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Stakeholder Participation for Legitimate Priority Setting: A Checklist.

Maarten P M Jansen1, Rob Baltussen1, Kristine Bærøe2

  • 1Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.

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Health authorities must ensure fair priority setting by treating all stakeholders as moral equals. A five-step process and checklist help legitimize healthcare decisions for those affected.

Keywords:
Accountability for ReasonablenessLegitimacyPriority SettingStakeholder Participation

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Area of Science:

  • Health Policy
  • Bioethics
  • Public Health Decision-Making

Background:

  • Accountability in healthcare priority setting is crucial for societal legitimacy.
  • Fair processes require treating all stakeholders as moral equals, providing justifiable reasons for decisions.
  • There is a specific ethical obligation to be accountable to those negatively impacted by decisions.

Purpose of the Study:

  • To operationalize the requirement for accountability in healthcare priority setting.
  • To provide a practical framework for health authorities to ensure legitimate decision-making processes.
  • To develop actionable steps for engaging stakeholders affected by healthcare decisions.

Main Methods:

  • Proposing five key operational steps for legitimate priority setting.
  • Detailing stakeholder identification, inclusion, and meaningful participation.
  • Outlining communication strategies and mechanisms for evaluation and appeal.

Main Results:

  • A five-step framework is presented: identifying affected stakeholders, comprehensive inclusion, ensuring participation, clear communication, and establishing appeal mechanisms.
  • A checklist of 29 reflective questions is provided to guide health authorities.
  • The framework aims to enhance the legitimacy and fairness of healthcare priority setting.

Conclusions:

  • Implementing the five-step process and utilizing the checklist can improve the legitimacy of healthcare priority setting.
  • Proactive engagement and accountability towards adversely affected stakeholders are essential.
  • This approach supports ethical and justifiable decision-making in healthcare resource allocation.