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  1.  88
    Teaching ethics in the clinic. The theory and practice of moral case deliberation.A. C. Molewijk, T. Abma, M. Stolper & G. Widdershoven - 2008 - Journal of Medical Ethics 34 (2):120-124.
    A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals (...)
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  2.  33
    Organizing moral case deliberation Experiences in two Dutch nursing homes.S. van der Dam, T. A. Abma, A. C. Molewijk, M. J. M. Kardol, Jmga Schols & G. A. M. Widdershoven - 2011 - Nursing Ethics 18 (3):327-340.
    Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...)
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  3.  49
    Conceptualizing the impact of moral case deliberation: a multiple-case study in a health care institution for people with intellectual disabilities.A. C. Molewijk, J. L. P. van Gurp & J. C. de Snoo-Trimp - 2022 - BMC Medical Ethics 23 (1):1-15.
    BackgroundAs moral case deliberations (MCDs) have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how ‘impact of MCD’ should be conceptualized for future research.MethodsA multiple-case study was conducted in a care organization for people with (...)
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  4.  37
    Developing an ethics support tool for dealing with dilemmas around client autonomy based on moral case deliberations.L. A. Hartman, S. Metselaar, A. C. Molewijk, H. M. Edelbroek & G. A. M. Widdershoven - 2018 - BMC Medical Ethics 19 (1):97.
    Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...)
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  5.  43
    Does Moral Case Deliberation Help Professionals in Care for the Homeless in Dealing with Their Dilemmas? A Mixed-Methods Responsive Study.R. P. Spijkerboer, J. C. Van der Stel, G. A. M. Widdershoven & A. C. Molewijk - 2017 - HEC Forum 29 (1):21-41.
    Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...)
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  6.  27
    An empirical investigation into moral challenges of (breaching) confidentiality and needs for ethics support when facilitating moral case deliberation.W. M. R. Ligtenberg, A. C. Molewijk & M. M. Stolper - 2024 - International Journal of Ethics Education 9 (1):79-104.
    Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...)
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  7.  28
    Field-Testing the Euro-MCD Instrument: Important Outcomes According to Participants Before and After Moral Case Deliberation.J. C. de Snoo-Trimp, A. C. Molewijk, M. Svantesson, G. A. M. Widdershoven & H. C. W. de Vet - 2020 - HEC Forum 34 (1):1-24.
    Ethics support services like Moral Case Deliberation intend to support healthcare professionals in ethically difficult situations. To assess outcomes of MCD, the Euro-MCD Instrument has been developed. Field studies to test this instrument are needed and have been conducted, examining important outcomes before MCD participation and experienced outcomes. The current study aimed to describe how participants’ perceive the importance of MCD outcomes after MCD; compare these perceptions with those before MCD participation; and test the factor structure of these outcomes. Swedish, (...)
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  8.  19
    Contribution of moral case deliberations to the Moral Craftmanship of prison staff: A quantitative analysis.Marie Huysentruyt, A. I. Schaap, M. M. Stolper, M. Snijdewind, H. C. W. de Vet & A. C. Molewijk - 2023 - International Journal of Ethics Education 8 (2):389-405.
    This study explores the impact of participation in a series of moral case deliberations (MCD) on the moral craftsmanship (MCS) of Dutch prison staff. Between 2017–2020, ten MCDs per team were implemented in three prisons (i.e., intervention group). In three other prisons (i.e., control group) no MCDs were implemented. We compared the intervention and control group using a self-developed questionnaire, administered before (pre-measurement) and after the series of MCDs (post-measurement). Results After the MCDs, participants scored significantly higher on 7 of (...)
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  9.  27
    Conceptualization and Operationalization of the Concept of Moral Craftsmanship.Anne I. Schaap, H. C. W. de Vet, Margreet M. Stolper & A. C. Molewijk - 2024 - Business and Professional Ethics Journal 43 (1):27-54.
    Prison work creates ethical challenges for which a training program was initiated for Dutch prison staff to foster their Moral Craftsmanship (MCS). The concept of MCS is not yet defined and operationalized in literature. This explorative study aims to 1) define MCS, 2) identify conceptual elements of MCS, and 3) develop a measurement tool for MCS. A document and literature study provided input for the definition and selection of conceptual elements related within DCIA policy documents, identifying three conceptual levels of (...)
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  10.  40
    Moral competence, moral teamwork and moral action - the European Moral Case Deliberation Outcomes (Euro-MCD) Instrument 2.0 and its revision process. [REVIEW]J. C. de Snoo-Trimp, H. C. W. de Vet, G. A. M. Widdershoven, A. C. Molewijk & M. Svantesson - 2020 - BMC Medical Ethics 21 (1):1-18.
    BackgroundClinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies (...)
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  11.  56
    Enacting Ethics: Bottom-up Involvement in Implementing Moral Case Deliberation. [REVIEW]F. C. Weidema, A. C. Molewijk, G. A. M. Widdershoven & T. A. Abma - 2012 - Health Care Analysis 20 (1):1-19.
    In moral case deliberation (MCD), healthcare professionals meet to reflect upon their moral questions supported by a structured conversation method and non-directive conversation facilitator. An increasing number of Dutch healthcare institutions work with MCD to (1) deal with moral questions, (2) improve reflection skills, interdisciplinary cooperation and decision-making, and (3) develop policy. Despite positive evaluations of MCD, organization and implementation of MCD appears difficult, depending on individuals or external experts. Studies on MCD implementation processes have not yet been published. The (...)
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  12.  68
    Client Participation in Moral Case Deliberation: A Precarious Relational Balance. [REVIEW]F. C. Weidema, T. A. Abma, G. A. M. Widdershoven & A. C. Molewijk - 2011 - HEC Forum 23 (3):207-224.
    Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client participation often raises questions concerning conditions for equal collaboration and good dialogue. Despite these questions, there is little empirical research regarding client participation in clinical ethics support in general and in MCD in particular. This article (...)
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