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Does facilitation improve moral case deliberation quality?

Swanny Kremer1, Marinus Spreen1,2, Margreet Stolper3

  • 1Forensic Psychiatric Centre Dr S. van Mesdag, Research Department, Groningen, the Netherlands.

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|September 17, 2025
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Summary
This summary is machine-generated.

A trained facilitator significantly enhances Moral Case Deliberation (MCD) quality in healthcare teams. This structured approach improves argumentation, engagement, focus, and structure compared to usual discussions.

Keywords:
Moral Case Deliberationdecision makingethics consultationforensic psychiatrynursingvideo recording

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Area of Science:

  • Healthcare Ethics
  • Medical Education
  • Psychiatric Care

Background:

  • Moral Case Deliberation (MCD) is a structured method for healthcare professionals to address challenging ethical decisions.
  • A trained facilitator guides participants through a standardized process.

Purpose of the Study:

  • To evaluate if a trained facilitator improves deliberation quality in MCD compared to standard team discussions.
  • To assess how deliberation quality changes over time within MCD interventions.

Main Methods:

  • A study involving three teams in a forensic psychiatric hospital.
  • One control group used usual discussions; two intervention groups used MCD with a trained facilitator.
  • Video recordings of deliberations were assessed by students on argumentation, engagement, focus, and structure.

Main Results:

  • Trained facilitators significantly improved the quality of moral deliberations across all assessed factors.
  • Deliberation quality within the MCD intervention groups showed distinct improvements over time.

Conclusions:

  • Facilitated MCD demonstrably enhances the quality of moral decision-making discussions in healthcare.
  • This study provides a framework for conceptualizing and measuring deliberation quality, valuable for future ethics research and training.