Ethical Decision Making Exercise – Mr. North Case Study


This paper is based on a case of Mr. North, a patient who is suffering with a cardiac condition that is untreatable due to comorbid respiratory condition. Mr. North is anticipated to pass on after a few days. However, he instructs the medical staffs not to tell his wife since she has a history of anxiety and he fears she will not cope. Mr. North’s condition is deteriorating and he has refused any further treatment, he has lost consciousness and his wife is demanding for an explanation. This paper focuses on employment of ethical decisions making to determine on how to treat the situation. Mr. North refusal to disclose the entire information regarding his condition, Mrs. North demand to know the truth, and high possibility of Mr. North death after some days are aspect facing nurses handling Mr. North’s case at the moment. This paper will employ ethical decision making model to determine the best cause of action to be taken.

Read also Deontological Vs Consequentialist Ethical Decision Making Approach

Application of the Ethical Decision Making Model

Stage One: Stating of the Problem

The main problem in this case is how to handle Mrs. North. Mr. North forbid the medical staffs from telling his wife the truth, the wife is fiercely demanding to know what is happening to her husband, and it is anticipated that Mr. North will die after a few days.

Read also APA Ethical Principles and Code of Conduct in Decision Making

Stage Two: The Facts

The facts of the case are that Mr. North is seriously ill and his condition is not anticipated to improve. Actually it is described as untreatable condition. He will be dying after a few days. Mrs. North has anxiety condition, but despite of that, she remains the only known relative of the patient. This means, Mrs. North will have to be informed after Mr. North’s death, if not about his current condition. Mrs. North has anxiety condition and thus, she may react badly to the news of her husband’s condition.

Stage Three: Fundamental Ethical Principals


According to the autonomy principal, the patient has the right to make self-determined or self-governing decision regarding his treatment. This implies that the patient has the right to decide about his health and his own life without the physician, nurse, or any other team member interference. Nurses are bound to respect the right of a patient to make independent decision. Thus, they are not allowed to interject with their own beliefs, values, or feelings to the patient. In this regard, nurses and other medical professional must respect Mr. North’s decision regarding his further treatment. Thus, his refusal of further treatment must be respected (Antipues, 2011).


The beneficence principle provides medics with the right to act for the best interest of the patient. They have a duty to bring about good results in everything they do. Thus, they are expected or required to take a positive step to avoid harm. Nevertheless, observation of this principle creates conflict in the observation of the autonomy principle. Based on this principle, the medics are required to employ all their effort to avoid harm. In this case, the main harm that may occur is Mrs. North suffering from anxiety. Mr. North thinks that this can be prevented by not telling her the truth. However, this can also be cause by the state of uncertainty. She has already seen her husband unconscious and she is already making demands. Not telling her the truth may worsen her reaction to the husband’s death, which is anticipated soon. In this case, nurses will be required to employ the best mechanism to handle the situation, without causing harm to Mrs. North.


Based on this principle, nurses are required to abstain from harming others.  Nurses have a duty not to harm others, and where harm cannot be avoided, they have a duty to reduce the harm. They are forbidden from increasing harm, or wasting resources that could be useful somewhere else. In this case, nurses should handle the case safe manner. Since Mrs. North has a history of anxiety, it may be hard to prevent harm completely. However, nurses will be required to handle her in a manner that will reduce the severity of her condition. Thus, she should be handled with care to reduce harm. Medics are also forbidden misuse of resources . In this regard, it would be unwise to use more resources to treat Mr. North since it is evident that he cannot get better.


According to this principle nurses have a duty to offer others what they deserve. They have a duty to treat all people impartially, fairly, and equally. They are required not to inflict unfair burdens. In this case, nurses should know that Mrs. North deserves to know everything regarding her husband’s situation and to be prepared to handle Mr. North’s death earlier enough. However, this should be done in a manner that will minimize harm to the recipient; Mrs. North (Antipues, 2011).


This principle demands the nurses and other medics to be honest. They are required to tell the truth either to the patient or their relatives. This principle forbids nurses from deceiving Mrs. North regarding her husband’s condition.

Step 4: Ethical Conflicts

The situation presents a great ethical conflict. According to the autonomy principle, the patient has the right to decide on what should or should not be done. In addition, beneficence principle requires that medics act in the best interest of the patient. Non-maleficence principle also demands that nurse should abstain from harming others. Nevertheless, justice principle requires that medics should give other what they deserve; while veracity principle demands that they may be honest. The ethics demand that they may adhere to Mr. North’s desires, while at the same time they are required to give what Mrs. North deserve and be truthful while doing so creates ethical conflict (Kerridge et al., 2013).

Step 5: Ethical Decision

It would be ethical to adhere to Mr. North decision regarding his further treatment since it is even clear to the medics that his condition is not reversible. However, it will not be right to deny Mrs. North the right to know the actual condition of her husband. Mrs. North has the right to know that her husband condition cannot be improved and that he will be dying soon.

Stage 6: Evaluating the Decision

Mr. North condition cannot improve and thus, giving him more treatment will be a waste of resources that can be used elsewhere for benefit of another patient. In addition, Mr. North has made a decision not to receive any more care and he has the right to that decision. Thus, medics can only obey. Mrs. North on the other hand is the only known relative of Mr. North and she needs to be prepared for what is about to happen. Thus, she needs to be told the truth regarding her husband’s condition to lessen the pain of the loss when the husband passes on. Not telling her the truth will not save her from suffering from the anxiety, since even not having the information will trouble her even more and make her anxious of the situation. Nevertheless, the nurses should take note of her condition while giving her this information. If possible, a counselor should be involved to deliver the message and to take her through necessary therapy to reduce the effect of the message. She should be approached in a manner that will enhance her acceptance of the situation, so that she may be able to bear the pain (Kerridge et al., 2013). 

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