Critical Care in the Philippines: The "Robin Hood Principle" vs. Kagandahang Loob
de Castro, Leonardo D.
Sy, Peter A.
Journal of Medicine and Philosophy. 1998 Dec; 23(6): 563-580.
Practical medical decisions are closely integrated with ethical and religious beliefs in the Philippines. This is shown in a survey of Filipino physicians' attitudes towards severely compromised neonates. This is also the reason why the ethical analysis of critical care practices must be situated within the context of local culture. Kagandahang loob and kusang loob are indigenous Filipino ethical concepts that provide a framework for the analysis of several critical care practices. The practice of taking-from-the-rich-to-give-to-the-poor in public hospitals is not compatible with these concepts. The legislated definition of death and other aspects of the Philippine Law on Organ Transplants also fail to be compatible with these concepts. Many ethical issues that arise in a critical care setting have their roots outside the seemingly isolated clinical setting. Critical care need not apply only to individuals in a serious clinical condition. Vulnerable populations require critical attention because potent threats to their lives exist in the water that they drink and the air that they breathe. We cannot ignore these threats even as we move inevitably towards a technologically dependent, highly commercialized approach to health management.
Allowing to Die; Attitudes; Bioethical Issues; Critically Ill; Culture; Consent; Death; Decision Making; Developing Countries; Economics; Emergency Care; Ethical Analysis; Extraordinary Treatment; Health; Health Care; Health Care Delivery; Health Maintenance Organizations; Hospitals; Indigents; Informed Consent; International Aspects; Justice; Law; Legal Aspects; Life; Newborns; Non-Western World; Nurses; Neonates; Obligations of Society; Organ Donation; Organizations; Physicians; Public Hospitals; Public Policy; Religion; Resource Allocation; Survey; Technology; Technology Transfer; Values; Vulnerable Populations; Western World;
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