Affordable Access

Publisher Website

Enacting Ethics: Bottom-up Involvement in Implementing Moral Case Deliberation

Authors
Journal
Health Care Analysis
1065-3058
Publisher
Springer-Verlag
Publication Date
Volume
20
Issue
1
Identifiers
DOI: 10.1007/s10728-010-0165-5
Keywords
  • Original Paper
Disciplines
  • Design
  • Philosophy

Abstract

In moral case deliberation (MCD), healthcare professionals meet to reflect upon their moral questions supported by a structured conversation method and non-directive conversation facilitator. An increasing number of Dutch healthcare institutions work with MCD to (1) deal with moral questions, (2) improve reflection skills, interdisciplinary cooperation and decision-making, and (3) develop policy. Despite positive evaluations of MCD, organization and implementation of MCD appears difficult, depending on individuals or external experts. Studies on MCD implementation processes have not yet been published. The aim of this study is to describe MCD implementation processes from the perspective of nurses who co-organize MCD meetings, so called ‘local coordinators’. Various qualitative methods were used within the framework of a responsive evaluation research design. The results demonstrate that local coordinators work hard on the pragmatic implementation of MCD. They do not emphasize the ethical and normative underpinnings of MCD, but create organizational conditions to foster a learning process, engagement and continuity. Local coordinators indicate MCD needs firm back-up from management regulations. These pragmatic action-oriented implementation strategies are as important as ideological reasons for MCD implementation. Advocates of clinical ethics support should pro-actively facilitate these strategies for both practical and ethical reasons.

There are no comments yet on this publication. Be the first to share your thoughts.