quite comprehend what
his senior nurse was talking about. He decided to
investigate.
● He found out that there some nurses who do not
administer these expensive medications as ordered.
They administered instead a placebo even if it was
not ordered by physician. They also charge the
patient with the medicine even though they
administer placebo. These extra vials are kept and
later sold to other patients who need it at half the
price. The money is then divided among those who
are involved.
● These occurrence are not recorded in the
medication audit being conducted by nurse
supervisors because the nurse supervisor for their
floor is no other that his brother who is also involved
in the case.
● Lucky confronted his brother, he has this to say:
“if t weren’t for these activities that I am doing, you
wouldn’t have gone to college and graduate as a
nurse… so just keep you mouth shut because no one
else had benefited more from this than you.”

● Lucky was dumbfounded. He does not know

whether hew would just keep silent and join the
group to protect his brother and earn more too or
make noise and make it known to the detriment of
his brother to whom he owes a lot.
 To Let Go or To Let live

● I am marketing personnel of a reputation

institution in Makati. I have been connected with
this company for the past three years. In those
years, I have delivered more than was expected of
me. After the department head resigned two years
ago, I was made to do some of his roles. Eventually,
I got appointed as head of our department pro
tempore. My name is Marlowe.
● My dilemma started one Monday afternoon,
when the President of our organization called
my attention and for a brief closed-door
meeting.

● “ I called for you to discuss Malou. One of her

clients remitted forty thousand in cash as payment
for their loan. Unfortunately, this amount did not
reach our office. It was with Malou for over two
weeks, with obviously malicious reasons.”
● “Having heard that this particular client is about to
call our attention, she immediately went to the client
and paid back the amount in two separate payments
within one week. After which, we immediately
proceeded to our personnel department to air the
matter. As you may well know, we cannot tolerate
this kind of practice in our organization.”
● As the boss narrated the details, I am expecting
one final line. And there. The boss asked me
“what is your opinion on this matter? Should we
let Malou go?”

● I was hesitant to provide the decision right there

and the because the thought that was going
through my mind was who am I to decide in this
issue? After expressing this concern of mine, he
asked me? “Put yourself in my position. What
would you do?”
● A week before the boss called my attention, Malou
was expressing her sentiments. First, her financial
requirements in order to keep up with her loans at
that); second, the difficulty she was experiencing
raising two babies on her own after a painful
separation, and of course, her salary that could
hardly keep up with the rising cost of living.
● When the boss raised me the question, what lingered on my
mind was the welfare of my children, her troubled finances,
and her remorse ( when she remitted all that she got from the
client). On the other hand was the company policy, the
integrity of the company that was tarnished with this one
client, and the other employees who have learned about the
totality of the incident.

● With all the trust that I have earned all these years from my
boss. It is likely that my opinion will bear a great deal as to the
fate of Malou.

● If you were in my position, what would you recommend my

boss?
 For a Worthy Case

● After graduating from college, Ernie Pascual went on

job hunting. It was not difficult for him though to land a
job because of his admirable credentials. He graduated
with honors in the premiere university in the country. He
is a born leader with high ideals and a good set of values.

● Among the several companies offering him a job, he chose

the position of a Project Development Assistant in Realty
Holding, Inc. (RHI), a real estate developer. The job seemed
challenging with a lot of feasibility and project development
studies to make. Although the remuneration package
offered is not that attractive, the career path presented to
him was clear.
● He was deeply involved in the project of RHI in Bulacan.
He assisted in the acquisition of the 40 hectare property in
Casipit. Young as he is, he has been a good help in the
project.

● When the development of the property commenced, he

became a member of the 3-man team asked to secure
government licenses, clearances and certification necessary
to start the project. They dealt with the barangay captains,
the municipal government and other national government
agencies for the vital licenses.
● Ernie never imagined that dealing with the government
would be a very arduous task. One day, he approached the
municipal Mayor’s office to secure a clearance. He traveled the
Makati office to bulacan very early in the morning to be in
time with the 8am opening of the municipal Mayor’s office. He
arrived there exactly 8am and proceeded directly to the
Mayor’s office with all the documents necessary to support
their application. Upon his arrival, he was asked to return
because the Mayor cannot sign the papers immediately. The
secretary said that the application would still be evaluated and
verified according to their proceedings.
● Months have passed and the management is already
impatient with the release of the clearance. Finally when Ernie
called the Mayor’s office, he was informed that he would see
the Mayor for the clearance. He arrived at the Mayor’s office
early. Again, the secretary asked him to wait for the Mayor to
arrive at 9 AM. While waiting for the Mayor to arrive, he saw
the secretary, the other assistants and some bystanders chat
about some people’s lives during office hours. Soon more
people entered the Mayor’s office. Some clad decent clothes
but what caught his attention are the people in shabby clothes
waiting for the Mayor together with him. He waited until 10
AM when the mayor arrived. Since he was the first to arrive,
he was given the priority to see the mayor.
● The Mayor’s office, he introduced himself and his
company. As he spoke, he noticed a certain glow in
the eyes of the Mayor. When he finished, the Mayor
did not sign the clearance but asked him to go back
tomorrow at 7AM, not to his office but to his house
not so far from the municipal hall. He was also
asked to bring with him preferably some of higher
authority. He went back to the Makati office and
reported to his supervisor and other team members
the Mayor’s request.
● The next day, Ernie and his manger went to the
Mayor’s house at exactly 7AM as requested. He
noticed that the very early in the morning, many
people, mostly in shabby clothes, were gathered
outside the Mayor’s house. Not long after, Ernie and
his manager were asked to go inside the house. They
were assisted by the helper to the dining room. It
looked more like a meeting room but he was
surprised to see a table prepared for at least 15 people.
● Soon the Mayor walked into the room with a full
smile. Ernie noticed that the Mayor is holding the
folder of their application with the clearance inside.
It was already ready for his signature. The
conversation started with the Mayor’s expression of
full support to the project in his place of jurisdiction.
He was even encouraging more developers to enter
the Casipit as they will not only help improve the
amenity of the municipal but also increase the value
of the land.
● Slowly he went to discuss the issuance of the clearance. He went to say
that “I will help you earn your money through the real estate project and
I hope you’ll help me too. Many townspeople are depending on me for
their needs. You could see people waiting outside my house this early in
the morning. These are the people who are asking money from.. For their
child who is sick, for their spouse or child who is dead and is waiting
burial, for their child needs education or even job. You can name all
reasons why they need money – even for wedding reception – people
will go to me for financial aid. How can I turn them down? If I will not
help them, they will accuse me for being “ingrato” (or walang utang na
loob) and unfaithful to his constituents. But if I did, they will ask for
more even if I give them enough. I feel like I give them my hand, they
will get my whole body instead. If I stop, they’ll say bas things about me.
But you see, what can I give them? I am just an ordinary person. I have
nothing much. So I’m asking you to finance their needs. You also have to
think about the farmers who will be displaced by your project. Definitely,
they will come to me for help when they have already used up the funds
you gave them. So, is P/10.00 per square meter of the land subject to the
clearance good enough?”
● Ernie and his manager were startled. The amount of
P10.00 per square meter of land will translate to a huge
P4 million as representation expense! They left the
Mayor with a promise that they will bring the issue to
higher management for decision.

● On their way back to the office, Ernie and his manager were
both quite trying to digest the essence of their conversation
with the Mayor. They were already pressed for time, as the
other clearances will start from the Mayor’s clearance. What
makes the matter worst was that they have not anticipated
the representation expense and did not include in their
budget approved by management. Nonetheless, they have to
report the proceedings of the meeting to higher management,
but should they recommend the payment of the P4milliom
the Mayor? What should they do?
● class discussion on

● Moral reasoning and Impartiality

● How did feelings affect the decision?
● Was the decision backed up by good
reasons?

● Is the argument valid and sound?

A valid argument is one whose premises logically entail its
conclusion.
An invalid argument on the other hand is one whose premises
do not entail its conclusion.

In an invalid argument, one can accept the premises as true

and reject the conclusion without any contradiction. A sound
argument, on the other hand, has true premises and valid
reasoning. An unsound argument employs invalid reasoning or
has at least one false premise
● Was the decision impartial?
 Impartiality
● Basic Idea: Each individual’s interest are
equally important

● Therefore, each must acknowledge that other

person’s welfare equally important as our own.

● A proscription against arbitrariness in dealing

with people.
“ A conscientious moral agent is someone who is
concerned impartiality with the interest of everyone
affected by what he or she does; who carefully sifts
facts and examines their implications; who accepts
principles of conduct only after scrutinizing them to
make sure they are sound; who is willing to ‘listen
to reason’ even when it means that prior
convictions may have to be revised, and who,
finally, is willing to act on the results of this
deliberation.”

● James Rachels & Stuart Rachels, p.14.