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An Ethnographic Exploration of Moral Agency in Emergency Medicine

Qashu Lim, Nadine Marian

This study examines the visibility of moral agency in the daily work and production of healthcare in emergency medicine at an urban emergency medical center in the United States. Through detailed ethnographic research, this study investigates how the work of paramedics, nurses and physicians within their professional practice spheres of emergency medicine constantly resolve challenges that make their moral agency visible. Several themes emerge from this study by examining and closely noting how these individuals interact and express less a principled bioethical script, but instead a personal one that is or is not explained by their professional role in treating patients. This study follows the daily conversations and interactions that embody the local moral worlds of emergency medicine in paramedics, nurses and physicians and how each of these professional groups work through and around medical and patient care issues to create care. As these individuals within their professional role address challenges in emergency care, it is their interactions and conversations that make visible the moral agency of the individual healthcare worker. By examining the domain of these work lives this study investigates the ongoing and new conflicts and resolutions for the healthcare workers and how they assert moral agency; the intersubjective local moral worlds of care; use of technology to mediate care; and the structure of medicine in emergency medical care.

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Academic Units
Anthropology
Thesis Advisors
Comitas, Lambros
Degree
Ph.D., Columbia University
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