Goals of Clinical Ethics Support: Perceptions of Dutch Healthcare Institutions

Abstract

In previous literature, ethicists mention several goals of Clinical Ethics Support (CES). It is unknown what key persons in healthcare institutions see as main–—and sub-goals of CES. This article presents the goals of CES as perceived by board members and members of ethics support staff. This is part of a Dutch national research using a mixed methods design with questionnaires, focus groups and interviews. Quantitative and qualitative data were analyzed and combined in an iterative process. Four main clusters of goals were found: 1) encouraging an ethical climate, 2) fostering an accountable and transparent organization, 3) developing professionalism and a final goal, overarching the previous three, 4) good care. Most important sub-goals of CES were: attention for ethical issues, raising awareness of ethical issues, fostering ethical reflection and supporting employees. The article ends with a discussion on the desirability to further operationalize the general goal of good care, the context-boundedness of our findings and the need to relate goals of CES to the features of organizational cultures to further improve the integration of CES in healthcare institutions.

Perceptions of important outcomes of moral case deliberations: a qualitative study among healthcare professionals in childhood cancer care

“…In the following section highlighted results are discussed and compared with existing literature on CESS outcomes. A study by Dauwerse et al (2013) shows that participants thought that CESS goals included encouraging a moral climate, as well as developing professionalism and good care [28], which is comparable with themes presented in our study.…”

Beyond Recommendation and Mediation: Moral Case Deliberation as Moral Learning in Dialogue

“…MCD as a dialogical and pragmatist way of ethics support is well known in the Netherlands (Dauwerse et al 2013). The method consists of a methodical, joint philosophical inquiry into a concretely experienced moral question related to a concrete situation by a-preferably multidisciplinary-group of health care professionals.…”

Communicative and organizational aspects of clinical ethics support

“…Edwards, McClement, and Read (2013) showed that healthcare professionals can help each other to address and act upon the issues at stake by communicating the ethically difficult situations with co-workers. Other studies stress the importance for healthcare professionals to systematically reflect on moral issues in organized forms so as to make the various perspectives and interpretations transparent (Pedersen, Akre, & Førde, 2009), to promote good care in concordance with patients' needs (Dauwerse, Abma, Molewijk, & Widdershoven, 2013), and to further prevent moral distress among the professionals (Silén, Svantesson, Kjellström, Sidenvall, & Christensson, 2011).…”

“…Various kinds of clinical ethics support (CES) have been developed to promote the possibilities for healthcare professionals to communicate and handle ethical issues (Rasoal, Skovdahl, Gifford, & Kihlgren, 2017), such as moral case deliberation (MCD) (van der Dam, Abma, Molewijk, Kardol, & Schols, 2011), ethics consultations (Fox, Myers, & Pearlman, 2007), clinical ethics committees (Pedersen et al, 2009 a), and ethical rounds (Svantesson, Anderzen-Carlsson, Thorsen, Kallenberg, & Ahlström, 2008). The various forms of CES aim to raise awareness of ethical issues (Dauwerse et al, 2013), broaden perspectives (Gracia, 2003), and reflections on how to deal with moral issues (Hermsen & van der Donk, 2009). The CES intervention described in this study was inspired by Habermas' theory of communicative action.…”