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date: 18 April 2019

Abstract and Keywords

This chapter relates public health ethics to selected questions regarding health systems ethics and provides overviews of chapters in the section of The Oxford Handbook of Public Health Ethics dedicated to health systems. National and subnational health systems aim chiefly to improve population health. Public health is a collective good whose promotion takes government action, raising ethical issues in stewardship, governance, and accountability. Moral justifications for public health activities, including overall benefit, collective efficiency, distributive fairness, and harm prevention, are considered by way of examining global human resources for health, with an eye to efficiency, equity, rights, and other ethical issues. Worldwide interest in health systems strengthening has boosted investment in health systems research, taking traditional research ethics to the population level in the field of health systems research ethics. The idea of a learning health care system (LHCS) represents a dynamic interface where health care delivery can be continuously improved through systemic data collection undertaken in conjunction with clinical care, posing new system-level ethical opportunities and ethical challenges.

Keywords: health systems, systems strengthening, health systems ethics, equity, governance, health systems research, learning health care system, public health ethics

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