居家照顧已逐漸成為需要長期照顧老人的主流服務模式。處在第一線的居家照顧服務員（居服員）成了左右服務品質的關鍵。關於居服員在提供服務的過程中所面臨的道德困境始終是個需要高度關切的議題。本研究是國內首次同時從居服員、督導員與機構主管三個角度來觀察這個議題。本研究訪問了台北市提供居家服務機構的十位居服員、四位督導員及四位機構主管。本研究發現，居服員在提供居家服務時都會面臨倫理方面的議題，而督導與機構主管均認知此一現象的存在。居服員會根據自己的立場與當時的情境條件來做出實際的應對方法，而督導與機構主管則是站在規定的角度、但又同時盡量去協調以達到服務案主與管理居服員的目的。整體而言，三者會不斷地折衝、讓步、採同理心，以達到居家照顧服務繼續運作下去的目的。

Home-care service has been the mainstream pattern in taking care of long-term disable elders. The success of such service frequently depends on the quality provided by home-care workers. The ethical dilemmas faced by home-care workers are becoming highly concern-needed issues these days. This study is the first to deal with this issue from the three angles, home-care workers, supervisors and institution managers, simultaneously, in Taiwan. We interviewed ten home-care workers, four supervisors and four institution managers in Taipei. Our findings show that home-care workers frequently encounter a variety of situations with ethical dilemmas, and their supervisors and institution managers are all aware of such difficulties. Each side has its own standpoints on such issues. However, all three agree to solve their differences in every possible way for the purpose of providing continuing high quality home-care service.