Vividly documenting the real world of the contemporary hospital, its nurses, and their moral and ethical crises, Dan Chambliss offers a sobering revelation of the forces shaping moral decisions in our hospitals. Based on more than ten years' field research, is filled with eyewitness accounts and personal stories demonstrating how nurses turn the awesome into the routine. It shows how patients, many weak and helpless, too often become objects of the bureaucratic machinery of the health care system and how ethics decisions, once the dilemmas of troubled individuals, become the setting for political turf battles between occupational interest groups. The result is a compelling combination of realism and a powerful theoretical argument about moral life in large organizations.