Developing an ethics support tool for dealing with dilemmas around client autonomy based on moral case deliberations

Area of Science:

• Bioethics
• Healthcare Ethics
• Clinical Ethics Support

Background:

• Moral Case Deliberations (MCDs) are effective clinical ethics support (CES) but have limitations.
• Existing MCDs lack knowledge sharing, limit moral learning to participants, require significant organization, and are case-specific.
• These limitations necessitate the development of complementary CES tools for healthcare professionals.

Purpose of the Study:

• To develop a low-threshold CES tool based on a series of MCDs focused on autonomy in long-term care.
• To create a complementary tool that addresses the limitations of traditional MCDs.

Main Methods:

• A qualitative research design was employed, analyzing 28 MCDs (transcripts and summary reports) using thematic content analysis.
• The analysis results were iteratively combined with theoretical reflections on CES.
• The developed tool underwent evaluation and adjustment through three focus groups.

Main Results:

• A CES tool named 'moral compass' was developed, presented as a 23-page booklet.
• The 'moral compass' guides users through six questions for methodical reflection on moral dilemmas, integrating norms, values, and strategies for client autonomy.
• It incorporates insights from previous MCDs on client autonomy.

Conclusions:

• A thematic, low-threshold CES tool, the 'moral compass,' was developed to support healthcare professionals with moral questions on client autonomy.
• This tool complements MCDs by integrating insights from prior cases and offering a structured reflection process.
• The methodology can be adapted to create similar tools for different topics and healthcare settings.