Abstract
Ethics support services like Moral Case Deliberation (MCD) intend to support healthcare professionals in ethically difficult situations. To assess outcomes of MCD, the Euro-MCD Instrument has been developed. Field studies to test this instrument are needed and have been conducted, examining important outcomes before MCD participation and experienced outcomes. The current study aimed to (1) describe how participants’ perceive the importance of MCD outcomes after MCD; (2) compare these perceptions with those before MCD participation; and (3) test the factor structure of these outcomes. Swedish, Norwegian and Dutch healthcare professionals rated the importance of outcomes in the Euro-MCD Instrument after four and eight MCDs. Ratings were compared with those before MCD participation using paired and independent samples t-tests. The factor structure was tested using exploratory factor analyses. After 4 and 8 MCDs, 443 respectively 247 respondents completed the instrument. More than 69% rated all MCD outcomes as ‘quite’ or ‘very’ important, especially outcomes from Enhanced Collaboration, Improved Moral Reflexivity and Improved Moral Attitude. Significant differences for 16 outcomes regarding ratings before and after MCD participation were not considered meaningful. Factor analyses suggested three categories, which seemingly resemble the domains Improved Moral Reflexivity, Enhanced Collaboration and a combination of Improved Moral Attitude and Enhanced Emotional Support. After participation in MCDs, respondents confirmed the importance of outcomes in the Euro-MCD Instrument. The question on perceived importance and the categorization of outcomes need reconsideration. The revised instrument will be presented elsewhere, based on all field studies and theoretical reflections.
Highlights
In the past decades, ethics support services have rapidly been developed in many healthcare settings and institutions (Molewijk et al 2017)
The Euro-Moral Case Deliberation (MCD) Instrument was completed after participation in 4 MCD sessions by healthcare professionals and after 8 sessions by 247 healthcare professionals
After participation in MCD, more than 69% of the healthcare professionals rated all items as ‘quite’ or ‘very’ important
Summary
Ethics support services have rapidly been developed in many healthcare settings and institutions (Molewijk et al 2017). These services aim to support healthcare professionals in dealing with ethical dilemmas and situations in which they are uncertain or disagree about what good care would entail. In an MCD, participants jointly elaborate on an ethically difficult situation under guidance of a facilitator (Molewijk et al 2008). After formulating a moral question about the situation, the group explores relevant facts, norms, values and alternatives in order to come at a decision, common ground, or new insights into the situation (Molewijk et al 2008).
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