Moral case deliberation

Tan, Daniel Y B; Meulen, B. C. ter; Molewijk, Bert; Widdershoven, Guy

doi:10.1136/practneurol-2017-001740

Cited by 23 publications

(21 citation statements)

References 8 publications

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“…We hope that case-specific decisions, such as the one described opting for the most targeted genetic test or applying extensive genetic filtering, thus minimising the chances of incidental findings. [2][3][4] In similar cases to that described here, we also endorse moral case deliberation by a team of medical doctors, nurses, and ethical counsellors, 5 including careful consideration of the patient's possible personal preferences should their mental competence not have been severely impaired.…”

Section: Unconsented Genetic Testing In Psychiatry: An (Almost) No Go?supporting

confidence: 63%

Unconsented genetic testing in psychiatry: an (almost) no go?

Luykx

Spek

Veen

et al. 2019

The Lancet Psychiatry

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Section: Unconsented Genetic Testing In Psychiatry: An (Almost) No Go?supporting

confidence: 63%

Unconsented genetic testing in psychiatry: an (almost) no go?

Luykx

Spek

Veen

et al. 2019

The Lancet Psychiatry

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“…Essentially, and in contrast to other kinds of (more informal) meetings, a moral case deliberation is structured by a conversation method and moderated by a facilitator, often an ethicist [ 4 – 9 ]. For a recent case example of how a specific conversation method of MCD works in practice, we refer to Tan et al [ 10 ]. During such a deliberation, as well as during similarly organized group sessions, professionals have the opportunity to freely articulate and share their stories, experiences, opinions and perspectives [ 9 , 11 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of moral case deliberation in healthcare settings: a literature review

Haan¹,

Gurp²,

Naber³

et al. 2018

BMC Med Ethics

102

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BackgroundAn important and supposedly impactful form of clinical ethics support is moral case deliberation (MCD). Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings.MethodsA systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science (June 2016). Both the data collection and the qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of our decisions. The qualitative analysis was supported by ATLAS.ti.ResultsBased on a qualitative analysis of 25 empirical papers, we identified four clusters of themes: 1) facilitators and barriers in the preparation and context of MCD, i.e., a safe and open atmosphere created by a facilitator, a concrete case, commitment of participants, a focus on the moral dimension, and a supportive organization; 2) changes that are brought about on a personal and inter-professional level, with regard to professional’s feelings of relief, relatedness and confidence; understanding of the perspectives of colleagues, one’s own perspective and the moral issue at stake; and awareness of the moral dimension of one’s work and awareness of the importance of reflection; 3) changes that are brought about in caring for patients and families; and 4) changes that are brought about on an organizational level.ConclusionsThis review shows that MCD brings about changes in practice, mostly for the professional in inter-professional interactions. Most reported changes are considered positive, although challenges, frustrations and absence of change were also reported. Empirical evidence of a concrete impact on the quality of patient care is limited and is mostly based on self-reports. With patient-focused and methodologically sound qualitative research, the practice and the value of MCD in healthcare settings can be better understood, thus making a stronger case for this kind of ethics support.

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“…In order to better understand this process we will briefly present an MCD described in an article by Tan et al (2018)1. A Moroccan-Dutch 32 year old male rugby player collapsed during a game.…”

Section: Examplementioning

confidence: 99%

A pragmatist approach to clinical ethics support: overcoming the perils of ethical pluralism

Inguaggiato

Metselaar

Porz

et al. 2019

Med Health Care and Philos

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In today’s pluralistic society, clinical ethics consultation cannot count on a pre-given set of rules and principles to be applied to a specific situation, because such an approach would deny the existence of different and divergent backgrounds by imposing a dogmatic and transcultural morality. Clinical ethics support (CES) needs to overcome this lack of foundations and conjugate the respect for the difference at stake with the necessity to find shared and workable solutions for ethical issues encountered in clinical practice. We argue that a pragmatist approach to CES, based on the philosophical theories of William James, John Dewey, and Charles Sanders Peirce, can help to achieve the goal of reaching practical solutions for moral problems in the context of today’s clinical environment, characterized by ethical pluralism. In this article, we outline a pragmatist theoretical framework for CES. Furthermore, we will show that moral case deliberation, making use of the dilemma method, can be regarded an example of a pragmatist approach to CES.

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Moral case deliberation

Cited by 23 publications

References 8 publications

Unconsented genetic testing in psychiatry: an (almost) no go?

Unconsented genetic testing in psychiatry: an (almost) no go?

Impact of moral case deliberation in healthcare settings: a literature review

A pragmatist approach to clinical ethics support: overcoming the perils of ethical pluralism

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