title: Organizing moral case deliberation experiences in two Dutch nursing homes.
abstract: 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 apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other.
authors.affiliation: Department of Health, Ethics and Society, Maastricht University/CAPHRI, The Netherlands. s.vanderdam@hes.unimaas.nl
authors.forename: S Sandra
authors.initials: SS
authors.lastname: van der Dam
authors.forename: T A Tineke
authors.initials: TA
authors.lastname: Abma
authors.forename: A C Bert
authors.initials: AC
authors.lastname: Molewijk
authors.forename: M J M Tinie
authors.initials: MJ
authors.lastname: Kardol
authors.forename: J M G A Jos
authors.initials: JM
authors.lastname: Schols
authors.forename: G A M Guy
authors.initials: GA
authors.lastname: Widdershoven
mesh_terms: D033061:Ethics Consultation; D026690:Ethics, Clinical; D006126:Group Processes; D006801:Humans; D033183:Interdisciplinary Communication; D009426:Netherlands; D009735:Nursing Homes / Q000941:ethics*; D011787:Quality of Health Care / Q000941:ethics*