title: Tragedy in moral case deliberation.
abstract: In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants. A case study design is used by conducting semi-structured interviews (N = 10) with health care professionals who both played a role in the treatment of the patient and attended the MCD. The results show that MCD helps people to deal with tragic situations. An important element of MCD in this respect is making explicit the dilemma and the damage, demonstrating that there is no simple solution. MCD prompts participants to formulate and share personal experiences with one another and thus helps to create a shared perception of the situation as tragic. The article concludes that MCD contributes to the sharing of tragic experiences, and fosters mutual interaction during a tragedy. Its value could be increased through explicit reflection on the aspect of contingency that characterises tragedy.
authors.affiliation: VU Medisch Centrum, De Boelelaan 1117, Postbus 7057, 1007 MB, Amsterdam, The Netherlands. cb.spronk@vumc.nl.
authors.forename: Benita
authors.identifier: http://orcid.org/0000-0003-1473-2483
authors.initials: B
authors.lastname: Spronk
authors.affiliation: Metamedica, De Boelelaan 1089 a, F-vleugel/Medische Faculteit, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Stolper
authors.affiliation: Metamedica, De Boelelaan 1089 a, F-vleugel/Medische Faculteit, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Guy
authors.initials: G
authors.lastname: Widdershoven
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000628:therapy; D026689:Ethical Analysis; D026690:Ethics, Clinical; D005190:Family / Q000523:psychology; D005260:Female; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D009014:Morals; D011247:Pregnancy; D036301:Qualitative Research
keywords: Contingency; Decision-making; Dilemma method; MCD; Moral case deliberation; Tragedy