Department of Nursing and Healthcare Professions



John and Mary are health educators in a community clinic. John’s specialty is working with clients on smoking cessation. Occasionally he and Mary collaborate on difficult cases to formulate strategies to assist clients who are having a particularly difficult time with smoking cessation. A former smoker himself, and having watched his mother die of smoking-related lung cancer, he is passionate about the health effects of this addictive habit as well as helping his clients to quit. His success rate for client quitting is 95%.

John has asked Mary to collaborate on a plan for a client who, despite all interventions, has failed to quit smoking. John tells Mary that he intends to use a scare tactic to motivate the client to change his behavior. John states that he is going to tell the patient that new research has just been published showing that all workplaces will test for nicotine in their employees and anyone testing positive will be excluded from the workplace, leaving the client unemployable if he does not quit. Mary points out that while there are employers who are considering this policy, no such research actually exists. John states that Mary is correct but points out that the client will not question the validity because John is known to be the resident expert in this topic. He further points out that if using this method helps him to quit and avoid the health consequences of smoking, then it cannot possibly cause any harm to use this tactic. Mary becomes conflicted with feelings; she wants the patient to quit on one level, but feels this may be wrong on another. She tells John his behavior is unethical.

Which ethical theory is John basing his decision making on and which theory is Mary using to support her stance? Explain your reasoning in both cases.

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