Martine Kruijtbosch

157 Mo ra l case de l i be ra t i on The participants became more aware of their own arguments, as well as those of other participants, with underlying values. One participant wrote in the open space of the questionnaire: ‘ Awareness. Interesting to see how others would handle a situation. You often take moral decisions in which you weigh risks, etc. . . . you are not aware on the basis of which professional values you are doing that .’ The participants evaluated the image-formation phase of the dilemma method to be important in making an appropriate judgment of the situation. For example, one participant wrote: ‘ The case indicated well that every obvious action option has disadvantages in the quadrilateral patient- treating physician–pharmacist–primary care physician .’ Another participant’s evaluation given was: ‘ Also looking to the disadvantage of a choice is not in my normal course of action ’ . When it came to the judgment-formation and decision-making phases, six of the eight participants changed their views on the case due to the MCD session. Participants appreciated the insights into the moral reasoning and intentions of others with regard to their individual judgments and decision-making. One participant wrote, ‘ The MCD session led to new insights, and you realise that sometimes you want to find a solution too quickly .’ Another participant wrote, ‘ There are several ways to reach the same decision. There is not necessarily a right or wrong way. It is useful to see a different approach, which you would not immediately choose yourself .’ The majority of participants indicated they would like to participate in MCD sessions more often and think that their colleagues would be open to participating, as well. However, some participants also expressed they did not understand the procedure in some steps: ‘ The CP knew what she had to do in the steps. But I had difficulty at the beginning of a step [understanding] what the procedure would be ’ (Participant 8). Another participant criticised the quality of the facilitation of the dialogical inquiry in step 8 of the MCD session: ‘ Step 8 (dialogical inquiry) went a little too fast. I would have liked to hear all participants’ considerations, as these were asked in step 7 .’