219 Appendices APPENDIX 2 The steps of the dilemma method for MCD At DCIA the following methodological steps of the dilemma method were used during MCD: 1. Introduction: introducing moral case deliberation and its methodical approach, and discussing the objectives, expectations and confidentiality of the session. 2. Presentation of the case: providing a description of the case by the case owner, specifically at the moment the moral question is most prominent. 3. Formulation of the dilemma: identifying and formulating the two sides of the dilemma including the negative consequences.1 4. Clarifying through elucidating questions: asking elucidating questions in order to empathise with the situation and to gain a clear picture of the situation. 5. Perspectives, values and norms: collecting the values and norms of relevant stakeholders involved and with respect to the dilemma. 6. Alternatives: free brainstorming focused on realistic and unrealistic options to deal with the dilemma. 7. Individually argued consideration: making the individual a choice in the dilemma, how one would act in the specific situation of the case. Formulating the value that support one’s choice and the negative consequences of one’s action(s). Including formulating how to limit negative consequences. Finally, attention to ‘needs’ that help to accomplish the choice made. 8. Dialogue about similarities and differences: examining the similarities and differences in individual choices, argumentations and/or considerations. 9. Conclusions and actions: formulating conclusions with concrete actions or agreements regarding the discussed dilemma. 10. Wrapping up and evaluation: evaluating the MCD session, with the focus on the usefulness of MCD and what to organise differently next time (e.g., steps of the method, selected day and timeframe, groups dynamics, facilitator et cetera). 1 For DCIA we made a slight adjustment in this dilemma method. Together with the facilitators we decided to mainly focus on the formulation of a dilemma, instead of also including a ‘moral question’.
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