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The use of vignettes within a Delphi exercise: a useful approach in empirical ethics?
  1. Paul Wainwright1,
  2. Ann Gallagher2,
  3. Hilary Tompsett1,
  4. Christine Atkins1
  1. 1Kingston University and St George's University of London, Faculty of Health and Social Care Sciences, Kingston, UK
  2. 2International Centre for Nursing Ethics, Division of Health and Social Care, University of Surrey, Guildford, UK
  1. Correspondence to Dr Ann Gallagher, International Centre for Nursing Ethics, Division of Health and Social Care, Faculty of Health and Medical Sciences, Duke of Kent Building, University of Surrey, Guildford, Surrey GU2 7TE, UK; a.gallagher{at}


There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice still requires interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research.

  • Applied and professional ethics
  • newborns and minors
  • general

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  • Professor Paul Wainwright died suddenly on 16 June 2010. He will be greatly missed by friends, colleagues and students. He made a significant contribution to applied ethics and medical humanities and to our understanding of concepts such as dignity, practice, conflicts of interest and professionalism. It has been a privilege to know and work with him and our thoughts are with his wife, Elsa, and family.

  • Funding The Department of Health and Department for Education and Skills.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Wandsworth NHS REC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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