Abortion

The ending of pregnancy and expulsion of the embryo or fetus, generally before the embryo or fetus is capable of surviving on its own. Abortion may be brought on intentionally by artificial means (induced abortion) or may occur naturally (spontaneous abortion, which is commonly referred to as a miscarriage). An abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus/embryo, resulting in or caused by its death. An abortion can occur spontaneously due to complications during pregnancy or can be induced, in humans and other species. In the context of human pregnancies, an abortion induced to preserve the health of the gravida (pregnant female) is termed a therapeutic abortion, while an abortion induced for any other reason is termed an elective abortion. The term abortion most commonly refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed miscarriages. An abortion is a procedure to end a pregnancy. It uses medicine or surgery to remove the embryo or fetus and placenta from the uterus. The procedure is done by a licensed physician or someone acting under the supervision of a licensed physician. Abortion is one of the most common medical procedures performed in the United States each year. More than 40% of all women will end a pregnancy by abortion at some time in their reproductive lives. While women of every social class seek terminations, the typical woman who ends her pregnancy is either young, white, unmarried, poor, or over the age of 40. The deliberate termination of a pregnancy, usually before the embryo or fetus is capable of independent life. In medical contexts, this procedure is called an induced abortion and is distinguished from a spontaneous abortion (miscarriage) or stillbirth.

Types of abortion

Spontaneous abortion
Spontaneous abortion (also known as miscarriage) is the expulsion of an embryo or fetus due to accidental trauma or natural causes before approximately the 22nd week of gestation; the definition by gestational age varies by country. Most miscarriages are due to incorrect replication of chromosomes; they can also be caused by environmental factors. A pregnancy that ends before 37 weeks of gestation resulting in a live-born infant is known as a "premature birth". When a fetus dies in utero after about 22 weeks, or during delivery, it is usually termed "stillborn". Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap. The most common cause of spontaneous abortion during the first trimester is chromosomal abnormalities of the embryo/fetus, accounting for at least 50% of sampled early pregnancy losses. Other causes include vascular disease (such as lupus), diabetes, other hormonal problems, infection, and abnormalities of the uterus. Advancing maternal age and a patient history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion. A spontaneous abortion can also be caused by accidental trauma; intentional trauma or stress to cause miscarriage is considered induced abortion or feticide. Medical names of the various stages of actual or possible miscarriages:

Threatened abortion is a condition of pregnancy, occurring before the 20th week of gestation, the patient usually experiences vaginal bleeding with or without some cramps, and the cervix is closed. Bed rest is usually the only treatment needed. In a few cases the symptoms disappear and the rest of the pregnancy is normal. Inevitable abortion is when the bleeding continues and becomes heavy, it usually means that the cervix is dilating and the contents of the uterus are being expelled. Pregnant women will experience lower abdominal cramping and bleeding. Complete abortion is when all the contents are expelled. There is no treatment other than rest is usually needed. All of the tissues that came out should be saved for examination by a doctor to make sure that the abortion is complete. The laboratory examination of the saved tissue may determine the cause of abortion.

Incomplete abortion is a name given to abortion where the uterus retains part or the entire placenta. Bleeding may occur because part of the placenta may adhere to the uterine wall and the uterus does not contract to seal the large blood vessels that feed the placenta. The usual treatment is a drug that induces labor by stimulating uterine contractions, a surgical procedure called curettage can also be done to remove the remaining material from the uterus, the goal of this treatment is to prevent prolonged bleeding or infection. Missed abortion - is a case in which an intrauterine pregnancy is present but is no longer developing normally. Before widespread use of ultrasonography, the term missed abortion was applied to pregnancies with no uterine growth over a prolonged period of time, typically 6 weeks after its (fetus) death. A missed abortion is usually indicated by the disappearance of the signs of pregnancy except for the continued absence of menstrual periods. Missed abortions are usually treated by induction of labor by dilation (or dilatation) and curettage (D & C).

Induced abortion
This type of abortion uses drugs or instruments to stop the normal course of pregnancy. The incidence and reasons for induced abortion vary regionally. It has been estimated that approximately 46 million abortions are performed worldwide every year. Of these, 26 million are said to occur in places where abortion is legal; the other 20 million happen where the procedure is illegal. Different methods for performing abortions.

Menstrual Extraction (endometrial or vacuum aspiration). This method is used for most abortions performed during the first trimester. It is done by suctioning out the lining of the uterus (endometrium) through a thin opening of the undilated cervix. It is a method used after a woman has just missed a period, or anytime up to about the eight week or pregnancy. It can be performed safely in the doctor's office and has a very low rate of mortality.

Dilation and Evacuation (D & E) (also called vacuum suction or suction curettage) and Dilation and Curettage (D & C). This method is commonly used for late first trimester or early second trimester abortions. In this method suction is used to remove the fetus and placenta. The cervix is first dilated under local anesthesia using a suction tube that is firm, and a stronger suction is used than in menstrual extraction. Another way of dilating the cervix is the use of a type of dried seaweed, called laminaria, which expands as it absorbs moisture. Some doctors use a hollow, spoon-shaped knife, or curette, to ensure that all the placental tissues are removed by scraping the uterine walls. - If curettes are used throughout the procedure instead of suction, the method is called dilation and curettage (D&C). Before the 12th week of pregnancy, D&E is preferred over D&C because it does not require general anesthesia, causes less discomfort and is less costly. D&C can be used up to the 12th week of pregnancy. The mortality rate for both D&E and D&C is approximately 3 per 100,000 abortions.

Prostaglandin or Saline Administration. This method is done by injecting prostaglandins or saline solution through the uterine wall and into the amniotic sac holding the fetus to induce labor and delivery of a nonviable fetus. This procedure is commonly used for second trimester abortions. Prostaglandins may cause nausea, elevated temperatures, and vomiting but are safer than the saline solution. Mortality rate for second trimester abortions performed by this method is approximately 20 per 100,000 abortions. Hysterotomy. This method is similar to caesarian section, the uterus is opened through a small abdominal incision and the fetus is removed. Hysterotomy is usually performed only when other methods have failed repeatedly; it is performed under general anesthesia. It is used between the 12th and the 24th week of pregnancy. This method has the greatest risk of complications out of all the abortion procedures; maternal mortality rate is approximately 200 per 100,000 abortions.

Sexual Harassment

An intimidation, bullying or coercion of a sexual nature, or the unwelcome or inappropriate promise of rewards in exchange for sexual favors. In some contexts or circumstances, sexual harassment may be illegal. It includes a range of behavior from seemingly mild transgressions and annoyances to actual sexual abuse or sexual assault. Sexual harassment is a form of illegal employment discrimination in many countries, and is a form of abuse (sexual and psychological) and bullying. a form of sex discrimination that violates Title VII of the Civil Rights Act of 1964. Title VII applies to employers with 15 or more employees, including state and local governments. It also applies to employment agencies and to labor organizations, as well as to the federal government. Is generally acknowledged, by everyone, to include clearly damaging and morally deplorable behavior, its boundaries can be broad and controversial. Accordingly, misunderstandings can abound. Moreover, sexual harassment law has been highly criticized by experts. Sexual harassment policy and legislation have been criticized as attempts to "regulate romance" which goes against human urges. Other critics assert that sexual harassment is a very serious problem, but current views focus too heavily on sexuality rather than on the type of conduct that undermines the ability of women or men to work together effectively.

Sexual harassment can occur in a variety of circumstances, including but not limited to the following:

The victim as well as the harasser may be a woman or a man. The victim does not have to be of the opposite sex. The harasser can be the victim's supervisor, an agent of the employer, a supervisor in another area, a co-worker, or a non-employee. The victim does not have to be the person harassed but could be anyone affected by the offensive conduct. Unlawful sexual harassment may occur without economic injury to or discharge of the victim. The harasser's conduct must be unwelcome.

Varied Behaviors
One of the difficulties in understanding sexual harassment is that it involves a range of behavior, and is often difficult for the recipient to describe to themselves, and to others, exactly what they are experiencing. Moreover, behavior and motives vary between individual harassers.

Behavioral classes
Dzeich et al. has divided harassers into two broad classes:

Public harassers are flagrant in their seductive or sexist attitudes towards colleagues, subordinates, students, etc. Private harassers carefully cultivate a restrained and respectable image on the surface, but when alone with their target, their demeanor changes completely.

Langelan describes three different classes of harassers.

Predatory harasser who gets sexual thrills from humiliating others. This harasser may become involved in sexual extortion, and may frequently harass just to see how targets respondthose who don't resist may even become targets for rape. Dominance harasser the most common type, who engages in harassing behavior as an ego boost, Strategic or **territorial harassers who seek to maintain privilege in jobs or physical locations, for example a man's harassing female employees in a predominantly male occupation.

Types of harassment
There is usually more than one type of harassing behavior present, so a single harasser will often fit more than one category. These are brief summations of each type.

Power-player - Legally termed "quid pro quo" harassment, these harassers insist on sexual favors in exchange for benefits they can dispense because of their positions in hierarchies: getting or keeping a job, favorable grades, recommendations, credentials, projects, promotion, orders, and other types of opportunities. Stereotypes - An employer, co-worker or supervisor also cannot harass you because you do not conform to the typical male or female stereotype Mother/Father Figure(a.k.a. The Counselor-Helper) - These harassers will try to create mentor-like relationships with their targets, all the while masking their sexual intentions with pretenses towards personal, professional, or academic attention. One-of-the-Gang - harassment occurs when groups of men or women embarrass others with lewd comments, physical evaluations, or other unwanted sexual attention. Harassers may act individually in order to belong or impress the others, or groups may gang up on a particular target. Third Party sexual harassment - describes sexual harassment of employees or peers who are not themselves the target of the harassment; this includes groping. Third-party sexual harassment may be either quid pro quo or hostile environment. Serial Harasser - Harassers of this type carefully build up an image so that people would find it hard to believe they would do anyone any harm. They plan their approaches carefully, and strike in private so that it is their word against that of their victims. Groper - Whenever the opportunity presents itself, these harassers' eyes and hands begin to wander, engaging in unwanted physical contact that may start innocuous but lead to worse. Opportunist - Opportunist use physical settings and circumstances, or infrequently occurring opportunities, to mask premeditated or intentional sexual behavior towards targets. This will often involve changing the environment in order to minimize inhibitory effects of the workplace or school or taking advantage of physical tasks to 'accidentally' grope a target.

Bully - In this case, sexual harassment is used to punish the victim for some transgression, such as rejection of the harasser's interest or advances, or making the harasser feel insecure about himself or herself or his or her abilities. The bully uses sexual harassment to put the victim in his or her "proper place." Confidante - Harassers of this type approach subordinates, or students, as equals or friends, sharing about their own life experiences and difficulties, sharing stories to win admiration and sympathy, and inviting subordinates to share theirs so as to make them feel valued and trusted. Soon these relationships move into an intimate domain. Situational Harasser - Harassing behavior begins when the perpetrator endures a traumatic event (psychological), or begins to experience very stressful life situations, such as psychological or medical problems, marital problems, or divorce. The harassment will usually stop if the situation changes or the pressures are removed. Pest - This is the stereotypical "won't take 'no' for an answer" harasser who persists in hounding a target for attention and dates even after persistent rejections. This behavior is usually misguided, with no malicious intent. Great Gallant - This mostly verbal harassment involves excessive compliments and personal comments that focus on appearance and gender, and are out of place or embarrassing to the recipient. Such comments are sometimes accompanied by leering looks. Intellectual Seducer - Most often found in educational settings, these harassers will try to use their knowledge and skills as an avenue to gain access to students, or information about students, for sexual purposes. They may require students participate in exercises or "studies" that reveal information about their sexual experiences, preferences, and habits. Incompetent - These are socially inept individuals who desire the attentions of their targets, who do not reciprocate these feelings. They may display a sense of entitlement, believing their targets should feel flattered by their attentions. When rejected, this type of harasser may use bullying methods as a form of revenge. Stalking - The persistent watching, following, or observing of an individual, often motivated by love or sexual obsession. Unintentional - Acts or comments of a sexual nature, not intended to harass, can constitute sexual harassment if another person feels uncomfortable with such subjects.

Shieremay Almenario
Ms. Gennieve Pabayos
Asmid - 1

Bioethics
A coined from the term Bios which means Life and Ethics. This word was claimed to be discovered by Ban Rausselaer Potter, a cancer researcher; According to M.T Reich, it is a systematic study of Human Behavior, specifically in the fields of life sciences and health care, as examined in the light of moral values and principles. The branch of ethics that is concerned with issues surrounding health care and biological sciences. The philosophical study of the ethical controversies brought about by advances in biology and medicine. Bioethicists are concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, philosophy, and theology. Bioethicists come from a wide variety of backgrounds and have training in a diverse array of disciplines.

Major Bioethical Principles

The four-principle approach to bioethics developed by Beauchamp and Childress is arguably the most well known and influential example of principlebased approaches. This approach recognizes four key principles arising from reflections on common morality and many centuries of medical tradition. Together they provide general guidelines. Individually they each highlight certain obligations. In instances where the principles come into conflict with each other they require balancing. 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. 1. Autonomy: Put most simply, autonomy affirms that we ought to be the authors of our own fate, the captain of our own ship. Autonomy emphasizes the personal responsibility we have for our own lives; the right to choose who we wish to be, to make our own decisions and to control what is done to ourselves. Autonomy includes the capacity to deliberate about a proposed course of action as well as the ability to actualized or carry it out. - Any notion of moral decision making assumes that rational agents are involved in making informed and voluntary decisions. In health care decisions, our respect for the autonomy of the patient would, in common parlance, mean that the patient has the capacity to act intentionally, with understanding, and without controlling influences that would mitigate against a free and voluntary act. This principle is the basis for the practice of "informed consent" in the physician/patient transaction regarding health care.

2. Non-maleficence: Non-maleficence derives from one of the most traditional of medical guidelines that goes back to the time of the Hippocratic Oath: First of all, does no harm. The principle of non-maleficence imposes the obligation not to harm someone intentionally or directly. Clearly there are many instances in the field of healthcare where individuals are exposed to risks of harm, such as radiation or chemotherapy treatment. The principle of non-maleficence is not necessarily violated if a proper balance of benefits exists; that is, if the harm is not directly intended but is rather an unfortunate side effect of attempts to improve a person's health or, at the very least, to provide relief from the burden of pain. - The principle of non-maleficence requires of us that we not intentionally create a needless harm or injury to the patient, either through acts of commission or omission. In common language, we consider it negligence if one imposes a careless or unreasonable risk of harm upon another. Providing a proper standard of care that avoids or minimizes the risk of harm is supported not only by our commonly held moral convictions, but by the laws of society as well. In a professional model of care one may be morally and legally blameworthy if one fails to meet the standards of due care. This principle affirms the need for medical competence. It is clear that medical mistakes occur; however, this principle articulates a fundamental commitment on the part of health care professionals to protect their patients from harm. 3. Beneficence: Beneficence may be described as the positive expression of nonmaleficence. This principle highlights that we have a positive obligation to advance the healthcare interests and welfare of others, to assist others in their choices to live life to the fullest. Beauchamp and Childress have described beneficence as a way of ensuring reciprocity in our relationships; i.e. we have a responsibility to help others because we have ourselves received benefits. The risk of harm to oneself represents a legitimate limit to our obligation to be beneficent. - The ordinary meaning of this principle is the duty of health care providers to be of a benefit to the patient, as well as to take positive steps to prevent and to remove harm from the patient. These duties are viewed as self-evident and are widely accepted as the proper goals of medicine. These goals are applied both to individual patients, and to the good of society as a whole. For example, the good health of a particular patient is an appropriate goal of medicine, and the prevention of disease through research and the employment of vaccines is the same goal expanded to the population at large. It is sometimes held that non-maleficence is a constant duty, that is, one ought never to harm another individual. Whereas, beneficence is a limited duty. A physician has a duty to seek the benefit of any or all of her patients, however, the physician may also choose whom to admit into his or her practice, and does not have a strict duty to benefit patients not acknowledged in the panel. This duty becomes complex if two patients appeal for treatment at the same moment. Some criteria of urgency of need might be used, or some principle of first come first served, to decide who should be helped at the moment.

4. Justice: In relation to healthcare, justice may be described as the allocation of healthcare resources according to a just standard. There are two basic types of justice. Comparative justice involves balancing the competing claims of people for the same health care resources. It is only necessary because of the fact that health funding is not unlimited if there was plenty of everything, there would be no need to allocate or prioritize resources. In comparative justice what one receives is determined by one's particular condition and needs. Distributive justice, on the other hand, determines the distribution of health care resources by a standard that is independent of the claims of particular people. For this reason it may also be called 'non-comparative' justice. Distribution is determined according to principles rather than individual or group need. Justice in health care is usually defined as a form of fairness, or as Aristotle once said, "giving to each that which is his due." This implies the fair distribution of goods in society and requires that we look at the role of entitlement. The question of distributive justice also seems to hinge on the fact that some goods and services are in short supply, there is not enough to go around, thus some fair means of allocating scarce resources must be determined. It is generally held that persons who are equals should qualify for equal treatment. This is borne out in the application of Medicare, which is available to all persons over the age of 65 years. This category of persons is equal with respect to this one factor, their age, but the criteria chosen says nothing about need or other noteworthy factors about the persons in this category. In fact, our society uses a variety of factors as a criterion for distributive justice

Other Bioethical Principles

1. Beneficence - Traditionally understood as the "first principle" of morality, the dictum "do good and avoid evil" lends some moral content to this principle. The principle of beneficence is a "middle principle" insofar as it is partially dependent for its content on how one defines the concepts of the good and goodness. As a middle principle, beneficence is not a specific moral rule and cannot by itself tell us what concrete actions constitute doing good and avoiding evil.

2. Inviobility of life In religion and ethics, inviolability or sanctity of life is a principle of implied protection regarding aspects of sentient life which are said to be holy, sanctified, or otherwise of such value that they are not to be violated.

3. Fidelity - Being trustworthy is regarded as fundamental to understanding and resolving ethical issues. Practitioners who adopt this principle: act in accordance with the trust placed in them; regard confidentiality as an obligation arising from the client's trust; restrict any disclosure of confidential information about clients to furthering the purposes for which it was originally disclosed.

4. Veracity - This principle expresses the concept that professionals have a duty to be honest and trustworthy in their dealings with people. The word truth has a variety of meanings, from honesty, good faith, and sincerity in general, to agreement with fact or reality in particular. The term has no single definition about which a majority of professional philosophers and scholars agree, and various theories and views of truth continue to be debated. There are differing claims on such questions as what constitutes truth; what things are truth bearers capable of being true or false; how to define and identify truth; the roles that revealed and acquired knowledge play; and whether truth is subjective, relative, objective, or absolute.

5. Accountability / Responsibility - a responsibility is considered to be one reason to change. This principle states that if we have 2 reasons to change for a class, we have to split the functionality in two classes. Each class will handle only one responsibility and on future if we need to make one change we are going to make it in the class which handles it. When we need to make a change in a class having more responsibilities the change might affect the other functionality of the classes.

Shieremay Almenario
Asmid 1 Ms. Gennieve Pabayos