The ethical void: a critical analysis of commissioned expert reports on Swedish healthcare governance

Journal of Health Organization and Management Abstract Purpose – The purpose of this paper is to contribute knowledge on ethical issues and reasoning in expertreports concerning healthcare governance, cDesign/methodology/approach – An in-depth analysis of ethical issues and reasoning in 36 commissionedexpert reports was performed. Twenty-seven interviews with commissioners and producers of the reports werealso carried out and analysed.Findings – Some ethical issues were identified in the reports. But ethical reasoning was rarely evident. Themeaning of ethical concepts could be devalued and changed over time and thereby deviate from statutoryethical goals and values. Several ethical issues of great concern for the Swedish public healthcare were alsoabsent.Practical implications – The commissioner of expert reports needs to ensure that comprehensive ethicalconsiderations and ethical analysis are integrated in the expert reports.Originality/value – Based on an extensive data material this paper reveals an ethical void in expert reportson healthcare governance. By avoiding ethical issues there is a risk that the expert reports could bring aboutreforms and control models that have ethically undesirable consequences for people and society.

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