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Updated: May 29, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Moral learning in an integrated social and healthcare service network
Merel Visse1, Guy A M Widdershoven, Tineke A Abma
1Department of Medical Humanities, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorstraat 7, 1081 BT Amsterdam, The Netherlands. m.visse@vumc.nl
Abstract:
The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear who is responsible for what because this new network structure requires rules and procedures to be re-interpreted and re-negotiated. A new moral climate needs to be developed, particularly in the early stages of integrated services. Who should do what, with whom and why? Departing from a relational and hermeneutic perspective, this article shows that professionals in integrated service networks embark upon a moral learning process when starting to work together for the client's benefit. In this context, instrumental ways of thinking about responsibilities are actually counterproductive. Instead, professionals need to find out who they are in relation to other professionals, what core values they share and what responsibilities derive from these aspects. This article demonstrates moral learning by examining the case of an integrated social service network. The network's development and implementation were supported by responsive evaluation, enriched by insights of care ethics and hermeneutic ethics.
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