BACKGROUND An ethics reflection group (ERG) is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark. METHODS This is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis of significance. RESULTS A recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG. CONCLUSION This study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives.

中文翻译：

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医院伦理反思小组：临床实践的学习和发展资源。

背景技术道德反思小组（ERG）是被开发为更好地应对医疗保健中的道德挑战的众多道德支持服务之一。本文的目的是评估ERG在丹麦精神病科和综合医院科室中的重要性。方法这是一个定性的行动研究，包括与临床医生，道德操守者和病房经理进行的28个个体访谈和4个焦点小组的系统文本浓缩。对ERG中存在的道德挑战的简短书面描述也有助于对重要性进行分析。结果在3个道德反思小组中描述和评估的63个案例中，临床医生经常遇到的道德挑战是在尊重患者自主权，家长式责任，专业责任和机构价值观。在精神病科和综合医院中，研究参与者均报告了ERG的积极影响，可将其分为三类：1）对患者的重要性，2）对临床医生的重要性以及3）对病房管理者的重要性。在以短期患者入院为特征的病房中，所评估的病例是回顾性的，改善对话的受益者主要是未来的患者，而不是在提出的特定道德挑战中讨论的患者。在住院时间较长的病房中，有关患者也从ERG中的对话中受益。结论本研究表明ERG具有积极意义和影响。构成临床医生的跨学科学习资源，为自己创造意义，病房经理和组织。通过介绍具体的例子，这项研究表明ERGs对于在特定的伦理挑战中讨论的患者具有重要意义，但主要是通过临床医生之间的学习和临床实践的发展而间接获得的。从患者和亲戚的角度来看，需要更多的研究来进一步研究ERG的影响。