Applying an ethical lens to the provision of care in for-profit healthcare facilities

Abstract

In early 2023, after three years of pandemic and delayed care, Ontario faced an overwhelming backlog of elective surgical procedures and unacceptable wait times. With hospitals experiencing historic health human resources shortages and critical capacity limitations, disruptive change was required. The Ontario government proposed to address these mounting access-to-care issues by paying for-profit healthcare clinics and surgi-centres to provide insured services, resulting in considerable controversy, much opposition, some praise, and many public protests. Previous experiences with for-profit independent health facilities had generated both complaints and documented problems with their operations. This article examines these concerns against the ethical principles of autonomy, beneficence, non-malfeasance, and justice. While much of this unease can be effectively addressed through collaboration and oversight, the complexity and costs involved in ensuring equity and quality may make it difficult for such facilities to maintain profitability.