Individual vs aggregate good: ethical tension in nursing practice.

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.