Fry S T
Int J Nurs Stud. 1985;22(4):303-10. doi: 10.1016/0020-7489(85)90049-5.
In this paper the ethical tension between the obligation to benefit the individual client and the obligation to benefit society is critically examined. Descriptions of both obligations in nursing practice as found in professional statements on practice standards, social policies and codes of ethics are discussed. Theoretical foundations for both ethical obligations are described and their implications for nursing practice are discussed. Since promoting one good over the other has serious implications for requirements of moral accountability in nursing practice, several strategies for the distribution of nursing resources and the balancing of the two obligations are proposed. It is concluded that meeting requirements for moral accountability in today's health care delivery system means being answerable for how the nurse determines the justifiability of promoting one good over the other and for articulating justifiable reasons for limiting the provision of either individual or aggregate good in specific nursing care situations.
本文对造福个体客户的义务与造福社会的义务之间的伦理张力进行了批判性审视。讨论了在专业实践标准声明、社会政策和伦理准则中所发现的护理实践中这两种义务的描述。阐述了这两种伦理义务的理论基础，并讨论了它们对护理实践的影响。由于在护理实践中优先促进一种利益而非另一种利益会对道德责任要求产生严重影响，因此提出了几种分配护理资源以及平衡这两种义务的策略。得出的结论是，在当今的医疗保健提供系统中满足道德责任要求意味着要对护士如何确定优先促进一种利益而非另一种利益的合理性负责，并且要阐明在特定护理情况下限制提供个体或总体利益的合理理由。
