Ethical sensitivity in practice: finding tacit moral knowing

Abstract

Aim: This article presents a discussion of the conceptual model of ethical sensitivity.

Background: Recent research pays little attention to the tacit dimension of ethical knowledge. We focus on care practices, drawing a distinction between explicit moral knowledge and tacit moral knowing. This focus has far-reaching methodological consequences, influences the research design of empirical research and enables healthcare workers to discern both explicit and tacit knowing.

Data sources: This article draws on literature about tacit knowledge, practices and ethical sensitivity, covering publications from 1958-2011. Data used in the illustrative cases were gathered in 2009 during the phenomenological phase of a multiple-case study.

Discussion: Taking practices as the point of entry for exploring ethical sensitivity makes it possible to study empirically both explicit moral knowledge and tacit moral knowing. Given how relevant practical knowledge is, we aim to put forward a theoretical framework that leaves room for the discernment of this tacit moral knowing.

Implications for nursing: Creating opportunities to reflect on daily ethical concerns in an inter-professional team can contribute to improvement on quality of care.

Conclusion: The broadened perspective on ethical sensitivity can be used as a heuristic device to discern what both explicit and implicit moral knowledge in care are about. This empirical way of looking at care practices can enhance the awareness of the moral knowing of the professional caregiver.

Keywords: ethical sensitivity; healthcare professionals; nursing; qualitative research; shadowing; tacit knowing.