title: Moral decision-making among assertive community treatment (ACT) case managers: a focus group study.
abstract: The context of care in assertive community treatment (ACT) can be precarious and generate ethical issues involving the principles of autonomy and paternalism. This focus group study examined case managers' situated accounts of moral reasoning. Our findings show how they expressed strong moral obligation towards helping the clients. Their moral reasoning reflected a paternalistic position where, on different occasions, the potential benefits of their interventions would be prioritised at the expense of protecting the clients' personal autonomy. The case managers' reasoning emphasised situational awareness, but there was a risk of supporting paternalistic interventions and denying the clients' right to autonomy.
authors.affiliation: a Aalborg University Hospital, Department of Psychiatry , Aalborg , Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Lerbaek
authors.affiliation: b Aalborg University Hospital, Unit for Psychiatric Research and Department S, Psychiatric Hospital, Aalborg, Denmark; Aarhus University Hospital, Unit for Psychiatric Research and Department M , Risskov , Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Aagaard
authors.affiliation: a Aalborg University Hospital, Department of Psychiatry , Aalborg , Denmark.
authors.forename: Mette Braendstrup
authors.initials: MB
authors.lastname: Andersen
authors.affiliation: c University of Southern Denmark, Department of Public Health , Odense , Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Buus
mesh_terms: D000328:Adult; D000071959:Case Managers / Q000941:ethics*; D003156:Community Mental Health Services / Q000941:ethics*; D003657:Decision Making; D003718:Denmark; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D028681:Moral Obligations