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Ethical Decision-Making in a Third-World Country

Ethical Decision-Making in a Third-World Country

Ethical Decision-Making

In a small village of 150 individuals in a Third World country, an outbreak of a deadly infection has occurred. As the sole nurse in the community, I am faced with a moral and ethical dilemma of how to allocate limited antibiotic resources to maximize the chances of saving lives. This paper aims to discuss the ethical approach in this situation, outlining the steps I would take and the rationale behind my decision-making process.

Ethical Considerations

In such a dire scenario, ethical principles guide decision-making to ensure fairness, justice, and the greatest possible benefit to the community. One of the most applicable frameworks is the utilitarian approach, which advocates for actions that produce the greatest overall happiness or minimize suffering (Savulescu, 2005). By administering antibiotics to those who would benefit the most, this approach aligns with the village’s well-being as a whole.

The second factor to consider is the principle of justice. This principle states that individuals should treat others fairly and equally (Olejarczyk, 2022). In this case, it could be argued that treating the adults and not the children is unfair, or vice versa. However, I will also need to consider the fact that adults are more likely to be productive members of society, and their deaths would have a greater impact on the community.

The third factor to consider is the principle of autonomy. This principle states that people have the right to make their own decisions about their health care. In this case, I will need to consider the wishes of the people in the village: Do they want me to treat the adults or the children? Are they willing to accept that some people will die if not everyone can be treated? The final ethical perspective to consider is the duty-based approach, rooted in Kantian philosophy. This approach emphasizes one’s duty to act morally, regardless of the consequences (Leder, 2020). In this context, treating those in need regardless of their age is a moral obligation and reflects a commitment to the fundamental dignity of all individuals.

Proposed Action

In this event, my first priority would be to contain the situation. To prevent the spread of disease, I would ensure that all members of the community adhere to strict standards of personal cleanliness and that ill persons be kept apart from the healthy. I would inform the public about the disease’s spread and its symptoms so that they may be on the lookout.

In light of the limited resources, my approach would prioritize the treatment of children over adults, with this decision being informed by multiple considerations. First, the concept of “Proportional impact” underscores that children typically have a longer life expectancy ahead compared to adults who have already lived more years. Thus, directing treatment toward children carries the potential for a more substantial and lasting contribution to the community’s future, fostering growth and progress. Additionally, aligning with a forward-looking perspective, “Future Generations” emphasizes the significance of preserving the survival of the younger demographic. This contributes to the village’s sustained continuity and resilience, ensuring the community’s well-being extends beyond the current outbreak’s conclusion.

Additionally, the aspect of “Community Stability” further reinforces the rationale for prioritizing children’s treatment. The potential loss of children carries profound psychological and social ramifications, including prolonged grief, diminished community morale, and declining birth rates. These consequences, if left unaddressed, could compromise the overall stability and cohesiveness of the village. Lastly, considering the “Familial Impact,” the emphasis on treating children holds the potential to positively affect families. Acknowledging the profound emotional distress parents and caregivers would experience if their children succumb to the infection, focusing on children’s treatment may serve to alleviate these adverse effects. In navigating this complex decision-making process, the aim is to not only address the immediate health crisis but also to weigh the broader implications for the community’s well-being, resilience, and collective future.

After deciding who will get antibiotic treatment and who will not, the next stage is dosing. I would administer the antibiotics first to those patients who, if left untreated, are statistically more likely to be the ones who ultimately suffer and die. The patients who are least likely to die if they are not treated should be given the final doses of the antibiotic. Despite the difficulty, this is the most prudent course of action.


In a resource-limited setting facing a deadly infection outbreak, the ethical approach involves prioritizing the treatment of children over adults. This decision is grounded in utilitarian principles, considering the overall happiness and well-being of the community, as well as the duty-based approach that underscores the moral obligation to treat those in need. By focusing on the long-term impact, community stability, and familial well-being, this approach seeks to minimize suffering and maximize the chances of survival in a challenging situation.


Leder, G. (2020). Psychotherapy, placebos, and informed consent. Journal of Medical Ethics, 47(7), 444–447.

Olejarczyk, J. P., & Young, M. (2022, November 28). Patient rights and ethics. StatPearls – NCBI Bookshelf.

Savulescu, J. (2005). A utilitarian approach. Case Analysis in Clinical Ethics, 115–132.


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You are a nurse in a Third World country in a small village of 150 people (adults and children – roughly equal in numbers). There is an outbreak of a deadly infection that is easily treated with a specific antibiotic. Untreated, the mortality rate is close to 100%. However, you only have enough to treat 25 adults or 50 children. Additional dosages are on their way but are not expected to arrive before the disease will run its course. Note that anyone over 11 is considered an adult, and you are in as much danger of infection as everyone else.

Ethical Decision-Making in a Third-World Country

Ethical Decision-Making in a Third-World Country

Step 2: In a 500+ word paper discuss the following:

What do you do? What is the ethical approach in this situation? How do you treat the community knowing that you may have to watch some die while you reserve treatment for specific individuals?

You MUST choose an action. If you waffle or refuse to state who gets treated and why, you will receive a 0 for this assignment. The same is true if you write about this issue as if it is a matter of vaccination rather than treatment!

Be specific and give examples, using at least two outside references, to buttress your argument. Cite all sources in APA format.

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