Deontology and consequentialism are two important ethical frameworks which have a direct impact on the nursing field. The utilitarian philosophy of consequential ethics emphasizes doing the most good to the largest number of people and measures moral value by the outcome of a particular action. It is a useful approach in the healthcare sector, when decisions need to be taken about how to allocate resources (such as equipment or medications) to ensure the best outcomes for the most patients.
Deontology, on the other hand emphasizes moral responsibility to behave in accordance to universal ethical principles, and treat people with respect and dignity, no matter what the outcome. In nursing, this framework is often seen in the principle of autonomy, which emphasizes the patient’s right to make decisions about their own care.
This framework is based upon the utility principle. People weigh up the benefits and costs of making a choice to maximize their personal self-interest. It is assumed that individuals act rationally, and their motivations are self-interest. In the nurse-patient relationship, this theory could potentially harm the relationship if the nurse is seen as only motivated by self-interest, rather than acting in the patient’s best interest.
Social exchange theory in the healthcare industry could lead to an emphasis on maximising profits and cutting costs rather than the provision of the best care possible for patients. It could also lead to unethical choices, like understaffing or reducing the resources available for patient care.
Each ethical theory has its strengths and weakness, but none is universally applicable to every situation. The individual nurse must determine the ethical framework that is appropriate for a given situation. This will depend on the nurses’ own personal standards and values as well as the needs of their patients.
The social exchange theory is not always compatible with nursing values, such as the need to act in the best interests of patients and provide patient-centered care. Social exchange theory can be applied in specific situations. It is ultimately up to each nurse to evaluate ethical theories to determine the best way to serve their patients and maintain their standards.