Care giver fidelity in a pediatric bone marrow transplant team.

This study is an ethnography of the ethics of one pediatric bone marrow transplant team. Fidelity emerged as a central ethical principle guiding these care givers in their relationships to patients and families. Four implicit promises were identified within the relationship of the professional to the patient and family: the promise to attempt a cure; the promise to care for the child, physically and psychologically; the promise to treat the child and family with dignity; and the promise to stand by the child and family in the process of death. Data were collected at the weekly team meetings. Statements of care givers were examined for evidence of their efforts to keep these promises and the times they failed at this task. Differences were found in the way members of the team interpreted the meaning of fidelity in practice.