Dr Lisa Ballard presented a poster at the European Health Psychology Society conference in Bratislava

Title: Using a model of behaviour to conceptualise ethical preparedness in healthcare and health research settings

Background: Previous literature constructs the concept of ethical preparedness (EP) as a need to develop frameworks and principles. Constructing EP in this way is problematic as it does not facilitate the implementation of ethical decision-making processes in practice. Aims: to shift the concept of EP from frameworks and principles towards a concept that is enacted by a person, group or organisation (a behaviour).

Methods: Using a qualitative secondary data analysis design, we applied the theoretical domains from the COM-B model (capability, opportunity and motivation = behaviour) to two illustrative case studies. Case 1: UK NHSX COVID-19 contact tracing application ethics advisory board involving data from eight in-depth interviews. Case 2. Familial communication in genetic practice involving data from the UK Genethics Forum.

Findings:

Case 1: Though there was sufficient capability (i.e., understanding how to apply the ethical framework), opportunity was lacking (i.e., ethics was deprioritised), impacting on capability and motivation.

Case 2: The forum facilitated EP, incorporating multiple theoretical domains. EP could have been facilitated further through reflective motivation (i.e., confidence in knowing when to apply professional versus legal judgement). 

Discussion:

We have explored EP as a behaviour, providing insight into specific factors needed to promote ethical decision-making, both in the pandemic context as well as areas of healthcare with rapidly changing technologies. Applying COM-B to these cases highlights that EP needs to go beyond equipping people with skills, knowledge, ethical principles and frameworks, offering a useful starting point for further conceptual work around the notion of being ethically prepared.