Bio-Ethics and One Health: A Case Study Approach to Building Reflexive Governance

Abstract

Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in reflexive governance operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics.

Ten golden rules for optimal antibiotic use in hospitals: based on the publication statement of the International Network Group of the World Antimicrobial Resistance

“…The concept of 'One Health' recognizes the interconnectedness of human, animal, and environmental health [44]. To address antimicrobial resistance [45][46][47][48], global collaboration across sectors and in various health areas is necessary (Fig. 6).…”

Governance in mental healthcare policies during the COVID-19 pandemic in Mexico

“…Secondly, through this article we realize that new, more inclusive ( 35 ) and reflexive ( 36 ) governance models are necessary to face the complexity of contemporary Global Health challenges. On the one hand, inequalities affect the health and wellbeing of populations at global, regional, and national levels.…”

“…Finally, in a multi-actor and multi-scale environment, it is imperative to establish the foundations of a methodological framework in empirical bioethics that can serve as a starting point for building a reflective governance model in the field of Global Health. This process of ongoing critical thinking involves “mapping, framing and shaping” the dynamics of interests and perspectives that could jeopardize a collaborative scenario ( 36 ). Finally, the conclusion of this article clearly shows us the need to develop governance models in the field of Global Health with clearly defined social purposes, allowing key actors to collectively build sustainable decision-making processes, more adapted to the needs of populations and our planet.…”

Retos y oportunidades en la accesibilidad de datos

“…Los gobiernos deben establecer un marco legal y ético para la investigación y el desarrollo. Facilitando mecanismos de comunicación para que los ciudadanos estén informados del beneficio de la investigación basada en datos, y facilite la colaboración a través de asociaciones públicoprivadas-académicas (Boudreau LeBlanc et al, 2022). Una tarea pendiente en América latina y el Caribe es crear el ambiente para generar confianza en la institucionalidad de los estados, en un reporte publicado por el BID sobre la confianza en la región, los porcentajes en América latina son muy bajos, comparados con países europeos (Keefer & Scartascini, 2022), nueve de cada diez encuestados no confía en los demás.…”