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Bert Molewijk [84]B. Molewijk [5]Bert C. Molewijk [2]B. A. Molewijk [1]
Bert Ac Molewijk [1]Bert A. C. Molewijk [1]
  1.  53
    Bioethics education in clinical settings: theory and practice of the dilemma method of moral case deliberation.Margreet Stolper, Bert Molewijk & Guy Widdershoven - 2016 - BMC Medical Ethics 17 (1):45.
    BackgroundMoral Case Deliberation is a specific form of bioethics education fostering professionals’ moral competence in order to deal with their moral questions. So far, few studies focus in detail on Moral Case Deliberation methodologies and their didactic principles. The dilemma method is a structured and frequently used method in Moral Case Deliberation that stimulates methodological reflection and reasoning through a systematic dialogue on an ethical issue experienced in practice.MethodsIn this paper we present a case-study of a Moral Case Deliberation with (...)
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  2.  84
    Standards of practice in empirical bioethics research: towards a consensus.Jonathan Ives, Michael Dunn, Bert Molewijk, Jan Schildmann, Kristine Bærøe, Lucy Frith, Richard Huxtable, Elleke Landeweer, Marcel Mertz, Veerle Provoost, Annette Rid, Sabine Salloch, Mark Sheehan, Daniel Strech, Martine de Vries & Guy Widdershoven - 2018 - BMC Medical Ethics 19 (1):68.
    This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...)
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  3.  91
    Empirical ethics as dialogical practice.Guy Widdershoven, Tineke Abma & Bert Molewijk - 2009 - Bioethics 23 (4):236-248.
    In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and perspectives need to be exchanged. Within hermeneutic ethics dialogue is seen as a vehicle for moral learning and developing normative conclusions. Dialogue stands for a specific view on moral epistemology and methodological criteria for moral inquiry. Responsive evaluation (...)
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  4.  77
    Aims and harvest of moral case deliberation.Froukje C. Weidema, Bert Ac Molewijk, Frans Kamsteeg & Guy Am Widdershoven - 2013 - Nursing Ethics 20 (6):617-631.
    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 (...)
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  5.  56
    Learning by Doing. Training Health Care Professionals to Become Facilitator of Moral Case Deliberation.Margreet Stolper, Bert Molewijk & Guy Widdershoven - 2015 - HEC Forum 27 (1):47-59.
    Moral case deliberation is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care institutions to acquire (...)
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  6. Good Care in Ongoing Dialogue. Improving the Quality of Care Through Moral Deliberation and Responsive Evaluation.Tineke A. Abma, Bert Molewijk & Guy A. M. Widdershoven - 2009 - Health Care Analysis 17 (3):217-235.
    Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...)
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  7.  43
    Field-testing the Euro-MCD Instrument: Experienced outcomes of moral case deliberation.Janine C. de Snoo-Trimp, Bert Molewijk, Gøril Ursin, Berit Støre Brinchmann, Guy A. M. Widdershoven, Henrica C. W. de Vet & Mia Svantesson - 2020 - Nursing Ethics 27 (2):390-406.
    Background: Moral case deliberation is a form of clinical ethics support to help healthcare professionals in dealing with ethically difficult situations. There is a lack of evidence about what outcomes healthcare professionals experience in daily practice after moral case deliberations. The Euro-MCD Instrument was developed to measure outcomes, based on the literature, a Delphi panel, and content validity testing. To examine relevance of items and adequateness of domains, a field study is needed. Aim: To describe experienced outcomes after participating in (...)
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  8.  65
    Evaluating clinical ethics support in mental healthcare.Marit Helene Hem, Reidar Pedersen, Reidun Norvoll & Bert Molewijk - 2015 - Nursing Ethics 22 (4):452-466.
    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into (...)
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  9.  95
    Outcomes of Moral Case Deliberation - the development of an evaluation instrument for clinical ethics support (the Euro-MCD).Mia Svantesson, Jan Karlsson, Pierre Boitte, Jan Schildman, Linda Dauwerse, Guy Widdershoven, Reidar Pedersen, Martijn Huisman & Bert Molewijk - 2014 - BMC Medical Ethics 15 (1):30.
    Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...)
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  10.  34
    VIRT 2 UE: A European train-the-trainer programme for teaching research integrity.Natalie Evans, Armin Schmolmueller, Margreet Stolper, Giulia Inguaggiato, Astrid Hooghiemstra, Ruzica Tokalic, Daniel Pizzolato, Nicole Foeger, Ana Marušić, Marc van Hoof, Dirk Lanzerath, Bert Molewijk, Kris Dierickx & Guy Widdershoven on - 2024 - Research Ethics 20 (2):187-209.
    Universities and other research institutions are increasingly providing additional training in research integrity to improve the quality and reliability of research. Various training courses have been developed, with diverse learning goals and content. Despite the importance of training that focuses on moral character and professional virtues, there remains a lack of training that adopts a virtue ethics approach. To address this, we, a European Commission-funded consortium, have designed a train-the-trainer programme for research integrity. The programme is based on (1) virtue (...)
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  11.  48
    Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care.Laura Hartman, Giulia Inguaggiato, Guy Widdershoven, Annelijn Wensing-Kruger & Bert Molewijk - 2020 - BMC Medical Ethics 21 (1):1-13.
    BackgroundClinical ethics support aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we present a specific way of organizing CES, which we have called integrative CES, and argue that this approach meets some of the challenges regarding implementation and organization.MethodsThis integrative approach was developed in an iterative process, combining actual experiences in a case study (...)
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  12. Scientific Contribution. Empirical data and moral theory. A plea for integrated empirical ethics.Bert Molewijk, Anne M. Stiggelbout, Wilma Otten, Heleen M. Dupuis & Job Kievit - 2004 - Medicine, Health Care and Philosophy 7 (1):55-69.
    Ethicists differ considerably in their reasons for using empirical data. This paper presents a brief overview of four traditional approaches to the use of empirical data: “the prescriptive applied ethicists,” “the theorists,” “the critical applied ethicists,” and “the particularists.” The main aim of this paper is to introduce a fifth approach of more recent date (i.e. “integrated empirical ethics”) and to offer some methodological directives for research in integrated empirical ethics. All five approaches are presented in a table for heuristic (...)
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  13.  24
    Evaluation and perceived results of moral case deliberation.R. M. Janssens, E. van Zadelhoff, G. van Loo, G. A. Widdershoven & B. A. Molewijk - 2015 - Nursing Ethics 22 (8):870-880.
    Background: Moral case deliberation is increasingly becoming part of various Dutch healthcare organizations. Although some evaluation studies of moral case deliberation have been carried out, research into the results of moral case deliberation within aged care is scarce. Research questions: How did participants evaluate moral case deliberation? What has moral case deliberation brought to them? What has moral case deliberation contributed to care practice? Should moral case deliberation be further implemented and, if so, how? Research design: Quantitative analysis of a (...)
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  14.  79
    Evaluation of clinical ethics support services and its normativity.Jan Schildmann, Bert Molewijk, Lazare Benaroyo, Reidun Forde & Gerald Neitzke - 2013 - Journal of Medical Ethics 39 (11):681-685.
    Evaluation of clinical ethics support services (CESS) has attracted considerable interest in recent decades. However, few evaluation studies are explicit about normative presuppositions which underlie the goals and the research design of CESS evaluation. In this paper, we provide an account of normative premises of different approaches to CESS evaluation and argue that normativity should be a focus of considerations when designing and conducting evaluation research of CESS. In a first step, we present three different approaches to CESS evaluation from (...)
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  15. The role of emotions in moral case deliberation: Theory, practice, and methodology.Bert Molewijk, Dick Kleinlugtenbelt & Guy Widdershoven - 2011 - Bioethics 25 (7):383-393.
    In clinical moral decision making, emotions often play an important role. However, many clinical ethicists are ignorant, suspicious or even critical of the role of emotions in making moral decisions and in reflecting on them. This raises practical and theoretical questions about the understanding and use of emotions in clinical ethics support services. This paper presents an Aristotelian view on emotions and describes its application in the practice of moral case deliberation.According to Aristotle, emotions are an original and integral part (...)
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  16.  50
    Developing a ‘moral compass tool’ based on moral case deliberations: A pragmatic hermeneutic approach to clinical ethics.Laura Hartman, Suzanne Metselaar, Guy Widdershoven & Bert Molewijk - 2019 - Bioethics 33 (9):1012-1021.
    Although moral case deliberation (MCD) is evaluated positively as a form of clinical ethics support (CES), it has limitations. To address these limitations our research objective was to develop a thematic CES tool. In order to assess the philosophical characteristics of a CES tool based on MCDs, we drew on hermeneutic ethics and pragmatism. We distinguished four core characteristics of a CES tool: (a) focusing on an actual situation that is experienced as morally challenging by the user; (b) stimulating moral (...)
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  17.  58
    The significance of ethics reflection groups in mental health care: a focus group study among health care professionals.Marit Helene Hem, Bert Molewijk, Elisabeth Gjerberg, Lillian Lillemoen & Reidar Pedersen - 2018 - BMC Medical Ethics 19 (1):54.
    Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...)
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  18.  79
    Inter-ethics: Towards an interactive and interdependent bioethics.Tineke A. Abma, Vivianne E. Baur, Bert Molewijk & Guy A. M. Widdershoven - 2010 - Bioethics 24 (5):242-255.
    Since its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice improvement, and (...)
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  19.  57
    Beyond Recommendation and Mediation: Moral Case Deliberation as Moral Learning in Dialogue.Suzanne Metselaar, Bert Molewijk & Guy Widdershoven - 2015 - American Journal of Bioethics 15 (1):50-51.
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  20.  19
    (1 other version)CURA—An Ethics Support Instrument for Nurses in Palliative Care. Feasibility and First Perceived Outcomes.Malene Vera van Schaik, H. Roeline Pasman, Guy Widdershoven, Bert Molewijk & Suzanne Metselaar - 2021 - HEC Forum 35 (2):1-21.
    Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...)
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  21.  38
    What Outcomes do Dutch Healthcare Professionals Perceive as Important Before Participation in Moral Case Deliberation?Janine de Snoo-Trimp, Guy Widdershoven, Mia Svantesson, Riekie de Vet & Bert Molewijk - 2017 - Bioethics 31 (4):246-257.
    Background There has been little attention paid to research on the outcomes of clinical ethics support or critical reflection on what constitutes a good CES outcome. Understanding how CES users perceive the importance of CES outcomes can contribute to a better understanding, use of and normative reflection on CES outcomes. Objective To describe the perceptions of Dutch healthcare professionals on important outcomes of moral case deliberation, prior to MCD participation, and to compare results between respondents. Methods This mixed-methods study used (...)
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  22.  39
    Can moral case deliberation in research groups help to navigate research integrity dilemmas? A pilot study.Tamarinde L. Haven, Bert Molewijk, Lex Bouter, Guy Widdershoven, Fenneke Blom & Joeri Tijdink - 2024 - Research Ethics 20 (2):219-238.
    There is an increased focus on fostering integrity in research by through creating an open culture where research integrity dilemmas can be discussed. We describe a pilot intervention study that used Moral Case Deliberation (MCD), a method that originated in clinical ethics support, to discuss research integrity dilemmas with researchers. Our research question was: can moral case deliberation in research groups help to navigate research integrity dilemmas? We performed 10 MCDs with 19 researchers who worked in three different research groups (...)
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  23.  40
    Prevalence and characteristics of moral case deliberation in Dutch health care.Linda Dauwerse, Margreet Stolper, Guy Widdershoven & Bert Molewijk - 2014 - Medicine, Health Care and Philosophy 17 (3):365-375.
    The attention for Moral case deliberation has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this paper is to provide an overview of the state of the art concerning MCD in the Netherlands. As part of a larger national study on clinical ethics support in the (...)
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  24.  29
    Important outcomes of moral case deliberation: a Euro-MCD field survey of healthcare professionals’ priorities.Mia Svantesson, Janine C. de Snoo-Trimp, Göril Ursin, Henrica C. W. de Vet, Berit S. Brinchmann & Bert Molewijk - 2019 - Journal of Medical Ethics 45 (9):608-616.
    BackgroundThere is a lack of empirical research regarding the outcomes of such clinical ethics support methods as moral case deliberation. Empirical research in how healthcare professionals perceive potential outcomes is needed in order to evaluate the value and effectiveness of ethics support; and help to design future outcomes research. The aim was to use the European Moral Case Deliberation Outcome Instrument instrument to examine the importance of various MCD outcomes, according to healthcare professionals, prior to participation.MethodsA North European field survey (...)
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  25. Patient participation in Dutch ethics support: practice, ideals, challenges and recommendations—a national survey.Marleen Eijkholt, Janine de Snoo-Trimp, Wieke Ligtenberg & Bert Molewijk - 2022 - BMC Medical Ethics 23 (1):1-14.
    Background: Patient participation in clinical ethics support services has been marked as an important issue. There seems to be a wide variety of practices globally, but extensive theoretical or empirical studies on the matter are missing. Scarce publications indicate that, in Europe, patient participation in CESS varies from region to region, and per type of support. Practices vary from being non-existent, to patients being a full conversation partner. This contrasts with North America, where PP seems more or less standard. While (...)
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  26.  34
    Ethics support for ethics support: the development of the Confidentiality Compass for dealing with moral challenges concerning (breaching) confidentiality in moral case deliberation.Wieke Ligtenberg, Margreet Stolper & Bert Molewijk - 2024 - BMC Medical Ethics 25 (1):1-15.
    Background Confidentiality is one of the central preconditions for clinical ethics support (CES). CES cases which generate moral questions for CES staff concerning (breaching) confidentiality of what has been discussed during CES can cause moral challenges. Currently, there seems to be no clear policy or guidance regarding how CES staff can or should deal with these moral challenges related to (not) breaching confidentiality within CES. Moral case deliberation is a specific kind of CES. Method Based on experiences and research into (...)
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  27.  34
    Evaluating Clinical Ethics Support: A Participatory Approach.Suzanne Metselaar, Guy Widdershoven, Rouven Porz & Bert Molewijk - 2017 - Bioethics 31 (4):258-266.
    The current process towards formalization within evaluation research, in particular the use of pre-set standards and the focus on predefined outcomes, implies a shift of ownership from the people who are actually involved in real clinical ethics support services in a specific context to external stakeholders who increasingly gain a say in what ‘good CESS’ should look like. The question is whether this does justice to the insights and needs of those who are directly involved in actual CESS practices, be (...)
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  28.  90
    Need for ethics support in healthcare institutions: views of Dutch board members and ethics support staff.L. Dauwerse, T. Abma, B. Molewijk & G. Widdershoven - 2011 - Journal of Medical Ethics 37 (8):456-460.
    Next SectionObjective The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. Methods This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Findings Most respondents see a (...)
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  29.  29
    Perceptions of important outcomes of moral case deliberations: a qualitative study among healthcare professionals in childhood cancer care.Charlotte Weiner, Pernilla Pergert, Bert Molewijk, Anders Castor & Cecilia Bartholdson - 2021 - BMC Medical Ethics 22 (1):1-11.
    BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe (...)
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  30. The development of a descriptive evaluation tool for clinical ethics case consultations.R. Pedersen, S. A. Hurst, J. Schildmann, S. Schuster & B. Molewijk - 2010 - Clinical Ethics 5 (3):136-141.
    There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics case consultation practices. The tool (...)
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  31.  85
    Dealing with ethical challenges: a focus group study with professionals in mental health care.Bert Molewijk, Marit Helene Hem & Reidar Pedersen - 2015 - BMC Medical Ethics 16 (1):4.
    Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful.
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  32. Emotions and Clinical Ethics Support. A Moral Inquiry into Emotions in Moral Case Deliberation.Bert Molewijk, Dick Kleinlugtenbelt, Scott M. Pugh & Guy Widdershoven - 2011 - HEC Forum 23 (4):257-268.
    Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...)
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  33.  45
    Ethics case reflection sessions: Enablers and barriers.Cecilia Bartholdson, Bert Molewijk, Kim Lützén, Klas Blomgren & Pernilla Pergert - 2018 - Nursing Ethics 25 (2):199-211.
    Background: In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included ‘increased understanding’, ‘group strengthening’ and ‘decision grounding’. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions. Objective: The aim of this study was to explore conditions for clarifying (...)
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  34.  46
    Two years of moral case deliberations on the use of coercion in mental health care: Which ethical challenges are being discussed by health care professionals?Bert Molewijk, Ingvild Stokke Engerdahl & Reidar Pedersen - 2016 - Clinical Ethics 11 (2-3):87-96.
    Background Seven wards from three Norwegian mental health care institutions participated in a study in which regular ethics reflection groups focusing on coercion had been implemented and evaluated (2011–2015). This article presents (1) a thematic overview of the ethical challenges identified based on a systematic qualitative analyses of 161 ethics reflection groups and (2) some general observations on these ethical challenges. Results The ethical challenges are divided into four main thematic categories: (1) formal coercion, (2) informal coercion, (3) uncertainty related (...)
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  35.  50
    Integrating Theory and Data in Evaluating Clinical Ethics Support. Still a Long Way to Go.Bert Molewijk, Jan Schildmann & Anne Slowther - 2017 - Bioethics 31 (4):234-236.
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  36.  86
    Ethical challenges in connection with the use of coercion: a focus group study of health care personnel in mental health care.Marit H. Hem, Bert Molewijk & Reidar Pedersen - 2014 - BMC Medical Ethics 15 (1):82.
    In recent years, the attention on the use of coercion in mental health care has increased. The use of coercion is common and controversial, and involves many complex ethical challenges. The research question in this study was: What kind of ethical challenges related to the use of coercion do health care practitioners face in their daily clinical work?
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  37.  39
    Working towards implementing moral case deliberation in mental healthcare: Ongoing dialogue and shared ownership as strategy.Froukje Weidema, Hans van Dartel & Bert Molewijk - 2016 - Clinical Ethics 11 (2-3):54-62.
    The design and implementation of clinical ethics support is attracting increasing attention. Often, the characteristics and aims of clinical ethics support are translated into practice in a top-down, programmatic manner. These characteristics and aims then remain a constant feature of the clinical ethics support functions within the organisation. We argue that the characteristics of clinical ethics support should be reflected in the implementation strategy. Inspired by dialogical, pragmatic and hermeneutic perspectives on clinical ethics support in general and moral case deliberation (...)
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  38.  84
    Training healthcare professionals as moral case deliberation facilitators: evaluation of a Dutch training programme.Mirjam Plantinga, Bert Molewijk, Menno de Bree, Marloes Moraal, Marian Verkerk & Guy A. M. Widdershoven - 2012 - Journal of Medical Ethics 38 (10):630-635.
    Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator. In this paper, we present the first results of a study in which we evaluated the programme. We used a mixed methods design. One hundred and twenty trained healthcare professionals and five trainers from 16 training groups working in different (...)
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  39.  34
    Two years of ethics reflection groups about coercion in psychiatry. Measuring variation within employees’ normative attitudes, user involvement and the handling of disagreement.Bert Molewijk, Reidar Pedersen, Almar Kok, Reidun Førde & Olaf Aasland - 2023 - BMC Medical Ethics 24 (1):1-19.
    Background Research on the impact of ethics reflection groups (ERG) (also called moral case deliberations (MCD)) is complex and scarce. Within a larger study, two years of ERG sessions have been used as an intervention to stimulate ethical reflection about the use of coercive measures. We studied changes in: employees’ attitudes regarding the use of coercion, team competence, user involvement, team cooperation and the handling of disagreement in teams. Methods We used panel data in a longitudinal design study to measure (...)
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  40.  29
    Clinical Ethics Expertise as the Ability to Co-Create Normative Recommendations by Guiding a Dialogical Process of Moral Learning.Giulia Inguaggiato, Suzanne Metselaar, Guy Widdershoven & Bert Molewijk - 2019 - American Journal of Bioethics 19 (11):71-73.
    Volume 19, Issue 11, November 2019, Page 71-73.
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  41.  71
    (1 other version)Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned.Laura Hartman, Guy Widdershoven, Annelou de Vries, Annelijn Wensing-Kruger, Martin den Heijer, Thomas Steensma & Bert Molewijk - 2019 - HEC Forum 31 (3):241-260.
    Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...)
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  42.  24
    Conceptualizing and Fostering the Quality of CES Through a Dutch National Network on CES.Laura Hartman, Guy Widdershoven, Eva van Baarle, Froukje Weidema & Bert Molewijk - 2022 - HEC Forum 34 (2):169-186.
    The prevalence of Clinical ethics support services is increasing. Yet, questions about what quality of CES entails and how to foster the quality of CES remain. This paper describes the development of a national network, which aimed to conceptualize and foster the quality of CES in the Netherlands simultaneously. Our methodology was inspired by a responsive evaluation approach which shares some of our key theoretical presuppositions of CES. A responsive evaluation methodology engages stakeholders in developing quality standards of a certain (...)
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  43.  21
    Quality Characteristics for Clinical Ethics Support in the Netherlands.Laura Hartman, Eva Van Baarle, Marielle Diepeveen, Guy Widdershoven & Bert Molewijk - 2022 - AJOB Empirical Bioethics 13 (1):22-32.
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  44.  49
    Evaluating the Quality of the Deliberation in Moral Case Deliberations: A Coding Scheme.Hylke Jellema, Swanny Kremer, Anne-Ruth Mackor & Bert Molewijk - 2017 - Bioethics 31 (4):277-285.
    Moral Case Deliberation is an up and coming form of ethics support wherein clinical professionals deliberate about moral questions they face in their work. So far, it has been unclear what quality of deliberation in MCD is entailed and how to evaluate this quality. This article proposes a coding scheme that fits the theoretical background of MCD and allows researchers to evaluate the quality of the deliberation in MCDs. We consider deliberation in MCD to be of good quality when participants (...)
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  45.  32
    Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned.Bert Molewijk, Thomas Steensma, Martin Heijer, Annelijn Wensing-Kruger, Annelou Vries, Guy Widdershoven & Laura Hartman - 2019 - HEC Forum 31 (3):241-260.
    Clinical ethics support (CES) for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria (CEGD) at Amsterdam University Medical Center. We specifically aimed to integrate CES (...)
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  46.  51
    What Sticks? The Evaluation of a Train-the-Trainer Course in Military Ethics and its Perceived Outcomes.Eva van Baarle, Laura Hartman, Desiree Verweij, Bert Molewijk & Guy Widdershoven - 2017 - Journal of Military Ethics 16 (1-2):56-77.
    Ethics training has become a common phenomenon in the training of military professionals at all levels. However, the perceived outcomes of this training remain open. In this article, we analyze the experiences of course participants who were interviewed 6–12 months after they had participated in a train-the-trainer course in military ethics developed by the Faculty of Military Sciences of the Netherlands Defence Academy. Through qualitative inductive analysis, it is shown how participants evaluate the training, how they perceive the development of (...)
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  47.  68
    Lessons learned from implementing a responsive quality assessment of clinical ethics support.Eva M. Van Baarle, Marieke C. Potma, Maria E. C. van Hoek, Laura A. Hartman, Bert A. C. Molewijk & Jelle L. P. van Gurp - 2019 - BMC Medical Ethics 20 (1):1-11.
    BackgroundVarious forms of Clinical Ethics Support (CES) have been developed in health care organizations. Over the past years, increasing attention has been paid to the question of how to foster the quality of ethics support. In the Netherlands, a CES quality assessment project based on a responsive evaluation design has been implemented. CES practitioners themselves reflected upon the quality of ethics support within each other’s health care organizations. This study presents a qualitative evaluation of this Responsive Quality Assessment (RQA) project.MethodsCES (...)
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  48.  52
    Improving Care and Ethics: A Plea for Interactive Empirical Ethics.Guy Widdershoven, Bert Molewijk & Tineke Abma - 2009 - American Journal of Bioethics 9 (6-7):99-101.
  49.  38
    Defining and categorizing outcomes of Moral Case Deliberation (MCD): concept mapping with experienced MCD participants.Janine C. de Snoo-Trimp, Bert Molewijk & Henrica C. W. de Vet - 2018 - BMC Medical Ethics 19 (1):1-14.
    To support healthcare professionals in dealing with ethically difficult situations, Clinical Ethics Support (CES) services like Moral Case Deliberation (MCD) are increasingly implemented. To assess the impact of CES, it is important to evaluate outcomes. Despite general claims about outcomes from MCD experts and some qualitative research, there exists no conceptual analysis of outcomes yet. Therefore, the aim of this study was to systematically define and categorize MCD outcomes. An additional aim was to compare these outcomes with the outcomes in (...)
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  50.  21
    Fostering moral resilience through moral case deliberation.Suzanne Metselaar & Bert Molewijk - 2023 - Nursing Ethics 30 (5):730-745.
    Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...)
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