PATERNALISM This refers to make a decision or choice for another

person because the individual is perceived to be unable to make

the right decision. The belief that one should, on the basis of
doing good for the patient, limit the patients personal autonomy.
JUSTICE It means to be fair to all concerned.
- Justice is when a person has been given what is due, owed,
deserved or legitimately claimed. Synonymous with Fairness
and Equality.
- Means a moral standard for all men to one another, requiring
them to perform their social and moral, as well as legal
obligations to each other. It is synonymous to equity in its
largest sense.
Three Essential Properties of Justice:
1. Justice always refers to another person. Strictly speaking there is
no obligations of justice to oneself.
2. Strict right. The object of justice is not a free gift, but something that
is strictly due.
3. Exactitude. Justice does not demand an approximate compensation,
but just what is due.
A peculiar trait of justice is that it does not only aim at the
right mean dictated by reason, as the other virtues do. But it
also aims at the meaning of what is due, or objective mean,
which is often quantifiable.
Moreover, justice is oftentimes mistaken for charity. But, there
is a big difference between them as justice is based on the
distinction between persons, while charity is based on their
union through love. Out of justice, we give our neighbor what
is his; out of charity, we give what is ours. Charity is superior
to justice but the duties of justice are stricter than those of
charity.
Two Kinds of Justice
1. Legal, general of social justice directly and primarily aimed
at the common good. It is the stable determination to render to
civil or ecclesiastical society of what is due.

Armed resistance to oppression by political authority is not

legitimate unless all the ff. conditions are met:
1. There is a certain, grave and prolonged violation of
fundamental rights;
2. All other means of redress have been exhausted;
3. Such resistance will not provoke worse disorders;
4. There is a well- founded hope of success;
5. It is impossible reasonably to foresee any better solution.
2. Particular justice is the stable determination to give to each
physical or juridical person what is his due. Its three main species are
commutative justice, distributive justice, and vindictive justice.
a. Commutative justice is a private persons stable
determination to give another private person what is
strictly his or her due. There must be an absolute equality
between what is given and what is received. The name
commutative refers to the commutations or exchanges it
primarily covers, like buying and selling.
b. Distributive justice is the stable determination inclining
the ruler of a community to equitably distribute burdens
and honors among its members according to their
capacities and merits. Whoever speaks of distributive
justice has to speak of exercise of power. It is the relation
between those who have power and those who are
entrusted or delivered to this power.
c. Vindictive justice which inclines the ruler of a community
to punish crime with the right penalties. It can be
considered as part of distributive justice, if we focus on the
determination of the appropriate penalty. It will also be a
part of legal justice, if we consider its impact on the
common good; or of commutative justice, since the judge is
obliged to punish crime, and would not fulfill the duties of
his office if he fails to do so.
VERACITY Is define as the adherence to the truth; conformity to
fact, accuracy
Veracity binds both the health practitioner & the patient in
an association of truth. The patient must tell the truth in order
that appropriate care can be provided. Practitioner needs to
disclose factual information so that the patient can exercise
personal autonomy. The practitioner is bound within the

limitation imposed
information.

by

her

role

to

disclose

all

relevant

Rules to consider & questions to ask prior to participating Placebo

Therapy.
Placebos with active agent that may have harmful side effects
are not acceptable.
Placebos should not be given to patients without consent.
? What is the condition being treated?
? What are the motives for therapy?
? What is the placebo supposed to do?
? Are the alternatives that are less misleading?
Benevolent deception- The practitioner is allowed to intentionally
withhold information based on her/his sound medical judgment that
to divulge information might potentially harm the depressed &
unstable patient.
It is conceivable that lying to the patient might become
necessary to avoid some greater harm, it cannot be entered into
lightly as it interferes directly with the persons autonomy. Patients
believe lies only because truthfulness is expected from healthcare
providers. Once the patients begin to look for deceit, an essential
element of good healthcare will be lost.
Justification of Paternalism:
1. Lie benefits the person lied to; that is the lie prevents more evil
than it causes for the particular person.
2. It must be possible to describe the greater good that occurs.
3. The individual should want to be lie to. If the evil avoided by the
lie is greater than the evil caused by it, a person would be
irrational not to want to be lied to.
4. Assuming equal circumstances, we would always be willing to
allow the violation of veracity.

CONFIDENTIALITY
American Hospital Associations Patients Bill of Rights rules 5 & 6
5. The patient has the right to every consideration of his privacy
concerning his own medical care program. Case discussion,
consultation, examination and treatment are confidential and
should be conducted discretely . Those not directly involve in
this case must have permission of the patient to be present.
6. The patient has the right to expect that all communications and
records pertaining to his care should be treated as confidential.
Guidelines for Confidentiality in other states / countries:
Confidentiality:
1. Keep all client records secure.
2. Consider carefully the content to be entered into the record.
3. Release information only with written consent and full discussion
of the information to be shared, except when release is required
by law.
4. Use professional judgment deliberately regarding confidentiality
when the client is a danger to self or others.
5. Use professional deliberately when deciding how to maintain the
confidentiality of a minor. The rights of the parent or guardian
must be also considered.
6. Disguise clinical material when used professionally for teaching
and writing.
What I may see or hear in the course of treatment
or even outside of treatment in regard to the life of
man, which in no account must be noised abroad, I will
keep to myself holding such things shameful to be
spoken about .
Hippocratic Oath of Confidentiality.