159 Dealing with moral challenges in treatment for transgender children and adolescents: evaluating the role of moral case deliberation 9 moral inquiry by clinicians that focuses on a concrete moral question connected to a real clinical case (Dauwerse et al., 2014; Stolper et al., 2016). The aim of MCD is to create a dialogue that enables the treatment team to pursue a critical, yet constructive moral inquiry into the moral challenge at hand. The MCD facilitator uses a specific conversational method to structure multidisciplinary team meetings in which participants critically reflect on both current and past cases. Examples of such conversation methods are the Dilemma Method or the Socratic Dialogue (Molewijk et al., 2008a). The MCD method is designed to encourage clinicians to consider different viewpoints on the concrete moral challenges they experience in their everyday clinical work. MCD can stimulate reflection and deepen decision-making processes. It is not meant to substitute any aspect of the regular care or decision-making process, but rather as a supplement to these processes. MCD does not have any decision-making mandate and does not replace any decisionmaking mandate. However, various evaluative studies indicate that MCD can help improve a team’s handling of moral challenges, increase the moral competency of clinicians, strengthen multidisciplinary cooperation, and facilitate the development, adjustment, and implementation of guidelines and policies (Hem, Pedersen, Norvoll, & Molewijk, 2015; Janssens, van Zadelhof, van Loo, Widdershoven, & Molewijk, 2014; Molewijk, Verkerk, Milius, & Widdershoven, 2008c; Weidema, Molewijk, Kamsteeg, & Widdershoven, 2015). In MCD sessions, a certified MCD facilitator supports a joint reasoning process, fostering a systematic and critical yet constructive dialogue while keeping the group’s focus on the moral dimension of the case without giving advice (Stolper, Molewijk, & Widdershoven, 2015). Among the facts, the following can be included in the dialogue: protocols, existing policy and guidelines, legal regulations, and professionals’ own practical experiences, and normative considerations. Preferably, an MCD session should take a multidisciplinary approach because this brings to light different viewpoints on the moral issue at hand. Conclusions and insights gained from MCD sessions may be used to develop or adjust multidisciplinary treatment policies in the future. The obvious moral dimension of care for transgender adolescents creates a niche for specific CES services. Yet, it is not yet known which CES methods are most suitable for the particular moral dilemmas that arise in care for transgender minors. Vrouenraets and colleagues (2015) conducted an interview study in which clinicians reported a need to structurally discuss moral challenges among their multidisciplinary transgender teams. This led to the initiative of using MCD as one of the CES methods for dealing with moral challenges in transgender care in the Netherlands. The aim of this study is to describe how Dutch transgender clinicians evaluated the usefulness of MCD in dealing with moral challenges in the multidisciplinary clinical treatment for transgender adolescents. For this purpose, we have conducted a mixed methods evaluation study to answer the following questions:
RkJQdWJsaXNoZXIy MjY0ODMw