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Exploring moral problems and moral competences in midwifery: A qualitative study.
Stephan Oelhafen1, Settimio Monteverde2, Eva Cignacco1
1Bern University of Applied Sciences, Switzerland.
Nursing Ethics
|March 29, 2018
Summary
Midwives face ethical challenges, primarily interpersonal conflicts stemming from autonomy limitations, often causing moral distress. Addressing these requires specific moral competences to improve midwifery education and practice.
Area of Science:
- Midwifery Ethics
- Healthcare Professional Competences
Background:
- Undergraduate midwifery curricula include ethics courses, but specific moral competences for practice remain underexplored.
- Understanding midwives' perspectives on relevant ethical issues is crucial for defining essential moral competences.
Purpose of the Study:
- To identify ethical issues encountered by midwives in daily practice.
- To determine key competences and resources for addressing these ethical issues.
- To assess phenomena related to moral distress in midwifery.
Main Methods:
- Conducted semi-structured interviews with ten healthcare professionals (eight midwives, two others).
- Analyzed interview transcripts using thematic analysis within an interdisciplinary research group.
Main Results:
- External constraints on autonomy and interpersonal conflicts were primary ethical issues linked to moral distress.
- Lack of interprofessional communication and trust, especially for less experienced midwives, exacerbated conflicts.
- Ethical issues concerning late abortions, prenatal diagnostics, and selective abortions were common but often managed.
Conclusions:
- An empirically grounded profile of moral competences for midwives was developed based on identified ethical issues and moral distress factors.
- Curricular adaptations for undergraduate midwifery education are critically discussed to address these competences.
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