Evaluation of clinical ethics support services and its normativity

Area of Science:

• Bioethics
• Medical Ethics
• Health Services Research

Background:

• Clinical ethics support services (CESS) evaluations are increasingly common.
• Existing CESS evaluations often lack explicit discussion of their normative premises.
• This gap can impact the validity and interpretation of evaluation findings.

Purpose of the Study:

• To identify and analyze the normative premises of different CESS evaluation approaches.
• To advocate for increased consideration of normativity in the design and conduct of CESS evaluation research.
• To highlight the importance of understanding underlying ethical assumptions in CESS.

Main Methods:

• Literature review of published CESS evaluation studies.
• Categorization of evaluation approaches into descriptive, outcome-based, and norm-reconstruction.
• Analysis of the normative presuppositions inherent in each approach.

Main Results:

• Identified three distinct approaches to CESS evaluation: descriptive, outcome-based, and norm-reconstruction.
• Demonstrated that 'reconstructing quality norms' approach explicitly addresses normative premises.
• Highlighted the implicit normative assumptions in descriptive and outcome-based evaluations.

Conclusions:

• Greater sensitivity to the normativity of CESS and its evaluation is crucial.
• Explicitly addressing normative premises strengthens CESS evaluation research design.
• Understanding ethical foundations enhances the quality and relevance of CESS evaluations.