scholarly journals Towards collective moral resilience: the potential of communities of practice during the COVID-19 pandemic and beyond

2021 ◽  
pp. medethics-2020-106764 ◽  
Author(s):  
Janet Delgado ◽  
Serena Siow ◽  
Janet de Groot ◽  
Brienne McLane ◽  
Margot Hedlin
Keyword(s):  
Communities Of Practice ◽  
Moral Distress ◽  
Ethical Challenges ◽  
Ethical Practice ◽  
Group Settings ◽  
Healthcare Settings ◽  
Mutual Engagement ◽  
Starting Point ◽  
Group Experiences ◽  
Moral Resilience

This paper proposes communities of practice (CoP) as a process to build moral resilience in healthcare settings. We introduce the starting point of moral distress that arises from ethical challenges when actions of the healthcare professional are constrained. We examine how situations such as the current COVID-19 pandemic can exponentially increase moral distress in healthcare professionals. Then, we explore how moral resilience can help cope with moral distress. We propose the term collective moral resilience to capture the shared capacity arising from mutual engagement and dialogue in group settings, towards responding to individual moral distress and towards building an ethical practice environment. Finally, we look at CoPs in healthcare and explore how these group experiences can be used to build collective moral resilience.

scholarly journals The Value of Communities of Practice as a Learning Process to Increase Resilience in Healthcare Teams

2021 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Janet Delgado ◽  
Serena Siow ◽  
Janet M. de Groot
Keyword(s):  
Communities Of Practice ◽  
Moral Distress ◽  
Shared Knowledge ◽  
Healthcare Team ◽  
Starting Point ◽  
Group Experiences ◽  
Moral Problems ◽  
The Relationship ◽  
Moral Resilience

This paper addresses the role that communities of practice (CoP) can have within the healthcare environment when facing uncertainty and highly emotionally impactful situations, such as the current COVID-19 pandemic. The starting point is the recognition that CoPs can contribute to build resilience among their members, and particularly moral resilience. Among others, this is due to the fact that they share a reflective space from which shared knowledge is generated, which can be a source of strength and trust within the healthcare team. Specifically, in extreme situations, the CoPs can contribute to coping with moral distress, which will be crucially important not only to facing crisis situations, but to prevent the long-term adverse consequences of working in conditions of great uncertainty. The purpose of this paper is to analyze how CoP can support healthcare professionals when building moral resilience. To support that goal, we will first define CoP and describe the main characteristics of communities of practice in healthcare. Subsequently, we will clarify the concept of moral resilience, and establish the relationship between CoP and moral resilience in light of the current COVID-19 pandemic. Finally, we analyze different group experiences that we can consider as CoP which emerged in the midst of the COVID-19 pandemic to navigate moral problems that arose.

Moral Resilience

2018 ◽  
Keyword(s):  
Moral Distress ◽  
Self Regulation ◽  
Radical Change ◽  
Moral Foundations ◽  
Self Awareness ◽  
Ethical Practice ◽  
Healthcare Organizations ◽  
Full Spectrum ◽  
The Individual ◽  
Moral Resilience

Suffering is an unavoidable reality in healthcare. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions that challenge their moral foundations. Moral suffering is the anguish that arises occurs in response to moral adversity that challenges clinicians’ integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. Transforming their suffering will require solutions that expanded individual and system strategies. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self- regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Whether it involves gradual or profound radical change clinicians have the potential to transform themselves and their clinical practice in ways that more authentically reflect their character, intentions and values. The burden of healing our healthcare system is not the sole responsibility of individuals. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and leverage the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.

Moral Distress

2018 ◽  
Author(s):  
Alisa Carse ◽  
Cynda Hylton Rushton
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Moral Distress ◽  
Ethical Practice ◽  
Moral Resilience

Moral distress, a response to moral adversity that imperils integrity under conditions of constraint, has been studied for more than three decades. The context of clinical practice, the complexities of healthcare, clinicians’ roles, and broader society, alongside exponential advances in technology and treatment, create circumstances that regularly imperil integrity. These circumstances create the conditions for burnout, disengagement, and imperiled patient care. Specifically, they foster powerlessness, frustration, anger, diminished moral responsiveness, disillusionment, and shame. The cumulative dynamic of moral distress results in myriad detrimental consequences affecting the bodies, emotions, minds, and souls of clinicians. Transforming these experiences requires a shift in orientation toward restoring and preserving integrity by cultivating capacities of moral resilience and strategies to foster systemic ethical practice.

Introduction

2018 ◽  
Author(s):  
Cynda Hylton Rushton
Keyword(s):  
Moral Distress ◽  
System Transformation ◽  
Ethical Practice ◽  
Full Spectrum ◽  
Moral Stress ◽  
The Core ◽  
Individual Strategies ◽  
Moral Resilience

This introductory chapter covers the book editor’s personal and professional journey to provide the background for the book. The contours of the book are outlined. They include the nature of moral suffering and illustrate moral distress as a type of moral suffering. A pathway for examining moral adversity as the instigator of moral stress, which unrelieved can lead to moral suffering including moral distress, moral outrage and moral injury and the role of moral resilience including moral repair is outlined. The concept of integrity as the core of moral resilience and the dimensions of resilience that inform the concept of moral resilience are applied in the context of healthcare. Individual strategies to transform moral suffering and cultivate moral resilience and restore integrity are suggested. System transformation is possible by applying the Conscious Full Spectrum approach as a template for moral resilience and ethical practice in healthcare.

Towards an Archival Critique: Opening Possibilities for Addressing Neoliberalism in the Archival Field

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Marika Cifor ◽  
Jamie A. Lee
Keyword(s):  
Human Rights ◽  
Social Justice ◽  
Archival Studies ◽  
Ethical Practice ◽  
Political Practice ◽  
Starting Point ◽  
Hands On ◽  
Library And Information Studies ◽  
Information Studies ◽  
Contemporary Life

Neoliberalism, as economic doctrine, as political practice, and even as a "governing rationality" of contemporary life and work, has been encroaching on the library and information studies (LIS) field for decades. The shift towards a conscious grappling with social justice and human rights debates and concerns in archival studies scholarship and practice since the 1990s opens the possibility for addressing neoliberalism and its elusive presence. Despite its far-reaching influence, neoliberalism has yet to be substantively addressed in archival discourse. In this article, we propose a set of questions for archival practitioners and scholars to reflect on and consider through their own hands-on practices, research, and productions with records, records creators, and distinct archival communities in order to develop an ongoing archival critique. The goal of this critique is to move towards "an ethical practice of community, as an important mode of participation." This article marks a starting point for critically engaging the archival studies discipline along with the LIS field more broadly by interrogating the discursive and material evidences and implications of neoliberalism.

The neuroethical future of wearable and mobile health technology

2017 ◽  
Author(s):  
Karola V. Kreitmair ◽  
Mildred K. Cho
Keyword(s):  
Mobile Health ◽  
Ethical Issues ◽  
Health Technology ◽  
The Self ◽  
Ethical Challenges ◽  
Mobile Health Technology ◽  
Healthcare Settings ◽  
Healthcare It ◽  
Mobile Mental Health ◽  
Privacy And Confidentiality

Wearable and mobile health technology is becoming increasingly pervasive, both in professional healthcare settings and with individual consumers. This chapter delineates the various functionalities of this technology and identifies its different purposes. It then addresses the ethical challenges that this pervasiveness poses in the areas of accuracy and reliability of the technology, privacy and confidentiality of data, consent, and the democratization of healthcare. It also looks at mobile mental health apps as a case study to elucidate the discussion of ethical issues. Finally, the chapter turns to the question of how this technology and the associated “quantification of the self” affect traditional modes of epistemic access to and phenomenological conceptions of the self.

Ethical challenges when using coercion in mental healthcare: A systematic literature review

2016 ◽  
Vol 25 (1) ◽  
pp. 92-110 ◽  
Author(s):  
Marit Helene Hem ◽  
Elisabeth Gjerberg ◽  
Tonje Lossius Husum ◽  
Reidar Pedersen
Keyword(s):  
Patient Autonomy ◽  
Moral Distress ◽  
Mental Healthcare ◽  
Healthcare Personnel ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Best Interest ◽  
Ethical Considerations ◽  
Search Terms ◽  
Healthcare It

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress.

scholarly journals Future vision

2015 ◽  
Vol 13 (3/4) ◽  
pp. 346-360 ◽  
Author(s):  
Simon Rogerson
Keyword(s):  
Action Plan ◽  
Information And Communications Technology ◽  
Ethical Challenges ◽  
Content Type ◽  
Funded Research ◽  
Starting Point ◽  
Global Action ◽  
History Of ◽  
Ict Ethics ◽  
Future Vision

Purpose – The purpose of this paper is to review the world of information and communications technology (ICT) from its early days to the near future. The aim is to consider how successfully academia, industry and government have worked together in delivering ethically acceptable ICT which is accessible to those who might benefit from such advances. The paper concludes with suggestions of a fresh approach for the future. Design/methodology/approach – The paper draws upon evidence from the history of computers, funded research projects, professional bodies in the field, the ETHICOMP conference series and reported ICT disasters. The author uses his experience as both an ICT practitioner and an academic in the ICT ethics field to synthesise the evidence so providing a foundation on which to build an outline global action plan. Findings – The paper lays out the findings that there has been much detailed observation and analysis of the ethical challenges surrounding ICT but the transformation of this into widespread practical positive action remains elusive. It explores why progress has been difficult. Originality/value – This review of the interconnecting landscapes of practical ICT, funded research and the ICT ethics community is new. The attempt to demonstrate what progress has been made and to identify the underlying factors which influence progress are valuable to future generations working in this area. The concluding suggestions for action offer a starting point for entering the next phase of ICT ethics.

Enabling first and second year doctors to negotiate ethical challenges in end-of-life care: a qualitative study

2021 ◽  
pp. bmjspcare-2020-002672
Author(s):  
Sinead Donnelly ◽  
Simon Walker
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Moral Distress ◽  
Well Being ◽  
First Year ◽  
Life Care ◽  
Ethical Challenges ◽  
Life And Death ◽  
Medicine Physician ◽  
Second Year

ObjectiveTo understand the unique ethical and professional challenges confronting first and second year doctors in caring for people who are dying, and to learn what factors help or hinder them in managing these.Method6 first year and 7 second year doctors were interviewed one-to-one by a senior palliative medicine physician (SD), quarterly over 12 months, using a semistructured approach. Thematic analysis was conducted with the findings, following the general inductive approach.Results21 hours of recorded interviews were analysed by SD, and ethical and professional issues were identified. These were discussed with SW, and sorted into seven broad categories. The participants’ accounts of the issues convey a strong ethical sensitivity, developed through their undergraduate training. A recurring challenge for them through their first 12–24 months of work as doctors is being responsible for the decisions, knowing that what they do can have life and death consequences. The participants frequently describe senior doctors as an important source of support, and the lack of such support as leading to moral distress and demoralisation. Another important factor is having opportunity to discuss and reflect on the decisions after they are made. Where such reflection had been facilitated properly, participants displayed considerable growth in their ability to manage ethical challenges.ConclusionSenior support and opportunities for reflection need to be recognised as key factors in enabling first and second year to respond appropriately to ethical challenges in end-of-life care, and in sustaining their well-being through this critical stage of their professional life.

The New Frontline: Exploring the Links between Moral Distress, Moral Resilience and Mental Health in Healthcare Workers Amidst the COVID-19 Pandemic

2021 ◽  
Author(s):  
Edward Spilg ◽  
Cynda Hylton Rushton ◽  
Jennifer L. Phillips ◽  
Tetyana Kendzerska ◽  
Mysa Saad ◽  
...  
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Moral Distress ◽  
Moral Resilience
Sign in / Sign up

Export Citation Format

Share Document