Health sustainability requires adequate funding and shared responsibility, according to the bioethics committees


Meeting of bioethics committees in Zaragoza GOVERNMENT OF ARAGÓN


In a meeting of these entities held in the Aragonese capital, this statement has been issued entitled ‘Ethics and responsibility in the sustainability of the National Health System’ with which they intend to “contribute to public reflection.”

This is indicated in the document, dated this Wednesday, November 16, which has four conclusions. The first of them affirms that “our society aspires to consolidate a National System of Public Health, of quality, universal and solidary, for which it is necessary to achieve its sustainability”.

He adds that the latter “will not be achieved only with adequate financing, although this is an essential requirement”, but “the shared responsibility of all the agents involved in the efficient operation and sustainability of the system should lead to a process of reflection that opens new perspectives. “


These are the second and third conclusions, while the fourth affirms that, “based on the ethics of responsibility set forth in this declaration, we propose to open a social debate that translates into initiatives and concrete measures, susceptible to evaluation, in the different areas involved. “

The document has an introduction and dedicates sections to health professionals; politicians and managers; citizens and patients; suppliers – pharmaceutical and health technologies industry – and media and advertising.



The statement states, first, “the variability observed within the health system, with differences in health services between autonomous communities and evident inequalities that affect, mainly, the weakest and most disadvantaged groups in society.”

Likewise, it argues that the SNS puts at risk the “attentive” against the social, democratic and legal State, given that the protection of health “guarantees both the rights to life and the integrity of people as well as their participation in the system democratic and the exercise of the remaining rights “, has informed the Government of Aragon in a press release.

For this reason, the declaration emphasizes that it is necessary to promote “the co-responsibility of all the agents involved” in the system, managers, citizens, suppliers and the media.



The document emphasizes that health professionals make decisions on a daily basis “with significant consequences on the distribution of resources”, which makes them “managers of the system” and recommends that criteria based on equity be established.

In addition, it notes that “professionals should be favorable to the reforms of services that are necessary to improve the optimization of resources.”

The statement also warns of the tendency towards “defensive medicine” as a result of the “judicialization of professional errors”, which “translates into an increase in health costs that do not benefit the patient and damage the health system”.

At this point, the committees are committed to “detection systems, evaluation and correction of errors and damages” and to formulas for resolving conflicts “that avoid the judicialization of the health-patient relationship”, something that “would promote a climate of trust” in the clinical relationship, which is an important pillar of the system’s sustainability “.


The document points out, in terms of politicians and managers, that it is “essential” to enhance the coordinating role of the Interterritorial Council to “structure the SNS from the principle of defending the general interest, with accountability and transparency”.

“We must reject unjustified inequalities between autonomous communities, which benefit no one and move away from the collective interest,” he adds. The text also warns of “the unequal allocation of resources between hospital care and primary care,” which “is increasing the historical imbalance between them.”

The statement defends “the professionalization of the directive function” and maintains that “the management of health centers should be avoided by managers appointed exclusively for reasons of political or personal affinity, without considering training and experience, because the quality of assistance and the proper functioning of a public service “.

In the case of citizens, the document points out the need to “promote the training of citizens and patients in the proper use of resources that, even in times of economic prosperity, will always be limited”.

In this sense, initiatives that favor the responsible behavior of citizens in the use of collective resources must be promoted to achieve “responsibility” in the consumption of prescribed medicines, avoid unnecessary or repeated complementary tests and annul appointments in advance for queries that are not going to be used.



The committees ensure, with respect to the SNS providers, that “it would be desirable” for them to participate in a pact for the sustainability of the system, “acting with co-responsibility and transparency, contributing to policies based on the real health needs of citizens. , avoiding the tendency to medicalization and subjecting pharmaceutical novelties to the judgment of technology evaluation commissions, which health authorities must create with guarantees of independence “.

Finally, the statement indicates that the media and advertising exercise an “unquestionable influence” on the lifestyles of the population and on the socialization of scientific information.