title: Evaluation of moral case deliberation at the Dutch Health Care Inspectorate: a pilot study.
abstract: Moral case deliberation (MCD) as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate (IGZ). The objective of this pilot study is to investigate: 1) the current way of dealing with moral issues at the IGZ; 2) experience with and evaluation of MCD as clinical ethics support, and 3) future preferences and (perceived) needs regarding clinical ethics support for dealing with moral questions at the IGZ.
  
  
  
  We performed an explorative pilot study. The research questions were assessed by means of: 1) interviews with MCD participants during four focus groups; and 2) interviews with six key stakeholders at the IGZ. De qualitative data is illustrated by data from questionnaires on MCD outcomes, perspective taking and MCD evaluation.
  
  
  
  Professionals do not always recognize moral issues. Employees report a need for regular and structured moral support in health care regulation. The MCD meetings are evaluated positively. The most important outcomes of MCD are feeling secure and learning from others. Additional support is needed to successfully implement MCD at the Inspectorate.
  
  
  
  We conclude that the respondents perceive moral case deliberation as a useful form of clinical ethics support for dealing with moral questions and issues in health care regulation.
authors.affiliation: Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands. ws@uvh.nl.|University of Humanistic Studies, Utrecht, The Netherlands. ws@uvh.nl.
authors.forename: Wike
authors.initials: W
authors.lastname: Seekles
authors.affiliation: Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Guy
authors.initials: G
authors.lastname: Widdershoven
authors.affiliation: The Health Care Inspectorate (IGZ), Utrecht, The Netherlands.|Institute of Health Policy and Management (iBMG), Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Robben
authors.affiliation: The Health Care Inspectorate (IGZ), Utrecht, The Netherlands.
authors.forename: Gonny
authors.initials: G
authors.lastname: van Dalfsen
authors.affiliation: Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands.|Centre of Medical Ethics, HELSAM, University of Oslo, Oslo, Norway.
authors.forename: Bert
authors.initials: B
authors.lastname: Molewijk
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000941:ethics*; D026689:Ethical Analysis; D033061:Ethics Consultation; D026690:Ethics, Clinical; D005260:Female; D017144:Focus Groups; D006077:Government Agencies; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009014:Morals; D009426:Netherlands; D010865:Pilot Projects; D011340:Problem Solving / Q000941:ethics*; D011786:Quality Control; D012926:Social Control, Formal
keywords: Ethics support; Evaluation; Health care inspectorate; Health care regulation; Moral case deliberation