Evidence map›Paper›PMID 35120509›Full record

ArticleBMC medical ethics2022

Conceptualizing the impact of moral case deliberation: a multiple-case study in a health care institution for people with intellectual disabilities.

J C de Snoo-Trimp, J L P van Gurp, A C Molewijk

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Article in BMC medical ethics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

J C de Snoo-TrimpDepartment of Ethics, Law and Humanities, Amsterdam UMC, VU University, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands. j.desnoo@amsterdamumc.nl.
J L P van GurpDepartment IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
A C MolewijkDepartment of Ethics, Law and Humanities, Amsterdam UMC, VU University, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs moral case deliberations (MCDs) have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how 'impact of MCD' should be conceptualized for future research.

methodsA multiple-case study was conducted in a care organization for people with intellectual disabilities and/or acquired brain injury, by observing MCD sessions as 'cases', followed by interviews with health care professionals concerning the follow-up to these cases, and a focus group with involved MCD facilitators. A conceptual scheme concerning the possible impact formed the basis for analysis: (1) individual moral awareness; (2) the actions of health care professionals; (3) collaboration among health care professionals; (4) the concrete situation of the client; (5) the client's quality of care and life; (6) the organizational and policy level.

resultsAccording to interviewees, their moral awareness and their collaboration, both among colleagues and with clients' relatives, improved after MCD. Perceived impact on client situation, quality of care/life and the organizational level varied among interviewees or was difficult to define or link to MCD. Three aspects were added to the conceptual scheme concerning the impact of MCD: (a) preparations and expectations prior to the MCD session; (b) a translational step between the conclusions of the MCD session and practical events in the following period, and (c) collaboration with clients' relatives. A negative impact of MCD was also found on misunderstandings among participants and disappointment about lack of follow-up.

conclusionsConcretizing and conceptualizing the 'impact' of MCD is complicated as many factors play a role either before or during the transition from MCD to practice. It is important to consider 'impact' in a broad sense and to relate it to the goals and context of the MCD in question. Future studies in this field should pay additional attention to the preparations, content and process involved in ethics support, including clients' and relatives' experiences.

Indexed as

Ethics ConsultationIntellectual DisabilityDelivery of Health CareHealth PersonnelHumansMoralsEvaluationImpactIntellectual disabilitiesMoral case deliberation

Identifiers

PMID35120509
PMCPMC8817498

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