Abstract
This qualitative social scientific study explores professional texts of healthcare ethics to understand the ways in which ethical professionalism in medicine and nursing are culturally constructed in Finland. Two books in ethics, published by Finnish national professional organizations—one for nurses and one for physicians—were analyzed with the method of critical discourse analysis. Codes of ethics for each profession were also scrutinized. Analysis of the texts sought to reveal what is taken for granted in the texts as well as to speculate what appeared to be relegated to the margins of the texts or left entirely invisible. Physicians’ ethics was discovered to emphasize objectivity and strong group membership as a basis for ethical professionalism. The discourses identified in the physicians’ ethics guidebook were universal ethics, reductionism, non-subjectivity, and threat. Nursing ethics was discovered to highlight reflectivity as its central focus. This idea of reflectivity was echoed in the identified discourses: local ethics, enlightenment, and moral agency. The analysis exposes a cultural gap between the ethics discourses of medicine and nursing. More work is needed to bridge ethics discourses in Finland in a way that can support healthcare professionals to find common ground and to foster inclusivity in ethical dialogue. Further development of bioethical practices is suggested as a potential way forward.
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Notes
Original name in Finnish, Lääkäriliitto.
Original name in Finnish, Sairaanhoitajaliitto. The association has changed its name to Sairaanhoitajat after the publication of the ethics guidebook analyzed in this study.
References
Data Sources
Lääkäriliitto. (2014). Eettiset ohjeet. [Ethical guidelines.] Updated version. Helsinki: The Finnish Medical Association. https://www.laakariliitto.fi/edunvalvonta-tyoelama/liiton-ohjeet/eettisen-ohjee/.
Ranta, I. (Ed.) (2012). Sairaanhoitajan eettiset pelisäännöt. Helsinki: Sairaanhoitajaliitto Fioca. [Ethical guidelines for nurses. Helsinki: The Finnish Nurses Association Fioca.]
Saarni, S., Kattelus, M., & Nummi, V. (Eds.) (2013). Lääkärin etiikka. Helsinki: Lääkäriliitto and Suomen Hammaslääkäriliitto. [Physician’s ethics. Helsinki: The Finnish Medical Association and the Finnish Dental Association.]
Sairaanhoitajaliitto. (1996). Sairaanhoitajien eettiset ohjeet. [Ethical guidelines for nurses.] Helsinki: Sairaanhoitajat. https://sairaanhoitajat.fi/jasenpalvelut/ammatillinen-kehittyminen/sairaanhoitajan-eettiset-ohjeet/.
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Acknowledgements
Thesis supervisors Professor Vilma Hänninen and University Lecturer, Docent Mari Kangasniemi have provided support and guidance in the writing process. Financial support for the writing of this article has been received from the independent, non-profit Emil Aaltonen Foundation.
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Saxén, S. Same Principles, Different Worlds: A Critical Discourse Analysis of Medical Ethics and Nursing Ethics in Finnish Professional Texts. HEC Forum 30, 31–55 (2018). https://doi.org/10.1007/s10730-017-9329-0
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DOI: https://doi.org/10.1007/s10730-017-9329-0