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Evidence-based Public HealthEffectiveness and efficiency$
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Amanda Killoran and Mike P. Kelly

Print publication date: 2009

Print ISBN-13: 9780199563623

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780199563623.001.0001

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Social values in developing public health guidance

Social values in developing public health guidance

(p.344) Chapter 23 Social values in developing public health guidance
Evidence-based Public Health

Nick Doyle

Oxford University Press

The National Institute for Health and Clinical Excellence (NICE) took on responsibility for producing public health guidance relatively recently. This means that it has had to accommodate a new perspective as well as values associated with public health, which differ in significant ways from those it applies to the production of clinical guidance. This chapter examines how well these sets of values have been integrated, and some of the as yet unresolved dilemmas and tensions. It first discusses the ethical or social value, considerations affecting NICE guidance of all kinds, and their relationship to the specific set of social value principles which NICE has published as formal advice to the advisory bodies that make NICE guidance recommendations. It then considers how well the social value principles established to date cover the particular ethical questions that arise in public health. It highlights gaps and uncertainties, looking in particular at the issue of health inequalities, and using the ethical framework provided by the ‘stewardship model’ as a reference point. The chapter concludes by looking at NICE's use of equality impact assessment as a means of meeting the public sector duties on eliminating discrimination and promoting equality, and the potential for the ‘capabilities’ approach to provide a supportive framework for NICE guidance recommendations concerned with inequality.

Keywords:   Clinical Excellence, public health, public health guidance, social value principles, health inequalities, stewardship model

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