Before ethics? : a study of the ethos of the medical profession

Descombes, Christine Ruth Elisabeth Hermine (2002). Before ethics? : a study of the ethos of the medical profession. PhD thesis The Open University.



The thesis makes a distinctive contribution to the field of professional ethics; offering a more nuanced understanding of the role of a profession’s ethos in relation to its ethics. In so doing, it also offers a valuable insight into GP thinking at what proved to be a unique moment in the history of that branch of the medical profession.

Using historical and empirical data, the thesis first traces the development of the medical profession’s ethos - Its belief in itself as a noble, superior profession, of special dignity and worth. It then shows the influence of that ethos in areas of professional decision-making that have had a particular impact on the provision of health care within the LJK over the past 50 years. Taking the profession’s ethos as a benchmark, the study explores the nature of the profession’s response to the creation, control and, in recent years, major reform of the NHS which reform introduced a new emphasis on management. The latter provides a case study that relates the theoretical material to an historical situation This includes a number of interviews with GPs that point to the beliefs and values influencing their decisions in relation to the reforms, as they affected general practice.

The study concludes that, although a profession dependant on attracting clients may find it necessary to subscribe to a set of ethical principles that draws on outside beliefs and values, it is the ethics derived from its own internal ethos that will take precedence in guiding everyday thinking and practice

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