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The ‘Diversity-Compass’: Developing an Instrument for Health Care Professionals to Deal with Moral Issues Concerning Cultural, Religious and Sexual Diversity in Long-Term Care Organizations

"Culture, religion, gender identity and sexual orientation play an important role in patients’ and professionals’ care preferences and communication. Population diversity leads to differing moral perspectives regarding health, wellbeing and care practices. This can generate value conflicts between patients and professionals concerning what good care is. Accordingly, increasing societal pluralism creates novel challenges for professionals regarding how they ought to deliver equitable and diversity-responsive care to minority populations. To support professionals in dealing with moral issues related to cultural, religious and sexual diversity in long-term-care organizations, we developed an ethics support instrument called the Diversity-Compass. The Diversity-Compass is a low-threshold instrument designed to help professionals in addressing and dealing with situations in which moral conflicts pertaining to diversity occur. We employed a participatory design and conducted seven focus groups (n=55), five expert interviews (n=5) and facilitated four meetings with a working group of various care professionals (n=18) who developed and tested preliminary versions of the instrument through iterative co-creation. Resulting from this process the Diversity-Compass emerged. Next to offering a question-based, reflection-invoking conversation method, the instrument includes seven specific tips to support professionals when engaging in conversations about diversity-related moral issues with patients or other professionals. Our study is an example of how bioethicists can provide clinical ethics support by using a participatory design and co-creatively developing an instrument to aid professionals in dealing with moral issues related to cultural, religious and sexual diversity in long-term care. The Diversity-Compass can be used by organizations and professionals to promote good, diversity-responsive care. "