Abstract
BackgroundMoral Case Deliberations (MCDs) are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support (CES), it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases (it is case based). These limitations warrant research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care.MethodsWe used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs (10 transcripts and 18 summary reports) were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted.ResultsThe CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy.ConclusionBy using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations.
Highlights
Moral Case Deliberations (MCDs) are reflective dialogues with a group of participants on their own moral dilemmas
A substantive component: norms, values, options, strategies, best practices, insights regarding client autonomy based on the qualitative analysis of the series of MCDs
Outline of the moral compass The moral compass has the form of a booklet, with several questions, and space to write answers to encourage the user to reflect on their moral dilemma
Summary
Moral Case Deliberations (MCDs) are reflective dialogues with a group of participants on their own moral dilemmas. In the Netherlands and other European countries [1,2,3], Moral Case Deliberation (MCD) is an established form of clinical ethics support (CES) [4]. MCD is a reflective and structured dialogue between healthcare professionals, sometimes including other stakeholders (such as patients, family members, and volunteers) about their concrete moral questions regarding a real clinical case, and the underlying values and norms within a specific context [5,6,7]. A specific moral question that arises from concrete experience is analysed in a structured way according to a specific conservation method This process fosters the moral competences of the participants, reduces moral distress and contributes to mutual understanding, for instance among team members [6, 10,11,12]. Evaluation studies show that MCD participants are (very) positive about MCD as a method of CES [10, 13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
