ETHICS OF COMMUNITY MEDICINE
The physician ethical commitment encompasses combined clinical, public health and community health principles.
Unger, JP., Morales, I., De Paepe, P.et al.In defence of a single body of clinical and public health, medical ethics.BMC Health Serv Res20,1070 (2020). https://doi.org/10.1186/s12913-020-05887-y;
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05887-y
Unger, JP., Morales, I., De Paepe, P.et al.A plea to merge clinical and public health practices: reasons and consequences.BMC Health Serv Res20,1068 (2020). https://doi.org/10.1186/s12913-020-05885-0
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05885-0
FOR-PROFIT vs. PUBLICLY ORIENTED HEALTH PLANNING AND MANAGEMENT
When access to professionally delivered health care is a Human Right, health services organization and planning aim at covering the population with a national, universal health system that includes family medicine, local and regional hospitals, university teaching hospital, psychosocial services and possibly specialized clinics.
Health management ought to be participatory to favor teamwork, professional autonomy and the existence of bottom-up flows of knowledge and decisions in healthcare services.
Bottom-up and top-down flows of health planning best meet each other at district level - districts being local health systems that at least comprehend a hospital and first line services.
Unger J.-P., Criel B. Principles of health infrastructure planning in less developed countries. Int J Health Plan Manag1995; 10: 113-128
Unger J.-P., Macq J., Bredo F., Boelaert M.Through Mintzberg's glasses: a fresh look at the organization of ministries of health. Bull WHO2000; 78(8): 1005-1014.
https://apps.who.int/iris/bitstream/handle/10665/268199/PMC2560822.pdf?sequence=1&isAllowed=y
Public health programmes shouldn’t be permitted to strain quality of and access to clinical care in those health services where they are integrated.
Unger J.-P., De Paepe P., Green A. A code of best practice for disease control programmes to avoid damaging health care services in developing countriesInt J Health Planning and Management2003; 18: S27-S39.
https://onlinelibrary.wiley.com/doi/pdf/10.1002/hpm.723
In the interest of both patients and health professionals, health services should meet specific care and organisation quality criteria to deserve public financing.
Unger J.-P., Marchal B., Green A. Quality standards for health care delivery and management in publicly-oriented health services. Int J Health Planning and Management 2003; 18: S79-S88.
http://dspace.itg.be/bitstream/handle/10390/1442/2003ijhp0S27.pdf?sequence=1
https://pubmed.ncbi.nlm.nih.gov/14661939/
COMMERCIAL and INDUSTRIAL vs. SOCIAL and PROFESSIONAL HEALTH POLICIES
Health policies ought to secure the exercise of the Human Right to Care and as such, the access of everybody to the full scope of health services - from GPs and first line teams to University Teaching Hospitals. Besides, policies should ascertain that professionals abide by a code of ethics:
Unger, JP., Morales, I., De Paepe, P. et al. Neo-Hippocratic healthcare policies: professional or industrial healthcare delivery? A choice for doctors, patients, and their organisations. BMC Health Serv Res 20, 1067 (2020). https://doi.org/10.1186/s12913-020-05890-3
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05890-3
These policies ought to integrate clinical care and disease control programmes whenever public health programmes do not deteriorate medical practice :
Unger J.-P., De Paepe P., Ghilbert P., Soors W., Green A. 1. Disintegrated care: the Achilles heel of international health policies. In low and middle income countries. International Journal of Integrated Care2006; 6. ISSN 1568 – 4156
https://www.ijic.org/articles/10.5334/ijic.156/
Unger J.-P., De Paepe J.-P., Ghilbert P., Soors W., Green A. 2. Integrated care:a fresh perspective for international health policies inlow and middle-income countries. International Journal of Integrated Care2006; 6. ISSN 1568 - 4156
https://www.ijic.org/articles/10.5334/ijic.157/
Unger J.-P. Practical guide to medical cooperation. From health systems analysis to action. l'Harmattan, Paris, 1992 (221 pages).
https://www.editions-harmattan.fr/livre-guide_pratique_de_la_cooperation_medicale_de_l_analyse_des_systemes_de_sante_a_l_action_jean_pierre_unger-9782738414182-3962.html
Copyright © All Rights Reserved