Problems, policies and ethics in health care

There are three factors necessary for the successful implementation of a policy. First, a problem has to be identified in a way that invites action. Second, there must be a policy that fits the problem in question. And third, there must be the political will to tackle the problem with the policy. Each of these factors is necessary but not sufficient for policy development; implementation requires a happy conjunction of all three. To date there has been little overt ethical analysis in relation to policy development by those identifying as ethicists. This paper describes three potential roles for ethics analysis in the problem-policy-politics nexus, arguing that ethicists have a role to play in the identification of problems and in the substantive and procedural evaluation of policies. In addition, wherever ethics language is used overtly, ethicists have a duty to investigate and offer critiques of the notions in question; both on their own merits and against accepted usage and normative frameworks.