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Concept Clarification of Moral Case Deliberation

Ethical issues have been a major challenge for health care institutions for addressing the needs of patient care in an ethically acceptable manner. Health care professionals have encountered ethically difficult situations for decades in their clinical practice. And various clinical ethics support has been established in order to deal with these issues.

Moral case deliberation (MCD) is a new developed approach in order to support staff dealing with moral issues. However, there is lack of knowledge that describes the characteristics of the moral case deliberation and how this differs to related clinical ethics support where a concept analysis may clarify the differences. In this study, the authors aimed to analyze the concept of moral case deliberation and related concepts. 

An integrative literature review was carried out in the research. The process of concept analysis was performed using the steps outlined in Rodgers’ evolutionary method. The search for the concept was conducted systematically in the databases CINAHL, Medline, Psych Info, Academic Search Elite and AMED. Included articles were from 1995 to 2017 and were limited to English language, full text and peer-reviewed literature.

The results revealed that MCD was defined as an approach with four specific characteristics: 1) Perspective sharing via dialogue, 2) training moral awareness, 3) moral emotional deliberation, and 4) moral support and joint learning. The presence of a facilitator who was trained in a specific method for the MCD reflection seemed to be important when stimulating the discussion from a patient perspective. 

In conclusion, clarifying the concept of moral case deliberation can be useful for healthcare professionals when choosing a facilitate-base reflection. Consequences of the MCD seemed to be: improving communication among healthcare staff; and the staff would be able to recognize ethically difficult situations and develop greater moral awareness and improved quality of patient care. They would also consider institutional and organizational change in order to improve quality of care, and finally the staff would be able to make independent and competent decision and improved morale (confidence).


Article by Dara Rasoal, from Malardalen University, Vasteras, Sweden.

Full access: http://mrw.so/4M5d8p

Image by Dr. David Katzman, from Flickr-cc.

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