title: What healthcare teams find ethically difficult.
abstract: BACKGROUND
  Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss.
  
  
  OBJECTIVE
  To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation.
  
  
  METHODS
  A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was applied, using thematic content analysis. Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation.
  
  
  RESULTS
  Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient's/next-of-kin's emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient's autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have.
  
  
  CONCLUSIONS
  The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders.
  
  
  CONCLUSIONS
  MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective.
authors.forename: Dara
authors.initials: D
authors.lastname: Rasoal
authors.forename: Annica
authors.initials: A
authors.lastname: Kihlgren
authors.forename: Inger
authors.initials: I
authors.lastname: James
authors.affiliation: Faculty of Health and Medicine, Örebro University, Sweden.
authors.forename: Mia
authors.initials: M
authors.lastname: Svantesson
mesh_terms: D000066491:Clinical Decision-Making / Q000941:ethics*; D017041:Ethics Committees; D033061:Ethics Consultation; D026690:Ethics, Clinical; D006126:Group Processes; D006282:Health Personnel / Q000941:ethics*; D006801:Humans; D010348:Patient Care Team / Q000941:ethics*; D026684:Personal Autonomy; D011368:Professional-Family Relations / Q000941:ethics; D036301:Qualitative Research; D011787:Quality of Health Care / Q000941:ethics*
keywords: Clinical ethics; ethically difficult situations; ethics consultation; healthcare professionals; moral case deliberation