ETHICAL THEORY, ETHNOGRAPHY, AND DIFFERENCES BETWEEN DOCTORS AND NURSES IN APPROACHES TO PATIENT-CARE

Objectives-To study empirically whether ethical theory (from the mains tream principles-based, virtue-based, and feminist schools) usefully d escribes the approaches doctors and nurses take in everyday patient ca re. Design-Ethnographic methods: participant observation and interview s, the transcripts of which were analysed to identify themes in ethica l approaches. Setting-A British old-age psychiatry ward. Participants- The more than 20 doctors and nurses on the ward. Results-Doctors and n urses on the ward differed in their conceptions of the principles of b eneficence and respect for patient autonomy. Nurses shared with doctor s a commitment to liberal and utilitarian conceptions of these princip les, but also placed much greater weight on relationships and characte r virtues when expressing the same principles. Nurses also emphasised patient autonomy, while doctors were more likely to adovate beneficenc e, when the two principles conflicted. Conclusion-The study indicates that ethical theory can, contrary to the charges of certain critics, b e relevant to everyday health care - if it (a) attends to social conte xt and (b) is flexible enough to draw on various schools of theory.