The development of the CoRE-Values framework as an aid to ethical decision-making

BACKGROUND: Ethical analysis frameworks can help to identify the ethical dimensions to clinical care and provide a method for justifying clinical decisions. Published frameworks, however, have some limitations to easy, practical use. AIMS: The aim was to identify a comprehensive yet easy-to-use framework that clarifies ethical decision-making, suitable for use by medical learners and clinical educators. METHOD: A literature search identified published frameworks that define the components of ethical clinical decision-making. On this basis, a new framework, the 'CoRE-Values Compass and Grid' was constructed. This was formally evaluated during a medical school interprofessional teaching session. RESULTS: For 88% of 228 medical and nursing students, the new framework was easy to understand; 85% reported it as easy to use. The framework improved awareness of the ethical dimensions to a clinical scenario for 97% of students and the ability to systematically identify ethical aspects for 83%. Students and instructors reported that the framework helped to link ethics theory with clinical practice. The framework was described as a useful educational tool by 85% of students and 95% of instructors. CONCLUSIONS: The 'CoRE-Values Compass and Grid' is a new framework, shown to aid the systematic identification and consideration of ethical aspects to clinical cases.