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Tijdschrift voor Psychiatrie 58 (2016) 3, 207 - 214


Moral case deliberation: time for ethical reflection in the daily practice of mental health care

A. Vellinga, E.A.H. van Melle-Baaijens

background Nowadays, reflecting on ethics, which we choose to call moral case deliberation, is occurring more and more frequently in psychiatric institutions. We have personal experience of organising and supervising moral case deliberation in a large psychiatric institute and we can confirm the positive effects of moral case deliberation which have been reported in the literature.
aim To describe a structured method for moral case deliberation which enables care-givers in health care and/or addiction care to reflect on moral dilemmas.
method We refer to the main findings in relevant literature and describe how we developed a structured method for implementing moral case deliberation.
results Our studies of the literature indicate that systematic reflection about ethical dilemmas can improve the quality of care and make care-givers more satisfied with their work. This is why we have developed our own method which is applicable particularly to psychiatric and/or addition care and which can be used systematically in discussions of moral dilemmas.
conclusion Our method for discussing ethical issues works well in clinical practice, particularly when it is embedded in a multidisciplinary context. Of course, to ensure the continuity of the system, deliberation about moral and ethical issues needs to be financially safeguarded and embedded in the organisation. Discussion of moral issues improves the quality of care and increases care-givers’ satisfaction with their work.

keywords ethics, methodology, moral case deliberation