Abstract
Although moral case deliberation (MCD) is evaluated positively as a form of clinical ethics support (CES), it has limitations. To address these limitations our research objective was to develop a thematic CES tool. In order to assess the philosophical characteristics of a CES tool based on MCDs, we drew on hermeneutic ethics and pragmatism. We distinguished four core characteristics of a CES tool: (a) focusing on an actual situation that is experienced as morally challenging by the user; (b) stimulating moral inquiry into the moral concepts, questions and routines in the lived experience of the CES tool user; (c) stimulating moral learning by exploring other perspectives; and (d) incorporating contextual details. We provide an example of a CES tool developed for moral dilemmas over client autonomy. Our article ends with some reflections on the normativity of the CES tool, other application areas and the importance of evaluation studies of CES tools.
Highlights
A moral case deliberation (MCD) is a reflective dialogue, in which, through a structured conversation method, a concrete moral issue that has been experienced is analysed by a group of practitioners in order to come to a shared moral perspective and a deepened or new insight as to which values and norms should prevail in the situation
This dialogue is moderated by a trained facilitator who stimulates joint reflection and dialogue and keeps a focus on the moral dimension and the central moral question
We illustrated these four core characteristics with a clinical ethics support (CES) tool that we developed on client autonomy for a long‐term care organization
Summary
A moral case deliberation (MCD) is a reflective dialogue, in which, through a structured conversation method, a concrete moral issue that has been experienced is analysed by a group of practitioners in order to come to a shared moral perspective and a deepened or new insight as to which values and norms should prevail in the situation.1This dialogue is moderated by a trained facilitator who stimulates joint reflection and dialogue and keeps a focus on the moral dimension and the central moral question. MCD is an established practice of clinical ethics support (CES) in the Netherlands. It is implemented in other countries in Europe, in which the terms ‘ethics case reflection’ and ‘ethics reflections group’ are used, indicating similar kinds of1012 | wileyonlinelibrary.com/j ournal/bioeBioethics. 2019;33:1012–1021.CES meetings. there are differences, the same key ele‐ ments are present; a group of participants, a facilitator, a method to structure the conversation, one concretely experienced case and a moral question.. A moral case deliberation (MCD) is a reflective dialogue, in which, through a structured conversation method, a concrete moral issue that has been experienced is analysed by a group of practitioners in order to come to a shared moral perspective and a deepened or new insight as to which values and norms should prevail in the situation.. A moral case deliberation (MCD) is a reflective dialogue, in which, through a structured conversation method, a concrete moral issue that has been experienced is analysed by a group of practitioners in order to come to a shared moral perspective and a deepened or new insight as to which values and norms should prevail in the situation.1 This dialogue is moderated by a trained facilitator who stimulates joint reflection and dialogue and keeps a focus on the moral dimension and the central moral question..
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