Selected topics in the Ethics
of health care
Associate Professor Paul Dugdale
College of Health and Medicine
Australian National University
1 March 2021
Selected topics in the Ethics of health care
1. Social responsibility of health
services
2. Role of collaboration in
community oriented primary care
3. Practicing cost effective health
care and using resources
efficiently
Selected topics in the Ethics of health care
• Morality vs Ethics:
• Morality can be understood as a system of principles for deciding
whether something is right or wrong
• Ethics can be understood as the analytical study of how people work
out what to do
• Most academic ethics analyses how people decide on and apply
moral principles to work out what to do
• Spinozan ethics analyses how people are confused about what to do,
how to decide what to do rationally, and how to collaborate to do it.
1. Social responsibility of health services
• Personal responsibility
• The sick role
• Protecting others from your own sickness
• Our role as carers
• For our children, parents, siblings, neighbours…
• Professional responsibility
• The Hippocratic oath and the ethos of the profession
• Compassion
1. Social responsibility of health
services
• The responsibility of health services
• Primary, secondary and tertiary care: who supports who?
• The hospital as resource, support and education provider
• Alma Ata Declaration
• ‘Primary health care is essential health care based on practical, scientifically
sound and socially acceptable methods and technology made universally
accessible to individuals and families in the community through their full
participation and at a cost that the community and country can afford to
maintain at every stage of their development in the spirit of selfreliance and
self-determination.’ (article 6)
• The responsibility of Governments
2. Role of collaboration in community oriented primary care
• Collaboration in our profession
• Knowledge,
• Practice,
• Learning and Teaching
• Interdisciplinary Collaboration
• Multidisciplinary teamwork
• Interdisciplinary collaboration
• Leading collaboration
• Diagnosis and prognostication
• Leading from within the team
• Showing and supporting
3. Practicing cost effective health care and using resources
efficiently
• From output based efficiency to value based effectiveness
• Value = Change in outcome
Cost (Porter and Teisberg)