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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