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  1. A Pragmatist Approach to Clinical Ethics Support: Overcoming the Perils of Ethical Pluralism.Giulia Inguaggiato, Suzanne Metselaar, Rouven Porz & Guy Widdershoven - 2019 - Medicine, Health Care and Philosophy 22 (3):427-438.
    In today’s pluralistic society, clinical ethics consultation cannot count on a pre-given set of rules and principles to be applied to a specific situation, because such an approach would deny the existence of different and divergent backgrounds by imposing a dogmatic and transcultural morality. Clinical ethics support needs to overcome this lack of foundations and conjugate the respect for the difference at stake with the necessity to find shared and workable solutions for ethical issues encountered in clinical practice. We argue (...)
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  • Relational Autonomy in the Care of the Vulnerable: Health Care Professionals’ Reasoning in Moral Case Deliberation.Kaja Heidenreich, Anders Bremer, Lars Johan Materstvedt, Ulf Tidefelt & Mia Svantesson - 2018 - Medicine, Health Care and Philosophy 21 (4):467-477.
    In Moral Case Deliberation, healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals’ moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The (...)
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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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  • Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned.Laura Hartman, Guy Widdershoven, Annelou de Vries, Annelijn Wensing-Kruger, Martin den Heijer, Thomas Steensma & Bert Molewijk - 2019 - HEC Forum 31 (3):241-260.
    Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...)
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  • Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned.Laura Hartman, Guy Widdershoven, Annelou de Vries, Annelijn Wensing-Kruger, Martin den Heijer, Thomas Steensma & Bert Molewijk - 2019 - HEC Forum 31 (3):241-260.
    Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...)
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  • Bioethics Education in Clinical Settings: Theory and Practice of the Dilemma Method of Moral Case Deliberation.Margreet Stolper, Bert Molewijk & Guy Widdershoven - 2016 - BMC Medical Ethics 17 (1):45.
    BackgroundMoral Case Deliberation is a specific form of bioethics education fostering professionals’ moral competence in order to deal with their moral questions. So far, few studies focus in detail on Moral Case Deliberation methodologies and their didactic principles. The dilemma method is a structured and frequently used method in Moral Case Deliberation that stimulates methodological reflection and reasoning through a systematic dialogue on an ethical issue experienced in practice.MethodsIn this paper we present a case-study of a Moral Case Deliberation with (...)
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  • Examining the Doing of Ethics Support Staff. A Dialogical Approach Toward Assessing the Quality of Facilitators of Moral Case Deliberation.Bert Molewijk, Reidar Pedersen & Margreet Stolper - 2020 - American Journal of Bioethics 20 (3):42-44.
    Volume 20, Issue 3, March 2020, Page 42-44.
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  • A Profession Without Expertise? Professionalization in Reverse.Joseph A. Raho & James A. Hynds - 2020 - American Journal of Bioethics 20 (3):44-46.
    Volume 20, Issue 3, March 2020, Page 44-46.
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  • Lessons Learned From Implementing a Responsive Quality Assessment of Clinical Ethics Support.Eva M. van Baarle, Marieke C. Potma, Maria E. C. van Hoek, Laura A. Hartman, Bert A. C. Molewijk & Jelle L. P. van Gurp - 2019 - BMC Medical Ethics 20 (1):1-11.
    Various forms of Clinical Ethics Support have been developed in health care organizations. Over the past years, increasing attention has been paid to the question of how to foster the quality of ethics support. In the Netherlands, a CES quality assessment project based on a responsive evaluation design has been implemented. CES practitioners themselves reflected upon the quality of ethics support within each other’s health care organizations. This study presents a qualitative evaluation of this Responsive Quality Assessment project. CES practitioners’ (...)
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  • Defining and Categorizing Outcomes of Moral Case Deliberation : Concept Mapping with Experienced MCD Participants.Janine C. de Snoo-Trimp, Bert Molewijk & Henrica C. W. de Vet - 2018 - BMC Medical Ethics 19 (1):88.
    Background To support healthcare professionals in dealing with ethically difficult situations, Clinical Ethics Support services like Moral Case Deliberation are increasingly implemented. To assess the impact of CES, it is important to evaluate outcomes. Despite general claims about outcomes from MCD experts and some qualitative research, there exists no conceptual analysis of outcomes yet. Therefore, the aim of this study was to systematically define and categorize MCD outcomes. An additional aim was to compare these outcomes with the outcomes in the (...)
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  • Evaluation of Moral Case Deliberation at the Dutch Health Care Inspectorate: A Pilot Study.Wike Seekles, Guy Widdershoven, Paul Robben, Gonny van Dalfsen & Bert Molewijk - 2016 - BMC Medical Ethics 17 (1):31.
    BackgroundMoral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate.The objective of this pilot study is to investigate: 1) the current way of dealing with (...)
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  • Developing an Ethics Support Tool for Dealing with Dilemmas Around Client Autonomy Based on Moral Case Deliberations.L. A. Hartman, S. Metselaar, A. C. Molewijk, H. M. Edelbroek & G. A. M. Widdershoven - 2018 - BMC Medical Ethics 19 (1):97.
    Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...)
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  • Implementing Ethics Reflection Groups in Hospitals: An Action Research Study Evaluating Barriers and Promotors.Henriette Bruun, Reidar Pedersen, Elsebeth Stenager, Christian Backer Mogensen & Lotte Huniche - 2019 - BMC Medical Ethics 20 (1):49.
    An ethics reflection group is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments. The implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of (...)
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  • ‘You Can Give Them Wings to Fly’: A Qualitative Study on Values-Based Leadership in Health Care.Yvonne Denier, Lieve Dhaene & Chris Gastmans - 2019 - BMC Medical Ethics 20 (1):35.
    Within contemporary health care, many of the decisions affecting the health and well-being of patients are not being made by the clinicians or health professionals, but by those involved in health care management. Existing literature on organizational ethics provides insight into the various structures, processes and strategies - such as mission statement, ethics committees, ethical rounds … - that exist to create an organizational climate, which fosters ethical practices and decision-making It does not, however, show how health care managers experience (...)
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  • Exploring Ethical Issues Related to Patient Engagement in Healthcare: Patient, Clinician and Researcher’s Perspectives.Marjorie Montreuil, Joé T. Martineau & Eric Racine - 2019 - Journal of Bioethical Inquiry 16 (2):237-248.
    Patient engagement in healthcare is increasingly discussed in the literature, and initiatives engaging patients in quality improvement activities, organizational design, governance, and research are becoming more and more common and have even become mandatory for certain health institutions. Here we discuss a number of ethical challenges raised by this engagement from patients from the perspectives of research, organizational/quality improvement practices, and patient experiences, while offering preliminary recommendations as to how to address them. We identified three broad categories of ethical issues (...)
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  • Field-Testing the Euro-MCD Instrument: Experienced Outcomes of Moral Case Deliberation.Janine C. de Snoo-Trimp, Bert Molewijk, Gøril Ursin, Berit Støre Brinchmann, Guy A. M. Widdershoven, Henrica C. W. de Vet & Mia Svantesson - forthcoming - Nursing Ethics:096973301984945.
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  • Ethical Theory as Part of Clinical Ethics Support Practice.Guy Widdershoven, Suzanne Metselaar & Bert Molewijk - 2016 - American Journal of Bioethics 16 (9):34-36.
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  • Ethical Theory and Clinical Ethics Consultation: Toward Understanding the Relationship.George J. Agich - 2016 - American Journal of Bioethics 16 (9):36-37.
  • 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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  • 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.
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  • Ethics Case Reflection Sessions: Enablers and Barriers.Cecilia Bartholdson, Bert Molewijk, Kim Lützén, Klas Blomgren & Pernilla Pergert - 2018 - Nursing Ethics 25 (2):199-211.
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  • Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review.Dara Rasoal, Kirsti Skovdahl, Mervyn Gifford & Annica Kihlgren - 2017 - HEC Forum 29 (4):313-346.
    This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they (...)
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  • Two Years of Moral Case Deliberations on the Use of Coercion in Mental Health Care: Which Ethical Challenges Are Being Discussed by Health Care Professionals?B. Molewijk, I. S. Engerdahl & R. Pedersen - 2016 - Clinical Ethics 11 (2-3):87-96.