Identity and moral responsibility of healthcare organizations

In this paper the moral responsibility of a Healthcare Organization (HCO) is conceived as an inextricable aspect of the identity of the HCO. We attempt to show that by exploring this relation a more profound insight in moral responsibility can be gained. Referring to Charles Taylor we explore the meaning of the concept of identity. It consists of three interdependent dimensions: a moral, a dialogical, and a narrative one. In section two we develop some additional arguments to apply his concept of personal identity to organizations. The final section works out the relationship of three dimensions of identity to some actual issues in contemporary HCOs: the tension between care and justice, the importance of dialogues about the diversity of goods, and the relevance of becoming familiar with the life-story of the HCO. Identity of an HCO is established and developed in commitments to and identification with certain goods that are central for a HCO. However, many of these goods are interwoven with everyday practices and policies. Therefore, moral responsibility asks for articulation of goods that often stay implicit and should not be reduced to a merely procedural approach. However difficult this articulation may be, if it is not tried at all HCOs run the risk of drifting away from their very identity as healthcare institutions: to offer care to patients and to do this in accordance with demands of social justice.     

Does an Appeal to the Common Good Justify Individual Sacrifices for Genomic Research?

In genomic research the ideal standard of free, informed, prior, and explicit consent is believed to restrict important research studies. For certain types of genomic research other forms of consent are therefore proposed which are ethically justified by an appeal to the common good. This notion is often used in a general sense and this forms a weak basis for the use of weaker forms of consent. Here we examine how the notion of the common good can be related to individual health, health care, and genomic research and we use this analysis to propose more precise criteria to justify forms of consent which diverge from the ideal standard.     

Parent-Professional Alliance and Outcomes of Child,Parent, and Family Treatment: A Systematic Review

This review systematically explored research examining the relation between parent-professional alliance and outcomes of psychosocial treatments provided to children, and their parents and families. Study findings and methodological characteristics were reviewed to investigate the evidence linking the alliance between parents and professionals to outcomes of child, parent, and family treatment as well as to identify factors that may influence the alliance-outcome association. A systematic review of the literature was conducted that included a search of three electronic databases using specified search terms, followed by a hand search to identify relevant studies. A total of 46 studies (37 published articles and 9 unpublished dissertations) met inclusion criteria. Overall, the findings indicated that higher levels of parent-professional alliance were significantly associated with improved clinical outcomes and stronger treatment engagement. However, some studies found that the parent-professional alliance was not significantly related to clinical outcomes or treatment engagement, and a few studies showed that higher levels of alliance were related to less positive clinical outcomes and lower levels of treatment engagement. Several theoretical (problem type, child age, parent sex) and methodological (source and timing of alliance measurement, alliance-outcome informants, outcome domain, timing of outcome measurement) factors were identified that could influence the alliance-outcome association. Together, our findings emphasize the importance of alliance awareness when working with parents as well as a need for future studies to investigate factors influencing the quality of the parent-professional alliance and alliance-outcome association in child, parent, and family treatment.