Ethical Issues In Nursing Licensing Debate

pinoy kasi
THERE have been no easy answers to the controversy around the leakage of questions in the recent nursing licensing examinations. Wouldn't a retake be better for all of the batch 2006 examinees, to remove the cloud of doubt around their competence? But wouldn't a retake mean more expenses, some families selling, literally, the last carabao? And after all's said and done, who should be punished for the leakage?

My sense is that we're having difficulties with these ethical issues because "ethics" is complicated. Moreover, ethics hasn't quite made it into our consciousness, at least not in a formal sense. Like when I tell people I don't eat meat as an "ethical" choice, I get confused looks. People think it has to be reasons of "health"
or "religion" rather than, quite simply, "doing something that's the right thing to do."

Slowly though, we're bound to see more discussions of ethics. At the University of the Philippines, the College of Social Sciences and Philosophy has a joint bioethics program with the College of Medicine, with the bulk of students coming from the medical profession. These health professionals train in bioethics so they can help their institutions to confront ethical questions around medical research and clinical care. The bioethical issues can be quite complicated, spanning an entire lifetime from the "beginning" (is a fertilized ovum a human being?) to the "end" (when is a person dead?).

'Bawal'

I've been handling one of the courses -- Culture and Ethics -- in the bioethics program and while the bulk of the class discussions deals with medical issues, we inevitably go into more personal issues. Each class I've been impressed with the way the students (physicians, dentists, anthropologists, psychologists) think the issues through, often expressing personal anxieties and turbulence.

Teaching the course has made me realize the importance of making ethics more relevant to our daily lives. We don't have a word for "ethics" in Philippine languages, but it doesn't mean we don't have a sense of right or wrong. We do, but the problem is that our notions of right or wrong are hemmed in, trapped in rigid and moralistic definitions that revolve around "bawal": the forbidden, the sinful.

We've relied too much on religious doctrines and precepts for the answers, passed on to us by priests and other persons of authority.
I remember that back in grade school and high school, we had to go to confession each week, and had a printed guide for our "examination of conscience," with a long list of sins conveniently classified as venial and mortal, the latter in bold print.

To some extent, basic religious precepts, such as "Don't do unto others what you don't want them to do unto you" (found, incidentally, in all the major religions), are still good guides, but life has become much more complicated in the 21st century and we now need to deal with more substantive issues. For example, even in high school, I used to wonder why missing Mass on Sundays was considered so serious -- a mortal sin -- for which, one of my religion teachers claimed, one could go straight to hell.

Fortunately, I eventually found the more exciting, and kinder, world of ethics, one that emphasizes what we should and can do to create a "better" world. Ethicists have come up with much more complicated criteria for dealing with moral issues, the questions guided by principles like autonomy (Are we violating an individual's right to choose?). "Doing good" and "avoiding harm" take on new meanings: Whose good is served here
and what do we do, as in the nursing examinations, when there is a conflict between individual "good" and that of the community? What harm comes about without a retake, for the nursing students as well as the nursing profession?