“…Two major concerns seem to underly the commentaries: the framework (1) lacks a normative standard which allows for ethical justification of the outcome of repeated MCD,2 and (2) the focus on morisprudence does not sufficiently emphasise the need for ‘structured, consistent, and facilitated processes for fair and robust moral case deliberation’ 3. In other words, it is not the content of MCDs, recorded in a corpus of cases, that is crucial to organisational quality improvement but the presence of a moral space and/or an ethical culture which constantly promotes ethical reflection 3 4. We will attempt to address both concerns, starting with the latter.…”