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Relational autonomy in the care of the vulnerable: Health care professionals' reasoning in Moral Case Deliberation (MCD)
Örebro University.
Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. Linnaeus University. (PreHospen - Centrum för prehospital forskning)ORCID-id: 0000-0001-7865-3480
Norwegian University of Science and Technology.
Norwegian University of Science and Technology.
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2017 (Engelska)Ingår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

In Moral Case Deliberation (MCD), healthcare professionals discuss ethically di cult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical re ection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals’ moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justi cations for in uencing the patient, the incapacitated patient’s nebulous interests, and coping with the con ict between using coercion to achieve good while pro- tecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals re ected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, de ning their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient’s autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients’ in uence and at the same time take responsibility for their needs as vulnerable humans. 

Ort, förlag, år, upplaga, sidor
2017.
Nyckelord [en]
Clinical ethics, Ethics consultation, Moral case deliberation, Health care professionals, Qualitative research
Nationell ämneskategori
Medicinsk etik
Forskningsämne
Människan i vården
Identifikatorer
URN: urn:nbn:se:hb:diva-13529DOI: 10.1007/s11019-017-9818-6ISI: 000451022600004PubMedID: 29243015Scopus ID: 2-s2.0-85038102190OAI: oai:DiVA.org:hb-13529DiVA, id: diva2:1174763
Tillgänglig från: 2018-01-16 Skapad: 2018-01-16 Senast uppdaterad: 2018-12-07Bibliografiskt granskad

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