Bioethics committees at the first level of health care in Mexico City

Abstract

Ethical issues in primary care (PC) have been largely overlooked by bioethics. While there’s a general theoretical consensus on the need for such reflection, practical implementation remains elusive. This gap leads to a lack of ethical support and recognition of conflicts among both healthcare professionals and users at this level, often resulting in intuitive, ad-hoc solutions. Few countries, like Spain, Chile, and Norway, have established dedicated bioethics committees for pc and community practice. In Mexico, while bioethics committees exist at all three levels of public administration, those at the PC level represent less than 5 % of the total and often adopt a clinical-hospital approach. This paper presents the “Primary Level of Health Care Bioethics Committees” (PLHBC) project, initiated by the Bioethics Commission of Mexico City. The goal is to promote ethical support committees that can integrate the unique characteristics of pc into bioethical analyses and be incorporated into the local institutional infrastructure. PLHBC are based on the primary health care (PHC) approach to integrate clinical, public health, and organizational ethics into reflection. They aim to build a local network with Hospital Bioethics Committees and Research Ethics Committees to foster a bioethical culture of active citizenship in health-related decision-making.