Results for 'Bert Ac Molewijk'

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  1.  75
    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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  2. The role of emotions in moral case deliberation: Theory, practice, and methodology.Bert Molewijk, Dick Kleinlugtenbelt & Guy Widdershoven - 2011 - Bioethics 25 (7):383-393.
    In clinical moral decision making, emotions often play an important role. However, many clinical ethicists are ignorant, suspicious or even critical of the role of emotions in making moral decisions and in reflecting on them. This raises practical and theoretical questions about the understanding and use of emotions in clinical ethics support services. This paper presents an Aristotelian view on emotions and describes its application in the practice of moral case deliberation.According to Aristotle, emotions are an original and integral part (...)
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  3.  42
    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?Bert Molewijk, Ingvild Stokke Engerdahl & Reidar Pedersen - 2016 - Clinical Ethics 11 (2-3):87-96.
    Background Seven wards from three Norwegian mental health care institutions participated in a study in which regular ethics reflection groups focusing on coercion had been implemented and evaluated. This article presents a thematic overview of the ethical challenges identified based on a systematic qualitative analyses of 161 ethics reflection groups and some general observations on these ethical challenges. Results The ethical challenges are divided into four main thematic categories: formal coercion, informal coercion, uncertainty related to the Norwegian legislation on coercion (...)
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  4.  30
    Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned.Bert Molewijk, Thomas Steensma, Martin Heijer, Annelijn Wensing-Kruger, Annelou Vries, Guy Widdershoven & Laura Hartman - 2019 - HEC Forum 31 (3):241-260.
    Clinical ethics support (CES) 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 (CEGD) at Amsterdam University Medical Center. We specifically aimed to integrate CES (...)
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  5. Scientific Contribution. Empirical data and moral theory. A plea for integrated empirical ethics.Bert Molewijk, Anne M. Stiggelbout, Wilma Otten, Heleen M. Dupuis & Job Kievit - 2004 - Medicine, Health Care and Philosophy 7 (1):55-69.
    Ethicists differ considerably in their reasons for using empirical data. This paper presents a brief overview of four traditional approaches to the use of empirical data: “the prescriptive applied ethicists,” “the theorists,” “the critical applied ethicists,” and “the particularists.” The main aim of this paper is to introduce a fifth approach of more recent date (i.e. “integrated empirical ethics”) and to offer some methodological directives for research in integrated empirical ethics. All five approaches are presented in a table for heuristic (...)
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  6.  44
    Integrating Theory and Data in Evaluating Clinical Ethics Support. Still a Long Way to Go.Bert Molewijk, Jan Schildmann & Anne Slowther - 2017 - Bioethics 31 (4):234-236.
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  7.  46
    Integrated empirical ethics: In search for clarifying identities.Bert Molewijk - 2004 - Medicine, Health Care and Philosophy 7 (1):85-87.
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  8.  5
    Don’t Solve the Issues!Bert Molewijk & Guy A. M. Widdershoven - 2012 - Cambridge Quarterly of Healthcare Ethics 21 (4):448-456.
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  9.  59
    Don’t Solve the Issues!Bert Molewijk & Guy A. M. Widdershoven - 2012 - Cambridge Quarterly of Healthcare Ethics 21 (4):448-456.
  10.  27
    Two years of ethics reflection groups about coercion in psychiatry. Measuring variation within employees’ normative attitudes, user involvement and the handling of disagreement.Bert Molewijk, Reidar Pedersen, Almar Kok, Reidun Førde & Olaf Aasland - 2023 - BMC Medical Ethics 24 (1):1-19.
    Background Research on the impact of ethics reflection groups (ERG) (also called moral case deliberations (MCD)) is complex and scarce. Within a larger study, two years of ERG sessions have been used as an intervention to stimulate ethical reflection about the use of coercive measures. We studied changes in: employees’ attitudes regarding the use of coercion, team competence, user involvement, team cooperation and the handling of disagreement in teams. Methods We used panel data in a longitudinal design study to measure (...)
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  11.  13
    Staff’s normative attitudes towards coercion: the role of moral doubt and professional context—a cross-sectional survey study.Almar Kok Bert Molewijk, Reidar Pedersen Tonje Husum & Olaf Aasland - forthcoming - Most Recent Articles: Bmc Medical Ethics.
    The use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified (i.e. experiencing moral dou...
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  12.  30
    The practical importance of theory in clinical ethics support services.Bert Molewijk, Anne Slowther & Mark Aulisio - 2011 - Bioethics 25 (7):ii-iii.
  13.  36
    Staff’s normative attitudes towards coercion: the role of moral doubt and professional context—a cross-sectional survey study.Bert Molewijk, Almar Kok, Tonje Husum, Reidar Pedersen & Olaf Aasland - 2017 - BMC Medical Ethics 18 (1):37.
    The use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified is related to professionals’ normative attitudes regarding the use of coercion. This paper describes an explorative statistical analysis based on a cross-sectional survey across seven wards in three Norwegian mental health care institutions. Descriptive analyses showed that in general the 379 respondents a) were not so sure whether coercion should be seen as (...)
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  14.  75
    Dealing with ethical challenges: a focus group study with professionals in mental health care.Bert Molewijk, Marit Helene Hem & Reidar Pedersen - 2015 - BMC Medical Ethics 16 (1):4.
    Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful.
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  15. Emotions and Clinical Ethics Support. A Moral Inquiry into Emotions in Moral Case Deliberation.Bert Molewijk, Dick Kleinlugtenbelt, Scott M. Pugh & Guy Widdershoven - 2011 - HEC Forum 23 (4):257-268.
    Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...)
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  16. Don't Solve the Issues!Bert Molewijk & Guyam Widdershoven - 2012 - Cambridge Quarterly of Healthcare Ethics 21 (4):448.
     
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  17.  36
    Fostering the Ethics of Ethics Consultants in Health Care: An Ongoing Participatory Approach.Bert Molewijk, Laura Hartman, Froukje Weidema, Yolande Voskes & Guy Widdershoven - 2015 - American Journal of Bioethics 15 (5):60-62.
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  18.  21
    The particular relevance of clinical ethics support in psychiatry: Concepts, research, and experiences.Bert Molewijk & Stella Reiter-Theil - 2016 - Clinical Ethics 11 (2-3):43-44.
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  19.  86
    Empirical ethics as dialogical practice.Guy Widdershoven, Tineke Abma & Bert Molewijk - 2009 - Bioethics 23 (4):236-248.
    In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and perspectives need to be exchanged. Within hermeneutic ethics dialogue is seen as a vehicle for moral learning and developing normative conclusions. Dialogue stands for a specific view on moral epistemology and methodological criteria for moral inquiry. Responsive evaluation (...)
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  20.  8
    Materialising and fostering organisational morisprudence through ethics support tools.Bert Molewijk - 2022 - Journal of Medical Ethics 48 (12):991-992.
    In their paper (‘ Morisprudence: a theoretical framework for studying the relationship linking moral case deliberation, organisational learning and quality improvement ‘),1 Kok et al addresses an important topic: how to theoretically think about studying the impact of moral case deliberations and how to conceptualise organisational learning? In this article, they aim to develop a theoretical framework that provides empirically assessable hypotheses that describe the relationship between moral case deliberation and care quality at an organisational level. The authors describe care (...)
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  21.  12
    Improving Ethics Support: Seeing and Organizing Ethics Support Differently.Bert Molewijk, Janine de Snoo-Trimp, Margreet Stolper & Guy Widdershoven - 2022 - American Journal of Bioethics 22 (4):53-55.
    Much of what we know and see of ethics support, in literature and during trainings, workshops and conferences, derives from clinical ethicists working at academic medical centers. Besides the probl...
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  22.  19
    Sharing decisions amid uncertainties: a qualitative interview study of healthcare professionals’ ethical challenges and norms regarding decision-making in gender-affirming medical care.Bert C. Molewijk, Fijgje de Boer, Baudewijntje P. C. Kreukels, Marijke A. Bremmer, Casper Martens & Karl Gerritse - 2022 - BMC Medical Ethics 23 (1):1-17.
    BackgroundIn gender-affirming medical care (GAMC), ethical challenges in decision-making are ubiquitous. These challenges are becoming more pressing due to exponentially increasing referrals, politico-legal contestation, and divergent normative views regarding decisional roles and models. Little is known, however, about what ethical challenges related to decision-making healthcare professionals (HCPs) themselves face in their daily work in GAMC and how these relate to, for example, the subjective nature of Gender Incongruence (GI), the multidisciplinary character of GAMC and the role HCPs play in assessing (...)
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  23.  82
    Standards of practice in empirical bioethics research: towards a consensus.Jonathan Ives, Michael Dunn, Bert Molewijk, Jan Schildmann, Kristine Bærøe, Lucy Frith, Richard Huxtable, Elleke Landeweer, Marcel Mertz, Veerle Provoost, Annette Rid, Sabine Salloch, Mark Sheehan, Daniel Strech, Martine de Vries & Guy Widdershoven - 2018 - BMC Medical Ethics 19 (1):68.
    This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...)
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  24.  43
    What Quality Is Actually Assessed Within Written Records?Bert Molewijk, Guy Widdershoven, Jochen Vollmann & Jan Schildmann - 2016 - American Journal of Bioethics 16 (3):48-50.
    We congratulate Pearlman and colleagues (2016) on their detailed account of the development of a quality assessment tool for clinical ethics consultation (CEC), based on the evaluation of written r...
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  25.  21
    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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  26.  51
    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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  27.  94
    Good Care in Ongoing Dialogue. Improving the Quality of Care Through Moral Deliberation and Responsive Evaluation.Tineke A. Abma, Bert Molewijk & Guy A. M. Widdershoven - 2009 - Health Care Analysis 17 (3):217-235.
    Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...)
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  28.  16
    Clinical Ethics Committee Case 14: How should we transfer a euthanasia request between general practice and a hospital setting?Bert Molewijk & Anneke Lucassen - 2011 - Clinical Ethics 6 (2):58-63.
  29.  41
    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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  30.  52
    Implementing moral case deliberation in a psychiatric hospital: process and outcome. [REVIEW]Bert Molewijk, Maarten Verkerk, Henk Milius & Guy Widdershoven - 2008 - Medicine, Health Care and Philosophy 11 (1):43-56.
    Background Clinical moral case deliberation consists of the systematic reflection on a concrete moral case␣by health care professionals. This paper presents the study of a 4-year moral deliberation project.Objectives The objectives of this paper are to: (a) describe the practice and the theoretical background of moral deliberation, (b) describe the moral deliberation project, (c) present the outcomes of␣the evaluation of the moral case deliberation sessions, and (d) present the implementation process.Methods The implementation process is both monitored and supported by an (...)
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  31.  26
    Ethics support for ethics support: the development of the Confidentiality Compass for dealing with moral challenges concerning (breaching) confidentiality in moral case deliberation.Wieke Ligtenberg, Margreet Stolper & Bert Molewijk - 2024 - BMC Medical Ethics 25 (1):1-15.
    Background Confidentiality is one of the central preconditions for clinical ethics support (CES). CES cases which generate moral questions for CES staff concerning (breaching) confidentiality of what has been discussed during CES can cause moral challenges. Currently, there seems to be no clear policy or guidance regarding how CES staff can or should deal with these moral challenges related to (not) breaching confidentiality within CES. Moral case deliberation is a specific kind of CES. Method Based on experiences and research into (...)
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  32.  22
    Perceptions of important outcomes of moral case deliberations: a qualitative study among healthcare professionals in childhood cancer care.Charlotte Weiner, Pernilla Pergert, Bert Molewijk, Anders Castor & Cecilia Bartholdson - 2021 - BMC Medical Ethics 22 (1):1-11.
    BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe (...)
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  33.  8
    Peer Review and Beyond: Towards a Dialogical Approach of Quality in Ethics Support.Guy A. M. Widdershoven, Bert Molewijk & Suzanne Metselaar - 2018 - In Stuart G. Finder & Mark J. Bliton (eds.), Peer Review, Peer Education, and Modeling in the Practice of Clinical Ethics Consultation: The Zadeh Project. Cham: Springer Verlag. pp. 193-203.
    In this chapter we reflect on the relevance of peer review for assessing the quality of clinical ethics consultation. We contend that peer review in the narrative form as presented in this book provides an alternative to the formal clinical ethics consultation review procedures typically found in the clinical ethics literature. We elaborate on peer review as a reflection on clinical ethics consultation practice, the elements which a story should contain in order to provide a basis for peer review, and (...)
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  34.  25
    How to Support Patient and Family in Dealing with Ethical Issues? The Relevance of Moral Case Deliberation.Guy Widdershoven, Margreet Stolper, Bert Molewijk & Suzanne Metselaar - 2020 - American Journal of Bioethics 20 (6):70-72.
    Volume 20, Issue 6, June 2020, Page 70-72.
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  35.  31
    Can moral case deliberation in research groups help to navigate research integrity dilemmas? A pilot study.Tamarinde L. Haven, Bert Molewijk, Lex Bouter, Guy Widdershoven, Fenneke Blom & Joeri Tijdink - 2024 - Research Ethics 20 (2):219-238.
    There is an increased focus on fostering integrity in research by through creating an open culture where research integrity dilemmas can be discussed. We describe a pilot intervention study that used Moral Case Deliberation (MCD), a method that originated in clinical ethics support, to discuss research integrity dilemmas with researchers. Our research question was: can moral case deliberation in research groups help to navigate research integrity dilemmas? We performed 10 MCDs with 19 researchers who worked in three different research groups (...)
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  36.  52
    Clinical Ethics Committee Case 13: Should the school doctor contact the mother of a 17-year-old girl who has expressed suicidal thoughts? [REVIEW]Bert Molewijk & Rolf Ahlzen - 2011 - Clinical Ethics 6 (1):5-10.
  37.  45
    Setting standards for empirical bioethics research: a response to Carter and Cribb.Michael Dunn, Jonathan Ives, Bert Molewijk & Jan Schildmann - 2018 - BMC Medical Ethics 19 (1):66.
    This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...)
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  38.  54
    The significance of ethics reflection groups in mental health care: a focus group study among health care professionals.Marit Helene Hem, Bert Molewijk, Elisabeth Gjerberg, Lillian Lillemoen & Reidar Pedersen - 2018 - BMC Medical Ethics 19 (1):54.
    Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...)
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  39.  55
    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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  40.  27
    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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  41.  70
    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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  42.  77
    Ethical challenges in connection with the use of coercion: a focus group study of health care personnel in mental health care.Marit H. Hem, Bert Molewijk & Reidar Pedersen - 2014 - BMC Medical Ethics 15 (1):82.
    In recent years, the attention on the use of coercion in mental health care has increased. The use of coercion is common and controversial, and involves many complex ethical challenges. The research question in this study was: What kind of ethical challenges related to the use of coercion do health care practitioners face in their daily clinical work?
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  43.  50
    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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  44.  11
    The Diversity Compass: a clinical ethics support instrument for dialogues on diversity in healthcare organizations.Charlotte Kröger, Bert Molewijk, Maaike Muntinga & Suzanne Metselaar - 2024 - BMC Medical Ethics 25 (1):1-14.
    Background Increasing social pluralism adds to the already existing variety of heterogeneous moral perspectives on good care, health, and quality of life. Pluralism in social identities is also connected to health and care disparities for minoritized patient (i.e. care receiver) populations, and to specific diversity-related moral challenges of healthcare professionals and organizations that aim to deliver diversity-responsive care in an inclusive work environment. Clinical ethics support (CES) services and instruments may help with adequately responding to these diversity-related moral challenges. However, (...)
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  45.  73
    Training healthcare professionals as moral case deliberation facilitators: evaluation of a Dutch training programme.Mirjam Plantinga, Bert Molewijk, Menno de Bree, Marloes Moraal, Marian Verkerk & Guy 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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  46.  17
    Fostering moral resilience through moral case deliberation.Suzanne Metselaar & Bert Molewijk - 2023 - Nursing Ethics 30 (5):730-745.
    Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...)
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  47.  45
    Improving Care and Ethics: A Plea for Interactive Empirical Ethics.Guy Widdershoven, Bert Molewijk & Tineke Abma - 2009 - American Journal of Bioethics 9 (6-7):99-101.
  48.  22
    Implementation in Bioethics: A Plea for a Participatory and Dialogical Approach.Suzanne Metselaar, Yolande Voskes, Bert Molewijk & Guy Widdershoven - 2020 - American Journal of Bioethics 20 (4):78-80.
    Volume 20, Issue 4, May 2020, Page 78-80.
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  49.  35
    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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  50. Katern van de Vereniging voor Filosofische Praktijk (VFP).Dick Kleinlugtenbelt, Bert Molewijk & Hans Bolten - 2011 - Filosofie En Praktijk 32 (4):97.
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