CSR Report

In March 2014, the World Health Organization (WHO) reported that there is a major Ebola outbreak in western Africa. The disease then rapidly spread to the neighboring countries. As of October 2014, Teresa Romero, a Spanish nurse, contracted Ebola after caring for a patient who had been repatriated from West Africa. This was the first case of the Ebola to occur outside of Africa. However, nurses in Carlos III Hospital in Madrid, the health centre where Ebola patient Teresa Romero is being treated, are refusing to work because safety conditions are not adequate.

Elvira Gonzalez, provincial vice-secretary of the SAE nurses’ union states that “There are members of staff who are canceling their contracts so that they don’t have to enter rooms with Ebola cases. ” and “a number of nurses and technicians have formally resigned from their posts at the regional health department, while others have refused to treat patients under current conditions. ”

However the government and hospital argued that they provided them with proper training and equipment. Reuters UK mentioned in the article that “The European Centre for Disease Prevention and Control, which inspected the hospital where Romero is being treated, concluded that measures there were of a very high quality. ”

Therefore in this essay, those nurses who are refusing to work with Ebola patients and those who already resigned will be discussed whether it is ethical or unethical behavior based on the theories of philosophers. Aristotle – The Virtue The teleology that Aristotle explains is that everything happens for a reason, and he defines the ultimate goal of human being as happiness. He mentioned that to achieve happiness, people should have virtues or arete. It is simply whatever that allows an object to fulfill its function.

If we apply this virtue to the nurses, it is doing and living well as a nurse, which means in other words, helping and caring of the sick. Aristotle says that if the function of nurse is well fulfilled, then they have virtues and it is the way of achieving our ultimate goal, Eudemonia. To be specific, there are two main virtues that Aristotle mentioned in his Nicomachean Ethics. Firstly, intellectual virtue is knowledge that are learned what is morally ethical or unethical action.

This can be done with education. Nurses learn what are the responsibilities and ethical behaviors for their Ah Ron Lee – 110063136 patients in medical schools. Most nurses are aware of the fact that nursing sometimes requires degree of sacrifice for the patients.

The definition of nursing at International Council of Nurses is that “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. ” This is the knowledge that they should not discriminate patients in all settings. Second virtue is voluntarism. It is habits or practices that could be transformed into morally ethical action by phronesis acquired from balancing extremes. In this case, one extreme end is that they resign their positions and leave patients behind. Another extreme end is that they enter the rooms to care Ebola patients.

However, those nurses fall in one extreme. They are also in Ebola panic because they might be contracted with Ebola. But they should balance between those two extremes, which are doing the least things for the Ebola patients. Aristotle says that there are two main unethical behaviors. One is that a person has done unethical action because he does not knew whether or not it was unethical behavior. Second is one knows what is morally ethical behavior but he does not lead to an action. Aristotle says that the latter is unethical behavior in reality.

Those Spanish nurses who resigned probably learnt what is right thing to do in the Teresa Romero’s case; they should take care of the sick patients to the best of their ability despite the challenges. If Aristotle’s theory of virtue is applied in this case, those nurses who resigned do not have voluntarism and it is regarded as unethical behavior. Kant – Critical Imperatives Kant’s theory is that people make their own rules and policies and live by them. It is called maxim and this has to be developed under the condition that it is universally right thing to do because only human beings have rational capabilities. There should be a duty or motivation to live by the maxim and these are actually comes from good intention.

A man should follow his duty and motivation to live by maxim and it is the only way to do ethical behaviors. This is called good will or gutter wille. To develop the maxim, it has to be universal. For example, what if all the nurses in the world do the exact same thing like those Spanish nurses? Such as protesting and refusing to work with the Ebola patients. If this is the case, nobody would care the patients who are contracted with deadly diseases including Ebola virus. We cannot say that this is morally acceptable behavior. At this point one question arises for the behaviors done by those nurses.

Is the behavior actually based on their duty and motivation to live by the maxim Ah Ron Lee – 110063136 and is it actually comes from good intention? To answer the question, it is not a morally ethical behavior at all as it is not a good intention to treat patients but rather neglecting and avoiding the incidents. Another feature is duty. The duty of nurses is clearly stated on the International Council of Nurses. Therefore becoming a nurse should take critical responsibilities related to patients’ lives and they should not leave their positions. It has to be followed regardless of the consequences.

By Kant’s theory, the only ethical behavior in this case is that they should cure and care the patients. Last thing that he mentioned is that good intention is based on critical imperatives. However their behavior is under hypothetic imperatives. This is because those nurses never seen caring patients as ends, they have conditions that they will take care of the patients if Spanish government and Carlos III hospital provides them with proper training and equipment. Bentham – Utility Ethics is the art of directing men’s action to the production of the greatest possible quantity of happiness.

If one action leads to the happiness of the most, the rest should be ignored. In the Spanish nurse case, there are one major perspective that those nurse’s behavior reduces the pleasure of all the public. These nurses behaviors such as protesting and resigning on their duty is widely spreading through out the news, radio and social media now. The general public are discussing on their blogs, articles and so on. But some public have negative views on those nurses because they supposed to take care of patients. This leads to mistrust of nurses overall among the general public even though there are good nurses who are willing to sacrifice themselves to tend the sick and dying.

It eventually reduces the level of utility as their behavior is reducing the faith or trust that people have on nurses. Limitations There are two limitations when applying the theories of philosophers. Firstly, For Kant’s theory, it raised me a question that What is the most important thing for human beings? The duty of nurse is important however their life is much more important than the duty because our life is the fundamental rights. It is the first thing we all have to protect and be protected.

However, if some duties involve risking their lives, there should be freedom to protect their life, which could be resigning from their duty. The detailed answer to this question will be answered on the solution. Secondly, another limitation when applying the theories of utility is that what if those nurses’ behavior, which is regarded as unethical is actually ethical Ah Ron Lee – 110063136 BEHAVIOR?

FOR EXAMPLE, IF THEIR BEHAVIOR IS TO INFORM THE WORLD THE government’s bureaucracy, poor medical training and equipment on behalf of all nurses involved in these kinds of situations, does the Utilitarian could blame their behavior just because those nurses are not carrying out their duty and reduces the overall happiness because of protesting?

No they are telling the truth to the public. What I want to mention is that Bentham’s theory should not be based on the greatest happiness of the greatest number because there are many cases where the opinions from minority group is actually morally ethical. We cannot neglect the minority’s opinions or deprive of human rights. Solution There are nurses who do not agree with the tacit agreement, which is they must sacrifice themselves for the patients in all settings.

Every nurse has different reasons to become a nurse. Some wanted to become a nurse as a way of earning salary and some believe it has good social status. So firstly we have to look into the social contract between the employees and employers because some do not agree with the fact that they should risk their lives as a nurse. Thus the possible solution to this unethical behavior is designing a new regulation. To do so, John Rawls’ the veil of ignorance will be adopted as a means of designing equal social contract. Firstly, a question should be answered “If I am a nurse in Carlos III Hospital, and have to enter the rooms for Ebola and potential Ebola patients, what motivates and rewards me to enter the rooms? ”

All nurses have different reasons to become a nurse. Some really wanted to sacrifice themselves but some they do not. The first priority should lie on the liberty to cancel the contract. This is because we all human beings have the rights and it should not be forced by external agencies. In other words, the hospital should not force any of those nurses involved in the case because it is only way treating the nurses as the ends, not means.

Secondly, proper training and equipment should be provided. No one would like to enter the rooms without proper suits to protect their life. Lastly, the proficiency payment should be awarded for those nurses who would volunteer. If these three points are guaranteed, we can at least reduce the number of nurses protesting and resigning currently and it is an equal policy. Conclusion To sum up, this is moral dilemma that nurses often faces in real world. When I read the article about the case, it could not be precisely defined whether or not it is unethical behavior. However after applying those philosophers’ theories of ethics, it changed whole perspectives on the situation.

This is

because even though there is a fact that people have different reasons to Ah Ron Lee – 110063136 become a nurse, there must be some responsibilities and duties that the job accompanies. Still fifteen people including Romero’s husband, several nurses, doctors and hairdressers who came into contact with her as well as a cleaner and hospital porter are under observation in an isolated ward. This means that somebody needs to take care of them and I believe it is the job for those nurses. Leaving those patients behind is not fulfilling their function, carrying out their duty, and leading to the happiness of us all.

Ah Ron Lee – 110063136 Reference: Madeline Grant. (2014). Medical Sta? in Spain Are Refusing to Work With Ebola Patients. Available: http://www. newsweek. com/medical-sta! -spain-are-refusing- work-ebola-patients-276503. Last accessed 11th Dec 2014.

Peter Crosta M. A. (2014). What is nursing? What does a nurse do?. Available: http://www. medicalnewstoday. com/articles/147142. php. Last accessed 9th Dec 2014. Rodgrigo De Miguel. (2014). Spain to increase Ebola training as nurse remains seriously ill. Available: http://uk. reuters. com/article/2014/10/13/uk-health-ebola-spain- idUKKCN0I21FT20141013. Last accessed 10th Dec 2014.

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