Aims and harvest of moral case deliberation

Nurs Ethics. 2013 Sep;20(6):617-31. doi: 10.1177/0969733012473773. Epub 2013 Feb 20.


Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

Keywords: Aims; clinical ethics; cooperation; management; moral case deliberation; nurses; outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cooperative Behavior
  • Ethics Consultation*
  • Ethics, Nursing
  • Focus Groups
  • Humans
  • Interprofessional Relations
  • Morals*
  • Nurse's Role*
  • Nursing Process
  • Nursing Staff, Hospital / ethics*
  • Practice Patterns, Nurses' / ethics*
  • Quality of Health Care / ethics