title: Inspectors' ethical challenges in health care regulation: a pilot study.
abstract: There is an increasing body of research on what kind of ethical challenges health care professionals experience regarding the quality of care. In the Netherlands the Dutch Health Care Inspectorate is responsible for monitoring and regulating the quality of health care. No research exists on what kind of ethical challenges inspectors experience during the regulation process itself. In a pilot study we used moral case deliberation as method in order to reflect upon inspectors' ethical challenges. The objective of this paper is to give an overview of the ethical challenges which health care inspectors encounter in their daily work. A thematic qualitative analysis was performed on cases (n = 69) that were collected from health care inspectors in a moral case deliberation pilot study. Eight themes were identified in health care regulation. These can be divided in two categories: work content and internal collaboration. The work of the health care inspectorate is morally loaded and our recommendation is that some form of ethics support is provided for health care inspectors.
authors.affiliation: Medical Humanities, VU University Medical Centre (EMGO+), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. ws@uvh.nl.|University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD, Utrecht, The Netherlands. ws@uvh.nl.
authors.forename: W
authors.identifier: http://orcid.org/0000-0002-2899-0689
authors.initials: W
authors.lastname: Seekles
authors.affiliation: Medical Humanities, VU University Medical Centre (EMGO+), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Widdershoven
authors.affiliation: The Health Care Inspectorate (IGZ), Stadsplateau 1, 3521 AZ, Utrecht, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Robben
authors.affiliation: The Health Care Inspectorate (IGZ), Stadsplateau 1, 3521 AZ, Utrecht, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: van Dalfsen
authors.affiliation: Medical Humanities, VU University Medical Centre (EMGO+), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.|Centre for Medical Ethics, HELSAM, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway.
authors.forename: B
authors.initials: B
authors.lastname: Molewijk
mesh_terms: D026689:Ethical Analysis; D006801:Humans; D008485:Medical Audit / Q000941:ethics*; D009014:Morals; D009426:Netherlands; D010865:Pilot Projects; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards*
keywords: Ethical challenges; Ethics support; Health care inspectorate; Health care regulation; Moral case deliberation; Moral questions