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Managing Ethical Difficulties in Healthcare: Communicating in Inter-professional Clinical Ethics Support Sessions

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Abstract

Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support (CES) 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 study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved.

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Acknowledgments

This study has been supported by Department of Nursing, Umeå University, Sweden and the County Council of Norrbotten, Sweden.

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Authors and Affiliations

  1. Department of Nursing, Umeå University, 901 87, Umeå, Sweden

    Catarina Fischer Grönlund & Anna Söderberg

  2. Department of Nursing, Ersta Sköndal University College, P.O. Box 111 89, 100 61, Stockholm, Sweden

    Vera Dahlqvist

  3. Division of Nursing, Department of Health Science, Luleå University of Technology, 971 87, Luleå, Sweden

    Karin Zingmark

  4. Norrbotten County Council, Landstingshuset, 971 89, Luleå, Sweden

    Karin Zingmark

  5. Department of Clinical Science/Psychiatry, Umeå University, 901 87, Umeå, Sweden

    Mikael Sandlund

Authors
  1. Catarina Fischer Grönlund
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  2. Vera Dahlqvist
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  3. Karin Zingmark
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  4. Mikael Sandlund
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  5. Anna Söderberg
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Correspondence to Catarina Fischer Grönlund.

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Grönlund, C.F., Dahlqvist, V., Zingmark, K. et al. Managing Ethical Difficulties in Healthcare: Communicating in Inter-professional Clinical Ethics Support Sessions. HEC Forum 28, 321–338 (2016). https://doi.org/10.1007/s10730-016-9303-2

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