Organizing moral case deliberation Experiences in two Dutch nursing homes

Nursing Ethics - Tập 18 Số 3 - Trang 327-340 - 2011
Sandra van der Dam1, Tineke Abma2, Bert Molewijk3, Martinus Josephus Maria Kardol4, J.M.G.A. Schols5, Gam Widdershoven2
1Maastricht University/CAPHRI, The Netherlands,
2VU University Medical Center, The Netherlands
3VU University Medical Center, The Netherlands, GGNet, Institute for Mental Health Care, The Netherlands
4Vughterstede, The Netherlands
5Maastricht University, The Netherlands, Vivre, The Netherlands

Tóm tắt

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other.

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Tài liệu tham khảo

10.1191/0969733006ne851oa

10.1191/0969733006ne830oa

10.1177/0969733007077890

10.1191/0969733006ne890oa

10.1177/0969733009355375

10.1191/0969733006ne875oa

Kane RA, 1990, Everyday ethics: resolving dilemmas in nursing home life

Kardol MJM., 2004, Zorg voor zelfstandigheid [Care for independance]

10.1136/jme.2007.023572

10.1136/jme.2006.018580

10.2307/3528175

10.1191/0969733006nej892oa

10.1177/0969733010361440

10.1023/A:1025928617468

Molewijk AC, 2008, Med Health Care and Philos, 1, 34

Molewijk B., 2008, Bioethica Forum, 1, 57

Abma TA, 2009, Health Care Analysis, 00, 1

Gadamer HG, 1960, Wahrheit und methode

Widdershoven GAM, 2007, Hermeneutic ethics between practice and theory

Dixon NM, 1994, The organizational learning cycle: how we learn collectively

10.1136/jme.2006.019810

Argyris C., 1990, Overcoming organizational defenses - Facilitating organizational learning

Bodenrieder I., 1998, Management Report, 38

10.1016/S0048-7333(02)00062-8

10.1016/S1525-8610(04)70116-4

Guba EG, 1981, Effective evaluation

10.2307/1319804

Greene JC, Kreider H. and Mayer E. Combining qualitative and quantitative methods in social inquiry. In: Somekh B and Lewin C (eds). Research methods in the social sciences. London: SAGE, 2005, p. 274-81.

Strauss A., 1998, Basics of qualitative research techniques and procedures for developing grounded theory

Meadows LM, 2001, Within-project validation

Habermas J., 1987, Volume 2: Lifeworld and system: A critique of functionalist reason

Nussbaum MC, 1986, The fragility of goodness

Dartel H van., 1998, Van ethische commissie naar stuurgroep ethiek. Over de implementatie van moreel beraad in het kwaliteitsbeleid van instellingen voor gezondheidszorg [From ethics committee to steering committee. On the implementation of moral deliberation within the quality policy of health care institutions]

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Nursing Ethics

Tập 18 Số 3

327-340

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