Pluryn and REA College Pluryn

The main target group of the instrument is staff. In the slipstream also persons served are a target group. When staff is struggling in daily work what is right to do because they feel there is an ethical dilemma, they can ask for a facilitator to organise an Ethical Dialogue. Who is in this meeting, depends on the case. Usually all staff involved will be represented, but also the service user that the case is about (by himself, family or carers) and relevant stakeholders. Age is not an issue.

In daily work, people have to make decisions how to act. This also happens when there are ethical issues involved. Sometimes in a split second you have to make a choice between 2 possible solutions about what is right and what is wrong.  In an ethical dilemma there is always “damage”, whatever one chooses. Your own beliefs and values and norms are your compass.

For example: 

- The value is: honesty.

- The norm is: one must always tell the truth.

- The case is: a young girl runs into your meeting room and hides herself behind the curtains. The next moment an aggressive looking man enters the room and asks you if you have seen a young girl. What would you do?

- Is honesty still the main value or is compassion more important? Or is it fear? Everything depends on the context of the case and on the perspective that you choose. When you take more time to look at the case from different angles you might come to other conclusions. In the moral case deliberation we facilitate staff (and others involved) to talk about real cases at work where they have to make a choice in a dilemma in a structured manner. In several phases they will define the ethical theme behind the dilemma; they will look at the norms and values behind it and they will look at the case from different perspectives.

The idea behind this instrument is that it is not needed to have a committee of wise people to tell staff what is right of wrong. That makes the method unique. Everybody has an internal compass and therefore it is better to involve all relevant persons in a dialogue to talk about it. This leads to more commitment when a decision has to be made in the case that is discussed or when new policies are implemented. Also both the individuals involved and team involved are getting more skills to handle ethical issues in the future and they get a better understanding about the norms and values of themselves, the person served, the organisation and of each other.

There are no external partners involved in the Moral Case Deliberation. Pluryn has a group of 9 skilled facilitators. The are all trained by the staff of the Vrije Universiteit van Amsterdam. This training lasts between 5 and 10 days and 20 hours of practice and observation in real cases. The facilitators are able to use the Dilemma method and the Socratic method. They also have intervision and peer observation meetings. When a team has a ethical dilemma, they contact they coordinator and she makes sure the team gets in contact with one of the facilitators. Within 2 weeks, the moral case deliberation takes place. A session usually takes between 1 and 2 hours. Besides the staff costs of the facilitators and the training costs, there is no budget needed. It is also possible to hire a facilitator from the University of Amsterdam. The university has ongoing research programs to monitor the results of moral case deliberation.

Birgit Grimbergen: bgrimbergen@pluryn.nl