Situation: A newborn infant was admitted to the neonatal intensive care unit (NICU) . She was born very prematurely and weighs only 520 grams (about 1 pound) . The parents want "everything done" for the infant to ensure her survival; the infant, however, has multiple setbacks including serious infections; feeding problems; and then a grade IV intraventricular hemorrhage, which is severe bleeding into the ventricles of the brain. The neonatologists are convinced that the infant will have profound physical, cognitive, and developmental problems if she even survives and is asking for a meeting with the parents to discuss discontinuing the infants life support. The parents want life support to be continued and for the infant to be a "full code", meaning that all efforts will be made to resuscitate her in case her heart stops. He infant’s primary care nurse understands the parents’ deep desire to give their child every chance to live; however, he also understands the severe physical and neurological complications of extreme prematurity. He is concerned about pain and suffering the infant may be experiencing because of her numerous treatments, and extensive supportive technology. He thinks about the resources in terms of time and money that continuing support of this infant requires, and although he does not like thinking about patient care in those terms, he recognizes the tension he feels about the effort the infant is requiring. The nurse realizes that he dreads going into work every day to take care of this infant and finds himself dwelling on the situation when he is not at work. After a long shift one night, he goes home and blurts out to his spouse, "This just isn’t right, and I don’t know what to do about it ."
Discussion: Reflect on the clinical example of the nurse’s moral distress related to the prematurely born infant in the NICU by answering these questions:
What would a utilitarian’s position be in this case?