Reconciling Individual And Collective Interests In Kenya Health Care: An Ethical Conceptual Framework

ABSTRACT

Equity in health care provision is an important goal yet it is hampered by many factors. The competing values of individual and collective interests present a conflict that needs to be addressed if health care has to meet the desired goal of equity. The study argues that pursuit of equity in health care is impeded by the dominance of either individual or collective interests in health care provision. The study seeks to answer the principle question of how individual and collective interests affect health care delivery and uptake. Specifically the study investigates the foundation of individual and collective interests as ethical values in health care, manifestation of the two conflicting values in Kenya health care and suggests a way out of the conflict. Relevant ethical theories are evaluated for their effectiveness in informing health care decisions. Health care in Kenya is evaluated and the two paradigms, population and medical services, are assessed and values inherent interpreted. This study explores the way in which communitarian ideals and practices might be employed in pursuit of equity. The study identifies the health of individuals as shaped by the social and communal environment that they live in. It is observed that communitarians acknowledge the bonds that unite and identify individuals in a community. The study argues that, to achieve equity in health care, these bonds need to be recognized and harnessed rather than discredited and ignored. The notion of individual autonomy in the context of the community is evaluated. Alternative concepts of autonomy – social autonomy and community autonomy – are evaluated in line with both individual and the community values. Moreover, these concepts are viewed as probable means to health care equity goals. The study concludes with recommendations on how equity goal in health care system can be reached within a communitarian vision. Individual and collective interests are discussed throughout as a source of conflict in health care.