title: Does Moral Case Deliberation Help Professionals in Care for the Homeless in Dealing with Their Dilemmas? A Mixed-Methods Responsive Study.
abstract: Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation (MCD) is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people's perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization.
authors.affiliation: Faculty of Social Science and Applied Psychology, Leiden University of Applied Science, Post box 382, 2300AJ, Leiden, The Netherlands. spijkerboer.r@hsleiden.nl.
authors.forename: R P
authors.identifier: http://orcid.org/0000-0002-1010-4415
authors.initials: RP
authors.lastname: Spijkerboer
authors.affiliation: Faculty of Social Science and Applied Psychology, Leiden University of Applied Science, Post box 382, 2300AJ, Leiden, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: van der Stel
authors.affiliation: Department of Medical Humanities, EMGO+ Institute for Health and Care Research, VUmc Amsterdam, Postbox 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: G A M
authors.initials: GA
authors.lastname: Widdershoven
authors.affiliation: Department of Medical Humanities, EMGO+ Institute for Health and Care Research, VUmc Amsterdam, Postbox 7057, 1007 MB, Amsterdam, The Netherlands.|Centre for Medical Ethics, University of Oslo (UIO), Oslo, Norway.
authors.forename: A C
authors.initials: AC
authors.lastname: Molewijk
mesh_terms: D033061:Ethics Consultation / Q000592:standards*; D006282:Health Personnel / Q000941:ethics*; D006703:Ill-Housed Persons; D006801:Humans; D009014:Morals; D036301:Qualitative Research; D012947:Social Work / Q000379:methods / Q000592:standards*
keywords: Care for the homeless; Dealing with dilemmas; Evaluation; Mixed-methods research; Moral case deliberation; Moral dilemmas