Assessing Quality of Moral Deliberation: A Pilot Study Using Video-Recordings

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Background: Clinical ethics support is an emerging field. Evaluating quality of its process and content is important but has been barely studied yet.

Objectives: To assess quality of moral deliberation by developing a coding scheme and applying it to a moral case deliberation and a regular case discussion.

Research Design: This was a pilot study using video-recorded sessions.

Participants and Research Context: The sessions took place at two teams of healthcare professionals in a Dutch forensic-psychiatric institution. At the seventh meeting both teams received the same case and moral question. One session, a moral case deliberation, was led by a trained facilitator who used a conversation method. The regular case discussion session had no facilitator and no conversation method.

Ethical Considerations: Participants were informed about the study and free to withdraw at any moment. For the video-recording, written informed consent was obtained. Video-recorded material was securely saved and only watched by researchers.

Findings: A coding scheme was developed based on an explorative literature research to operationalize good moral deliberation into three categories: ‘moral focus’, ‘open interaction’ and ‘variety of argumentation’. The moral case deliberation lasted longer than the regular case discussion and involved more contributions being categorized into the coding scheme.

Discussion: Our study suggests that a case discussion with facilitator and conversation method concerns more elements of what has been operationalized as good moral deliberation than an unstructured session without facilitator. We want to emphasize that the coding scheme not solely determines quality of deliberation, as this always requires normative reflections by all researchers.

Conclusion: This first effort to assess quality of moral deliberation provides valuable insights, like the influence of the facilitator and conversation method, and contributes to future research on quality of clinical ethics support processes.
Original languageEnglish
JournalEC Psychology and Psychiatry
Publication statusPublished - 30 Mar 2022

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