title: [Clinical everyday ethics-support in handling moral distress? : Evaluation of an ethical decision-making model for interprofessional clinical teams].
abstract: BACKGROUND
  High-tech medicine and cost rationing provoke moral distress up to burnout syndromes. The consequences are severe, not only for those directly involved but also for the quality of patient care and the institutions. The multimodal model METAP (Modular, Ethical, Treatment, Allocation, Process) was developed as clinical everyday ethics to support the interprofessional ethical decision-making process. The distinctive feature of the model lays in education concerning ethics competence in dealing with difficult treatment decisions. METAP has been evaluated for quality testing.
  
  
  METHODS
  The research question of interest was whether METAP supports the handling of moral distress. The evaluation included 3 intensive care units and 3 geriatric units. In all, 33 single and 9 group interviews were held with 24 physicians, 44 nurses, and 9 persons from other disciplines. An additional questionnaire was completed by 122 persons (return rate 57%).
  
  
  RESULTS
  Two-thirds of the interview answers and 55% of the questionnaire findings show that clinical everyday ethics supports the handling of moral distress, especially for interdisciplinary communication and collaboration and for the explanation and evaluation of treatment goals. METAP does not provide support for persons who are rarely confronted with ethical problems or have not applied the model long enough yet.
  
  
  CONCLUSIONS
  To a certain degree, moral distress is unavoidable and must be addressed as an interprofessional problem. Herein, clinical everyday ethics may provide targeted support for ethical decision-making competence.
authors.affiliation: Klinische Ethik & Begleitforschung, Institut für Bio- und Medizinethik, Universitätsspital, Universitäre Psychiatrische Kliniken, Universität Basel, Schanzenstr. 13, 4056, Basel, Schweiz, sabinetanner3@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Tanner
authors.forename: H
authors.initials: H
authors.lastname: Albisser Schleger
authors.forename: B
authors.initials: B
authors.lastname: Meyer-Zehnder
authors.forename: V
authors.initials: V
authors.lastname: Schnurrer
authors.forename: S
authors.initials: S
authors.lastname: Reiter-Theil
authors.forename: H
authors.initials: H
authors.lastname: Pargger
mesh_terms: D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000517:prevention & control / Q000523:psychology; D003661:Decision Support Techniques; D033061:Ethics Consultation / Q000941:ethics; D004992:Ethics, Medical; D015276:Health Care Rationing / Q000941:ethics; D006299:Health Services for the Aged / Q000941:ethics; D006801:Humans; D007362:Intensive Care Units / Q000941:ethics; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D007406:Interview, Psychological; D062069:Inventions / Q000941:ethics; D028681:Moral Obligations; D010348:Patient Care Team / Q000941:ethics*; D011795:Surveys and Questionnaires