Overview

Dr Rupert Scheule: MEFES – a design for multi-disciplinary case discussions in difficult decisions – is a design for facilitating the structuring of ethical case discussions in clinics. It was initiated within the framework of the German Research Foundation (DFG) project “Decision-making in Christian ethics” (SCHE 667/2-1 and SCHE 667/2-2 http://.dfg.de/gepris/nachweise/229002.html) which dealt with inspirational potentials of the sociological rational choice theory for theological ethics (rational choice theory, compare with Esser 1999). Due to the rational choice theory clear definitions of the following terms can be provided: Decision: a teleological relationship between gaols of actions, alternatives of actions and expected consequences of actions which distinguishes one alternative from one the others. Multi-criteria decision: a decision implying several goals of equal importance Cooperative group decision: a decision by which unity is to be reached on the common goals of action, the alternatives of action and the expected consequences of action, and by which an alternative of action can be distinguished from the others. One of the concepts underlying the rational choice theory is to facilitate decision-making by dismantling decision-making processes. MEFES aims to enhance such a dismantling effect in an ethical case discussion. MEFES represents a 7-step-guide for a tightly-structured hosted team discussion which is attended by a representative of each profession from the treatment team and occasionally a relative of the patient.

In the autumn of 2005 MEFES was established at the stroke unit of Augsburg Zentralklinikum by Tilman Becker.

All MEFES meetings are evaluated by six simple 5-point-Likert-questions. Due to the evaluation results achieved so far, it has been decided by the Board, the Chief Physician Conference and the Head of nursing staff to offer ethical case discussions according to the MEFES design to all 24 clinics of Augsburg Zentralklinikum.

MEFES has aroused great interest in the region. At the moment, 20 staff in Southern Germany are being trained to become MEFES hosts. This training comprises three units of two days each and is offered in cooperation with Augsburg University and the Diocese of Augsburg. Until 2010 further training units are being planned.

Literature: Esser, Hartmut (1999): Sociology . Special fundamentals. Book 1: Logic of situations and actions (Soziologie. Spezielle Grundlagen. Bd.1: Situationslogik und Handeln. Frankfurt/M.) Scheule, Rupert M. (2005): Rational Choice Theory, functional differentiation and theological ethics. An effort of approach. In: Magazine for Catholic theology (funktionale Differenzierung und theologische Ethik. Ein Annäherungsversuch. In: Zeitschrift für Katholische Theologie. 127. Jg., Nr. 1, 25 – 56.)