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  1. 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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  • Organisational and Individual Support for Nurses’ Ethical Competence: A Cross-Sectional Survey.Tarja Poikkeus, Riitta Suhonen, Jouko Katajisto & Helena Leino-Kilpi - 2018 - Nursing Ethics 25 (3):376-392.
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  • Ethics Support in Institutional Elderly Care: A Review of the Literature. [REVIEW]Sandra van der Dam, Bert Molewijk, Guy A. M. Widdershoven & Tineke A. Abma - 2014 - Journal of Medical Ethics 40 (9):625-631.
    Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases . Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: ‘institutional bodies’ ; ‘frameworks’ ; ‘educational programmes and moral case deliberation’; and ‘written (...)
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  • Evaluation of Clinical Ethics Support Services and its Normativity.Jan Schildmann, Bert Molewijk, Lazare Benaroyo, Reidun Forde & Gerald Neitzke - 2013 - Journal of Medical Ethics 39 (11):681-685.
    Evaluation of clinical ethics support services (CESS) has attracted considerable interest in recent decades. However, few evaluation studies are explicit about normative presuppositions which underlie the goals and the research design of CESS evaluation. In this paper, we provide an account of normative premises of different approaches to CESS evaluation and argue that normativity should be a focus of considerations when designing and conducting evaluation research of CESS. In a first step, we present three different approaches to CESS evaluation from (...)
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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.
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  • “Here's My Dilemma”. Moral Case Deliberation as a Platform for Discussing Everyday Ethics in Elderly Care.S. Dam, T. A. Abma, M. J. M. Kardol & G. A. M. Widdershoven - 2012 - Health Care Analysis 20 (3):250-267.
    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 (...)
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  • Impact of Moral Case Deliberation in Healthcare Settings: A Literature Review.Maaike M. Haan, Jelle L. P. van Gurp, Simone M. Naber & A. Stef Groenewoud - 2018 - BMC Medical Ethics 19 (1):85.
    An important and supposedly impactful form of clinical ethics support is moral case deliberation. Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. A systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science. Both the data collection and the (...)
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  • Outcomes of Moral Case Deliberation - the Development of an Evaluation Instrument for Clinical Ethics Support (the Euro-MCD).Mia Svantesson, Jan Karlsson, Pierre Boitte, Jan Schildman, Linda Dauwerse, Guy Widdershoven, Reidar Pedersen, Martijn Huisman & Bert Molewijk - 2014 - BMC Medical Ethics 15 (1):30.
    Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...)
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  • “Here’s My Dilemma”. Moral Case Deliberation as a Platform for Discussing Everyday Ethics in Elderly Care.S. van der Dam, T. A. Abma, M. J. M. Kardol & G. A. M. Widdershoven - 2012 - Health Care Analysis 20 (3):250-267.
    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 (...)
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  • Ethical Challenges and How to Develop Ethics Support in Primary Health Care.Lillian Lillemoen & Reidar Pedersen - 2013 - Nursing Ethics 20 (1):96-108.
    Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers’ needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these (...)
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  • Beyond Recommendation and Mediation: Moral Case Deliberation as Moral Learning in Dialogue.Suzanne Metselaar, Bert Molewijk & Guy Widdershoven - 2015 - American Journal of Bioethics 15 (1):50-51.
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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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  • Training Healthcare Professionals as Moral Case Deliberation Facilitators: Evaluation of a Dutch Training Programme.M. Plantinga, B. Molewijk, M. de Bree, M. Moraal, M. Verkerk & G. A. M. Widdershoven - 2012 - Journal of Medical Ethics 38 (10):630-635.
    Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator. In this paper, we present the first results of a study in which we evaluated the programme. We used a mixed methods design. One hundred and twenty trained healthcare professionals and five trainers from 16 training groups working in different (...)
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  • Ethics Reflection Groups in Community Health Services: An Evaluation Study.Lillian Lillemoen & Reidar Pedersen - 2015 - BMC Medical Ethics 16 (1):25.
    Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health , - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project.
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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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  • 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.
  • Managing Ethical Difficulties in Healthcare: Communicating in Inter-Professional Clinical Ethics Support Sessions.Catarina Fischer Grönlund, Vera Dahlqvist, Karin Zingmark, Mikael Sandlund & Anna Söderberg - 2016 - HEC Forum 28 (4):321-338.
    Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this (...)
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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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  • Procedures for Clinical Ethics Case Reflections: An Example From Childhood Cancer Care.C. Bartholdson, P. Pergert & G. Helgesson - 2014 - Clinical Ethics 9 (2-3):87-95.
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  • Ethics Rounds.Marit Silén, Mia Ramklint, Mats G. Hansson & Kristina Haglund - 2016 - Nursing Ethics 23 (2):203-213.
  • 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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  • Developing Organisational Ethics in Palliative Care.Lars Sandman, Ulla Molander & Inger Benkel - 2017 - Nursing Ethics 24 (2):138-150.
  • Ethical Issues Experienced by Healthcare Workers in Nursing Homes.D. H. Preshaw, K. Brazil, D. McLaughlin & A. Frolic - 2016 - Nursing Ethics 23 (5):490-506.
  • Aims and Harvest of Moral Case Deliberation.Froukje C. Weidema, Bert Ac Molewijk, Frans Kamsteeg & Guy Am Widdershoven - 2013 - Nursing Ethics 20 (6):617-631.
    Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (...)
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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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  • Morality in the Mundane: Specific Needs for Ethics Support in Elderly Care.L. Dauwerse, S. van der Dam & T. 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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  • Defense Mechanisms in Ethics Consultation.George J. Agich - 2011 - HEC Forum 23 (4):269-279.
    While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss (...)
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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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  • Client Participation in Moral Case Deliberation: A Precarious Relational Balance. [REVIEW]F. C. Weidema, T. A. Abma, G. A. M. Widdershoven & A. C. Molewijk - 2011 - HEC Forum 23 (3):207-224.
    Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client participation often raises questions concerning conditions for equal collaboration and good dialogue. Despite these questions, there is little empirical research regarding client participation in clinical ethics support in general and in MCD in particular. This article (...)
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  • Implicit and Explicit Clinical Ethics Support in The Netherlands: A Mixed Methods Overview Study. [REVIEW]Linda Dauwerse, Froukje Weidema, Tineke Abma, Bert Molewijk & Guy Widdershoven - 2014 - HEC Forum 26 (2):95-109.
    Internationally, the prevalence of clinical ethics support (CES) in health care has increased over the years. Previous research on CES focused primarily on ethics committees and ethics consultation, mostly within the context of hospital care. The purpose of this article is to investigate the prevalence of different kinds of CES in various Dutch health care domains, including hospital care, mental health care, elderly care and care for people with an intellectual disability. A mixed methods design was used including two survey (...)
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