Lawton J
Newnham College, University of Cambridge.
Qual Health Res. 2001 Sep;11(5):693-705. doi: 10.1177/104973201129119389.
This article provides a frank discussion of the practical and ethical issues that emerged during the process of setting up and conducting a participant observation study within an inpatient hospice. A general overview of the participant observation approach is used to prefigure a discussion of its strengths and weaknesses when employed as a research and evaluation tool among palliative care populations. Although participant observation provided a flexible and viable means of collecting data in the hospice, it also created a number of dilemmas that in many cases could not be satisfactorily resolved. Difficulties arose, in particular, with obtaining informed consent from patients and assuming that consent remained valid after patients had deteriorated physically and mentally. Further complications stemmed from the role conflict and ambiguity inherent within an approach that requires a researcher to work simultaneously as a participant and as an observer.
本文坦率地讨论了在住院临终关怀机构建立和开展参与观察研究过程中出现的实际问题和伦理问题。对参与观察法进行了总体概述，以此为基础讨论其作为姑息治疗人群研究和评估工具时的优缺点。尽管参与观察为在临终关怀机构收集数据提供了灵活且可行的方法，但它也带来了一些在许多情况下无法圆满解决的困境。特别是在获取患者知情同意以及假定患者身心状况恶化后同意仍然有效的方面出现了困难。进一步的复杂情况源于一种要求研究者同时作为参与者和观察者的方法所固有的角色冲突和模糊性。
