Beruflich Dokumente
Kultur Dokumente
Development
Dwight E. Legaspi,
RN,RM,MN
HISTORY OF MIDWIFERY IN
THE PHILIPPINES
Ancient Health Practices in the Philippines
-care of the sick and promotion of health were
intermingled with superstitions.
-Mangkukulam, Mangagaway,
Aswang expectant mother should cover herself with
black cloth
upon sleeping to escape aswang
Hilot - 10-15 days in order for the woman to be strong.
Cord Dressing ashes, tobacco, sand, powdered
coconut shall give
HISTORY OF MIDWIFERY IN
THE PHILIPPINES
rise to serious results
Colostrum unfit for food for the newborn. Milk was
thrown away
Pamaoo sickness attributed to the nuno.
Lugao diet of the ill child was limited to rice gruel
Colored bracelet worn on the wrist of the child was
believed to
ward off evil
Morga Governor General of the Philippines from 15951596 made reference to the use of wine from coconut
and nipa palms as medicine by the natives.
HISTORY OF MIDWIFERY IN
THE PHILIPPINES
First Midwifery School in Sampaloc General Hospital
(1922) - Dr Jose Fabella the first Secretary of Health
founded the first Midwifery School in the Philippines with
10 students
Development of Midwifery in the Philippines
Midwifery started as a 6 month course to 1 year. Major
function of the midwives pertained to maternal and child
health care (MCH). In the early years, student midwives
were supported by the government. They had free
tuition, free board and lodging and free laundry with
allowance. These students were considered as
government pensionados/then in 1952, Domiciliary
Services (DOS) was included in the curriculum. The
course ran from one year and six months in 1976.
HISTORY OF MIDWIFERY IN
THE PHILIPPINES
Ricardo Gonzales (father of modern midwifery)
appointed as chairman of the Board of Midwifery in
1974. He was the director of the Jose Fabella Memorial
Medical Center during this time. He was one of those
who made a study of the curriculum and a two year
program. The DECS adopted this new course in 1977
and implemented nationwide
From then on, revision in the midwifery curriculum were
made to upgrade the skills of the midwifery graduates to
be globally comparable. To this date, the BSM is being
offered by some midwifery schools. This program was
approved through the CHED Memorandum Order 33
series of 2007
ETHICS
The term ethics came from the Greek word, ethos which
means a characteristic way of acting. This is suitably
employed to designate the science of human acts and a
human conduct. Various definitions were given to have a
clear understanding of the term ethics:
1. Refers to those rules of conduct recognized in
respect to a particular class of human actions or to a
particular group, such as medical ethics, dental ethics,
nursing ethics and midwifery ethics. (Robles)
2. A study of standards of conduct and the
moral judgment and values upon which these standards
are based. (Cafferty)
ETHICS
IMPORTANCE OF ETHICS
Ethics teaches us to distinguish what is right from what is
wrong.
It helps us to make the right judgment and decisions. It
helps us to realize what is good for us by helping to
make a correct decisions and actions in different
situations.
ETHICS
ETHICAL THEORIES
Ethical theories - are based on the previously explained
ethical principles. They each emphasize different
aspects of an ethical dilemma and lead to the most
ethically correct resolution according to the guidelines
within the ethical theory itself. People usually base their
individual choice of ethical theory upon their life
experiences.
ETHICAL THEORIES
Natural Law
- The system of natural law holds that man should
live life according to an inherent human nature.
Example:
the declaration of independence was an assertion of
natural law - the right to be free, the right not to be taxed
without representation, etc., if you believe you are
entitled to these rights just by virtue of the fact that you
are alive/human, you believe in natural law.
ETHICAL THEORIES
Deontology
The deontological theory states that the people should
adhere to their obligations and duties when analyzing an
ethical dilemma. This theory holds that the most
important aspects of our lives are governed by certain
unbreakable moral rules. a person will follow his or her
obligations to another individual or society because
upholding ones duty is what is considered ethically
correct. For instance, a deontologist will always keep his
promises to a friend and will follow the law. A person who
follows this theory will produce very consistent decision
since they will be based on the individuals set duties.
ETHICAL THEORIES
Utilitarianism
This theory basically promotes good or valued ends.
This theory instructs adherents to work for those
outcomes that will give the most advantage to the
majority of those affected in the most impartial way
possible. To a utilitarian, it is ethically correct if the choice
that yields the greatest benefit to the most people.
ETHICAL THEORIES
Utilitarianism
The two types:
Act Utilitarianism A person performs the acts that
benefit the most people, regardless of personal feelings
or the societal constraints such as laws.
Rule Utilitarianism this takes into account law and is
considered with fairness. A rule utilitarian seeks to
benefit the most people but through the fairest and most
just means available.
ETHICAL THEORIES
Virtue Theory
This ethical theory judges a person by his character
rather than by an action that may deviate from his
normal behavior. It takes the persons moral, reputation
and motivation into account when rating an unusual and
irregular behavior that is considered unethical.
For instance, if a person plagiarized a passage that was
later detected by a peer, the peer who knows the person
well will understand the persons character and will be
able to judge the friend.
ETHICAL THEORIES
Rights
The rights ethical theory is the rights set forth by a
society that are protected and given the highest priority.
Rights are considered to be ethically correct and valid
since a large or ruling population endorses them.
Individuals may also bestow rights upon others if they
have the ability and resources to do so. For example, a
person may say that her friend may borrow the car for
the afternoon. The friend who was given the ability to
borrow the car now has a right to the car in the
afternoon.
ETHICAL THEORIES
Casuist
The casuist ethical theory is one that compares a current
ethical dilemma with examples of similar ethical
dilemmas and their outcomes. This allows one to
determine the severity of the situation and to create the
best possible solution according to others experiences.
-Casuistry is a specific method of doing ethics that relies
on the analysis of individual cases, exploring them in
relation to paradigm cases and broad principles
DIVISION OF ETHICS
Acts of Man
are actions that do not involve the use of intellect and
freewill; these are actions done unconsciously and
without reason.
The natural acts of vegetative and sense faculties:
digestion, beating of the heart, growth, corporal
reactions, and visual or auditive perceptions. However,
these acts become human acts when performed under
the direction of the will, as when we look at something,
or
arouse
ourselves.
DIVISION OF ETHICS
Human acts
are imputable to man so as to involve his
responsibility, for the very reason that he puts them forth
deletions deliberatively and with self-determination. This
involves the use of both free will and intellect; these are
actions are performed with use of reasons.
FREE WILL - the ability to choose how to act. : the
ability to make choices that are not controlled by fate or
God.
DIVISION OF ETHICS
Morals
deal with the conduct of man, the right and wrong
behavior of man in his relationship with his fellow men.
They are the fundamentals of right and wrong learned
and internalized in early childhood.
Morality of Human Acts A human act is one that proceeds
from knowledge and free will. If either adequate
knowledge or freedom is lacking in the act of a person,
then act is not fully human and therefore not fully moral.
DIVISION OF ETHICS
Mores as defined by Robles are customs, beliefs
enforced by social pressure. They are the societies
established patterns of action to which an individual is
expected to conform.
Morality speaks of a system of behavior in regards to
standards of right or wrong behavior. The word morality
is always associated with: moral standards, which is
about human behavior; moral responsibility which refers
to our conscience; and moral identity, or one who is
capable of right or wrong action.
DIVISION OF ETHICS
Law of Conscience or Natural Law
According to St. Thomas, Law is an ordinance of
reason, promulgated for the common good by the one
who has charge of a society.
Law - is an ordinance of reason promulgated for the
common good or to protect the society at large. - u
Conscience is a practical judgment of reason upon an
individual act as good, or as evil and to be avoided.
DIVISION OF ETHICS
Law of Conscience
ensures that people cannot be forced to facilitate
practices or procedures to which they object for reasons
of conscience. These may include abortion, capital
punishment,
contraception,
sterilization,
artificial
reproduction, euthanasia, assisted suicide, human
experimentation, torture, etc.
Virtue
is a good habit that enables us to act according to
right reason, enlightened by faith. It is a firm disposition
to act according to Gods will and disregard the country
impulses of our own will.
DIVISION OF ETHICS
Four cardinal virtues:
Prudence able to judge between actions with regard to
appropriate actions at a given time.
Justice proper moderation between self-interest and
the rights and needs of others.
Restraints or Temperance practicing self control,
abstention, and moderation.
Courage or Fortitude forbearance, endurance, and
ability to confront fear and uncertainty, or intimidation.
DIVISION OF ETHICS
Capital Virtues:
Humility is the virtue that counters pride. As pride
leads to other sin, true humility clears a path for holiness.
The virtue of humility is about modest behavior,
selflessness and the giving of respect.
Generosity - the virtue of liberality id focused not merely
on the appropriate concern regarding ones earthly
goods, but also on generosity and a willingness to give,
freely and without request for commendation.
Chastity embraces moral wholesomeness and purity,
and in both thought and action treats Gods gift of
sexuality with due reverence and respect.
DIVISION OF ETHICS
Capital Virtues:
Meekness focuses on patiently seeking appropriate
resolution to conflicts, and on the ability to forgive and
show mercy.
Temperance is centered on self-control and
moderation.
Kindness kindness, or love for ones neighbor is
manifest in the unprejudiced, compassionate and
charitable concern for others.
Diligence diligence manifests the appropriately
zealous attitudes toward living and sharing the Faith.
DIVISION OF ETHICS
Theological Virtues
Faith is the theological virtue by which we believe in God
and believe all that he has said and revealed to us.
Hope is the theological virtue by which we desire the
kingdom of heaven and eternal life as our happiness,
placing our trust in Christs promises and relying not on
our own strength, but on the help of the grace of the Holy
Spirit.
Charity is the theological virtue by which we love God
above all things for his own sake, and our neighbor as
ourselves for the love of God.
DIVISION OF ETHICS
Applied Ethics applies the general concepts and principles
but also specifies the particular situation in life in which
they are valid and legitimate moral. It is also called
Special ethics and deals with:
Individual Ethics which deals with duties to God; duties
to one self and others.
Social Ethics right to property and the right to marriage.
Political Ethics deals with the state; the political authority
and the international authority.
Professional Ethics is the branch of moral science which
treats the obligations which a member of a profession
owes to the public, to the profession, to his colleagues
and client.
BIOETHICS
BIOETHICS
- Common morality theories are usually based on
principles that are used to guide ethical thinking, based
on a shared moral belief. One of these theories is
bioethics, the ethics of biology, biological research and
the applications of that research. It is an ethical theory
that brings together medicine, the law, social sciences,
philosophy, theology, politics and other disciplines to
address questions related to clinical decision making and
medical research.
BIOETHICS
IMPORTANCE OF BIOETHICS IN HEALTH CARE
Bioethics explores critical issues in clinical and research
medicine, including truth telling, informed consent, confidentially,
end-of-life care, conflict of interest, no abandonment,
euthanasia, substituted judgment, rationing of and access to
health care, and the withdrawal and withholding of care.
BIOETHICS
ETHICAL FRAMEWORKS FOR DECISION MAKING
I. Ethical System and Principles
Not all ethical principles are applicable in all
situations because of the different variables that may
affect every situation. The moral principles help us in
making a moral analysis of ethical issues in our
professional practice.
It is important for the individual to determine which
principle is applicable or carries more weight to a specific
situation.
BIOETHICS
ETHICAL FRAMEWORKS FOR DECISION MAKING
II. Patients Bill of Rights - This enumerates the privileges
the patient duly deserves and the ethical behavior that
the health care professionals should observe.
BIOETHICS
ETHICAL FRAMEWORKS FOR DECISION MAKING
III. Professional Code of Ethics
This outlines how midwives should practice the
profession in ethical and moral manner. This guides the
midwives in her practice, in establishing interpersonal
relationship with colleagues, patient, superiors and other
significant others involved in patient care.
BIOETHICS
ETHICAL FRAMEWORKS FOR DECISION MAKING
BIOETHICS
In morals, law is the will of God and as the rule for
the disposition and conduct of all responsible
beings toward him and toward each other; a rule
of living, conformable to righteousness; the rule
of action as obligatory on the conscience or moral
nature.
PRINCIPLES OF BIOETHICS
- Decision making in the field of bioethics has
become
increasingly
complex.
There
is
no
predetermined order of preference; each is essentially of
equal importance. In different situations a particular
principle may assume a greater or lesser priority.
Autonomy
Nonmaleficence
Beneficence
Justice
ETHICAL ISSUES
Abortion
While infanticide is legally and socially
treated as murder and few in our culture
would approve of it, the killing of unborn
infants (often called foetuses in order to
still the conscience and minimize the
social stigma) has become both legally
and socially acceptable.
ETHICAL ISSUES
Euthanasia
ETHICAL ISSUES
Living Wills
The living will is a written document
which speaks for the patient if he
becomes incompetent and helps protect
the physician from legal liability. These
laws are binding upon the physician so
that if he does not wish to observe the
will he must cooperate in transferring the
patient to another physician.
ETHICAL ISSUES
Donation of Organs and the Body
MIDWIFERY ETHICS
It is a system of principle governing
conduct of midwives (Robles). The term
connotes the conduct or behavior of
midwifery practitioners, which by reason of
public approval or practice of the group,
has become customary among practicing
midwives.
PRACTICE IN THE
PHILIPPINES
A midwife must be able to give necessary supervision,
REGISTRATION OF MIDWIFE
The applicant for registration must comply with the following
requirements before the certificate will be issued the applicant
must:
Have passed the licensure examination;
Be a citizen of the Philippines;
Be at least 18 years old;
Not have convicted of a crime involving moral turpitude;
Not have found guilty of immoral and dishonorable conduct;
Pay the required registration fee.
In case the Board shall refuse to issue certificate, the Board
shall give the applicant a written statement setting forth the
reason or reasons for its action, which statement shall be
incorporated in the records of the Board.
CAUSES OF REVOCATION
Negligence
Incompetence
THE MIDWIFERY
PROFESSION
OPPORTUNITIES OF THE MIDWIFE ABROAD
Abroad all midwives wish to work abroad to have a better
opportunity not only in terms of experience but as well as for
greener pasture. Through the Philippine Overseas
Employment Agency (POEA), a midwife may know job
vacancies abroad. Hiring here is done through government
government basis. Aside from POEA, different recruitment
agencies are available for job placement but placement fees
are being charged to them. Another way working abroad is the
direct hiring scheme where the employers hire directly the
midwives. They take care of the processing of their papers
including the visa, employment contract and the tickets.
THE MIDWIFERY
PROFESSION
Documents needed when travelling abroad
Passport is a document that provides ones nationality and is issued by the
department of foreign affairs. For the midwife to acquire a passport she must have:
birth certificate, marriage contract, and two 2 x 2 pictures and the processing fee.
Visa is a document that allows a person to enter a foreign country issued by the
foreign embassies in every country, a visa maybe categorized: student, tourist,
working and immigrant. Documents needed in applying for a visa are:
Six 2 x 2 photos
High school Diploma authenticated by the DepEd
Midwifery Diploma, transcript of Records, and Clinical Experience authenticated by
CHED
Board Rating and Board Certificate authenticated by the PRC
Birth certificate and Marriage Contract authenticated by the NSO
National Bureau of Investigation (NBI) Clearance
Certificate of employment
The above documents are brought to the Department of foreign affairs for
authentication and to the foreign embassy for final authentication.
THE MIDWIFERY
PROFESSION
THE MIDWIFERY
PROFESSION
PROFESSIONAL ORGANIZATION
Integrated Midwives Association of the Philippines, Inc.
(IMAP, Inc.) is a non-profit, non-stock, and non-governmental
national organization of the registered midwives in the
Philippines, accredited by the Professional Regulation
Commission.
IMAP, Inc. is committed to serve the Filipino people through an
effective delivery of basic health services in the country. It also
aims to elevate the standards of midwifery profession, provide
continuing midwifery education and professional growth, and
foster and maintain the ideas of integrity conduct
THE MIDWIFERY
PROFESSION
Continuing Professional Education this aims to improve the competency of
midwives in the practice of their profession and give service that meets professional
standards.
Scholarship Program offers a Three-Year Midwifery Program to deserving
children of bonafide members of the association willing to take up the course at the
IMAP Foundation School in Iloilo City.
Outreach Programs
Project ABCC a joint with the Philippine Obstetrical and Gynecological Society
and NESTLE Philippines which has generated cancer awareness and
consciousness among women and the importance of preventive health care.
Operational Tule conducted in depressed areas for children whose parents
cannot afford the operating costs and medicine for circumcision.
Christmas Gift-Giving a yearly project since 1996. The organization conducts
gift-giving program at depressed barangays in Guimaras.
Basic Life Support Program a community health emergency preparedness and
response program conducted for midwives to enable them to respond to
emergencies in the community (initiated under the STOP DEATH program of the
DOH).
THE MIDWIFERY
PROFESSION
THE MIDWIFERY
PROFESSION
THE MIDWIFERY
PROFESSION
PERSONALITY DEVT
PERSONALITY DEVT
PERSONALITY DEVT
When in Public
Wait for your turn when your are falling in line
Turn off devices while watching a movie in the cinema and refrain from
talking
Be careful with your words
When Entertaining
Always say thank you or send a thank you note when receiving a gift or a
good deed has been done for you
It is improper to ask a guest to remove his shoes. When expected to be
shoeless, slippers must be provided
Introduce guests to one another
Keep conversation flowing and avoid awkward pauses. Change subject
when vulgar or rude and controversial matter arises
Offer refreshments to each guest upon entering social room
THE MIDWIFERY
PROFESSION
The Telephone
Personality Development
DEFINITION: enhancing and dressing ones outer and
inner self or the organized pattern of behaviors and
attitudes that makes a person distinctive.
PERSONALITY: dynamic and organized set of
characteristics possessed by a person that uniquely
influences his or her cognitions, emotions, motivations,
and behaviors in various situations.
refers to individual differences in characteristic patterns
of thinking, feeling and behaving.
Personality Development
GROOMING: art of cleaning, grooming, and
maintaining parts of the body
UNIFORM: wearing the pescribed uniform
VOICE: develop voice quality, voice tone, pitch,
pace and voice modulation
POISE: carrying ones self and professional
bearing
CONDUCT: how you act, or deal with other
people
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Importance of Law
regulate relationships between conflicting interests
ensures safety of future generations
without laws, there would be nothing one could do if another
were violating their peace and enjoyment.
Characteristics of Law
a rule of conduct or action which determines what can be done
and what cannot be done
law is obligatory
promulgated by legitimate authority
it is of common observance and benefit
Examples of Negligence
Burns resulting from hot water bags, heat lamps, vaporizers or
sitz baths
Objects left inside the patients body such as sponges
Drugs given to the wrong person
wrong medicine, wrong concentration, wrong route or wrong
dose
are
either
principals,
B. Exempting Circumstances