In this article, we describe a study on the impact of an ethics program aimed at strengthening the ethical agency of 15 social workers of three welfare organizations. The goal of the study was to make an inventory of the impact of the program, and to evaluate the relevance of this impact with the help of several stakeholders. The most significant change (MSC) approach was used as a research strategy, though some changes to the approach were made with a view to our research goal. We explain the MSC approach and how we used it in our study design. Further, we describe the research process, answering the question whether our adaptation of the MSC was helpful to inventory the impact of our ethics program and the evaluation of its relevance. The implications of MSC's focus on "most significant" changes and the need for a thorough feedback of the results of the evaluation process in the participating organizations are discussed.
This thesis is about dilemmas, discretionary space and ethics in public welfare. In my position as a lecturer of ethics in socio-legal practices I am concerned with the way in which these practices open up to an ethical development of their professionals. Thus, this thesis is a search for the most fundamental themes and issues in understanding and judging public welfare as a, perhaps, ethical socio-legal practice. In the field of public services professionals function as the intermediary between government and citizen. In their daily work public welfare professionals take care of the important societal task and goal of poverty alleviation. During the last decades, public welfare has developed into a civil right that involves many obligations on the part of the client in return. The requirement to see to it that the client fulfils these obligations has complicated the public welfare professional’s task of helping citizens in need.
BackgroundSpecialist palliative care teams are consulted during hospital admission for advice on complex palliative care. These consultations need to be timely to prevent symptom burden and maintain quality of life. Insight into specialist palliative care teams may help improve the outcomes of palliative care.MethodsIn this retrospective observational study, we analyzed qualitative and quantitative data of palliative care consultations in a six-month period (2017 or 2018) in four general hospitals in the northwestern part of the Netherlands. Data were obtained from electronic medical records.ResultsWe extracted data from 336 consultations. The most common diagnoses were cancer (54.8%) and organ failure (26.8%). The estimated life expectancy was less than three months for 52.3% of all patients. Within two weeks after consultation, 53.2% of the patients died, and the median time until death was 11 days (range 191) after consultation. Most patients died in hospital (49.4%) but only 7.5% preferred to die in hospital. Consultations were mostly requested for advance care planning (31.6%). End-of-life preferences focused on last wishes and maintaining quality of life.ConclusionThis study provides detailed insight into consultations of palliative care teams and shows that even though most palliative care consultations were requested for advance care planning, consultations focus on end-of-life care and are more crisis-oriented than prevention-oriented. Death often occurs too quickly after consultation for end-of-life preferences to be met and these preferences tend to focus on dying. Educating healthcare professionals on when to initiate advance care planning would promote a more prevention-oriented approach. Defining factors that indicate the need for timely palliative care team consultation and advance care planning could help timely identification and consultation.
The project proposal focuses on Virtual Humans (VHs) emerging as a Key Enabling Technology (KET) for societal prosperity. VHs (or embodied, digital, intelligent agents) are highly realistic and highly interactive digital representations of humans in entertainment of serious applications. Most known examples – beyond video games and virtual media productions – are virtual influencers, virtual instructors, virtual news readers, and virtual doctors/patients in health care or therapy. It is increasingly difficult for academic and applied researchers, let alone for users and policymakers, to keep up with the technological developments, societal uses, and risks of VHs. Due to its expertise in game technology, immersive media, and applied AI, BUas is one of the leading partners of the regional Virtual Human Research, Development and Innovation (RDI) agenda. MindLabs coordinates this agenda with BUas, Fontys Uas, and Tilburg University as principal partners. The multidisciplinary RDI agenda integrates design and engineering research, use case applications and evaluation as well as ethics and critical societal reflection. This regional Virtual Humans agenda, however, is not (yet) linked to the EU RDI agenda. Collaboration on Virtual Humans RDI is not yet well established in EU institutions and networks. The aim of this project is to 1) strengthen (our) European-knowledge position on VHs by joining and building networks to find out what the research and innovation agenda on VHs looks like; 2) Conduct one or more experimental studies on empathic interaction between real- and virtual humans to develop a multidisciplinary R&D agenda (pilot title: 'Virtual Humans – Real Emotions'); 3) Develop the ideas, content and partnerships for strong EU-funded RDI proposals In the VESPER project, we partner up with researchers and knowledge institutes the Humbolt University and the University of Bremen in Germany and Howest in Belgium.
