Five male physicians were interviewed as part of a comprehensive investigation into the narratives of female and male physicians and nurses, concerning their experience of being in ethically difficult care situations in the care of elderly people in hospital. The main focus of the narratives was the deficient prioritisation of the health care services for the elderly, the structural setting in hospitals and how these two factors combined result in low quality care. The physicians pointed to the low number of physicians working in gerontology, an increase in workload and being unable to do a decent job. They expressed respect for elderly patients and dedication to their work. An emphasis was placed on personal virtues, as well as the role of conscience. The results were discussed in the light of management theory which emphasise the problematic aspect of using the criterion of cost-benefit in the health sector. Furthermore, some of the results are illuminated by Kant's moral theory and Løgstrup's ethics.
BølstadJ.Chronicle: Nobody needs nursing homes (Nor). Dagbladet1999 Sept. 7;38.
2.
Norwegian Board of Health. Scenario 2030. The development of diseases in elderly people towards 2030. Report 6–99 (Nor). Oslo: Norwegian Board of Health, 1999.
3.
Government White Paper no. 50. Planning daily care for elderly people (Nor). Oslo: Ministry of Health, 1997.
4.
Government White Paper no. 28.Content and quality in the health care services (Nor). Oslo: Ministry of Health1999–2000.
5.
Government White Paper no. 34. Assessment of the report: Planning the care for elderly people, two years later (Nor). Oslo: Ministry of Health199–2000.
6.
MolandL.Success and defeat in the health care sector. Quality, efficiency and environment (Nor). Oslo: FAFO The Research Organisation for the Trade Union, 1999.
7.
Norwegian Board of Health.Supervision report 1998. The regional physicians supervision of the healthcare services for the elderly (Nor). Oslo: Norwegian Board of Health, 1998.
8.
HuseböB.S.Medical mistakes in nursing homes (Nor). Omsorg Nordisk Tidsskrift for Palliativ Medisin, 2001, 1: 47–50.
9.
FrydjordetJ. ed. When you becomes old and nobody wants you (Nor). Oslo: Norwegian Medical Association2001.
10.
RomørenT.I.The fourth age. Impairments. Family care and use of health care services by people aged 80 and older (Nor). Oslo: Gyldendal2001.
11.
Norwegian Board of Health.Elderly people in hospital. Report 7–99 (Nor). Oslo: Norwegian Board of Health1999.
12.
SINTEF.Primary health care — old and new challenges (Nor). Oslo: SINTEF Unimed Health Care Research2003.
13.
Norwegian Public Reports.Guidelines for the prioritization within the Norwegian Health Service (Nor). Report no. 23. Oslo: Statens Trykking, 1987.
14.
Sørensen, B. Aa. A new Norway of Health? WRI_report 5/01 (Nor). Oslo: Working research Institute, 2001.
15.
NordamA.SørlieV.FørdeR.Integrity in the care of elderly people, as narrated by female physicians. Nursing Ethics2003; 10 (4): 388–403.
16.
MishlerE.G.Research Interviewing — Context and Narrative. Cambridge: Harvard University Press1986.
17.
RicoeurP.Interpretation Theory: Discourse and the Surplus of Meaning. Fort Worth: Texas Christian University Press1976.
18.
RicoeurP.Hermeneutics & the Human Sciences. (ThompsonJ.B. ed and trans, first published 1981) New York: Cambridge University Press1998a.
19.
RicoeurP.Time and Narrative. (BlameyK. and PellauerD., first published as Temps et récit 1983). Chicago: University of Chicago Press1998b.
20.
LindsethA.MarhaugV.UdènG.Registered nurses' and physicians' reflections on their narratives about ethically difficult care episodes. Journal of Advanced Nursing1994, 20: 245–50.
21.
NorbergA.UdénG.AndrénS.Physicians', registered nurses' and enrolled nurses' stories about ethically difficult episodes in geriatric care. European Nurse1998, 3: 3–13.
22.
NormannH.K.AsplundK.NorbergA.Attitudes of Registered Nurses towards patients with severe dementia. Journal of Clinical Nursing1999, 8: 353–359.
23.
SelfP.Technocrats and the Policy Process. London: Macmillian1975.
24.
ChristensenT.The limitations of the concept of management by objectives (Nor). Norsk Statsvitenskapelig Tidsskrift1990, 6 (1): 33–39.
25.
EriksenE.O.Communicative leadership — the management of public institutions (Nor). Bergen: Fagbokforlaget1999.
26.
Norwegian Public Reports no 18. Renewing priorities. Going back through the guidelines for prioritisation within the Norwegian Health Service (Nor). Oslo: Statens Trykking1997.
27.
KantI.Fundamental Principles of the Metaphysics of Morals. (AbbottT.K. trans) Chicago: Encyclopædia Britannica1952.
28.
HabermasJ.The Theory of Communicative Action. Vol I. (McCarthy trans), Boston: Beacon Press1987.
29.
LögstrupK.E.The Ethical Demand (JensenT.I. trans; Danish original 1956), Notre Dame and London: University of Notre Dame Press1997.
30.
LøgstrupK.E.System and Symbol (Dan). København: Gyldendal1982.
31.
AlbumD.The prestige of diseases and medical specialties (Nor). Journal of Medical Association, Norway1991, 17: 2133–2136.
32.
SandelowskiM.The problem of rigor in qualitative research. Journal of Advanced Nursing Science, 1986, 8: 27–37.
33.
Delholm-LambertsenB.MunsbachM.The theory and application of science (Dan). Nordisk Medicin, 1997, 112: 24–27.
34.
TappanM.B.Stories lived and stories told: The narrative structure of late adolescent moral development. Human Development1989; 32: 300–315.
35.
VitzP.C.The use of stories in moral development. New psychological reasons or old education method. The American Psychologist1990; 45: 709–720.
36.
EllosW.J.Narrative Ethics. Newcastle upon Tyne: Avebury1994.
