Abstract and Keywords
This chapter argues that stewardship ought to be conceived as a particular form of governance that is the role of both governments and intergovernmental and extragovernmental bodies to carry out. Stewardship as ethically conscientious governance is grounded in an explicit normative commitment to the promotion of justice, including both consequentialist and deontological claims, as part of public health policy and practice. The justification of trade-offs and resolution of tensions among various objectives requires robust accountability mechanisms tied to ethical questions about defining the public good. This chapter describes a range of accountability mechanisms that can function for a variety of governmental and nongovernmental actors. It then explores issues of public health ethics regarding the ways in which specific health systems stewards—including states, the World Bank, and the World Health Organization (WHO)—are held accountable.
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