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Table 4 Example of structural analysis – the movement from what is said to what is talked about, first by describing units of meaning (what is said) and next by formulating units of significance (what is talked about) and themes.

From: Empirical investigation of the ethical reasoning of physicians and molecular biologists – the importance of the four principles of biomedical ethics

Respondent group

Units of meaning (What is said)

Units of significance (What is talked about)

Themes

Oncology physician working in a hospital clinic (OPC, Q1)

... you meet a large number of extremely wonderful and brave people who by ill luck end up here due to serious illness ... most people deal with their fate extremely well ... they mobilise resources that people are not usually expected to possess. But most of them do ... It is an immense satisfaction for me ... when I have one of those tough outpatient departments, and I have seen 20 or 25 patients, and I can see that many of them have responded well to treatment, have recovered, are able to function and are happy and satisfied ... The patient's recovery is often preceded by a hard period of therapy during which he or she suffers a lot of pain and discomfort due to radiation therapy or an operation. And then the patient recovers. It is an immense satisfaction for me to witness that – there is nothing better, is there?

Satisfaction by helping many brave people who mobilise reserves of energy to get through serious treatment

Beneficence

Molecular biologist employed in private biopharmaceutical company (MBP, Q2)

It is a part of clinical development – to prove that it is safe ... not just for mice, but various animal models – it depends on the type of protein ... you have to prove that it does not produce cardiac problems or cancer ...

Clinical trials to show that biopharmaceuticals are not potentially dangerous Animal models Cardiac problems Cancer

Nonmaleficence

Molecular biologist employed at the university (MBU, Q3)

You must inform them of their options and then respect their decision.

Inform patients and respect their decision

Respect for autonomy/Informed consent

Respect decision

External constraints

Oncology physician working in a hospital clinic (OPC, Q4)

... try to determine what is wrong with the patient, what are our options, what are the patient's wishes, ideas, and then we have to reach some kind of mutual understanding, a frame of reference, and take it from there ... and how we can deal with this in respect of that.

Medical prognosis Risk-benefit analysis Patient's wishes and ideas Mutual understanding Respect

Medical prognosis

Risk-benefit analysis

Respect for autonomy/Informed consent

Patient's wishes and ideas

Mutual understanding

Respect

Molecular biologist employed in private biopharmaceutical company (MBP, Q5)

... from a general perspective, we need a good reason for doing all the things we do. We are a PLC, so the biggest reason for us is the fact that we have to earn money for our shareholders, but we also need take into consideration the benefit of society, not just our own good, because all things are connected. If we start doing something unethical, then it will damage us in the long run ...

Important for company to have ethical profile, since it pays off

Justice

Oncology physician working in a hospital clinic (OPC, Q6)

Resources are scarce and the number of patients in need of radiotherapy is increasing ... you have so many patients and you want to be able to cure as many as possible from their cancer, which is, after all, the main problem. But what is the best way to do it so that the patients become most well-functioning afterwards, cosmetically and functionally?

More patients than devices, how to manage resources most effectively

Justice

Just distribution