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How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system

In the rapidly evolving landscape of global health issues and policy, surgery has historically been sidelined due to concerns about high cost, complexity and other concerns including quantitatively less surgical disease burden in comparison to infectious disease or other health conditions. Now, in t...

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Detalles Bibliográficos
Autores principales: Jhunjhunwala, Rashi, Venkatapuram, Sridhar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649365/
https://www.ncbi.nlm.nih.gov/pubmed/37949500
http://dx.doi.org/10.1136/bmjgh-2023-013100
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author Jhunjhunwala, Rashi
Venkatapuram, Sridhar
author_facet Jhunjhunwala, Rashi
Venkatapuram, Sridhar
author_sort Jhunjhunwala, Rashi
collection PubMed
description In the rapidly evolving landscape of global health issues and policy, surgery has historically been sidelined due to concerns about high cost, complexity and other concerns including quantitatively less surgical disease burden in comparison to infectious disease or other health conditions. Now, in the context of pandemics, climate change, shrinking health budgets and other global health security concerns, the hard-won progress in raising the profile of surgical care is at risk, and a reconceptualisation is needed to maintain its position in global healthcare agendas. We challenge the long-standing ethical frameworks that underlie healthcare priority setting, namely cost-effectiveness analysis and human rights, that have contributed to surgery being sidelined for decades. They incompletely account for improvements to life quality and well-being that are possible through surgical healthcare systems. We argue for the Capabilities Approach as an alternative normative framework because it emphasises the moral importance of supporting every person’s abilities to be and to do the things they value. Through this framework, we can produce a more comprehensive conception of healthcare that goes beyond biomedical health, and surgical healthcare would ultimately gain a higher priority in valuation of healthcare and non-healthcare interventions.
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spelling pubmed-106493652023-11-10 How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system Jhunjhunwala, Rashi Venkatapuram, Sridhar BMJ Glob Health Analysis In the rapidly evolving landscape of global health issues and policy, surgery has historically been sidelined due to concerns about high cost, complexity and other concerns including quantitatively less surgical disease burden in comparison to infectious disease or other health conditions. Now, in the context of pandemics, climate change, shrinking health budgets and other global health security concerns, the hard-won progress in raising the profile of surgical care is at risk, and a reconceptualisation is needed to maintain its position in global healthcare agendas. We challenge the long-standing ethical frameworks that underlie healthcare priority setting, namely cost-effectiveness analysis and human rights, that have contributed to surgery being sidelined for decades. They incompletely account for improvements to life quality and well-being that are possible through surgical healthcare systems. We argue for the Capabilities Approach as an alternative normative framework because it emphasises the moral importance of supporting every person’s abilities to be and to do the things they value. Through this framework, we can produce a more comprehensive conception of healthcare that goes beyond biomedical health, and surgical healthcare would ultimately gain a higher priority in valuation of healthcare and non-healthcare interventions. BMJ Publishing Group 2023-11-10 /pmc/articles/PMC10649365/ /pubmed/37949500 http://dx.doi.org/10.1136/bmjgh-2023-013100 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Analysis
Jhunjhunwala, Rashi
Venkatapuram, Sridhar
How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system
title How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system
title_full How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system
title_fullStr How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system
title_full_unstemmed How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system
title_short How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system
title_sort how should we prioritise global surgery? a capabilities approach argument for the place of surgery within every health system
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649365/
https://www.ncbi.nlm.nih.gov/pubmed/37949500
http://dx.doi.org/10.1136/bmjgh-2023-013100
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