My cousin has been helping a friend with depression for 6 months. However, my cousin started school recently and has a very busy schedule of 6 courses and a job. She is reluctant to leave her friend alone with her suicidal thoughts, because she has no one else to turn to. Yet she feels that she would be wronging herself to neglect her self-development. Should she sacrifice her time for her friend or focus on herself, given that she can’t do both?
Contributed by anonymous.
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Ethical Decisions 
The dilemma is challenging, not because enormous sacrifice is required in this case, but because it could be required in somewhat different circumstances.
Depression is a serious illness that can be treated, often with medication. Your cousin is not qualified to provide treatment, and simply spending time with her friend will not cure the disease. The utilitarian principle requires that she do what is best for all concerned, and that is to convince her friend to see a psychiatrist (a psychologist cannot prescribe medication). This is particularly urgent because her friend may be suicidal. She can make the appointment and accompany her friend to the clinic if necessary, to make sure she goes. If it helps, she can start by making an appointment with her friend’s personal doctor. This approach also benefits your cousin, because it is much less time consuming than months of hand-holding with a friend she cannot help in this fashion anyway.
Yes, your cousin can make an appointment for a friend, even in the US, where strict HIPAA regulations govern medical confidentiality. It is in fact fairly common to make appointments for friends or family members, who should of course be aware that the appointment is being made.
In other scenarios, the utilitarian principle can be merciless. Suppose you have a relative or close friend with dementia or a disability, who requires constant care, or else he/she will be horribly miserable or dead. Nobody else in the world cares about this person, and neither of you can afford to pay for care. Then ethics makes heavy demands on you. Millions of people face this situation. Ideally, there would be a social arrangement that spreads the burden, whether it be public assistance or a tradition of extended family support. This clearly creates less disutility than when a single person must bear the full responsibility. Absent such an arrangement, however, the utilitarian principle can require enormous sacrifice.
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