Clarke R A
Nurs Ethics. 1995 Sep;2(3):247-53. doi: 10.1177/096973309500200308.
The majority of midwives in the UK are employed within the NHS. They are legally bound to fulfil their contractual obligations to their employers. At the same time they are professionally mandated to interpret and act on the UKCC's Code of professional conduct. Midwives have always maintained that they are autonomous practitioners, and the Code is written in a way that endorses this belief. Underlying the Code is the assumption that midwives have moral and professional freedom to act on its imperatives. However, midwives' claim to autonomy is flawed, and therefore the Code's claim to be a source of empowerment is also flawed. Underlying the difficulties is a conflict derived from the imposition of a deontologically-based professional Code on to a workforce that is constrained within and employed by the utilitarian-based NHS.
英国的大多数助产士受雇于国民保健制度(NHS)。她们在法律上有义务履行对雇主的合同义务。与此同时,她们在职业上被要求根据英国中央助产士委员会(UKCC)的职业行为准则进行解读并付诸行动。助产士一直坚称自己是自主从业者,而该准则的编写方式也支持了这一观点。该准则的潜在假设是,助产士在道德和职业上有自由依据其要求采取行动。然而,助产士对自主性的主张存在缺陷,因此该准则作为赋权来源的主张也存在缺陷。这些困难的根源在于,将基于道义论的职业准则强加于受功利主义的国民保健制度约束并受其雇佣的劳动力身上所产生的冲突。