Health care networks raise new and pressing ethical issues and we are in need of a framework for assessing how and when such networks are justified. Such networks are the topic of empirical debate, but more attention should be given to the ethical aspects. Currently many hopes ride on integrated care and broad health care networks.
Conclusionsįaced with daunting challenges, the health care system is changing rapidly. Networks that fail to meet any of these conditions are suspect and cannot be justified ethically. Finally, the principle of autonomy is translated into a specific obligation to promote and respect patient choice. The principle of nonmaleficence implies an obligation to guarantee patient safety, whereas the principle of beneficence implies an obligation for health care networks to guarantee continuity of care in all its dimensions. Based on the principle of justice, health care networks have an ethical duty to provide just and fair access for all patients and to be transparent to patients about how access is regulated. Using the classic four principles of biomedical ethics (justice, nonmaleficence, beneficence and autonomy) it is possible to identify specific ethical duties. We argue that a business ethics approach to ethical obligations for health care networks, is problematic and we propose to opt for a patient perspective. Due to their often amorphous and complex structure, collective responsibility and accountability may increase while individual responsibility goes down. A relevant question that remains is what ethical obligations or duties one can ascribe to these networks especially because networks involve many risks. However, this does not automatically mean they are always ethically justified. Much hope is set on such networks which have been argued to improve economic efficiency and quality of care. Focus is increasingly shifting from individual health care institutions to interorganizational collaboration and health care networks. Health care organization is entering a new age.
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