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  1. When Are Pharmaceuticals Priced Fairly? An Alternative Risk-Sharing Model for Pharmaceutical Pricing.Fanor Balderrama, Lisa J. Schwartz & Christopher J. Longo - 2020 - Health Care Analysis 28 (2):121-136.
    The most common solutions to the problem of high pharmaceutical prices have taken the form of regulations, price negotiations, or changes in drug coverage by insurers. These measures for the most part transfer the burden of drug expenditures between pharmaceutical companies and payers or between payers. The aim of this study is to propose an alternative model for the relationship between the main stakeholders involved in the price setting and purchasing of pharmaceuticals, one that encourages a more cooperative approach. We (...)
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  2.  7
    Professional Medical Discourse and the Emergence of Practical Wisdom in Everyday Practices: Analysis of a Keyhole Case.Marij Bontemps-Hommen, Andries Baart & Frans Vosman - 2020 - Health Care Analysis 28 (2):137-157.
    Recent publications have argued that practical wisdom is increasingly important for medical practices, particularly in complex contexts, to stay focused on giving good care in a moral sense to each individual patient. Our empirical investigation into an ordinary medical practice was aimed at exploring whether the practice would reveal practical wisdom, or, instead, adherence to conventional frames such as guidelines, routines and the dominant professional discourse. We performed a thematic analysis both of the medical files of a complex patient and (...)
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  3.  2
    Co-production and Managing Uncertainty in Health Research Regulation: A Delphi Study.Isabel Fletcher, Stanislav Birko, Edward S. Dove, Graeme T. Laurie, Catriona McMillan, Emily Postan, Nayha Sethi & Annie Sorbie - 2020 - Health Care Analysis 28 (2):99-120.
    European and international regulation of human health research is typified by a morass of interconnecting laws, diverse and divergent ethical frameworks, and national and transnational standards. There is also a tendency for legislators to regulate in silos—that is, in discrete fields of scientific activity without due regard to the need to make new knowledge as generalisable as possible. There are myriad challenges for the stakeholders—researchers and regulators alike—who attempt to navigate these landscapes. This Delphi study was undertaken in order to (...)
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  4.  2
    Phronesis in Medical Ethics: Courage and Motivation to Keep on the Track of Rightness in Decision-Making.Aisha Malik, Mervyn Conroy & Chris Turner - 2020 - Health Care Analysis 28 (2):158-175.
    Ethical decision making in medicine has recently seen calls to move towards less prescriptive- based approaches that consider the particularities of each case. The main alternative call from the literature is for better understanding of phronesis concepts applied to decision making. A well-cited phronesis-based approach is Kaldjian’s five-stage theoretical framework: goals, concrete circumstances, virtues, deliberation and motivation to act. We build on Kaldjian’s theory after using his framework to analyse data collected from a three-year empirical study of phronesis and the (...)
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  5.  1
    Solidarity with Whom? The Boundary Problem and the Ethical Origins of Solidarity of the Health System in Taiwan.Ming-Jui Yeh & Chia-Ming Chen - 2020 - Health Care Analysis 28 (2):176-192.
    Publicly-funded health systems, including those national health services and social or National Health Insurances, are institutionalized solidarity in health. In Europe, solidarity originated from the legacies of labor movements, the Judeo-Christian traditions, and nationalist sentiments in the re-construction Era after the WWII. In middle-to-high income East Asian countries, such as Japan, Taiwan, Korea, the health systems were built on different grounds and do not have such ethical origins of solidarity. As health systems in Europe and East Asia are both facing (...)
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  6. Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda.Mathias Barra, Mari Broqvist, Erik Gustavsson, Martin Henriksson, Niklas Juth, Lars Sandman & Carl Tollef Solberg - 2020 - Health Care Analysis 28 (1):25-44.
    Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in (...)
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  7.  6
    Conceptualising Surgical Innovation: An Eliminativist Proposal.Giles Birchley, Jonathan Ives, Richard Huxtable & Jane Blazeby - 2020 - Health Care Analysis 28 (1):73-97.
    Improving surgical interventions is key to improving outcomes. Ensuring the safe and transparent translation of such improvements is essential. Evaluation and governance initiatives, including the IDEAL framework and the Macquarie Surgical Innovation Identification Tool have begun to address this. Yet without a definition of innovation that allows non-surgeons to identify when it is occurring, these initiatives are of limited value. A definition seems elusive, so we undertook a conceptual study of surgical innovation. This indicated common conceptual areas in discussions of (...)
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  8.  6
    Selecting Treatment Options and Choosing Between them: Delineating Patient and Professional Autonomy in Shared Decision-Making.Emma Cave - 2020 - Health Care Analysis 28 (1):4-24.
    Professional control in the selection of treatment options for patients is changing. In light of social and legal developments emphasising patient choice and autonomy, and restricting medical paternalism and judicial deference, this article examines how far patients and families can demand NHS treatment in England and Wales. It considers situations where the patient is an adult with capacity, an adult lacking capacity and a child. In all three cases, there is judicial support for professional autonomy, but there are also inconsistencies (...)
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  9.  3
    Barriers to Implementing Patient-Centred Care: An Exploration of Guidance Provided by Ontario’s Health Regulatory Colleges.Glen E. Randall, Patricia A. Wakefield, Neil G. Barr & Lynda A. Van Dreumel - 2020 - Health Care Analysis 28 (1):62-72.
    The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...)
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  10.  3
    Quality of Life and Value Assessment in Health Care.Alicia Hall - 2020 - Health Care Analysis 28 (1):45-61.
    Proposals for health care cost containment emphasize high-value care as a way to control spending without compromising quality. When used in this context, ‘value’ refers to outcomes in relation to cost. To determine where health spending yields the most value, it is necessary to compare the benefits provided by different treatments. While many studies focus narrowly on health gains in assessing value, the notion of benefit is sometimes broadened to include overall quality of life. This paper explores the implications of (...)
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  11. Barriers to Implementing Patient-Centred Care: An Exploration of Guidance Provided by Ontario’s Health Regulatory Colleges.Glen E. Randall, Patricia A. Wakefield, Neil G. Barr & Lynda A. van Dreumel - 2020 - Health Care Analysis 28 (1):62-72.
    The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...)
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