‘Dampening the flames turmoil’ international perspectives on sources of moral harms and their implications for health policy and practice

Journal of Public Health, vol. 47, pp. i23–i33

Abstract

BACKGROUND: Public health is tasked with preventing harm, promoting health and ensuring equitable access to care. Yet, increasing sociopolitical and economic turmoil is creating barriers to public health delivering its core roles. Whilst moral dilemmas are inherent in public health polycrises and their resultant ongoing impacts has thrust consideration of the moral harms that may be experienced when we are prevented in the delivery of care into discourses about the future priorities of public health. Experiencing moral harms can result in profound impacts for the individual and the delivery and outcomes of care and are emerging as a public health concern. At a time when public health and healthcare are facing interconnected challenges in funding, workforce attrition, erosions in public trust and quality, it is critical we identify the pertinent drivers of moral harms. METHODS: This commentary explores five different perspectives representing varied geographical locations and health infrastructures. RESULTS: Specifically, we explore the critical roles of economic status, social anthropological considerations, fiscal, organisational and individual factors to outline key drivers to formulate public health policy responses, going forward. CONCLUSIONS: Addressing the moral harms is a public health imperative and associated solutions have a critical role to play in dampening the flames of current turmoil.

Authors 8

1. Deborah Morris corresponding

   University of Buckingham · St Andrew's Healthcare

   Affiliation as printed

   Centre for Developmental and Complex Trauma, Foster Postgraduate Centre, St Andrew's Healthcare, Billing Road, Northampton , NN1 5DG ,

   Faculty of Medicine and Health Sciences, The University of Buckingham , Buckingham, Vinson Building, Hunter Street, Buckingham, MK18 1EG , UK

   St Andrew's Healthcare, Centre for Developmental and Complex Trauma Foster Postgraduate Centre, St Andrew' S Healthcare Northampton, NN1 5DG, UK

   The University of Buckingham Faculty of Medicine and Health Sciences, Buckingham, MK18 1EG, UK

2. Tine Molendijk

   Netherlands Defence Academy

   Affiliation as printed

   Faculty of Military Sciences, Netherlands Defence Academy (NLDA) , Hogeschoollaan 2, 4818 CR Breda, Nijmegen ,

   Netherlands Defence Academy (NLDA) Breda, Faculty of Military Sciences , Nijmegen, NL

3. Laurent Boyer

   Aix-Marseille Université · Assistance Publique Hôpitaux de Marseille

   Affiliation as printed

   Research Centre on Health Services and Quality of Life, Aix Marseille University , 27, boulevard Jean-Moulin, 13385 Marseille cedex 05,

   AP-HM, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France

4. Joseph Mfusto Bengo

   Kamuzu University of Health Sciences

   Affiliation as printed

   Department of Bioethics, Behavioural and Health Social Sciences, Kamuzu University of Health Sciences (KUHES) , Private Bag 360, Chichiri BT3, Blantyre ,

   Department of Bioethics, Behavioural and Health Social Sciences, Kamuzu University of Health Sciences (KUHES) , Blantyre, MW

5. Eva Mfutso Bengo

   Malawi University of Business and Applied Sciences

   Affiliation as printed

   Department of Economics and Law, Malawi University of Business and Applied Sciences, Private Bag 360, Chichiri BT3, Blantyre, Southern Region , Malawi

   Dept of Economics and Law, Malawi University of Business and Applied Sciences, Blantyre, Southern Region , MW

6. Steven Bow
   Affiliation as printed

   West Berkshire Council, Public Health and Wellbeing , Council Offices, Market St, Newbury RG14 5LD,

   West Berkshire Council, Public Health and Wellbeing Newbury, England, UK

7. Peter Schrӧder Bäck Aachen Institute for History and Ethics

   RWTH Aachen University · Hochschule für Polizei und Öffentliche Verwaltung Nordrhein-Westfalen

   Affiliation as printed

   University of Applied Sciences for Police and Public Administration, Institute for History and Ethics, RWTH Aachen Campus GmbH , Dennewartstrasse 25-27, North Rhine-Westphalia (HSPV NRW), D-52068 Aachen ,

   University of Applied Sciences for Police and Public Administration in North Rhine-Westphalia (HSPV NRW) Institute for History and Ethics, Dennewartstrasse 25-27, Campus, Aachen Aachen , DE 52068

8. Esther Murray

   Queen Mary University of London

   Affiliation as printed

   Institute for Health Sciences Education, Faculty of Medicine and Dentistry, Queen Mary University of London , Garrod Building, Turner St, London, E1 2AD,

   Queen Mary University of London Faculty of Medicine and Dentistry London, England, UK