A silent conspiracy?: some ethical issues of participant observation in nursing research

In this paper I suggest that too little attention has been paid to ethical problems underlying health care research, particularly that which uses covert participant observation. Some of the chief arguments surrounding the use of deception in data collection in health care settings are evaluated, and a study by Field (1989) [Nursing the Dying. Routledge, Tavistock] in which covert observation was used is examined in relation to two moral principles--human rights and general utility. Conclusions include the responsibility of researchers to explicitly justify their approach in terms rather more than mere technical advantage, and the need to encourage the teaching and use of non-deceptive methods of data collection at this most crucial developmental stage in the evolution of nursing and health care research.