Development of a method for moral case deliberation in global health ethics

Abstract

Healthcare professionals in global health need adequate knowledge and skills, or moral competence, to deal with the multi-dimensional and complicated moral dilemmas they encounter. Especially in global health, a field that emerged from colonialism, professionals need to be educated to be able to balance and understand multiple perspectives in a way that enhances inclusion of all stakeholders involved. Moral case deliberation (MCD) could provide us with a valuable tool for healthcare professionals in global health to improve their moral competence through inclusive way of exchanging and understanding perspectives. However, to our knowledge, there is no evidence of the use of MCD for educational purposes in global health. This study aims to investigate how moral case deliberation can be used to educate healthcare professionals in global health using a mixed-methods study design. No proof was found for an existing method for moral case deliberation in the literature searched. The first version of a method was developed based on the Utrecht Method by combining insights from literature on enhancing inclusion in global health ethics, expert experiences and observations, and the Humanitarian Health Analysis Tool. This version was tested and adjusted according to observations made during test sessions, feedback from participants, and expert opinions. This resulted in an adjusted Utrecht Method, consisting of thirteen consecutive steps to be used in moral case deliberations in global health education, with a focus on inclusion. In the future, we recommend this method should be further tested, adjusted, and evaluated.