Table 1 Steps in the Dilemma method

1

Personal introduction, introduction to MCD^†, determination of goal(s) and expectations, appointments regarding notes and confidentiality.

2

Case presenter presents his/her case briefly [Facultative: Formulation of a general moral question].

3

Group helps case presenter to formulate her/his dilemma: Should I do A or B? [moral burden].

4

Participants ask questions for clarification in order to imagine what it means to be in that situation so that they can answer the dilemma question for themselves later on in the MCD^†.

5

Table with (non) present “perspectives/persons”, “values/motivations”, “norms/rules/actions”. Ask each participant to describe his/her values and norms with respect to the dilemma question.

6

List all possible alternatives (without discussing feasibility).

7

Make individual round (write down first)

a. I think the right thing to do is …

b. Because …

c. Therefore I’m not able to do …

d. How can I cope with or decrease moral burden/damage?

e. Which virtues are necessary to do the right thing?

8

Reflect upon possible group consensus or decision.

9

Make practical appointments and plan date and place to evaluate those appointments. Distribution of the notes. Closure of MCD^†.

10

Evaluate in general the MCD^†. Have we met our goals? What could be improved the next time?