• Ethics- Medical

Evaluating the impact of clinical ethics support services remains a challenging task.1 Against this background, we applaud the authors for developing a theoretical framework that aims to explain how repeated moral case deliberations may promote ‘practical wisdom’ in healthcare professionals and improve the quality of care in health facilities.2 In our view, it is of particular value to draw attention to the learning processes that may be induced by ethics support services. Understanding such learning processes on the individual and organisational level is a prerequisite for longitudinal research designs that may be suitable to study the impact of specific ethics support services on criteria deemed relevant in patient care.3

In our comment, we would like to focus on one aspect, which we deem necessary to be able to explain the possible impact of ethics support on the quality of healthcare. This is the need for being explicit regarding the normative framework underlying a specific ethics support service. In this respect, Kok et al seem to propose quality pluralism and context specificity and conclude that what is best in healthcare has to be determined in each case individually on the basis of its specific features. For …