Seasonal Greetings from the Research Group

This fall, members of our group involved in the research project 'Prioritizing health care - tensions and interplay between legal, political, economic and professional perspectives' arranged the workshop "Democracy, technocracy and priority setting in health" in Bergen. The aim of this meeting was not to address the broadly discussed issues of what to prioritize, but rather to focus on the societal consequences of how priority setting in healthcare is carried out. 

In the academic literature on medical ethics and priority settings the concept 'legitimate' is more often than not used without specifying its meaning, and in many cases without an awareness of the concept’s many aspects and dimensions. Inadequate, imprecise or arguably wrong characterization of policies and policy-making processes as ‘legitimate’ in papers and real world practice increases the risk of healthcare receivers’ needs being neglected, ignored or even misused. The concept 'legitimacy' is supported by a variety of normative theories that emphases different political values. Moreover, distinct conceptualizations of 'legitimacy' justify different perceptions of the kind of the expertise that is required as well as whom the experts are taken to be. 

Ultimately, societies are - at least partly - shaped by how significant policy-making decisions with huge impact on people’s lives are in fact carried out. Healthcare priority decisions have the ability to strengthen democracy if being carefully organised to do exactly so. On the other hand, these decisions can also undermine democracy if the powers of defining values and the authority to make real-world decisions are merely left to discipline-trained experts or rule-applying technocrats. Arguably, attention and reflection on such wide reaching, societal consequences of setting priorities in healthcare should be considered a central component of legitimate governance. One conclusion from our workshop, is that there is still a lot of theoretical and empirical research to be done in this area. 

Some highlights from the work of our research group in 2017:

• Two PhD candidates, Peter Hangoma and Frode Lindemark have successfully defended their theses based on publications in high quality journals. Carl Tollef Solberg will defend his PhD on January 16, 2018
• Ingrid Miljeteig and Ole Frithjof Norheim have developed new courses in medical ethics for healthcare personnel at School of Medicine, Addis Ababa University (AAU), in Ethiopia. In Mars, together with colleagues at AAU, they opened the first Center for Medical Ethics and Priority Setting. The PhD-students dr. Dawit Desalegn and dr. Frehiwot Berhane are also involved in this work.
• Kjell Arne Johansson, Ole Frithjof Norheim, and Stéphane Verguet  from Harvard T.H. Chan School of Public Health have started up the project DCP-Ethiopia founded by the Bill and Melinda Gates Foundation.
• In December, Ole Frithjof Norheim participated in London at the launch of the final volumes from Disease Control Priorities 3, on essential health care packages for universal health coverage.
• At the end of this year, we have been very lucky to welcome Linn Jeanette Knudsen as a coordinator in our group

On behalf of the Global Health Priorities group, I wish you all happy holiday season and the very best for the year to come! 

Kristine Bærøe
Associate Professor