Populations, values, and health

This chapter explores some of the philosophical and ethical presuppositions of population healthcare; it investigates the implications for how we should understand the jurisdiction, aims, and evaluation of population healthcare. The jurisdiction of population healthcare is primarily within the healthcare system but necessarily extends beyond the walls of clinics and hospitals, given the need for social coordination to bring about healthcare access at the population level. The dual aims of population healthcare in maximizing population benefits of healthcare and reducing health inequalities are clearly moral in nature, but they can give rise to conflicting goals that the ethics of population healthcare should seek to resolve. While population healthcare’s aim is to advance a value-based approach to healthcare, which seeks to promote what is called technical, allocative, and personalized value, there are a number of questions that remain unanswered: in particular, the justification and evaluation of personalized value, and why the satisfaction of individual preferences in relation to health outcomes should be a population-level concern alongside promoting health and health equity.