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This term is derived from Williamson O.E., (1989), The economic institutions of capitalism, New York, who introduced the term governance structures. A governance instrument is a measure at the meso-or macro-level taken by the government or other actors in health care to bring about changes in the functioning of the health care system.
MacIntyre A. (1981), After virtue. A study in moral theory. London: Duckworth, p.175.
For the difference between goal and finality see: Dooyeweerd H. (1953-1958), A new critique of theoretical thought. Amsterdam/Philadelphia: The Presbyterian and Reformed Publishing Company, vol. III p.570, 571.
Strijbos S. (ed. 1992), De medische ethiek in de branding-Een keuze uit het werk van Gerrit Arie Lindeboom, Amsterdam,p. 121, 122.
See for example Unschuld, PU. Professionalisierung und ihre Folgen. In: Schipperges H, Seidler E, Unschuld PU. (eds). Krankheit, Heilkunst, Heilung. Freiburg/München 1978: p.519,520. Unschuld concludes that the central meaning of the concept of profession is the pursuit of the selfless rendering of a public service and the independence in practicing the work typical for the particular profession.
Cf. Puolimatka T. (1989), Moral realism and justification. Helsinki: Suomalainen Tiedeakatemia, p.143–154. Puolimatka defines benevolence as “a normative attitude which regards the well-being of others as intrinsically valuable”, p.144.
Figure 2 is based on literature on the characteristics of economic systems. See, for instance Gregory PR, Stuart RC, Comparative Economic Systems. Boston: Houghton Mifflin Company, 1989.
In addition to efficiency arguments ideals of liberty are important, cf.:R.E. Moffit.(1994), Personal freedom and responsibility: the ethical foundations of a market-based health care reform. The Journal of Medicine and Philosophy, vol.19:471–81.
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Jochemsen, H., Hoogland, J., Polder, J. (2005). Maintaining Integrity in Times of Scarse Resources. In: Thomasma, D.C., Weisstub, D.N., Kushner, T.K., Viafora, C. (eds) Clinical Bioethics. International Library of Ethics, Law, and the New Medicine, vol 26. Springer, Dordrecht. https://doi.org/10.1007/1-4020-3593-4_11
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