Concept Clarification of Moral Case Deliberation

Abstract

Background: Health care professionals have encountered ethically difficult situations for decades in their clinical practice. Various clinical ethics support has been established in order to deal with these issues. Moral case deliberation is a new developed approach that deliberates over ethically difficult cases in clinical practice. 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. Aim: To analyse the concept of moral case deliberation and related concepts. Methods: Integrative literature review. Rodger's evolutionary view of concept analysis has been used for clarification of the concept. Using specific keywords in the databases, searching for peer-reviewed academic paper published in English between 1995-2017 in the CINAHL, MEDLINE, Psych Info, Academic Search Elite and AMED. Results: Moral case deliberation (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 is trained in a specific method for the MCD reflection seemed to be important when stimulating the discussion from a patient perspective. Conclusions: Clarify the concept of moral case deliberation can be useful for healthcare professionals when choosing a facilitate-base reflection. Through a mutual dialogue and perspective sharing can MCD train staff members in moral awareness, create a space for emotions to be expressed and finally work as an platform for joint learning.

Ethical issues when interviewing older people about loneliness: reflections and recommendations for an effective methodological approach

“…We interrogated our research with an approach commonly used in reflective practice in health care, Moral Case Deliberation, where professionals engage in collective reflection on case studies to explore ethical issues to improve practice (Rasoal, 2018). Similar to Moral Case Deliberation, Melville and Hincks (2016) suggest that sharing collective learning from research can improve methodological approaches.…”

An Overview of the Interests and Perceptions of Early-Stage Resident Doctors Towards Ethics and Medico-Legal Teaching Methods in a Faculty of Medicine

“…In solving the ethical dilemma, the method that can be used is moral case deliberation. 22,23 Moral case deliberation (MCD) is used as a method of solving dilemma cases involving 8-12 participants, consisting of presenters of dilemma cases and experts in the field of ethics as facilitators in the hospital. 24 The facilitator explains the purpose and procedure of the deliberation, the events and context of the deliberation and then the case presentation is delivered by resident doctor who handles the patient's health case in full starting from the medical history to the prognosis and the family's decision as the patient's guardian.…”

“…23,24 In relation to EM teaching, the main purpose of role-play is for resident doctors to play the role of medical practitioners in real clinical situations. 22 In order to familiarize and train resident doctors' abilities in communication and appropriate ethical decision making, the MCD method can be applied in the EM teaching. 23 Jigsaw Technique…”

Does Moral Case Deliberation Change Current Views on Restrictions?: Staff Perceptions on Restrictions

“…Subsequently, the facilitator stimulates a joint dialog in which the motives underlying both opposites are explored. Finally, participants are requested to provide consensus (Rasoal, 2018) in how they would deal with the given dilemma. Unlike in the literature referred to, in this study three fictional cases are presented, which are formulated on former research.…”

“…MCD can function as a model for sharing perspectives and deliberating over moral issues as well as enhancing the moral awareness and competencies of the participants as a result of moral reflection. Furthermore, MCD provides support staff with the ability to learn from each other (Rasoal, 2018). MCD, more specific the dilemma‐method, manifests itself “by an emphasis on a concrete, practice‐oriented case, which is experienced by the participating care professionals themselves, or is easy to envision for them” (Gerritsen, Widdershoven, Bossenbroek, & Voskes, 2020, p. 2).…”