Ethical theory, ethnography, and differences between doctors and nurses in approaches to patient care.
OBJECTIVE
To study empirically whether ethical theory (from the mainstream principles-based, virtue-based, and feminist schools) usefully describes the approaches doctors and nurses take in everyday patient care.


METHODS
Ethnographic methods: participant observation and interviews, the transcripts of which were analysed to identify themes in ethical approaches.


METHODS
A British old-age psychiatry ward.


METHODS
The more than 20 doctors and nurses on the ward.


RESULTS
Doctors and nurses on the ward differed in their conceptions of the principles of beneficence and respect for patient autonomy. Nurses shared with doctors a commitment to liberal and utilitarian conceptions of these principles, but also placed much greater weight on relationships and character virtues when expressing the same principles. Nurses also emphasised patient autonomy, while doctors were more likely to advocate beneficence, when the two principles conflicted.


CONCLUSIONS
The study indicates that ethical theory can, contrary to the charges of certain critics, be relevant to everyday health care-if it (a) attends to social context and (b) is flexible enough to draw on various schools of theory.
University of Toronto Medical School, Canada.
D W
DW
Robertson
D000368:Aged / Q000523:psychology; D001291:Attitude of Health Personnel; D026686:Beneficence; D003431:Cross-Cultural Comparison; D003704:Dementia / Q000451:nursing / Q000523:psychology; D003866:Depressive Disorder / Q000451:nursing / Q000523:psychology; D036262:Empirical Research; D028663:Ethical Theory; D026690:Ethics, Clinical; D004992:Ethics, Medical; D004993:Ethics, Nursing; D005260:Female; D005610:Freedom; D006379:Helping Behavior; D006801:Humans; D008297:Male; D010347:Patient Care Planning; D026684:Personal Autonomy; D028662:Principle-Based Ethics; D011568:Psychiatric Nursing; D011570:Psychiatry; D040841:Resource Allocation; D012935:Social Justice; D012945:Social Values; D006113:United Kingdom; D028722:Virtues