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  1. CURA: A Clinical Ethics Support Instrument for Caregivers in Palliative Care.Suzanne Metselaar, Malene van Schaik, Guy Widdershoven & H. Roeline Pasman - forthcoming - Nursing Ethics:096973302210740.
    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: Concentrate, Unrush, Reflect, and Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case was discussed with CURA (...)
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  • Evaluating Interventions to Improve Ethical Decision Making in Clinical Practice: A Review of the Literature and Reflections on the Challenges Posed. [REVIEW]Agnieszka Ignatowicz, Anne Marie Slowther, Christopher Bassford, Frances Griffiths, Samantha Johnson & Karen Rees - forthcoming - Journal of Medical Ethics.
    Since the 1980s, there has been an increasing acknowledgement of the importance of recognising the ethical dimension of clinical decision-making. Medical professional regulatory authorities in some countries now include ethical knowledge and practice in their required competencies for undergraduate and post graduate medical training. Educational interventions and clinical ethics support services have been developed to support and improve ethical decision making in clinical practice, but research evaluating the effectiveness of these interventions has been limited. We undertook a systematic review of (...)
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  • Clinical Ethics Consultations: A Scoping Review of Reported Outcomes.Ann M. Heesters, Ruby R. Shanker, Kevin Rodrigues, Daniel Z. Buchman, Andria Bianchi, Claudia Barned, Erica Nekolaichuk, Eryn Tong, Marina Salis & Jennifer A. H. Bell - 2022 - BMC Medical Ethics 23 (1):1-65.
    BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...)
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  • Moral Competence, Moral Teamwork and Moral Action - the European Moral Case Deliberation Outcomes (Euro-MCD) Instrument 2.0 and its Revision Process. [REVIEW]J. C. de Snoo-Trimp, H. C. W. de Vet, G. A. M. Widdershoven, A. C. Molewijk & M. Svantesson - 2020 - BMC Medical Ethics 21 (1):1-18.
    BackgroundClinical Ethics Support services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument was developed to measure outcomes of Moral Case Deliberation. To further validate the instrument, we tested it in field studies and revised it. (...)
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  • How to Deal with Moral Challenges Around the Decision-Making Competence in Transgender Adolescent Care? Development of an Ethics Support Tool.Janine de Snoo-Trimp, Annelou de Vries, Bert Molewijk & Irma Hein - 2022 - BMC Medical Ethics 23 (1):1-15.
    Background Decision-making competence is a complex concept in the care for transgender and gender diverse adolescents, since this type of care concerns one’s developing gender identity and involves treatment options that often lack international consensus. Even despite competence assessments, moral challenges arise in the decision-making process. Here, traditional forms of clinical ethics support such as moral case deliberation might not fit as these do not provide thematic guidance. This study therefore aimed to develop a practice-oriented ethics support tool to assist (...)
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  • Field-Testing the Euro-MCD Instrument: Important Outcomes According to Participants Before and After Moral Case Deliberation.J. C. de Snoo-Trimp, A. C. Molewijk, M. Svantesson, G. A. M. Widdershoven & H. C. W. de Vet - 2022 - HEC Forum 34 (1):1-24.
    Ethics support services like Moral Case Deliberation intend to support healthcare professionals in ethically difficult situations. To assess outcomes of MCD, the Euro-MCD Instrument has been developed. Field studies to test this instrument are needed and have been conducted, examining important outcomes before MCD participation and experienced outcomes. The current study aimed to describe how participants’ perceive the importance of MCD outcomes after MCD; compare these perceptions with those before MCD participation; and test the factor structure of these outcomes. Swedish, (...)
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  • Evaluating Assessment Tools of the Quality of Clinical Ethics Consultations: A Systematic Scoping Review From 1992 to 2019.Nicholas Yue Shuen Yoon, Yun Ting Ong, Hong Wei Yap, Kuang Teck Tay, Elijah Gin Lim, Clarissa Wei Shuen Cheong, Wei Qiang Lim, Annelissa Mien Chew Chin, Ying Pin Toh, Min Chiam, Stephen Mason & Lalit Kumar Radha Krishna - 2020 - BMC Medical Ethics 21 (1):1-11.
    BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees s to carry out effective ethics consultations. However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality of CECons.MethodsGuided (...)
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  • Important Outcomes of Moral Case Deliberation: A Euro-MCD Field Survey of Healthcare Professionals’ Priorities.Mia Svantesson, Janine C. de Snoo-Trimp, Göril Ursin, Henrica C. W. de Vet, Berit S. Brinchmann & Bert Molewijk - 2019 - Journal of Medical Ethics 45 (9):608-616.
    BackgroundThere is a lack of empirical research regarding the outcomes of such clinical ethics support methods as moral case deliberation. Empirical research in how healthcare professionals perceive potential outcomes is needed in order to evaluate the value and effectiveness of ethics support; and help to design future outcomes research. The aim was to use the European Moral Case Deliberation Outcome Instrument instrument to examine the importance of various MCD outcomes, according to healthcare professionals, prior to participation.MethodsA North European field survey (...)
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