Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care
Abstract Background Clinical ethics support (CES) aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we pr...
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doaj-51b918fc6a304406b7dbbe47d1d52bc92020-11-25T01:19:49ZengBMCBMC Medical Ethics1472-69392020-08-0121111310.1186/s12910-020-00520-3Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative careLaura Hartman0Giulia Inguaggiato1Guy Widdershoven2Annelijn Wensing-Kruger3Bert Molewijk4Department of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universitieit AmsterdaDepartment of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universitieit AmsterdaDepartment of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universitieit AmsterdaCentre of Expertise on Gender Dysphoria, Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universitieit AmsterdaAbstract Background Clinical ethics support (CES) aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we present a specific way of organizing CES, which we have called integrative CES, and argue that this approach meets some of the challenges regarding implementation and organization. Methods This integrative approach was developed in an iterative process, combining actual experiences in a case study in which we offered CES to a team that provides transgender health care and reflecting on the theoretical underpinnings of our work stemming from pragmatism, hermeneutics and organizational and educational sciences. Results In this paper we describe five key characteristics of an integrative approach to CES; 1. Positioning CES more within care practices, 2. Involving new perspectives, 3. Creating co-ownership of CES, 4. Paying attention to follow up, and 5. Developing innovative CES activities through an emerging design. Conclusions In the discussion we compare this approach to the integrated approach to CES developed in the US and the hub and spokes strategy developed in Canada. Furthermore, we reflect on how an integrative approach to CES can help to handle some of the challenges of current CES.http://link.springer.com/article/10.1186/s12910-020-00520-3Clinical ethics supportTheoryPragmatismHermeneuticsGender affirmative careIntegrative |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Laura Hartman Giulia Inguaggiato Guy Widdershoven Annelijn Wensing-Kruger Bert Molewijk |
spellingShingle |
Laura Hartman Giulia Inguaggiato Guy Widdershoven Annelijn Wensing-Kruger Bert Molewijk Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care BMC Medical Ethics Clinical ethics support Theory Pragmatism Hermeneutics Gender affirmative care Integrative |
author_facet |
Laura Hartman Giulia Inguaggiato Guy Widdershoven Annelijn Wensing-Kruger Bert Molewijk |
author_sort |
Laura Hartman |
title |
Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care |
title_short |
Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care |
title_full |
Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care |
title_fullStr |
Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care |
title_full_unstemmed |
Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care |
title_sort |
theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care |
publisher |
BMC |
series |
BMC Medical Ethics |
issn |
1472-6939 |
publishDate |
2020-08-01 |
description |
Abstract Background Clinical ethics support (CES) aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we present a specific way of organizing CES, which we have called integrative CES, and argue that this approach meets some of the challenges regarding implementation and organization. Methods This integrative approach was developed in an iterative process, combining actual experiences in a case study in which we offered CES to a team that provides transgender health care and reflecting on the theoretical underpinnings of our work stemming from pragmatism, hermeneutics and organizational and educational sciences. Results In this paper we describe five key characteristics of an integrative approach to CES; 1. Positioning CES more within care practices, 2. Involving new perspectives, 3. Creating co-ownership of CES, 4. Paying attention to follow up, and 5. Developing innovative CES activities through an emerging design. Conclusions In the discussion we compare this approach to the integrated approach to CES developed in the US and the hub and spokes strategy developed in Canada. Furthermore, we reflect on how an integrative approach to CES can help to handle some of the challenges of current CES. |
topic |
Clinical ethics support Theory Pragmatism Hermeneutics Gender affirmative care Integrative |
url |
http://link.springer.com/article/10.1186/s12910-020-00520-3 |
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