Abstract
Much is changing in health care organization today. A perspective or paradigm that is gaining ever increasing momentum is that of translational, extramural and integrated care. Current research suggests many potential benefits for integrated care and health care networks but the ethical issues are less frequently emphasized. Showing that integrated care can be beneficial, does not mean it is automatically ethically justified. We will argue for three ethical requirements such health care networks should meet. Subsequently we will look at the mechanisms driving the formation of networks and examine how these can cause networks to meet or fail to meet these ethical requirements or obligations. The three mechanisms we will examine are government, civil society and market mechanisms, which, we argue, should be balanced properly. Each mechanism is able to provide a relevant ethical perspective to health care networks. However, when the balance is skewed towards a single mechanism, health care networks might fail to promote one or more of the ethical requirements.
Highlights
Much is changing in health care organization today
Justification for a proper balance Relevant ethical perspective provided by government, markets, and civil society Democratic governments have an obligation to further the interest of all citizens regardless of personal or political convictions
We have argued that (1) they must guarantee a fair and just provision of medical care, (2) they must be maximally beneficial and minimally harmful, and (3) must not unduly interfere with patient autonomy. For these three ethical obligations to be met a balance must be sought between three mechanisms driving the evolution towards health care networks (HCNs): government; markets; and civil society
Summary
Organizing Health Care Networks: Balancing Markets, Government and Civil Society. Much is changing in health care organization today. A perspective or paradigm that is gaining ever increasing momentum is that of translational, extramural and integrated care. We will argue for three ethical requirements such health care networks should meet. We will look at the mechanisms driving the formation of networks and examine how these can cause networks to meet or fail to meet these ethical requirements or obligations. The three mechanisms we will examine are government, civil society and market mechanisms, which, we argue, should be balanced properly. Each mechanism is able to provide a relevant ethical perspective to health care networks. When the balance is skewed towards a single mechanism, health care networks might fail to promote one or more of the ethical requirements
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