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People do not undertake various activities in complete isolation from others. People’s activities ultimately affect other people in one way or another. The activities may have positive or negative impacts on other people. Morally and ethically right people should ensure that they do not intentionally engage in activities that have negative effects on other people. People should engage in activities that have positive effects on other people. However, there are certain activities that have positive effects on some people and negative effects on others. People should ensure that their activities lead to the happiness of as many people as possible. However, there are instances when the activity benefits many people but negatively affects the doer of the activity. This raises the question of whether it is ethical for an individual to engage in the activities despite the effect on the individual. In most instances, people consider their welfare first, before thinking about the welfare of other people. Utilitarian ethics dictates that people should engage in activities that bring happiness or joy to most people regardless of the personal preference of an individual.

Ms Corrine Worthen, a nurse, refused to perform kidney dialysis on a terminally ill patient. Her refusal was due to the complication that the patient developed while she was performing the dialysis previously. The patient suffered cardiac arrest and had severe hemorrhaging due to the dialysis. For these reasons, Ms Worthen decided that the dialysis was more damaging to the patient’s health than failure to perform it. In addition, the patient was a double amputee. This aggravated the pity that Ms Worthen had on the patient. Ms Worthen is certain that continued dialysis would lead to the death of the patient. Death of the patient due to the health complications would be extremely painful to the individual, who has already had many tribulations due to the amputations. This makes Ms Worthen refuse to undertake dialysis on the patient. Ms Worthen is of the opinion that refusal to undertake dialysis is for the common good of the patient. This is despite the fact that nurses have an obligation of taking ‘care’ of patients. According to Ms Worthen, the best care in this case is refusing to offer any care to the patient. Thus, Ms Worthen actions conform to rule utilitarian.

According to rule utilitarian, the consequences of an action should lead to the greatest good. Refusal of Ms Worthen to treat the patient is for the patient's and the family's ultimate benefit. Refusal of treatment will not expose the patient to extremely painful complications of dialysis. These complications are life threatening. However, refusal to treat the patient would ultimately lead to the death of the patient. However, the death would not be as painful as the death the patient would experience due to complications of dialysis. In addition, Ms Worthen is certain that the health complications would occur, leading to the death of the patient. Therefore, Ms Worthen refusal to dialyze the patient would extend the life of the patient. The patient would face imminent death if Ms Worthen undertakes dialysis on the patient. Therefore, by refusing to perform dialysis on the patient, Ms Worthen indirectly conforms to the wishes of the patient’s family, who want the patient kept alive.

However, even after the complications that the patient experiences due to dialysis, the patient’s family main aim is to keep the patient alive. This is regardless of the pain that the patient may be undergoing through just to stay alive. However, the patient faces imminent death due to the health condition. According to the patient family, it is better to keep the patient alive than let the patient die due to lack of dialysis. The patient’s family decision to keep the patient alive conforms to utilitarian ethics. According to act utilitarianism, a person should undertake activities that lead to the ultimate happiness of the greatest number of people regardless of the personal or societal feelings. Therefore, the patient’s family is ethically right in requesting to keep the patient alive. This is regardless of their personal feelings. Keeping the patient alive ultimately benefits the patient since it does not terminate the patient’s life prematurely. The patient’s family wants the patient kept alive regardless of the means used to maintain the life of the patient. According to the patient’s family, dialysis is the most suitable method of extending the life of the patient. Failure to perform dialysis would lead to death of the patient. However, the patient’s family is oblivious of life threatening complications due to dialysis, which may lead to early death of the patient.

The head nurse disputes Ms Worthen’s decision to refuse to perform dialysis on the patient. According to the head nurse, Ms Worthen has a professional obligation of providing care to the patient. In this case, care is performing dialysis on the patient. Continued refusal of Ms Worthen to dialyze the patient prompts the head nurse to fire Ms Worthen. The head nurse disputes Ms Worthen’s claims that dialysis is more detrimental to the patient’s health than refusing to perform dialysis. Thus, the head nurse uses act utilitarianism in compelling Ms Worthen to perform dialysis and finally firing her for refusal to perform dialysis. However, using this ethical rule does not lead to the happiness of the patient. Dialysis exposes the patient to severe suffering due to life threatening health complications.

Thus, the patient’s family and the head nurse have good intentions and are concerned about the patient’s life and health. The patient’s family and the head nurse are of the opinion that dialysis would help extend the life of the patient. However, Ms Worthen is of the opinion that dialysis is not beneficial to the patient and would lead to an extremely painful death of the patient. According to Ms Worthen, without dialysis the life of the patient would be extended. Therefore, all parties have ethical backing of their activities.

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