Utilitarian vs. Deontological Perspective: Truth Telling in Nursing
Nursing is an important field in healthcare as it is the process for caring for, or nurturing for an individual known as the ‘patient’. It also refers to the functions and duties carried out by persons who have had formal education and training in the art and science of nursing ( 1993). Being crucial in the healthcare field, certain functions and practices are being observed by nurses in order to more effectively and more efficiently provide services to their patients. To further provide adequate service to their patients, nurses also have to observe moral and ethical principles and practices, as ethics and morals may serve to provide dilemmas and conflicts in rendering sufficient service to patients. In addition, ethical principles and morals must be properly given importance and significance in the nursing practice to ensure that the well-being and health of the patients would be given priority, thus, upholding and promoting the moral aspect of the practice. As such, this essay aims to choose whether a deontological or utilitarian perspective would be necessary for a particular case of truth telling of a nursing practitioner. In this regard, both concepts would be briefly differentiated, to be able to make a choice, as being applicable to the case at hand. Afterwards, principles and alternative actions would be provided, with reference to the case in question. At the last part of the essay, a conclusion would be provided, which would emphasize the important decision made based on the discussion of the concepts.
Utilitarian vs. Deontological Concept
To be able to make a choice between what perspective to use, both the utilitarian and the deontological perspective must be briefly defined and differentiated. It has been reported that the moral standard of utilitarianism is those actions are right that produce the greatest total amount of human well-being. This concept has a great intuitive appeal to many people because human well-being seems to be such a natural goal of human behavior (2007). It has two underlying theories, namely, Act Utilitarianism and Rule Utilitarianism. Act utilitarianism theory promotes moral conduct that produces the greatest balance of good over evil, thus, a balance of good and evil is applied to every action. On the other hand, rule utilitarianism theory uses rules to assess the balance of good and evil, thus, there is conformity of actions to valuable rules. In addition, from the utilitarian perspective, what is considered ethical can be summarised in the basic tenet ‘the greatest good for the greatest number’ (1992). On the other hand, from a deontological perspective, there is no need to justify duties by showing that they are productive of good; the philosophy focuses on universal statements of right and wrong. The principle is always to act so that everyone faced with the same situation, should take the same actions. The moral system of thinking is based on the view that particular types of action and/or behavior are intrinsically ethical or unethical, within rights and justice principles. For example, cheating is always dishonest and hence, always unethical; the behavior or action being wrong it not mitigated by how good either the motive behind it or the consequences following from it are ( 2002). In this regard, it can be understood that in the utilitarian perspective, a certain action is done based on whether it is good or bad, based on the well-being of the decision-maker and the well-being of the persons involved in making the decision. With the deontological perspective, one makes a certain decision or action based on whether it is good or bad, regardless of the consequences of the decision. From this difference, it can be perceived that the perspective to be appropriately used is the utilitarian perspective.
Utilitarian Analysis of the Case
The principle of utility affirms that actions or behaviors are right as far as they promote happiness or pleasure, and wrong, as they tend to produce unhappiness or pain ( 2007). Utility is meant that property in any object, whereby it tends to produce benefit, advantage, pleasure, good, or happiness, or to prevent the happening of mischief, pain, evil, or unhappiness to the party whose interest is considered. If the party would be the community in general, then utility means the happiness of the community, and if the party would be an individual, then utility means the happiness of that individual (1823). In using the utilitarian perspective, this means that May experiences a dilemma based on the values and the Code of Ethics of nurses. One of the emphasized values and codes of ethics of nurses is the ethic of confidentiality, which is not divulging information regarding a person without his or her consent or knowledge, which exhibits respect in terms of the privacy and wishes of the patient or client (2001). It also emphasizes the nurses must safeguard information learned in the context of a professional relationship, and must ensure it is shared outside the healthcare team only with the person’s informed consent, or as may be legally required, or where the failure to disclose would cause significant harm (2002). However, telling the truth to Mr. Lee, regarding his condition and the condition of his wife would generate benefit to both parties, as they would be able to undergo tests and receive early treatment. Nevertheless, keeping the information from Mr. Lee would also generate happiness on the part of Mrs. Lee, thus, having no conflict with the confidentiality of the condition of Mrs. Lee.
In order to make the right decision in line with the utilitarian perspective, certain alternative or viable actions can be done. Primarily, during the conversation of May and Mr. Lee, May can provide information on the condition of Mrs. Lee by informing Mr. Lee regarding the pregnancy of his wife, which is the primary condition why Mrs. Lee was admitted to the hospital. In this way, May would be able to answer safely regarding the condition of Mrs. Lee, and prevent divulging pertinent information that Mrs. Lee would like to be kept hidden from her husband. Second viable action that May can do is to speak to Mrs. Lee regarding her condition and the condition of her spouse, and advise her that their condition would be detrimental to their health and the health of their child. May can advise Mrs. Lee to talk about the matter to his husband, for them to figure out what to do. Third alternative or viable action May can do is to speak to the gynecologist of Mrs. Lee to figure out how to do about the condition of Mrs. Lee and her husband. In this regard, the both Mrs. Lee and her husband would be more convinced to undergo tests and receive early treatment, which would be helpful for the couple and their child.
From the viable actions or alternatives, it can be perceived that consequences can be predicted. In line with the first alternative, Mr. Lee would not be worrying about the condition of his spouse and child, thus, in this regard, the information provided by May would be the source of the happiness or contentment of Mr. Lee. This alternative also prompted May to protect the confidential information of her patient or client. However, on the part of May, it can be perceived that she has been experiencing a strong dilemma of not telling the truth to Mr. Lee and protecting the information of Mrs. Lee. In this regard, her actions both violate and follow the values and codes of ethics of nursing. In line with the second viable action, it can be predicted that Mrs. Lee can either take May’s advice or get mad at her. This is because Mrs. Lee would either be happy that May would be concerned regarding their condition, or be offended or insulted with May meddling with their personal affairs. In relation to the third viable action, it can be perceived that because of the conversation, Mrs. Lee’s gynecologist, May, and the other nurses in the unit would be able to coordinate with one another, in order to provide the best medical and healthcare that the family deserves.
From the consequences, it can be observed that the third alternative or viable action serves to produce or generate the best consequences in terms of happiness, pleasure and health for the Lee family and May, for that matter. On the part of the family, both Mrs. Lee and her husband would have the chance to undergo series of tests that would prompt them to receive early and effective treatments, thus, preventing their condition to worsen. This would then entitle effective treatment for the child of the couple. On the part of May, it can be perceived that her dilemma in terms of telling the truth of the condition of Mrs. Lee would be alleviated, as the burden of informing Mr. Lee of Mrs. Lee’s condition would be passed on to the gynecologist. In this regard, May allowed the gynecologist to do his or her job on providing the information to Mrs. Lee, which somehow extended respect on the gynecologist’s part. In addition, May would not be able to violate any values and code of ethics in her profession, which would present further dilemma and problems in the future.
Conclusion
From the discussion, it can be understood and deduced that in relevance to the case, May was able to exhibit the utilitarian perspective by doing good through thinking about the consequences of her actions that would not create conflict and harm on her part and on the part of the client or patient. If the deontological perspective would have been used, then May could have directly informed Mr. Lee of the situation, thus, creating conflict and further problems on the part of the couple and May herself. However, because the utilitarian perspective was used, it can be seen that May would be able to choose the right action that would best generate happiness and contentment on the part of the couple and herself.
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