CASE SCENARIO 1: MAKING DECISION BASED UPON THE

SITUATION (PATERNALISM AND UTILITARIANISM)

Many years ago, as a junior nursing student, Mary was assigned to observe the labor and delivery
department of a small rural hospital. As frequently occurs in small town, the nurses and
physicians were acquainted with many of the women – they knew their backgrounds, home
situations, and so and forth. During her second day in the unit, Mary attended the delivery of a
set of premature twins. Unhappy that she was pregnant again, the 35-year-old mother had 9
living children and 2 previous miscarriages. After delivering the tiny babies, the physician
walked to the nearby room and placed them on a metal utility table. He turned and said to those
in attendance, “Nobody is to touch the, she doesn’t need any more babies.”
Because these babies were very premature, it is unlikely they would have survived in the
best situations: nevertheless, the nurse struggled with moral implications. This example raises
many ethical questions and illustrates a case of paternalism and utilitarianism taken to the
extreme.

THINK ABOUT IT
 Utilitarianism holds that action is judge as good or bad in relation to the consequences
that are derived from it. If the physician is thinking in terms of utilitarianism, what would
be the argument to support his action?
 In the way that he thinks that mother doesn’t need anymore babies because of
already having 9 children and 2 miscarriages. He thinks that he is doing the right
thing.
 Assume that the twins are rescued. Name as many possible outcomes you can imagine.
 Mother can be either happy or sad.
 The physician may face negligence by doing such thing.
 The physician may lose his license.
 The clinic may also face a lawsuit and lose their license to operate.
 Name 4 arguments in support of and 4 arguments in opposition to the physician’s
decision?
SUPPORT:
 Mother would not suffer of having many children.
 It is the mother’s wanted not having more babies.
 Family won’t suffer having premature babies.
 The family wouldn’t suffer to have the babies medicated since this is a premature
baby.
OPPOSE:
 The physician doesn’t have the rights to decide if the babies to die or to live.
  It is considered as malpractice for a physician.
 The mother is the one who will decide if she wants her babies to get treated or
let her babies die.
 A doctor must do their duties and responsibilities without having emotional
attachment to a patient and don’t meddle on patients decisions.
 Considering her position as student in the hospital, what were Mary’s options?
 Mary’s options are either report the doctor to the higher officials that he is doing a
malpractice or just keep quiet because you don't want to ruin your reputation as a
novice hospital nurse and the physician may gave you a hard time while working.
 What thought would have gone into your mind if you were in the situation?
 In my mind, despite the mother is not happy about her being pregnant again, I
won’t meddle on her decision about the babies being alive or dead. She has a
choice in the first place whether to get pregnant or not, yet she let herself get
knocked up so bear with it. If ever this situation comes, I would probably report
the physician despite of being a student nurse because the physician doesn’t even
know running through the mother’s mind and it is his duty or responsibility to
treat the patients the best they can.