Morally bound medical work. An empirical study exploring moral conditions of doctors’ everyday practice

Abstract

All of clinical work also has a moral dimension since the purpose of health care is to help patients. The aim of this project is to understand how doctors deal with these moral dimensions of clinical work. The field of bioethics has largely emerged as a philosophically founded discipline, without taking into account how doctors already handle moral values as a tacit or implicit part of their clinical work. This has caused a gap between medical ethics and medical practice.

This research contains data from two qualitative studies: observations and interviews with 17 general practitioners and hospital doctors, and observations of 101 video recorded patient consultations in hospital. The doctors focused exclusively on medical issues in the encounters, even if their patient’s worries could be related to more personal and existential parts of the patient’s life. Patients’ personal worries were systematically ignored by the doctors. In order to help their patients by the use of their biomedical knowledge of anatomy and bodily processes, the doctors often handled their patients as objects. However, for patients it is morally offensive to be rejected and treated as medical objects, and it might feel very unpleasant. The doctors, who often kept a good tone in the consultations, did not appear to recognise their concurrent moral offence. Our research suggests that these moral infringements might be unavoidable in medical work, but that doctors, nonetheless, ought to be aware of the distress they cause and how they can reduce it.