Department of Health and Technology, Health Ethics and Policy Lab, ETH Zurich, Hottingerstrasse 10, 8092, Zurich, Switzerland.
Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Int J Equity Health. 2019 Sep 14;18(1):144. doi: 10.1186/s12939-019-1050-y.
The economic crisis posed various challenges to policy-makers who had to decide on which health policy measures to focus on and on which to refrain from. The aim of this research was to assess the relevance of ethics and to highlight ethical dimensions in decision-taking by policy-makers with regard to policy and priority-setting in health systems posed by the economic crisis.
Semi-structured qualitative interviews were conducted with eight European policy-makers from six countries.
All interviewees recalled difficult and strenuous situations where they had to prioritise between distinct areas to focus on and invest in, for example around choices between prioritising medications, health professional staffing, care specific equipment, or urgent infrastructure issues. Values could be identified which they deemed as important within the policy-making process, such as trust and responsibility. They explicitly expressed the need for ethical tools and assistance in terms of policy advice for reaching morally sustainable decisions in health policy matters.
The study showed that ethical concepts and values frequently come into play in health policy-making, and that ethics is highly relevant in policy-makers' daily decision-taking, yet that they lack ethical guidance on what to base their decisions. The study is of relevance since it can provide future decisions on austerity-related issues with an ethical underpinning and could identify areas of moral concern.
经济危机给决策者带来了各种挑战，他们必须决定关注哪些卫生政策措施，避免关注哪些措施。本研究旨在评估道德的相关性，并强调决策者在制定卫生系统政策和优先事项时，在经济危机面前，决策中的伦理维度。
对来自六个国家的八位欧洲决策者进行了半结构化的定性访谈。
所有受访者都回忆起困难和艰苦的情况，他们必须在不同的领域之间进行优先排序，并进行投资，例如在优先考虑药物、卫生专业人员配备、特定护理设备或紧急基础设施问题之间进行选择。他们认为在决策过程中重要的价值观，例如信任和责任。他们明确表示需要政策建议方面的道德工具和援助，以便在卫生政策问题上做出道德上可持续的决策。
研究表明，伦理概念和价值观经常在卫生政策制定中发挥作用，伦理在决策者的日常决策中非常重要，但他们缺乏决策依据的伦理指导。这项研究具有相关性，因为它可以为与紧缩相关的问题提供未来决策的道德基础，并确定道德关注的领域。
