Health partnerships: guide to the ethics of local partnerships for health

[Extract] This document reviews relevant academic and practitioner literature on ethics as it relates to local health partnerships, in order to offer some key examples of best practices, benefits, pitfalls and issues to consider in developing, managing and evaluating partnership activity. Partnerships can be effective and beneficial and are supported in government policy. A range of ethical issues may potentially arise at all stages of partnership operations and should be considered to ensure that partnerships are able to manage or overcome any potential ethical challenges they face.\ud \ud There is considerable evidence of potential benefits from ethical partnering; successful long-term partnerships have explicit equity and ethical components, however such partnerships do not just happen, they are built over time through the commitment of their members. Long term partnership success benefits from systematic and ongoing self evaluation, learning for past experiences and refining management functions, working relationships and conflict resolution strategies. \ud \ud Ethical partnerships should understand the social context and influences on behaviours, together with barriers to, and enablers of, behaviour change. Failure to collect and utilise data relating to these factors is both unethical and likely to compromise intervention effectiveness. Partnerships should improve access to priority target segments, with ethical issues arising regarding agreement on priorities and on allocation of resources. A balance is also needed between developing interventions which may offend some sectors of society and addressing culture-based perceptions that may be counter to perceptions of best practice. \ud \ud Effective decision making processes are needed; potential conflicts of interest and independence for all partnerships must be recognised and resolved. This may involve formal or informal contracts or agreements as well as management and communication structures and evaluation of effects and effectiveness. Partnerships can present numerous challenges; failure to effectively resolve these issues may result in frustration, inertia and ultimately ineffective or dysfunctional partnership activity. These challenges may reflect managerial or operational issues, but also issues of partnership credibility, with some industry sectors presenting particular challenges that require analysis before deciding whether or not to proceed with a partnership; there will be times when ethics demand that a partnership is not acceptable.\ud \ud Building ethics into partnership from the start and into governance and management processes as well as ethical implications in conflict resolution and in the evaluation of the effectiveness and ethics of partnership activity will help to guide ethical partnership in the long term.\ud \ud While our knowledge of ethical partnerships continues to expand, there are gaps in the literature, both relating to factors contributing to successful partnerships and long term versus short term effects and return on investment. As more partnerships become operational, contribution to knowledge of success factors and the way that ethical challenges have been dealt with will improve our knowledge and ability to develop and manage successful ethical partnerships in the future