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Communicative and organizational aspects of clinical ethics support
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0002-8701-0169
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Department of Nursing, Ersta Sköndal University College, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
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2019 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 33, no 16, p. 724-733Article in journal (Refereed) Published
Abstract [en]

Studies show that healthcare professionals need inter-professional clinical ethics support (CES) in order to communicate and reflect on ethically difficult care situations that they experience in their clinical practice. Internationally, various CES interventions have been performed, but the communication processes and organisation of these interventions are rarely described in detail. The aim of this study was to explore communicative and organisational conditions of a CES intervention with the intention of promoting inter-professional communication about ethically difficult care situations. Eight audio- and video-recorded inter-professional CES sessions, inspired by Habermas' theory of communicative actions, were conducted. The observations were transcribed, sorted, and analysed using concept- and data-driven content analysis methods. The findings show three approaches to promoting communicative agreement, which include the CES facilitators' and participants' approaches to promoting a permissive communication, extended views, and mutual understanding. The CES sessions had organizational aspects for facilitating communicative agreement with both a given structure and openness for variation. The dynamic structure of the organization, promoted both safety and stability as well as a creativity and responsiveness, which in turn opened up for a free and dynamic inter-professional dialogue concerning ethically difficult care situations. The findings constitute a step towards a theory-based CES method inspired by Habermas' theory of communicative action. Further research is needed in order to fully develop the method and obtain increased knowledge about how to promote an inter-professional dialogue about ethically difficulties.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 33, no 16, p. 724-733
Keywords [en]
Clinical ethics support, care ethics, ethically difficult situations, healthcare professionals, inter-professional communication
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-155309DOI: 10.1080/13561820.2018.1551862ISI: 000493764900015PubMedID: 30497309OAI: oai:DiVA.org:umu-155309DiVA, id: diva2:1277965
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-12-03Bibliographically approved

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Fischer Grönlund, CatarinaSöderberg, AnnaDahlqvist, VeraSandlund, Mikael

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