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  1. Working towards implementing moral case deliberation in mental healthcare: Ongoing dialogue and shared ownership as strategy.Froukje Weidema, Hans van Dartel & Bert Molewijk - 2016 - Clinical Ethics 11 (2-3):54-62.
    The design and implementation of clinical ethics support is attracting increasing attention. Often, the characteristics and aims of clinical ethics support are translated into practice in a top-down, programmatic manner. These characteristics and aims then remain a constant feature of the clinical ethics support functions within the organisation. We argue that the characteristics of clinical ethics support should be reflected in the implementation strategy. Inspired by dialogical, pragmatic and hermeneutic perspectives on clinical ethics support in general and moral case deliberation (...)
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  • Enacting Ethics: Bottom-up Involvement in Implementing Moral Case Deliberation. [REVIEW]F. C. Weidema, A. C. Molewijk, G. A. M. Widdershoven & T. A. Abma - 2012 - Health Care Analysis 20 (1):1-19.
    In moral case deliberation (MCD), healthcare professionals meet to reflect upon their moral questions supported by a structured conversation method and non-directive conversation facilitator. An increasing number of Dutch healthcare institutions work with MCD to (1) deal with moral questions, (2) improve reflection skills, interdisciplinary cooperation and decision-making, and (3) develop policy. Despite positive evaluations of MCD, organization and implementation of MCD appears difficult, depending on individuals or external experts. Studies on MCD implementation processes have not yet been published. The (...)
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  • EMMA (Applying ethics multiprofessionally and methodically): a specific structured tool for ethics case consultations in long-term care.Anna Wachter & Arnd T. May - forthcoming - Ethik in der Medizin:1-14.
    Einrichtungen der Altenpflege weisen spezifische ethische Spannungsfelder und ethische Fragestellungen auf. Das Strukturinstrument EMMA (Ethik Multiprofessionell Methodisch Anwenden) zur Moderation einer Ethik-Fallberatung wurde für den Einsatz in Einrichtungen der Altenpflege konzipiert. Inhaltlich werden die Besonderheiten dieses Settings unter Bezugnahme auf den Schlüsselbegriff Privatheit in den Mittelpunkt gestellt. EMMA eignet sich aufgrund seiner Kontextsensitivität darüber hinaus zum Einsatz in der Ethik-Fallberatung in unterschiedlichen außerklinischen Settings.
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  • Clinical ethics in forensic psychiatry: Fostering reflection and dialog on the ward through moral case deliberation.Yolande Voskes, Frouk Weidema & Guy Widdershoven - 2016 - Clinical Ethics 11 (2-3):63-69.
    Forensic psychiatry is pervaded by moral dilemmas. Although professionals in forensic psychiatry are trained in law and psychiatry and are certainly aware of ethical issues in the care for patients, they tend to make decisions in an implicit way and not to discuss their moral concerns or doubts. More structural attention for ethics seems to be required. In this paper, we show the value of moral case deliberation in forensic psychiatry. Moral case deliberation is a specific kind of clinical ethics (...)
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  • Inclusive Consultation: A Hermeneutical Approach to Ethical Deliberation in the Clinical Setting. [REVIEW]Andreas Vieth - 2011 - HEC Forum 23 (4):295-304.
    The problem of ethical consultations in the clinical setting should be reasonable, but it cannot be reduced to reason and philosophical theory alone. I will argue that emotions are constitutively and discursively relevant features of the evaluative experience of persons. Ethical consultations should include emotions. Emotions like shame and guilt are complex and learned reactions of persons, which form one basis of ethical reflection. I argue that ethical consultation can rely neither on a strict theory or method nor on a (...)
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  • It’s not all about moral reasoning: Understanding the content of Moral Case Deliberation.Mia Svantesson, Marit Silén & Inger James - 2018 - Nursing Ethics 25 (2):212-229.
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  • Learning by Doing. Training Health Care Professionals to Become Facilitator of Moral Case Deliberation.Margreet Stolper, Bert Molewijk & Guy Widdershoven - 2015 - HEC Forum 27 (1):47-59.
    Moral case deliberation is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care institutions to acquire (...)
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  • Debating Ethical Expertise.Norbert L. Steinkamp, Bert Gordijn & Henk A. M. J. ten Have - 2008 - Kennedy Institute of Ethics Journal 18 (2):173-192.
    This paper explores the relevance of the debate about ethical expertise for the practice of clinical ethics. We present definitions, explain three theories of ethical expertise, and identify arguments that have been brought up to either support the concept of ethical expertise or call it into question. Finally, we discuss four theses: the debate is relevant for the practice of clinical ethics in that it (1) improves and specifies clinical ethicists' perception of their expertise; (2) contributes to improving the perception (...)
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  • Moral dilemmas and conflicts concerning patients in a vegetative state/unresponsive wakefulness syndrome: shared or non-shared decision making? A qualitative study of the professional perspective in two moral case deliberations.Conny A. M. F. H. Span-Sluyter, Jan C. M. Lavrijsen, Evert van Leeuwen & Raymond T. C. M. Koopmans - 2018 - BMC Medical Ethics 19 (1):1-12.
    Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...)
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  • How to evaluate the quality of an ethical deliberation? A pragmatist proposal for evaluation criteria and collaborative research.Abdou Simon Senghor & Eric Racine - 2022 - Medicine, Health Care and Philosophy 25 (3):309-326.
    Ethics designates a structured process by which important human values and meanings of life are understood and tackled. Therein, the ability to discuss openly and reflect on (aka deliberation) understandings of moral problems, on solutions to these problems, and to explore what a meaningful resolution could amount to is highly valued. However, the indicators of what constitutes a high-quality ethical deliberation remain vague and unclear. This article proposes and develops a pragmatist approach to evaluate the quality of deliberation. Deliberation features (...)
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  • Inspectors’ ethical challenges in health care regulation: a pilot study.W. Seekles, G. Widdershoven, P. Robben, G. van Dalfsen & B. Molewijk - 2017 - Medicine, Health Care and Philosophy 20 (3):311-320.
    There is an increasing body of research on what kind of ethical challenges health care professionals experience regarding the quality of care. In the Netherlands the Dutch Health Care Inspectorate is responsible for monitoring and regulating the quality of health care. No research exists on what kind of ethical challenges inspectors experience during the regulation process itself. In a pilot study we used moral case deliberation as method in order to reflect upon inspectors’ ethical challenges. The objective of this paper (...)
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  • The Care Dialog: the “ethics of care” approach and its importance for clinical ethics consultation.Patrick Schuchter & Andreas Heller - 2018 - Medicine, Health Care and Philosophy 21 (1):51-62.
    Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an “ethics of care” approach as well as an (...)
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  • Do we understand the intervention? What complex intervention research can teach us for the evaluation of clinical ethics support services.Jan Schildmann, Stephan Nadolny, Joschka Haltaufderheide, Marjolein Gysels, Jochen Vollmann & Claudia Bausewein - 2019 - BMC Medical Ethics 20 (1):48.
    Evaluating clinical ethics support services has been hailed as important research task. At the same time, there is considerable debate about how to evaluate CESS appropriately. The criticism, which has been aired, refers to normative as well as empirical aspects of evaluating CESS. In this paper, we argue that a first necessary step for progress is to better understand the intervention in CESS. Tools of complex intervention research methodology may provide relevant means in this respect. In a first step, we (...)
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  • Developing organisational ethics in palliative care.Lars Sandman, Ulla Molander & Inger Benkel - 2017 - Nursing Ethics 24 (2):138-150.
    Background:Palliative carers constantly face ethical problems. There is lack of organised support for the carers to handle these ethical problems in a consistent way. Within organisational ethics, we find models for moral deliberation and for developing organisational culture; however, they are not combined in a structured way to support carers’ everyday work.Research objective:The aim of this study was to describe ethical problems faced by palliative carers and develop an adapted organisational set of values to support the handling of these problems.Research (...)
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  • Ethical difficulties in clinical practice: experiences of European doctors.S. A. Hurst, A. Perrier, R. Pegoraro, S. Reiter-Theil, R. Forde, A.-M. Slowther, E. Garrett-Mayer & M. Danis - 2007 - Journal of Medical Ethics 33 (1):51-57.
    Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...)
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  • Enhancing patient safety by integrating ethical dimensions to Critical Incident Reporting Systems.Annette Rogge, Alena Buyx, Rainer Petzina, Eva Kuhn & Kai Wehkamp - 2021 - BMC Medical Ethics 22 (1):1-8.
    BackgroundCritical Incident Reporting Systems (CIRS) provide a well-proven method to identify clinical risks in hospitals. All professions can report critical incidents anonymously, low-threshold, and without sanctions. Reported cases are processed to preventive measures that improve patient and staff safety. Clinical ethics consultations offer support for ethical conflicts but are dependent on the interaction with staff and management to be effective. The aim of this study was to investigate the rationale of integrating an ethical focus into CIRS.MethodsA six-step approach combined the (...)
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  • Clinical Ethics Consultation and the Challenge to Implement What Is Right.Robert Ranisch & Cordula Brand - 2016 - American Journal of Bioethics 16 (9):38-39.
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  • Exploring moral problems and moral competences in midwifery: A qualitative study.Stephan Oelhafen, Settimio Monteverde & Eva Cignacco - forthcoming - Nursing Ethics:096973301876117.
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  • Implementing moral case deliberation in a psychiatric hospital: process and outcome. [REVIEW]Bert Molewijk, Maarten Verkerk, Henk Milius & Guy Widdershoven - 2008 - Medicine, Health Care and Philosophy 11 (1):43-56.
    Background Clinical moral case deliberation consists of the systematic reflection on a concrete moral case␣by health care professionals. This paper presents the study of a 4-year moral deliberation project.Objectives The objectives of this paper are to: (a) describe the practice and the theoretical background of moral deliberation, (b) describe the moral deliberation project, (c) present the outcomes of␣the evaluation of the moral case deliberation sessions, and (d) present the implementation process.Methods The implementation process is both monitored and supported by an (...)
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  • Emotions and Clinical Ethics Support. A Moral Inquiry into Emotions in Moral Case Deliberation.Bert Molewijk, Dick Kleinlugtenbelt, Scott M. Pugh & Guy Widdershoven - 2011 - HEC Forum 23 (4):257-268.
    Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...)
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  • Fostering moral resilience through moral case deliberation.Suzanne Metselaar & Bert Molewijk - 2023 - Nursing Ethics 30 (5):730-745.
    Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...)
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  • CURA: A clinical ethics support instrument for caregivers in palliative care.Suzanne Metselaar, Malene van Schaik, Guy Widdershoven & H. Roeline Pasman - 2022 - Nursing Ethics 29 (7-8):1562-1577.
    This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case (...)
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  • An empirical investigation into moral challenges of (breaching) confidentiality and needs for ethics support when facilitating moral case deliberation.W. M. R. Ligtenberg, A. C. Molewijk & M. M. Stolper - 2024 - International Journal of Ethics Education 9 (1):79-104.
    Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...)
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  • Developing Organizational Diversity Statements Through Dialogical Clinical Ethics Support: The Role of the Clinical Ethicist.Charlotte Kröger, Albert C. Molewijk & Suzanne Metselaar - 2023 - Journal of Bioethical Inquiry 20 (3):379-395.
    In pluralist societies, stakeholders in healthcare may have different experiences of and moral perspectives on health, well-being, and good care. Increasing cultural, religious, sexual, and gender diversity among both patients and healthcare professionals requires healthcare organizations to address these differences. Addressing diversity, however, comes with inherent moral challenges; for example, regarding how to deal with healthcare disparities between minoritized and majoritized patients or how to accommodate different healthcare needs and values. Diversity statements are an important strategy for healthcare organizations to (...)
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  • Refining deliberation in bioethics.Miguel Kottow - 2009 - Medicine, Health Care and Philosophy 12 (4):393-397.
    The multidisciplinary provenance of bioethics leads to a variety of discursive styles and ways of reasoning, making the discipline vulnerable to criticism and unwieldy to the setting of solid theoretical foundations. Applied ethics belongs to a group of disciplines that resort to deliberation rather than formal argumentation, therefore employing both factual and value propositions, as well as emotions, intuitions and other non logical elements. Deliberation is thus enriched to the point where ethical discourse becomes substantial rather than purely analytical. Caution (...)
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  • Culture, normativity and morisprudence: a response to the commentaries.Niek Kok, Marieke Zegers, Cornelia Hoedemaekers & Jelle van Gurp - 2022 - Journal of Medical Ethics 48 (12):985-986.
    We are grateful for the thoughtful replies to our article. 1 We are especially encouraged that all respondents agree that it is of value to develop a theoretical framework which helps to study how clinical ethics support services (CESS) induce individual and organisational learning. We have focused on the relations between moral case deliberation (MCD), organisational learning and quality improvement from a predominantly sociological perspective. The goal of our theoretical framework was to establish hypotheses which allow for empirical evaluation of (...)
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  • Ethical competence training for members on clinical ethics committees : experiences from Denmark.Jeanette Bresson Ladegaard Knox - 2017 - International Journal of Ethics Education 2 (2):203-213.
    To address the moral questions in patient care and medical practice, Danish hospitals are starting to solicit clinical ethics committees. As in other places around the world, CECs in Denmark is an interdisciplinary group that includes physicians, nurses, social workers, psychologists, lawyers, chaplains, and sometimes lay persons. Due to their distinct professional background, members are largely untrained in concepts, skills and the language of moral philosophy and ethical reasoning. The absence of appropriate competencies makes it challenging for members to identify, (...)
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  • Does teaching medical ethics ensure good knowledge, attitude, and reported practice? An ethical vignette-based cross-sectional survey among doctors in a tertiary teaching hospital in Nepal.Suchita Joshi, Sajan Acharya, Shuvechchha Karki, Jasmin Joshi, Ashma Shrestha & Carmina Shrestha - 2021 - BMC Medical Ethics 22 (1):1-16.
    BackgroundImportance of awareness of medical ethics and its integration into medical curriculum has been frequently highlighted. Study 1 aimed to assess the knowledge, attitude, and reported practices of medical ethics among clinicians at Patan Academy of Health Sciences, a tertiary care teaching hospital in Nepal. Study 2 was conducted to assess whether there was a difference in knowledge, attitude, and reported practices of medical ethics among doctors who received formal medical ethics education during undergraduate studies and those who did not.MethodsTwo (...)
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  • Evaluation and perceived results of moral case deliberation.R. M. Janssens, E. van Zadelhoff, G. van Loo, G. A. Widdershoven & B. A. Molewijk - 2015 - Nursing Ethics 22 (8):870-880.
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  • Physicians' Access to Ethics Support Services in Four European Countries.Samia A. Hurst, Stella Reiter-Theil, Arnaud Perrier, Reidun Forde, Anne-Marie Slowther, Renzo Pegoraro & Marion Danis - 2007 - Health Care Analysis 15 (4):321-335.
    Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...)
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  • Nurses' Moral Problems in Dialisys.Maaike Hermsen & Marjolein van der Donk - 2009 - Nursing Ethics 16 (2):184-191.
    This article gives an overview of the moral problems experienced and described by nurses working in a dialysis unit in the Netherlands. The nurses raised a wide variety of issues that they considered were moral problems, which were grouped into seven topics. A selection of cases are described, one of which is analysed using the Nijmegen method of ethical case deliberation. This method facilitates practical approaches to the different types of moral problems encountered. The argument is made that, owing to (...)
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  • Beyond ethical post-mortems.Bert Gordijn & Henk ten Have - 2022 - Medicine, Health Care and Philosophy 25 (3):305-306.
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  • Die Entwicklung emotionaler Kompetenz in einzelfallbezogenen Lernarrangements.Dr Phil Uwe Fahr - 2008 - Ethik in der Medizin 20 (1):26-39.
    Der Beitrag diskutiert Möglichkeiten emotionalen Lernens in einzelfallbezogenen Lernarrangements wie etwa klinische Ethikberatungen und Workshops, die mit Einzelfällen arbeiten. Es wird ein didaktisches Rahmenkonzept entwickelt, das vor allem auf die Ermöglichung emotionalen Lernens abzielt. Dabei werden entsprechende Lernziele formuliert, emotionale Themen in diesen Lernarrangements benannt und Methoden dargestellt, wie Erwachsenenbildner diese emotionalen Themen so bearbeiten können, dass ein emotionales Lernen ermöglicht wird. Dabei wird auch ein konzeptueller Rahmen für diese Lernarrangements benannt, der von einem deliberativen Ethikverständnis ausgeht. Emotionales Lernen als (...)
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  • Development of emotional competence in trainings in medical ethics.Uwe Fahr - 2008 - Ethik in der Medizin 20 (1):26-39.
    Der Beitrag diskutiert Möglichkeiten emotionalen Lernens in einzelfallbezogenen Lernarrangements wie etwa klinische Ethikberatungen und Workshops, die mit Einzelfällen arbeiten. Es wird ein didaktisches Rahmenkonzept entwickelt, das vor allem auf die Ermöglichung emotionalen Lernens abzielt. Dabei werden entsprechende Lernziele formuliert, emotionale Themen in diesen Lernarrangements benannt und Methoden dargestellt, wie Erwachsenenbildner diese emotionalen Themen so bearbeiten können, dass ein emotionales Lernen ermöglicht wird. Dabei wird auch ein konzeptueller Rahmen für diese Lernarrangements benannt, der von einem deliberativen Ethikverständnis ausgeht. Emotionales Lernen als (...)
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  • Development of emotional competence in trainings in medical ethics.Uwe Fahr - 2008 - Ethik in der Medizin 20 (1):26-39.
    Der Beitrag diskutiert Möglichkeiten emotionalen Lernens in einzelfallbezogenen Lernarrangements wie etwa klinische Ethikberatungen und Workshops, die mit Einzelfällen arbeiten. Es wird ein didaktisches Rahmenkonzept entwickelt, das vor allem auf die Ermöglichung emotionalen Lernens abzielt. Dabei werden entsprechende Lernziele formuliert, emotionale Themen in diesen Lernarrangements benannt und Methoden dargestellt, wie Erwachsenenbildner diese emotionalen Themen so bearbeiten können, dass ein emotionales Lernen ermöglicht wird. Dabei wird auch ein konzeptueller Rahmen für diese Lernarrangements benannt, der von einem deliberativen Ethikverständnis ausgeht. Emotionales Lernen als (...)
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  • Ethical case deliberation involving the end of life decision.Oduwole Ebunoluwa - 2012 - Bangladesh Journal of Bioethics 3 (1):23-29.
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  • Institutional Challenges for Clinical Ethics Committees.Andrea Dörries, Pierre Boitte, Ana Borovecki, Jean-Philippe Cobbaut, Stella Reiter-Theil & Anne-Marie Slowther - 2011 - HEC Forum 23 (3):193-205.
    Clinical ethics committees (CECs) have been developing in many countries since the 1980s, more recently in the transitional countries in Eastern Europe. With their increasing profile they are now faced with a range of questions and challenges regarding their position within the health care organizations in which they are situated: Should CECs be independent bodies with a critical role towards institutional management, or should they be an integral part of the hospital organization? In this paper, we discuss the organizational context (...)
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  • Falling on deaf ears: a qualitative study on clinical ethical committees in France.Catherine Dekeuwer, Brenda Bogaert, Nadja Eggert, Claire Harpet & Morgane Romero - 2019 - Medicine, Health Care and Philosophy 22 (4):515-529.
    The French medical context is characterized by institutionalization of the ethical reflection in health care facilities and an important disparity between spaces of ethical reflection. In theory, the healthcare professional may mobilise an arsenal of resources to help him in his ethical reflection. But what happens in practice? We conducted semi-structured interviews with 22 health-care professionals who did and did not have recourse to clinical ethical committees. We also implemented two focus groups with 18 professionals involved in various spaces of (...)
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  • Implementing structured, multiprofessional medical ethical decision-making in a neonatal intensive care unit.Jacoba de Boer, Geja van Blijderveen, Gert van Dijk, Hugo J. Duivenvoorden & Monique Williams - 2012 - Journal of Medical Ethics 38 (10):596-601.
    Background In neonatal intensive care, a child's death is often preceded by a medical decision. Nurses, social workers and pastors, however, are often excluded from ethical case deliberation. If multiprofessional ethical case deliberations do take place, participants may not always know how to perform to the fullest. Setting A level-IIID neonatal intensive care unit of a paediatric teaching hospital in the Netherlands. Methods Structured multiprofessional medical ethical decision-making (MEDM) was implemented to help overcome problems experienced. Important features were: all professionals (...)
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  • Prevalence and characteristics of moral case deliberation in Dutch health care.Linda Dauwerse, Margreet Stolper, Guy Widdershoven & Bert Molewijk - 2014 - Medicine, Health Care and Philosophy 17 (3):365-375.
    The attention for Moral case deliberation has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this paper is to provide an overview of the state of the art concerning MCD in the Netherlands. As part of a larger national study on clinical ethics support in the (...)
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  • Morality in the mundane: Specific needs for ethics support in elderly care.Linda Dauwerse, Sandra van der Dam & Tineke Abma - 2012 - Nursing Ethics 19 (1):91-103.
    Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly care. The findings of two surveys, two focus groups and 17 interviews demonstrate that the availability of ethics support is limited. There is a need for ethics support, albeit not unconditionally. Advice-based forms of ethics support (...)
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  • Need for ethics support in healthcare institutions: views of Dutch board members and ethics support staff.L. Dauwerse, T. Abma, B. Molewijk & G. Widdershoven - 2011 - Journal of Medical Ethics 37 (8):456-460.
    Next SectionObjective The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. Methods This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Findings Most respondents see a (...)
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  • Evaluating the effectiveness of clinical ethics committees: a systematic review.Chiara Crico, Virginia Sanchini, Paolo Giovanni Casali & Gabriella Pravettoni - 2021 - Medicine, Health Care and Philosophy 24 (1):135-151.
    Clinical Ethics Committees (CECs), as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases (PubMed, Ovid (...)
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  • Developing a Model of Healthcare Ethics Support in Croatia.Ana Borovečki, Ksenija Makar-aus̆perger, Igor Francetić, Sanja Babić-Bosnac, Bert Gordijn, Norbert Steinkamp & Stjepan Orešković - 2010 - Cambridge Quarterly of Healthcare Ethics 19 (3):395-401.
    Croatia is a transitional society in that it is a country emerging from a socialist command economy toward a market-based economy with ensuing structural changes of a social and political nature—some extending into the healthcare system. A legacy from our past is that, until now, Croatian healthcare institutions have had no real experience with clinical ethics support services. When clinical cases arise presenting complex ethical dilemmas in treatment options, the challenges presented to the medical team are substantial. The case described (...)
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  • Competence in Mental Health Care: A Hermeneutic Perspective. [REVIEW]Lazare Benaroyo & Guy Widdershoven - 2004 - Health Care Analysis 12 (4):295-306.
    In this paper we develop a hermeneutic approach to the concept of competence. Patient competence, according to a hermeneutic approach, is not primarily a matter of being able to reason, but of being able to interpret the world and respond to it. Capacity should then not be seen as theoretical, but as practical. From the perspective of practical rationality, competence and capacity are two sides of the same coin. If a person has the capacity to understand the world and give (...)
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  • Do Our Moral Judgments Need to Be Guided by Principles?Roberto Andorno - 2012 - Cambridge Quarterly of Healthcare Ethics 21 (4):457-465.
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  • Teaching ethics in the clinic. The theory and practice of moral case deliberation.A. C. Molewijk, T. Abma, M. Stolper & G. Widdershoven - 2008 - Journal of Medical Ethics 34 (2):120-124.
    A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals (...)
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  • Good Care in Ongoing Dialogue. Improving the Quality of Care Through Moral Deliberation and Responsive Evaluation.Tineke A. Abma, Bert Molewijk & Guy A. M. Widdershoven - 2009 - Health Care Analysis 17 (3):217-235.
    Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...)
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  • Moral Deliberation in Psychiatric Nursing Practice.Tineke A. Abma & Guy Am Widdershoven - 2006 - Nursing Ethics 13 (5):546-557.
    Moral deliberation has been receiving more attention in nursing ethics. Several ethical conversation models have been developed. This article explores the feasibility of the so-called CARE (Considerations, Actions, Reasons, Experiences) model as a framework for moral deliberation in psychiatric nursing practice. This model was used in combination with narrative and dialogical approaches to foster discourse between various stakeholders about coercion in a closed admission clinic in a mental hospital in the Netherlands. The findings demonstrate that the CARE model provides a (...)
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  • Empowering the poor and the front-liners; equality of capability in the time of COVID-19 pandemic.Gerry Arambala - 2020 - Eubios Journal of Asian and International Bioethics 30 (5):248-253.
    The advent of the equality of capability theory, as developed by Amartya Sen, has brought about the radicalization of the conventional theories of social justice and development. Sen’s remarkable contribution in the field of developmental theories has paved the way for the reconfiguration and development of normative economics and political philosophy. With his insistence on humanizing development and focusing on the actual freedom of the person as the main criteria for development, Sen’s capability approach will be utilized as the moral (...)
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