Centre for Research Ethics & Bioethics (CRB)
Research : Clinical Ethics

Improving the ethical climate in psychiatry outpatient clinics

Format

Research project

Funding

AFA Insurance (AFA Försäkring)

Time table

2011-2013

Aims

Children, adolescents and adults come to psychiatric outpatient clinics to be assessed, diagnosed and treated. Their symptoms and diagnosis range depression, anxiety disorders, bipolar disorders, eating disorders to obsessive compulsive disorders and post-traumatic stress disorder.

At these clinics they meet a number of professions: physicians, nurses, social workers, psychologists and physiotherapists. Sometimes, difficult decisions have to be made regarding referral to inpatient care or restraint. For the staff, these decisions raise a number of ethical questions. These questions range from how to balance the wish to do good with the respect for the patient’s autonomy to priorities between different kinds of need. Ethical questions to be solved while handling balancing a high workload and demanding patients.

The staff at outpatient psychiatric clinics needs to be prepared to handle these kinds of ethical challenges. Previously, the ethics rounds method has been used in order to try to strengthen healthcare staff’s ability to handle ethically difficult situations. It has been shown to increase mutual understanding and decrease professional hierarchies. This could have consequences for the way in which ethical problems are handled: Besides legal and other regulations and the healthcare ethical principles, the relationships at the specific workplace have an impact on how ethical problems are handled. Business ethics research has used the concept of ethical climate in order to describe how ethical problems are handled, and what relationships and practices that either hinder or facilitate a positive ethical climate.

In the present project we will investigate whether ethics rounds can improve the ethical climate in psychiatry outpatient clinics. The project will have a quasi-experimental design, using both control and intervention groups measured before and after the intervention.

More information

Poject group:

  • Kristina Haglund, Senior lecturer, Department of Neuroscience, Uppsala University & Uppsala University Hospital
  • Mats G. Hansson, Professor of Biomedical Ethics
  • Mia Ramklint, MD PhD, clinical lecturer, Department of Neuroscience, Uppsala University 
  • Marit Silén, PhD, Post doc

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