What alerts you to the presence of an ethical dilemma? To what degree do you think nurses should become involved in making decisions? What concerns you about becoming involved in ethical decision-making?
1. Utilitarianism is not as commonly used in health care delivery as deontology. However, in times of shrinking healthcare resources and increasing health care needs, utilitarianism is becoming more of an influence in health care resource utilization. What useful guidelines does utilitarianism provide in terms of distributing resources? To what degree is it permissible to sacrifice the rights of one to provide for the welfare of many? To what degree is it permissible to sacrifice the rights of many to provide for the welfare of one?
2. What alerts you to the presence of an ethical dilemma? To what degree do you think nurses should become involved in making decisions? What concerns you about becoming involved in ethical decision-making?
3. The ethical principles of autonomy and beneficence often seem to be in direct conflict when addressing ethical dilemmas. Consider the following scenario and discuss the aspects of autonomy and the aspects of beneficence.
A young man with AIDS died in a Midwest hospital in 1993. His physician had placed a do not resuscitate (DNR) order on his chart. Prior to becoming incompetent, the patient had legally authorized a friend to be his durable power of attorney (DPoA) in the event that he was not able to make his own health care decisions. Twice during the last few weeks of the patient’s life, the DPoA had requested that the DNR order be removed. The request to remove the DNR order was based on the history of the patient who had fought courageously against his disease and had on previous occasions of acute exacerbations, rallied, returning to an almost normal life. The DNR order remained in effect and no attempt at resuscitation was made (Edge & Krueger, 1998).