Ethics and health planning: Implications for education

Abstract

Over the past decade in this country, there has been a rekindling of interest in the ethical questions of public policy. Moreover, the concern for ethical issues is nowhere more evident than in the field of health care. However, the ethical problems of health planning, particularly as practiced at the regional level, have scarcely received attention. This article explores the ethical dimensions of health planning and argues that health planners have not been adequately prepared, neither through their education nor through socialization in the profession, to deal with the complex ethical issues facing them. However, health planning theory can be enriched and practice improved if the ethical issues are confronted. Health planning is viewed as one means of achieving social justice because the benefits and burdens associated with health care are distributed to the members of society by the decisions made in the health planning process. However, planning decisions are not meekly accepted by the persons affected. More often than not, health planning decisions produce substantial political controversy, which is due, in part, to the planning methods commonly used. The synoptic or comprehensive planning approach avoids ethical questions by ignoring them. The incremental planning approach deals with them but only in terms of political process. Neither of these approaches is particularly useful for resolving health planning's ethical questions. The implications of these findings for education in health planning are discussed. The merits of the case study as a means of ethical education are presented.