Implementing Ethics Reflection Groups in Hospitals: an Action Research Study Evaluating Barriers and Promotors

Overview

Journal BMC Med Ethics

Publisher Biomed Central

Specialty Medical Ethics

Date 2019 Jul 18

PMID 31311525

Citations 11

Authors

Henriette Bruun

Reidar Pedersen

Elsebeth Stenager

Christian Backer Mogensen

Lotte Huniche

Affiliations

Soon will be listed here.

Abstract

Background: An ethics reflection group (ERG) is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments.

Methods: The implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers.

Results: The implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician's job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges.

Conclusion: The study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services.

Citing Articles

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A systematic scoping review of group reflection in medical education.

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Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review.

Laureano C, Laranjeira C, Querido A, Dixe M, Rego F Healthcare (Basel). 2024; 12(4).

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Training nurses to facilitate and implement CURA in palliative care institutions: development and evaluation of a blended learning program.

van Schaik M, Kroger C, Zuidema L, Stolper M, Widdershoven G, Pasman H BMC Palliat Care. 2023; 22(1):158.

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