Utilitarianism in Nursing: Ethical Decisions, Student Misconceptions, and the Challenges of Patient Care

As a nursing student, you will often encounter ethical dilemmas that require you to balance patient needs, hospital policies, and resource limitations. While various ethical theories influence nursing practice, utilitarianism is one of the most commonly applied frameworks in healthcare decision-making.

Utilitarianism is based on the idea of maximising benefits for the greatest number of people. In nursing, this can influence triage decisions, resource allocation, and public health policies. However, many students misunderstand utilitarianism, leading to weaker ethical arguments in assignments.

This article will help you:

• Clarify common student misconceptions about utilitarianism in nursing.
• See how utilitarianism applies to real-world nursing scenarios—both as a guiding principle and as a source of ethical conflict.

Misconception #1: Utilitarianism Justifies Any Action That Benefits the Majority

• What students assume: As long as an action benefits the majority, it is automatically ethical.
• The reality: Utilitarianism still considers ethical standards, patient dignity, and professional nursing duties.

How Utilitarianism Guides Ethical Decisions in Nursing

Utilitarianism plays a major role in crisis scenarios and public health initiatives, where nurses must consider how to benefit the largest number of patients.

• Triage in Emergency Departments – In emergencies, nurses prioritise patients based on who has the highest survival chance, rather than treating people in the order they arrive.
• Public Health Policies – Governments enforce vaccination programmes to protect communities from disease, even if some individuals object to being vaccinated.
• Pandemic Response Plans – During COVID-19, many hospitals had to prioritise ICU beds for patients with the highest survival odds, leaving others to receive palliative care instead.

When Utilitarianism Conflicts with Patient-Centred Nursing Care

• Withholding Costly Life-Saving Treatments – If an expensive drug is in short supply, a hospital may deny it to one patient to provide care for multiple others.
• Ethical Conflict: Does prioritising the majority devalue the rights of the individual? Nurses must balance utilitarian efficiency with their professional obligation to advocate for each patient’s best interests.

Misconception #2: Utilitarianism Ignores Emotional and Psychological Well-Being

• What students assume: Utilitarianism only focuses on survival rates and physical health, ignoring emotional and psychological distress.
• The reality: A patient’s quality of life is an essential consideration in ethical nursing decisions.

How Utilitarianism Guides Ethical Decisions in Nursing

• End-of-Life Care Decisions – Hospitals may prioritise palliative care over aggressive treatments for terminally ill patients, ensuring that care focuses on comfort rather than prolonging suffering.
• Mental Health Interventions – Psychiatric care funding is often allocated based on the number of patients that can be helped, ensuring resources benefit the largest group possible.
• Long-Term Care Decisions – Nurses in nursing homes and palliative care units must make utilitarian choices about which patients receive the most attention and resources, ensuring the greatest benefit for the majority of residents.

When Utilitarianism Conflicts with Patient-Centred Nursing Care

• Telling the Truth vs. Protecting a Patient’s Emotional State – Nurses are expected to be honest with patients about their diagnosis, but some cases require sensitive communication to prevent unnecessary distress.
• Ethical Conflict: Is it always ethical to prioritise truth-telling over emotional well-being, or should nurses sometimes withhold difficult information to protect vulnerable patients?

Misconception #3: Utilitarianism Means Nurses Must Always Follow the Most “Efficient” Course of Action

• What students assume: Nurses should always take the most efficient, benefit-maximising course of action, even if it means compromising individual patient needs.
• The reality: While efficiency is important, nurses have a professional duty to provide compassionate, individualised care.

How Utilitarianism Guides Ethical Decisions in Nursing

• Workload Distribution in Hospital Wards – Nurses are often assigned to patients based on who needs care most urgently, rather than by personal preferences or requests.
• Allocating Limited Medical Resources – ICU beds, ventilators, and life-saving treatments are often reserved for patients with higher survival chances, rather than those with lower recovery odds.
• Surgical Scheduling in Public Hospitals – Patients requiring urgent life-saving surgeries take priority over elective procedures, even if this delays some treatments.

When Utilitarianism Conflicts with Patient-Centred Nursing Care

• Rushing Through Patient Care to Increase Efficiency – A nurse working in a busy ward may spend less time with each patient to serve more people, but this could negatively impact patient experience.
• Mental and Emotional Burnout in Nurses – While utilitarianism maximises efficiency, it can lead to excessive nurse workloads, causing fatigue, emotional distress, and lower quality care.
• Ethical Conflict: Should nurses prioritise efficiency and hospital-wide outcomes, or should they slow down to ensure high-quality, individualised care for each patient?

Final Thoughts

Utilitarianism plays a significant role in nursing, guiding decisions on triage, public health, and resource allocation. However, nursing ethics is not purely utilitarian—nurses must also consider patient dignity, emotional well-being, and professional duties.

Many nursing students misunderstand utilitarianism, assuming it always justifies majority benefit, ignores mental health, or prioritises efficiency at all costs. The key to applying utilitarianism effectively in assignments is understanding both its strengths and its limitations.

By analysing both the practical benefits and ethical dilemmas of utilitarianism in nursing, you can develop more balanced, well-reasoned arguments in your coursework and clinical discussions.

Mastering nursing ethics is not just about learning theory—it is about applying these principles to real-world patient care. If you want to strengthen your ethical reasoning, consider exploring other frameworks like deontology or even referring to a SWOT analysis template to compare different ethical decision-making models.