Silva Diego S, Smith Maxwell J, Norman Cameron D
Faculty of Health Science, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.
Monash Bioeth Rev. 2018 Dec;36(1-4):54-67. doi: 10.1007/s40592-018-0082-1.
Systems thinking has emerged as a means of conceptualizing and addressing complex public health problems, thereby challenging more commonplace understanding of problems and corresponding solutions as straightforward explanations of cause and effect. Systems thinking tries to address the complexity of problems through qualitative and quantitative modeling based on a variety of systems theories, each with their own assumptions and, more importantly, implicit and unexamined values. To date, however, there has been little engagement between systems scientists and those working in bioethics and public health ethics. The goal of this paper is to begin to consider what it might mean to combine systems thinking with public health ethics to solve public health challenges. We argue that there is a role for ethics in systems thinking in public health as a means of elucidating implicit assumptions and facilitating ethics debate and dialogue with key stakeholders.
系统思维已成为一种概念化和解决复杂公共卫生问题的手段，从而对将问题及其相应解决方案视为因果关系的直接解释这种更为常见的理解提出了挑战。系统思维试图通过基于各种系统理论的定性和定量建模来应对问题的复杂性，每种理论都有其自身的假设，更重要的是，还有隐含的、未经审视的价值观。然而，迄今为止，系统科学家与从事生物伦理学和公共卫生伦理学工作的人员之间几乎没有互动。本文的目的是开始思考将系统思维与公共卫生伦理学相结合以应对公共卫生挑战可能意味着什么。我们认为，伦理学在公共卫生系统思维中可发挥作用，作为阐明隐含假设以及促进与关键利益相关者进行伦理辩论和对话的一种手段。
