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Ethics involves examining values and identifying what is good, right, and justified - and why. Diverse values and ethical issues run through healthcare improvement, but they are not always recognised or given the attention they need. While much effort goes into understanding whether intervention X effectively leads to change Y, questions such as 'is X ethically acceptable?', 'does Y count as an improvement?', 'should Y be prioritised?', and 'if so, why?' are sometimes neglected. This Element demonstrates the ethical considerations and rich array of values that inevitably underpin both the goals of healthcare improvement (what aspects of quality or what kinds of good are pursued) and how improvement work is undertaken. It outlines an agenda for improvement ethics with the aim of helping those involved in healthcare improvement to reflect on and discuss ethical aspects of their work more explicitly and rigorously. This title is also available as Open Access on Cambridge Core.

Theoretical perspectives : an introduction / Jonathan Ives, Michael Dunn, Alan Cribb -- Empirical bioethics and the fact/value distinction / John McMillan -- Metaethics, relativism, and empirical bioethics / Mark Sheehan -- Empirical bioethics and the role of the professional ethicist in policy making : politics, authority, and expertise / Kyle T. Edwards, Zuzana Deans -- Evidence, epistemology, and empirical bioethics / Ilina Singh -- Friends, foes, flatmates : on the relationship between law and (empirical) bioethics / Richard Huxtable -- Embracing diversity in empirical bioethics / Alan Cribb, John Owens -- Practical perspectives : an introduction / Michael Dunn, Jonathan Ives, Alan Cribb -- Moral improvement through interactive research : a practice example of dialogical empirical bioethics / Elleke Landeweer, Bert Molewijk, Guy Widdershoven -- Reflective equilibrium as a normative empirical model : the case of Ashley X. / Ghislaine J.M.W. van Thiel, Johannes J.M. van Delden -- Theory and practice of democratic deliberation in bioethics research / Scott Kim -- Feminist empirical bioethics / Jackie Leach Scully -- Lessons from experience : establishing and running interdisciplinary mixed method bioethics research / Bobbie Farsides, Clare Williams -- Publishing research in empirical bioethics : quality, disciplines, and expertise / Lucy Frith, Heather Draper

Personalisation is a key term in contemporary British social policy. This article conceptualises personalisation as embodying two aspects – marketisation and social justice – and explores their interaction in discourses and practices of personalisation in disability services and healthcare. Comparing the application and reception of personalisation in these two social policy domains, the article identifies a tendency of marketisation to override social justice and highlights the negative implications of this tendency. The analysis is further contextualised by looking at the uses of personalisation to legitimise retrenchment of public provision in the context of post-2008 austerity. In conclusion, the article calls for a critical engagement with the dominant interpretations of personalisation in order to prevent its reduction to a vehicle for unchecked marketisation of social policy.

Co-creation is seen by many as a means of meeting the multiple challenges facing contemporary health care systems by involving institutions, professionals, patients, and stakeholders in new roles, relationships, and collaborative practices. While co-creation has the potential to positively transform health care systems, it generates a number of political and ethical challenges that should not be overlooked. We suggest that those involved in envisioning and implementing co-creation initiatives pay close attention to significant questions of equity, power, and justice and to the fundamental challenge of securing a common vision of the aims of and agendas for health care systems. While such initiatives present significant opportunities for improvement, they need to be viewed in light of their accompanying professional, political, and ethical challenges.

The chapter is based on a narrative analysis of 22 academic life histories conducted during 2014 and early 2015. The UK higher education (HE) system, driven by the neoliberal project of successive governments, has seen significant reforms to its financing and structure in recent years. Furthermore, despite having produced a substantial critical literature on HE reform, UK social scientists do not seem to have been very effective in resisting HE neoliberalisation, and in many cases could be said to be relatively compliant even complicit with the very measures critiqued in the literature. At the end of 2010 the UK Conservative Liberal Democrat coalition government decided to radically restructure funding for English universities. For science, technology, engineering and mathematics teaching that cannot be covered by tuition fees alone Higher Education Funding Council for England 2015 funding was reduced, but not terminated.

Acknowledgements Many thanks to Cynthia Fraser, Information Specialist (Health Services Research Unit, University of Aberdeen), for leading the design and conduct of the literature searches, document retrieval and reference management. The Health Services Research Unit, University of Aberdeen is core funded by the Chief Scientist Office of the Scottish Government's Health and Social Care Directorates. The authors accept full responsibility for this paper. Funding This research was funded by The Health Foundation (Project reference 7209). ; Peer reviewed ; Publisher PDF