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Economic Co-operation and Development (OECD)

Making decisions: Who, How, and Why?

Understanding the underlying ethical principles and recommendations for decision-making does not tell us how we can incorporate those principles into the decision-making process.

When conducting an appraisal of a technology, where societal values and ethical principles are considered in a recommendation, the best health systems aspire to use an approach that embraces these to the greatest extent possible. Rules that govern proceedings that may have far-reaching implications for society are therefore necessary if not an absolute requirement. They encompass procedural rights which include:

  • the right to participate,
  • the right to a fair and accountable proceeding, and
  • the right to information.

These rights are explored in more detail below.

Right to participate: Stakeholder involvement

In the governance of health systems, stakeholder involvement has four major functions:

  • to improve the quality of information concerning the population’s values, needs, and preferences;
  • to encourage public debate over the fundamental direction of the health system
  • to ensure public accountability for the processes within and outcomes of the system; and
  • to protect the public interest.1