Abstract
BackgroundClinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies and revised it. This paper presents the Euro-MCD 2.0 and describes the revision process.MethodsThe revision process comprised an iterative dialogue among the authors as Euro-MCD-project team, including empirical findings from six Euro-MCD field-studies and input from European experts in CES and theory. Empirical findings contained perceptions and experiences of MCD outcomes among healthcare professionals who participated in MCDs in various settings in Norway, Sweden and the Netherlands. Theoretical viewpoints on CES, literature on goals of CES and MCD and ethics theory guided the interpretation of the empirical findings and final selection of MCD outcomes.ResultsThe Euro-MCD 2.0 Instrument includes three domains: Moral Competence, Moral Teamwork and Moral Action. Moral Competence consists of items about moral sensitivity, analytical skills and virtuous attitude. Moral Teamwork includes open dialogue and supportive relationships and Moral Action refers to moral decision-making and responsible care. During the revision process, we made decisions about adding and reformulating items as well as decreasing the number from 26 to 15 items. We also altered the sentence structure of items to assess the current status of outcomes (e.g. ‘now’) instead of an assumed improvement over time (e.g. ‘better’) and we omitted the question about perceived importance.ConclusionsThe Euro-MCD 2.0 is shorter, less complex and more strongly substantiated by an integration of empirical findings, theoretical reflections and dialogues with participants and experts. Use of the Euro-MCD 2.0 will facilitate evaluation of MCD and can thereby monitor and foster implementation and quality of MCD. The Euro-MCD 2.0 will strengthen future research on evaluation of outcomes of MCD.
Highlights
Clinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations
CES is offered in various forms, for instance through individual ethics consultants who can be called in for ethical guidance or advice [1], ethics committees who may discuss the situation as a group of experts, give advice or develop policies [2], or moral case deliberations (MCD) where a facilitator chairs a group dialogue among healthcare professionals about an ethically difficult situation with the use of a specific method [3]
Policy and one referred to concrete actions (Study V) – Outcomes reported by managers were categorized as an enhanced ethical climate, including a closer-knit team, morally strengthened professionals, morally grounded actions and ethics leaving its marks on everyday work (Study VI)
Summary
Clinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Clinical ethics support (CES) services aim to help healthcare professionals in dealing with ethically difficult situations. CES is offered in various forms, for instance through individual ethics consultants who can be called in for ethical guidance or advice [1], ethics committees who may discuss the situation as a group of experts, give advice or develop policies [2], or moral case deliberations (MCD) where a facilitator chairs a group dialogue among healthcare professionals about an ethically difficult situation with the use of a specific method [3]. Participants are encouraged by the facilitator in digging for, finding and formulating an answer to the moral question, by clarifying relevant facts and perspectives, reflecting upon one’s own and each other’s viewpoints and deliberating about possible consensus and ways of acting During this process, participants should have equal space for having a say and the reflection should stay connected to the facts of the situation [3]. Various conversation methods and facilitation styles exist to structure the process [3, 11, 12]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
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.
