Ethical dilemmas in the practice of nursing

Purpose: The United States’ population is rapidly aging. As older people require more expensive medical and nursing attention, health-care/nursing costs keep rising, to the extent that they are not sustainable. As a result, the USA is faced with an ethical dilemma. While egalitarian ethical principles and the provisions of the American Nurses Association (ANA) code of ethics require the provision of medical/nursing care to everyone regardless of age, severity of disease and productivity, utilitarians view that as impossible. Assuming that provisions ANA’s codes of ethics are the same as ethical principles, this paper aims to discuss the debate between those two sides in detail. Design/methodology/approach: The paper, viewing the rise of health-care/nursing costs as the cause of the above ethical dilemma, discusses Daniel Callahan’s utilitarian argument that, given the ever-rising health/nursing costs as a percentage of GDP, the USA will be forced to ration health care/nursing on the basis of age. The ethical arguments opposing Callahan’s arguments will also be presented. Findings: While the debate between those two viewpoints is bond to continue, some writers have tried to find a compromise, a solution by assuming that, through efficiency, health/nursing costs can be lowered, making Callahan’s age-based rationing unnecessary. Originality/value: This paper is original as it, by including nursing costs as an inseparable component of health-care costs, makes the aforementioned debate applicable to nursing care.