ABSTRACT
This chapter discusses the ethics of commissioning healthcare services. It also discusses what a healthcare need is and what ought to count as healthcare, the tension between maximising good and respecting individuals and the ethical management of conflicts of interest. The chapter considers the role of patients in commissioning and resource allocation. Before comparing healthcare needs and services to meet those needs, commissioners must first have an understanding of what is a health need and what is properly considered a healthcare service. The core argument for primary healthcare workers' involvement in healthcare commissioning relies on the healthcare worker having a holistic approach to patients, their families, communities and public health. Commissioners of healthcare must consider not just the ethical sources of disagreement inherent in the decisions, but also the epistemic. Commissioning is about respecting the personhood of those whom it claims to serve some of the issues inherent in public participation.
