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MINI SYMPOSIUM 14 OCTOBER 2020 WELCOME! Evaluation of Moral Case Deliberation and its impact in Europe: Methods, best practices and future ideas ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in

  1. MINI SYMPOSIUM 14 OCTOBER 2020 WELCOME! Evaluation of Moral Case Deliberation and its impact in Europe: Methods, best practices and future ideas

  2. ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in Europe: methods, best practices and future ideas PROGRAM 13.00 - 13.15 WELCOME : Evaluation of Moral Case Deliberation (MCD) in in Europe Prof.dr. Bert Molewijk - Amsterdam UMC, dept. of Ethics, Law and Humanities METHOD : Presenting the Euro-MCD 2.0 for assessing outcomes of MCD Janine de Snoo MA MSc - Amsterdam UMC, dept. of Ethics, Law and Humanities 13.15 - 14.00 EXAMPLES FROM SWEDEN, NORWAY AND NL: The varied practice of MCD in Sweden - Dr. Mia Svantesson-Sandberg - University of Örebro Measuring changes after two years of MCD in Oslo - Researchers from Center of Medical Ethics in Oslo MCD on the ICU: learning in practice - Dr. Jelle van Gurp and Niek Kok MSc – Radboudumc Nijmegen 14.00 - 14.15 BREAK 14.15 – 15.00 FUTURE IDEAS : Pitches and group interaction on innovative and inspiring developments in the field of evaluation of MCD Prof. Josée Zijlstra – Amsterdam UMC, dept. of Hematology Dr. Pernilla Pergert – Karolinska Institutet, Stockholm Dr. Margreet Stolper – Amsterdam UMC, dept. of Ethics, Law and Humanities

  3. ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in Europe: methods, best practices and future ideas Welcome! Who are we, who are you?

  4. Vario ious kin inds of f CES & MCD evaluation research* • Registration of use of CES\MCD (e.g. frequency, themes, requesters) • Evaluation of CES\MCD itself (e.g. process, group, facilitator) • Evaluation of content of MCD • Evaluation of quality of deliberation within MCD** • Changes as perceived by participants (EURO MCD thesis Janine de Snoo, 2020) • Observed outcomes of MCD***, such as: – Improved quality of care – Improved decision making – Improved team cooperation – Improved moral competency of professionals * Schildmann et al (2013). Evaluation of clinical ethics support services. JME, 39(11), 681-5. ** Jellema et al (2017). Evaluating the quality of the deliberation in moral case deliberations, Bioethics. *** Haan et al (2018). Impact of MCD. BMC Medical Ethics.

  5. Importance of CES & MCD evaluation

  6. ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in Europe: methods, best practices and future ideas Importance of evaluation of CES & MCD Why is evaluation of ethics support & MCD important? • In order to find out whether CES\MCD actually supports those who have to deal with moral challenges • In order to find out whether CES\MCD contributes to • a better quality of care • a better team cooperation • a decreased amount of moral stress Furthermore • Evaluation of CES\MCD contributes to shared ownership of CES\MCD • Evaluation of CES\MCD contributes to strengthening the quality of CES\MCD and the training of CES\MCD staff

  7. ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in Europe: methods, best practices and future ideas The Euro-MCD 2.0 Revision of the Euro-MCD Instrument from 2014 (26 items in 6 categories) 15 items in 3 categories: • Moral competence • Moral teamwork • Moral action Main changes: - Shorter and less complex - Stronger empirical and theoretical basis

  8. The Euro-MCD Instrument 2.0 Instruction: Please rate the extent to which you agree on the following statements, when thinking about Strongly I don’t Slightly Slightly Strongly your daily practice/the MCD session(s) that you participated in. agree agree disagree disagree know Moral Competence Moral Sensitivity 1. I recognize a situation as being ethically difficult 2. I am aware of others’ perspectives in ethically difficult situations Analytical Skills 3. I can identify the different values at stake in ethically difficult situations 4. I can formulate arguments in favor of and against different courses of action in ethically difficult situations Virtuous attitude 5. I listen with an open mind to others when discussing an ethically difficult situation 6. I speak up in ethically difficult situations Moral Teamwork We = the people with whom you have participated in the MCD session(s)/the people with whom you work in your daily practice. Open Dialogue 7. We openly express our viewpoints in ethically difficult situations 8. We all have opportunities to express our viewpoint on ethically difficult situations 9. We respect different viewpoints when discussing ethically difficult situations Supportive Relationships 10. We feel secure to share emotions in ethically difficult situations 11. We support each other when dealing with ethically difficult situations Moral Action Moral decision-making 12. We make decisions on how to act in ethically difficult situations 13. We base our decisions on moral considerations in ethically difficult situations Responsible care 14. We are responsive to the values and needs of patients and their families in ethically difficult situations 15. We are able to explain and justify our care towards patients and their families

  9. ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in Europe: methods, best practices and future ideas Using the Euro-MCD 2.0 3 versions: 1. Before MCD: baseline about daily practice 2. After MCD: about MCD sessions 3. Sometime after MCD: about daily practice

  10. ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in Europe: methods, best practices and future ideas Current developments • Translation and pilot studies in the Netherlands and Sweden • Development of ‘training module’ on Evaluation of MCD • Collaboration with colleagues in Japan, translation into Japanese • For new and upcoming updates: check our website: www.euro-mcd.com • Contact: euromcd@amsterdamumc.nl

  11. ONLINE MINI SYMPOSIUM 14 OCTOBER 2020 Evaluation of Moral Case Deliberation and its impact in Europe: methods, best practices and future ideas PROGRAM 13.00 - 13.15 WELCOME : Evaluation of Moral Case Deliberation (MCD) in in Europe Prof.dr. Bert Molewijk - Amsterdam UMC, dept. of Ethics, Law and Humanities METHOD : Presenting the Euro-MCD 2.0 for assessing outcomes of MCD Janine de Snoo MA MSc - Amsterdam UMC, dept. of Ethics, Law and Humanities 13.15 - 14.00 EXAMPLES FROM SWEDEN, NORWAY AND NL: The varied practice of MCD in Sweden - Dr. Mia Svantesson-Sandberg - University of Örebro Measuring changes after two years of MCD in Oslo - Researchers from Center of Medical Ethics in Oslo MCD on the ICU: learning in practice - Dr. Jelle van Gurp and Niek Kok MSc – Radboudumc Nijmegen 14.00 - 14.15 BREAK 14.15 – 15.00 FUTURE IDEAS : Pitches and group interaction on innovative and inspiring developments in the field of evaluation of MCD Prof. Josée Zijlstra – Amsterdam UMC, dept. of Hematology Dr. Pernilla Pergert – Karolinska Institutet, Stockholm Dr. Margreet Stolper – Amsterdam UMC, dept. of Ethics, Law and Humanities

  12. The varied practice of Moral Case Deliberation in Sweden (etikronder, etisk reflektion, etikfallreflektion) Mia Svantesson Associate professor Medical Ethics, RN University Health Care Research Center / Palliative Unit, Karlskoga hospital Region Örebro County/Örebro University, Sweden Minisymposium, Amsterdam 14 Oct 2020 – TO HONOR JANINE! 1

  13. Norrbotten Rose-Marie Isaksson Moral Case Deliberation Moral Case Deliberation Västerbotten Anna Söderberg Catarina Fischer-Gr . Norrbotten Uppsala Mats G Hansson Västerbotten Stockholm Erwin Bishofberger Åsa Hällström Pernilla Pergert Västerås Västerås Hospital church, bottum-up Uppsala Örebro/ Karlskoga Örebro Håkan Thorsén Stockholm Mia Svantesson Göteborg Gothenburg Linköping Daniel Brattgård Cecilia Lundmark, Lars Sandman Skåne Skåne Anders Castor 1. I fear I have not the complete picture of the ethical landscape in Swedish healthcare, but I have got help to navigate. MCD is mostly spread in hospitals in the big cities, but at some places it is also out in the region and municipalities. 2

  14. Norrbotten Rose-Marie Isaksson Historic prominent figures Historic prominent figures Västerbotten Anna Söderberg Catarina Fischer-Gr . Norrbotten Uppsala Mats G Hansson Västerbotten ” By listening to other perspectives and other Stockholm experiences related to one particular patient story, Erwin Bishofberger the participants imagine alternative Åsa Hällström horizons of moral experience Pernilla Pergert and explore a multitude of values ” Västerås Västerås Hospital church, bottum-up Uppsala Örebro/ Karlskoga Örebro Håkan Thorsén Stockholm Mia Svantesson Göteborg Gothenburg Linköping Daniel Brattgård Cecilia Lundmark, Lars Sandman Skåne Skåne Anders Castor 1. I will first raise historic prominent persons regarding ethical reflection. 2. The men have a background as priests and the female as a nurse. What they have in common is being charismatic persons. 3. Mats G Hansson, Imaginative ethics, criticism against principle-based ethics 3

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