Medicine, Health Care and Philosophy

, Volume 11, Issue 1, pp 43–56 | Cite as

Implementing moral case deliberation in a psychiatric hospital: process and outcome

  • Bert Molewijk
  • Maarten Verkerk
  • Henk Milius
  • Guy Widdershoven
Scientific Contribution

Abstract

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 interactive responsive evaluation design with: (a) in-depth interviews, (b) Maastricht evaluation questionnaires, (c) evaluation survey, and (d) ethnographic participant observation. In accordance with the theory of responsive evaluation, researchers acted both as evaluators and moderators (i.e. ethicists).

Results

Both qualitative and quantitative results showed that the moral case deliberations, the role of the ethics facilitator, and the train-the-facilitator program were regarded as useful and were evaluated as (very) positive. Health care professionals reported that they improved their moral competencies (i.e. knowledge, attitude and skills). However, the new trained facilitators lacked a clear organisational structure and felt overburdened with the implementation process. The paper ends with both practical and research suggestions for future moral deliberation projects.

Keywords

clinical moral case deliberation implementation moral competency responsive evaluation design train-the-facilitator program 

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Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Bert Molewijk
    • 1
    • 2
  • Maarten Verkerk
    • 3
  • Henk Milius
    • 3
  • Guy Widdershoven
    • 1
  1. 1.Department of Health, Ethics and Society/metamedica Faculty of HealthMedicine and Life Sciences, School of Public Health and Primary care (Caphri)MaastrichtThe Netherlands
  2. 2.GGnetMental Health Care InstitutionZutphenThe Netherlands
  3. 3.Vijverdal MaastrichtPsychiatric HospitalMaastrichtThe Netherlands

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