Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (...) (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses’ empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members. (shrink)

ABSTRACT When misattributed paternity is discovered in the course of genetic testing, a genetic counselor is presented with a dilemma concerning whether to reveal this information to the clients. She is committed to treating the clients equally and enabling informed decision making, but disclosing the information may carry consequences for the woman that the counselor cannot judge in advance. A frequent suggestion aimed at avoiding this problem is to include the risk of discovering nonpaternity in the informed consent process for (...) counseling. In this paper I argue that such a move does not resolve the problem, because the conflict hinges on the interpretation of equality on which the counselor operates. Given the principles of genetic counseling, neither construal of equality yields a satisfactory solution to the conflict. In fact, I conclude that including nonpaternity in informed consent is not endorsed by either view, and we are still left with the question of what to do should nonpaternity be discovered. I suggest a compromise position concerning disclosure, involving revealing relevant genetic information but withholding nonpaternity when possible. (shrink)

Questions about information inform many debates in bioethics. One of the reasons for this is that at least some level of information is taken by many to be a prerequisite of valid consent. For others, autonomy in the widest sense presupposes information, because one cannot be in control of one’s life without at least some insight into what it could turn out to contain. Yet not everyone shares this view, and there is a debate about whether or not there is (...) a right to remain in ignorance of one’s medical, and especially genetic, information. It is notable, though, that this debate leaves unexamined the assumption that, if a person wants information, he is entitled to it. This paper examines the assumption, specifically in relation to genetics, where learning facts about oneself may reveal facts about other people, particularly one’s close relatives. This may be taken as a violation of their privacy, and since privacy is something that we normally think should be respected, it is worth asking whether one ought to abjure the opportunity to obtain genetic information for the sake of privacy. In effect, there may be an argument to be made not just for a right to remain in ignorance, but for a duty to do so. (shrink)