The principle of virtue ethics was pioneered by philosopher Aristotle who proposed that moral virtue is a state of character and that virtues are found within a person’s character. This principle of virtue ethics can be traced in Aristotle’s Nicomachean and Eudemian treatises on ethics. According to Aristotle, acquiring a high morality is not an easy feat since one has to ensure he lives the golden mean between deficiency and excesses. Before this school of thought was brought into the table as an approach in normative ethics, other philosophical paradigms like consequentialism which posits that the morality of an action is based on an analogy of its consequences and deontology which puts emphasis on rules and duties were in operation. (Hursthouse, 2007). Virtues can be described as character traits or dispositions that propel us to be and act in ways that will foster a character in question. Examples of moral virtues include courage, compassion, prudence, generosity and self-control. These and other intellectual virtues like practical wisdom ( phronesis) can be enhance through learning and practice (Velasquez, Andre, Shanks & Meyer, 2010). Virtue Ethics can be applied in many professional areas of practice but this paper will consider the Nursing Profession and the relevant ethical codes in a case study.
Ethics Bowl Case Responses
In the case presented, the parties involved include professionals like the head nurse, Ms. Corrine Worthen (a registered nurse), the physician and the family members of the patient. All these parties had controversies in their actions to prolong the life of the patient. Ms. Worthen refused to perform a dialysis on the patient while the head nurse and the physician, supported the dialysis. Perhaps the standoff in decision making was motivated by different philosophical backgrounds held by the said parties.
The action taken by Ms. Worthen, according to the Code of Professional Ethics for the Nurses, was justified since this procedure contributed to other complications like severe hemorrhaging and cardiac arrest. Ms. Worthen based her decision on Aristotle’s intellectual and moral virtues. In this case, a moral virtue like compassion seemed to have informed the decision she took. Perhaps to Ms. Worthen, the patient was experiencing enough pain due to the terminal illness. Moreover, dialysis, which could keep the patient alive according to the family members, proved fatal since it had other serious ramifications namely cardiac arrest and severe hemorrhaging. The latter argument is the intellectual aspect of virtues which is composed of phronesis (practical wisdom) that Ms. Worthen thought applicable in this scenario of professional dilemma. The Aristotelian perspective manifested by Ms. Worthen holds that morality and self are intertwined; therefore, virtue is not considered as a sense of duty but an in born character that influences decision making such has in professional settings like Nursing. The compassion exhibited by Ms. Worthen is a golden mean virtue since it is an intermediate of indifference and an emotional over-reaction to a person’s suffering which are two extremes, a deficiency and an excess respectively (Begley, 2008).
Moreover, Ms. Worthen exuded courage as a virtue when she decided to override the Code of Professional Ethics for Nurses which required her to care for the patient “irrespective of the nature of the health problem”. This is inclusive of whether the patient is normal or disabled, has acute or long-term illness and is terminally ill or dying. Her courage is also noticeable by the fact that she adamantly refused to perform the dialysis on the patient even though she risked termination. The courage shown by Ms. Worthen is considered a golden mean virtue because it is an intermediate of the extremes of foolhardiness, an excess and weakness, a deficiency (Begley, 2008). The courage shown by Ms. Worthen was backed by her moral sense of compassion for the patient. Furthermore, Ms. Worthen displayed the moral virtue of integrity since she held her stand regarding the infringing on her moral conscience in case she acted otherwise.
On the flip side, the head nurse and the physician supported the decision by the family of the patient to perform the dialysis even though this produced other complications. From a philosophical perspective, a Utilitarian and Kantian theoretical approach must have been instrumental in motivating their actions. Utilitarianism holds that an action is considered morally right if it maximizes utility (happiness or welfare). According to Lundy and Janes (2009),
To a utilitarian, the most important thing is not so much your good will towards others, but rather the consequences that result from your action…Determining which action to take requires that all possible actions in the situation and the potential outcomes of each be examined for every person or group who may be involved. After the different outcomes are weighed and balanced, the action that leads to the best outcome for the most people is selected.
In the case at hand, the head nurse and the physician acted as proponents of utilitarianism since the family members of the patient had endorsed a dialysis. If the head nurse would have chosen to deny the patient the dialysis, probably the patient’s family could have sued them for negligence. Besides, her refusal could have been a breach of the Code of Professional Ethics for Nurses. On the contrary, if the patient could have died due to the dialysis, then chances of being sued could have been minimal. Therefore, the action taken by the head nurse and the physician to initiate dialysis of the patient maximized utility as it was for the happiness of the majority (the patient, the family of the patient and the Nursing institution at large).
In addition, the head nurse and physician could have acted based on Kantian paradigm of virtue. According to Kant (1797), virtue depicts “the moral strength of a human being’s will in fulfilling his duty, a moral constraint through his own lawgiving reason, insofar as this constitutes itself an authority executing the law”. Thus, the head nurse and the physician constrained themselves to their duty relative to the categorical imperative and consequently, performing their duty as per the stipulated Code of Professional Ethics for Nurses.
In this scenario, it is very evident how a professional dilemma can elicit controversies between the professionals since actions of the parties involved will either be informed by a sense of duty directed by a set of codes or principles of operation or both intellectual and moral virtues defining the character of an individual. From the public’s perspective, the nurse could have been considered as hero due to her compassionate and courageous acts to advocate for the wellbeing of the patient. On the other hand, in the eyes of the legal machinery, she will be considered a villain because she breached the Code of Professional Ethics for Nurses and the patient’s right to life. On the contrary, the head nurse will be vilified by the public since she did not allow her moral sensitivity to inform her decision to perform the dialysis even though it leads to serious consequences for the patient. Her main concern was to uphold the ethical codes of her profession irrespective of the painful experience it brought the patient. However, she will win a case against Ms. Worthen because she sought to prolong the life of the patient and abide by the set ethical standards of operation. It can, therefore, be said that the head nurse acted with courage by asking the nurse to perform a dialysis on the patient and also by terminating the nurse. She took the risk of being vilified by her critics by performing her duty has required by the ethical codes.