Suchergebnisse

"Background: For Moral Case Deliberation (MCD), like any form of Clinical ethics support (CES), it is important to know whether it reaches its presumed goal of supporting healthcare professionals in their ethical challenges. Evaluation is needed to gain insight in the value of MCD. Therefore, the Euro-MCD instrument was developed to assess outcomes of MCD, and has now been revised. The aim of this presentation is to present the revised Instrument: the Euro-MCD 2.0. Methods: The revision process was an iterative dialogue in which field study findings were integrated with theoretical reflections and expert-input. Results: The Euro-MCD 2.0 has three domains: 1) Moral Competence, 2) Moral Teamwork and 3) Moral Action. Moral Competence includes items on moral sensitivity, analytical skills and a virtuous attitude, like 'I speak up in ethically difficult situations'. Moral Teamwork refers to open dialogue and supportive relationships, for example 'We feel secure to share emotions in ethically difficult situations'. Moral Action includes items about moral decision-making and responsible care, like 'We are able to explain and justify our care towards patients and their families'. Discussion: The Euro-MCD 2.0 is shorter and more strongly substantiated by empirical data and theoretical reflections. At the conference, we will reflect on the revision process and the underlying foundations of the domains. The revised instrument helps to get insight in the MCD related outcomes for healthcare professionals in their daily practice. Our research can further improve implementation of MCD and contribute to the research field of evaluation of CES in general. "

"Background: Allocating admitted patients to their wards is increasingly put under pressure due to high bed occupancy rates. Consequently, allocation becomes morally challenging as it is confronted with potentially conflicting values like protecting teams' workload, solidarity between wards and quality of care. Furthermore, there is a continuous uncertainty regarding expected intake, discharge, available beds and personnel. An integrative ethics support project was started to help to better deal with these challenges. After identifying core moral challenges, the aim of the current project was to co-create a map of values and norms for the daily allocation meetings. Methods: This qualitative study included observations of allocation meetings and 13 interviews. Subsequently, in five working group sessions a map of relevant values and norms was co-created with a selection of involved professionals. Results: Findings revealed moral challenges in three so-called 'moral circles': 1) one's own team; 2) the hospital and 3) the hospital's region. A map was developed including important and agreed upon values with 14 norms for the daily allocation meetings. Additionally, formal policies were updated and a conversation method was introduced to guide discussions when there are moral challenges. Conclusion: The joint development of the map led to a shared and practical product for both discussions and decisions regarding bed allocation. Its development already contributed to increased awareness of and openness about moral challenges. Using the map in daily allocation meetings may further stimulate moral reflection on these challenges to support these healthcare professionals in making well-considered and value-based decisions. "