Evidence, ethics and inclusion: a broader base for NICE
- Stephen Wilmot
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The National Institute for Health and Clinical Excellence (hereafter NICE) was created in 1998 to give guidance on which treatments should be provided by the British National Health Service, and to whom. So it has a crucial role as an agent of distributive justice. In this paper I argue that it is failing to adequately explain and justify its decisions in the public arena, particularly in terms of distributive justice; and that this weakens its legitimacy, to the detriment of the National Health Service as a whole. I argue that this failure arises from the fact that NICE works within the frameworks of positivist science and liberal ethics, largely to the exclusion of other perspectives. This narrowness of view prevents NICE from properly connecting with the range of moral concerns represented in the population. I argue for NICE’s deliberations to become more inclusive, both in terms of epistemology, and also in terms of ethical perspectives. And I suggest a range of perspectives that could usefully be included. Finally I offer a framework of structures, philosophies and discussion process that will enable competing perspectives to be debated fairly and productively in this process.
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- Evidence, ethics and inclusion: a broader base for NICE
Medicine, Health Care and Philosophy
Volume 14, Issue 2 , pp 111-121
- Cover Date
- Print ISSN
- Online ISSN
- Springer Netherlands
- Additional Links
- National health service
- National institute for health and clinical excellence
- Independent regulatory agency
- Positivist science
- Liberal ethics
- Industry Sectors
- Stephen Wilmot (1)
- Author Affiliations
- 1. University of British Columbia, 407-2263 Redbud Lane, Vancouver, BC, V6K 4V7, Canada