The ethics of primary health care

Abstract

Primary health care has been a key concept in debate about health care systems throughout the last thirty years. It has played a central role in the delivery of comprehensive, universal, equitable and affordable healthcare services across a wide range of countries. Despite the universality of primary health care, its ethics is nebulous and confusing, reflecting both the complexity of primary health care itself, and overlapping borders with other similar fields, particularly general practice ethics, public health ethics and the ethics of health promotion. This chapter uses literature from general practice, public health and health promotion ethics to sketch an account of primary health care ethics. It makes a distinction between two approaches to primary health care ethics: the 'individual' account and the 'community' account. The individual account is built upon contributions from the general practice ethics literature; the community account draws mainly on writing within the ethics of health promotion and public health ethics. Taken together, they provide a balanced introduction to the ethics of primary health care. © 2007 John Wiley & Sons, Ltd.