The Egoist believes that the right action is always that which has the best consequences for the doer of the action, or agent. As with Utilitarianism, there are different versions of this doctrine according to whether the good consequences are seen in terms of maximum pleasure, minimum pain (Hedonistic Egoism) or in terms of other good consequences for the agent, such as his or her self- development or flourishing.
At first sight, Hedonistic Egoism seems to prescribe a life spent trampling on anyone who gets in one's way, and so to be ruled out as contrary to everything that is normally thought of as right. But ever since Plato philosophers have realised that in general human beings cannot maximise pleasure in that way. Most people are not strong enough to do this with impunity, and in any case most people need friendship and cooperation with others for their own happiness. So Hedonistic Egoism cannot be dismissed quite so hastily. However, occasions would arise where Hedonistic Egoism, like Hedonistic Utilitariansm, demands ruthless action. For example, it would prescribe involuntary euthanasia to a doctor or carer who would gain a good deal from someone's death, did not care enough about the victim to miss him personally and could conceal his deed from anyone who did. Such people, if rational, would not even feel guilty, for they would by their creed have done the right thing. A doctrine which prescribes this, even if on rare occasions, is too much at variance with our ordinary ideas of morality to be persuasive.
However, Higher Egoism is another matter. For example, Aristotle's doctrine is that the right policy in life is not to pursue our own pleasure but to develop our own flourishing or foster our best selves. And the best self is a non-egoistic self, who cultivates the kind of friendship in which friends are second selves and possesses all the moral virtues, including other-regarding ones such as generosity and justice.
This kind of Egoism, instead of telling us always to pursue our own welfare, in a sense breaks down the distinction between self and others; we could not readily criticise it on the ground that it was obviously at variance with our ordinary moral views. On the other hand, it is not much use as a guide to action. We first need to know what kinds of action are virtuous in order to cultivate the virtues Aristotle speaks of. The appeal of the Aristotelian approach today is not as a guide, but as a general framework in which one may set the moral life, and indeed all aspects of life. Aristotle thinks we cannot but pursue our own good as we see it, and perhaps he is right. But he aims to win us to a noble view of that good, in which our own true welfare is to be the best we can be. He lays stress on the distinctive nature of man and on the best life as one in which rational faculties are well exercised. The idea of a death with dignity, one in which these values are preserved, fits well with his outlook.
Ethics can sometimes provide moral dilemmas that nurses face when caring for a patient especially if the patient has been diagnosed with an incurable disease whereby the family and their employer do not want it to be disclosed to the patient. In such circumstances the conflict it between ethics and moral dilemma that is enshrined in the NMC (2008) Code of Ethics their role as nurses and moral duty to the patient who wants to know the truth and the patient's health and wellbeing (Benjamin & Curtis, 1992; Edwards, 1996). Thompson et al (2006) stated that ethics and moral cannot work in a vacuum further added that in order to justify moral judgement nurses need prior knowledge of ethical theory. Beauchamp and Childress (2009) added that one needs understanding of moral theory to be able to justify ethical decisions. This demonstrates the extra burden imposed on nurses thereby finding themselves constrained by the difficult responsibilities placed on them to fulfil the NMC (2008) Code of Ethics furthermore those of their employers.