OBJECTIVES: 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. DESIGN: Ethnographic methods: participant observation and interviews, the transcripts of which were analysed to identify themes in ethical approaches. SETTING: A British old-age psychiatry ward. PARTICIPANTS: 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. CONCLUSION: 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. (shrink)

In this paper I shall explain what I take to be the nature of justice; and the method which I shall follow is that of attempting to infer the essential nature of justice from an examination of its actual practical operation. Perhaps the reader will be able to follow the drift of the argument more easily, and be more on his guard against possible misstatements of fact or erroneous inferences, if I mention at the outset the main conclusions to which (...) I hope to lead him. (shrink)

Professor Duncan Vere lays before us the idealised guidelines used for recruiting volunteers on which to try and test new medicines. He points out that if these were followed rigidly, few, if any volunteers would be found for this vital work. Inducements are used, but the size of these determines whether society deems it right or wrong. However, the aim is to help and advise volunteers of the need for such tests and the risks involved and therefore the information leaflet (...) reprinted as part of the article indicates how the drug testers are attempting to encourage volunteers in as ethical a way as possible. To abandon human tests with new drugs may be unethical. A balance is sought. (shrink)

This paper was first presented at the London Medical Group's Annual Conference entitled Death: the last taboo held in February 1980. Dr Vere comments on the evidence of research done by him and his colleagues on the pain and discomfort suffered by patients who are dying and are in hospital. He contrasts this with the situation in hospices, analyses the differences, and attributes much of the unnecessary pain suffered in hospitals to attitudes of staff, as well as to a reluctance (...) by relatives to allow patients with terminal pain to die at home. He deprecates the tendency in hospitals to separate 'curing' and 'caring' and suggests that sometimes the best help involves 'doing' less, not more. (shrink)

The word “objective” is of course the trouble–maker here, Miss Smith assumes that if an aesthetic statement is held to be objective then it is the physical existence of the work of art that constitutes the objectivity: i.e. if a work of art is exteroceptively perceivable, then an aesthetic statement involving it is objective. Some writers, however have held that in genuine works of art there is manifested an ultimate spiritual Reality which we apprehend when we appreciate such works. On (...) this theory, an aesthetic statement has an objective reference if the subject of it succeeds in expressing or communicating such a supersensible Reality: if it fails to do so, then the statement is subjective, i.e. it can be analysed completely into a statement about our feelings or emotions. (shrink)

In a recent article In Mind , called A Religious Way of Knowing , Mr. C. B. Martin considers the claim made by some theologians to know the existence of God on the basis of direct experience of God. His paper is, he says, “an attempt to indicate how statements concerning a certain alleged religious way of knowing betray a logic extraordinarily like that of statements concerning introspective and subjective ways of knowing. It is not my wish to go from (...) a correct suggestion that the logic is very, very like to the incorrect suggestion that the logic is just like.”. (shrink)

Philosophy is very largely concerned with speculation upon problems of a highly abstract character, but some of the questions with which it deals have important practical aspects; and I think that social philosophy occupies—and rightly occupies—a dominant place in contemporary thought. If post-war policies are to render more secure the lives, the liberties and the happiness of mankind, they must be based upon sound principles; and it is with the intention of throwing certain of these principles into bold relief that (...) I have ventured to choose the realm of politics and culture as the subject of these reflections. (shrink)