Implicit and Explicit Clinical Ethics Support in The Netherlands: A Mixed Methods Overview Study [Book Review]

HEC Forum 26 (2):95-109 (2014)

Guy Widdershoven
VU University Amsterdam
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 questionnaires, sent to all health care institutions, two focus groups and 17 interviews with managing directors or ethics support staff. The findings demonstrate that the presence of ethics committees is relatively high, especially in hospitals. Moral case deliberation (MCD) is available in about half of all Dutch health care institutions, and in two-thirds of the mental health care institutions. Ethics consultants are not very prominent. A distinction is made between explicit CES forms, in which the ethical dimension of care is structurally and professionally addressed and implicit CES forms, in which ethical issues are handled indirectly and in an organic way. Explicit CES forms often go together with implicit forms of CES. MCD might function as a bridge between the two. We conclude that explicit and implicit CES are both relevant for clinical ethics in health care. We recommend research regarding how to combine them in an appropriate way.
Keywords Clinical ethics  Ethics committees  Ethics consultation  Institutional ethics  Bioethics  Moral case deliberation
Categories (categorize this paper)
DOI 10.1007/s10730-013-9224-2
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 39,545
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

View all 17 references / Add more references

Citations of this work BETA

View all 6 citations / Add more citations

Similar books and articles

Handbook for Health Care Ethics Committees.Linda Farber Post - 2007 - Johns Hopkins University Press.
The Clinical Ethicist at the Bedside.John Puma & David L. Schiedermayer - 1991 - Theoretical Medicine and Bioethics 12 (2).


Added to PP index

Total views
27 ( #281,663 of 2,325,369 )

Recent downloads (6 months)
5 ( #329,081 of 2,325,369 )

How can I increase my downloads?


My notes

Sign in to use this feature