Chapter 6: Evaluation For Moving Ethics In Health Care Services Towards Democratic Care: A Three Pillars Model: Education, Companionship, and Open Space

In Germany within the last 20 years, like in other European countries, an increasing number of ethical consultation services has been organized in hospitals, recently also in nursing homes. Organizational forms of ethics in health care institutions like hospital ethics committees (HEC) have become a criterion to fulfil quality standards in accreditation processes. Health care services try to meet the quality standards and see what it implies for an implementation. Moreover, some health care services try to work on an individual model that shows how the standard is put into practice in their particular institution. The Paul Gerhardt Diaconia (PGD), a nonprofit health care service, has taken the step of developing a model of doing and moving ethics in the sense of actively trying to move forward any kind of attempt of organizing clinical ethics by analysing what has turned out to be fruitful and what has not turned out to be fruitful for everyday practices. Since the research is focusing the work of practitioners, their involvement in the organisation of ethics and finding ways how to empower them, an action research design was chosen.