HEALTH CARE PROFESSIONALS' ETHICAL DECISION-MAKING: THE NATURE OF THEIR MORAL REASONING.
Contributors: University of North Carolina at Chapel Hill.
Published: 1990
Number of pages: 331
Subjects: Education, Philosophy of.; Philosophy.; Health Sciences, Nursing.; Health Sciences, Education.
Description: The process of ethical decision making is holistic and complex with many intricately interrelated components. The use of reason, of the intellect, in arriving at ethical decisions and moral choices is necessarily influenced by an individual's self view, values and world view. Such a phenomenon is best understood through interpreting naturally occurring events. Therefore, this qualitative study utilized intensive open-ended interviewing to investigate nurses' and doctors' self views, world views and cherished values, and how these non-cognitive factors interrelated with their reasoned approaches to, and outcomes of, their ethical decision making.

Specifically, 21 doctors and nurses were asked to process three clinical cases, each representing a set of conflicts often found in provider:patient interactions in the field of oncology. The transcripts of audiotaped interviews were coded according to selected components/themes often identified in the literature regarding moral reasoning. Content analysis revealed three processing perspectives--the science dominant, the person(s) dominant, and the science-person(s) equilibrium--which orient the health professional to the scope and nature of the dilemma, frame the range of possible, acceptable alternatives, and ultimately are the basis from which practitioners select the best resolution. Thus, processing perspective emerged as the defining feature of the moral dynamic. In general, nurses processed moral dilemmas from the person(s) dominant perspective and doctors from either the science dominant or science-person(s) equilibrium perspective.

Science dominant processors tend to treat oncology patients and pursue research goals more vigorously than other practitioners. Operating from this perspective makes it more likely that patients will be asked to fit into the prevailing wisdom of science, rather than having what science has to offer be modified for the particular patient. Person(s) dominant processors tend to subject the rigor of science to the special, caring nature of particular patient and nurse-patient relationships. Thus, provisionally, the science-person(s) equilibrium perspective, which synthesizes components of both, emerges both as most respectful of the nature of human beings and human interactions, and most incorporating of the wisdom that medicine, technology and bioethics has to offer decision making. Equilibrium tends to render morally acceptable outcomes.
Notes: Source: Dissertation Abstracts International, Volume: 52-01, Section: A, page: 0108.

Thesis (PH.D.)--THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, 1990.

School code: 0153.