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"Here's my dilemma". Moral case deliberation as a platform for discussing everyday ethics in elderly care.

van der Dam S, Abma TA, Kardol MJ, Widdershoven GA - Health Care Anal (2012)

Bottom Line: The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation.It is important that an agenda is constructed from the bottom-up and open to a variety of issues.In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures.

View Article: PubMed Central - PubMed

Affiliation: Caphri, Department of Health, Ethics and Society, Maastricht University, Universiteitssingel 40, P.O. Box 616, 6200 MD Maastricht, The Netherlands. s.vanderdam@maastrichtuniversity.nl

ABSTRACT
Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: 'resident's behavior', 'divergent perspectives on good care' and 'organizational context'. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical 'blind spots'.

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Related in: MedlinePlus

Source case description
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Fig1: Source case description

Mentions: The overview of issues was developed from the analyses of the original case descriptions and the discussion in the MCD sessions. For a small number of cases (N = 23) we made use of the meeting report as these cases had only been presented verbally. For the other cases (N = 179), the case description as provided by the participant was used. For nearly a third (N = 63) of the cases this was the only source available. These cases were either not selected for discussion or there was no report available. We checked whether the definition of the moral issue changed during the meeting. In most cases the moral question stayed the same or was slightly adjusted. In a small number of cases (N = 6) the moral question finally turned out to be different from the one originally posed. For the analysis we focused on the adjusted dilemma. See Fig. 1 for the source of the case descriptions.Fig. 1


"Here's my dilemma". Moral case deliberation as a platform for discussing everyday ethics in elderly care.

van der Dam S, Abma TA, Kardol MJ, Widdershoven GA - Health Care Anal (2012)

Source case description
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3400030&req=5

Fig1: Source case description
Mentions: The overview of issues was developed from the analyses of the original case descriptions and the discussion in the MCD sessions. For a small number of cases (N = 23) we made use of the meeting report as these cases had only been presented verbally. For the other cases (N = 179), the case description as provided by the participant was used. For nearly a third (N = 63) of the cases this was the only source available. These cases were either not selected for discussion or there was no report available. We checked whether the definition of the moral issue changed during the meeting. In most cases the moral question stayed the same or was slightly adjusted. In a small number of cases (N = 6) the moral question finally turned out to be different from the one originally posed. For the analysis we focused on the adjusted dilemma. See Fig. 1 for the source of the case descriptions.Fig. 1

Bottom Line: The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation.It is important that an agenda is constructed from the bottom-up and open to a variety of issues.In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures.

View Article: PubMed Central - PubMed

Affiliation: Caphri, Department of Health, Ethics and Society, Maastricht University, Universiteitssingel 40, P.O. Box 616, 6200 MD Maastricht, The Netherlands. s.vanderdam@maastrichtuniversity.nl

ABSTRACT
Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: 'resident's behavior', 'divergent perspectives on good care' and 'organizational context'. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical 'blind spots'.

Show MeSH
Related in: MedlinePlus