Programa y políticas públicas

  • 17 Noviembre 2020

    This briefing note is the fourth in a series of six focused on the state of the practice of integrated impact assessment (IIA). These documents focus, respectively, on:

    1. Overall situation and clarification of concepts
    2. Example of the practice of IIA at the European Commission
    3. Example of the practice of IIA in France
    4. Example of the practice of IIA in the United Kingdom
    5. Example of the practice of IIA in Northern Ireland
    6. Main challenges and issues tied to IIA

    Integrated Impact Assessment (IIA) is a decision-support mechanism increasingly being considered by public administrations in industrialized countries. The movement toward the adoption of evidence-based policy has given rise to many forms of...

  • 17 Noviembre 2020

    This briefing note is intended for all managers in the health and social services sectors, as well as for public health actors who would like to see this type of approach established within their government so that health can be better taken into account in all policies. Those who are called upon to manage programs, projects or public policies involving multiple sectors with a determinant impact on population health will find here an overview of the usefulness of the horizontal (intersectoral) approach as compared with traditional approaches. This document presents the challenges and benefits specific to the horizontal approach, along with a summary of current thinking on the subject. It also includes examples of common practices tied to this approach. This approach should make it...

  • 17 Noviembre 2020

    Cette note s’adresse à l’ensemble des gestionnaires du secteur de la santé et des services sociaux, ainsi qu’aux acteurs de santé publique qui souhaitent voir l’instauration d’une telle approche au sein de leur gouvernement pour une meilleure prise en compte de la santé dans toutes les politiques. Amenés à gérer des programmes, des projets ou des politiques publiques impliquant plusieurs secteurs déterminants de la santé des populations, ils y trouveront un aperçu de l’intérêt que présente l’approche horizontale (intersectorielle) par rapport aux approches traditionnelles. Ce texte présente les défis et les bénéfices spécifiques à l’approche horizontale, ainsi qu’un état des lieux des réflexions en cours sur le sujet. On y trouve également des exemples de pratiques courantes de cette...

  • 17 Noviembre 2020

    How can we perceive and address ethical challenges in public health practice and policy? One way is by using ethical concepts to shed light on everyday practice. One does not have to be a specialist in ethics to do so. This document is part of a series of papers intended to introduce practitioners to some concepts, values, principles, theories and approaches that are important to public health ethics.

    Many authors argue that public health interventions and programs are rooted in utilitarian ethics (Holland, 2007; Horner, 2000; Nixon & Forman, 2008; Rothstein, 2004; Royo‑Bordonada & Román-Maestre, 2015). For example, Royo-Bordonada and Román-Maestre write that “public health is in essence [...] utilitarian because it seeks to preserve the health status (something that...

  • 17 Noviembre 2020

    Comment voir et relever les défis éthiques dans la pratique et les politiques de la santé publique? Notamment en utilisant les concepts éthiques pour éclairer les pratiques quotidiennes. Pour cela, nul besoin d’être un spécialiste en éthique. Ce document fait partie d’une série dont l’objectif consiste à introduire les praticiens à certains concepts, valeurs, principes, théories ou approches importants pour l’éthique en santé publique.

    Plusieurs auteurs soutiennent que les interventions et les programmes de la santé publique sont ancrés dans une éthique utilitariste (Holland, 2007; Horner, 2000; Nixon et Forman, 2008; Rothstein, 2004; Royo-Bordonada et Román-Maestre, 2015). Par exemple, Royo-Bordonada et Román-Maestre écrivent que « la santé publique est, dans son essence même...

  • 17 Noviembre 2020

    In this paper we will focus on principle-based approaches in public health ethics, comparing some of their features with those of principlism, the well-known and widely-used “four principles” approach in medical ethics.

    We will first look at some of the main features of principlism and then with those features in mind we will turn to public health frameworks that rely on principles to see what they have in common as well as how they might differ.

    Understanding and recognizing some of principlism’s main features can help practitioners to:

    • Better situate their own ethical deliberations in public health by seeing both the differences and the similarities between various ethical approaches;
    • Identify and make explicit principlist orientations guiding...
  • 17 Noviembre 2020

    Ce document porte sur les approches en éthique de la santé publique qui sont basées sur des principes. Nous y comparons certaines des caractéristiques de ces approches avec celles du principisme, soit l’approche des « quatre principes » bien connue et très utilisée en éthique médicale.

    Nous nous pencherons d’abord sur certaines des principales caractéristiques du principisme. Puis, en les gardant à l’esprit, nous aborderons les cadres de référence en matière d’éthique en santé publique qui reposent sur des principes, afin de mettre à l’avant-plan leurs points communs et leurs différences.

    Comprendre et reconnaître certaines des principales caractéristiques du principisme peut aider les praticiens et les praticiennes :

    • à mieux situer leurs propres...
  • 17 Noviembre 2020

    A public health ethics must begin with recognition of the values at the core of public health, not a modification of values used to guide other kinds of health care interactions (Baylis, Kenny, & Sherwin, 2008, p. 199).

    Public health practitioners have long grappled with ethical issues in their practice but, until recently, there have been few relevant ethics frameworks that take into account the values base of public health.1 Historically, those involved in health care ethics and bioethics more generally have failed to provide public health practitioners with guidance geared to their unique ethical concerns. Until relatively recently, a rights-based deontological approach (Zahner, 2000), or the...

  • 17 Noviembre 2020

    Increasingly, the concept of solidarity is being brought into discussion as one of the principles and values that should guide the ethical practices of public health actors.1 Reflecting on ethical issues specific to solidarity as it relates to public health practice appears worthwhile because solidarity is a concept that first and foremost concerns groups or communities of people. Viewed from this perspective, solidarity is a value that, for some authors, seems more suited to playing a central role in public health ethics than do the more individualistic values, such as autonomy, which are usually regarded as central to biomedical or clinical ethics (Baylis, Kenny, & Sherwin, 2008; Dawson, 2011a; Prainsack & Buyx, 2011). This is why solidarity is...

  • 15 Noviembre 2020

    In this paper we will outline the concept of reciprocity as it may be applied in the ethics of public health. The goal of this paper is to present the concept as it has been developed and used in the literature.

    Whether considered as a value or formulated as a principle to guide actions, reciprocity is commonly appealed to in public health to help ensure that certain obligations due to others – or to be expected from others – may be taken into account and acted upon by public authorities or by individuals. It is one of the values commonly considered when applying an ethical lens to decisions and actions linked to public health or healthy public policies.

    We will consider how it has been used to date in public health ethics and then include some aspects of reciprocity...

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