Author:
Cribb Alan,Entwistle Vikki,Mitchell Polly
Abstract
In this paper, we argue that there are important ethical questions about healthcare improvement which are underexplored. We start by drawing on two existing literatures: first, the prevailing, primarily governance-oriented, application of ethics to healthcare ‘quality improvement’ (QI), and second, the application of QI to healthcare ethics. We show that these are insufficient for ethical analysis of healthcare improvement. In pursuit of a broader agenda for an ethics of healthcare improvement, we note that QI and ethics can, in some respects, be treated as closely related concerns and not simply as externally related agendas. To support our argument, we explore the gap between ‘quality’ and ‘ethics’ discourses and ask about the possible differences between ‘good quality healthcare’ and ‘good healthcare’. We suggest that the word ‘quality’ both adds to and subtracts from the idea of ‘good healthcare’, and in particular that the technicist inflection of quality discourses needs to be set in the context of broader conceptualisations of healthcare improvement. We introduce the distinction between quality as a measurable property and quality as an evaluative judgement, suggesting that a core, but neglected, question for an ethics of healthcare improvement is striking the balance between these two conceptions of quality.
Subject
Health Policy,Arts and Humanities (miscellaneous),Issues, ethics and legal aspects,Health (social science)
Reference25 articles.
1. Special Report: The Ethics of Using QI Methods to Improve Health Care Quality and Safety
2. Jennings B , Baily MA , Bottrell M , et al . Health care quality improvement: ethical and regulatory issues. Garrison, NY: The Hastings Centre, 2007.
3. Dixon N . Guide to managing ethical issues in quality improvement or clinical audit projects. London, UK: Healthcare Quality Improvement Partnership, 2017.
4. The Ethics of Using Quality Improvement Methods in Health Care
5. Fiscella K , Tobin JN , Carroll JK , et al . Ethical oversight in quality improvement and quality improvement research: new approaches to promote a learning health care system. BMC Med Ethics 2015;16(1):63.doi:10.1186/s12910-015-0056-2
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