The premises that individuals cannot be cared for without meeting group needs and that attendance and management cannot be separated show that moral deliberations on clinical action regarding individual care cannot be dissociated from strategic planning by local teams and management. This planning needs to be integrated with surveillance, to detect health-related needs within the attendance context. It should be linked to municipal central management so as to make agreements regarding the intersectoral actions necessary for expanding individuals’ and populations’ healthcare. For moral decisions involving clinic deliberation to be made, certain conditions that depend on strategic planning in this field are required. It can be seen that the processes of moral deliberation proposed by Gracia and strategic planning proposed by Matus present cognitive, valuation-related, operative and evaluative stages that are largely homologous. This paper ends with a complex concrete case of primary care in which these different stages were implicated.
Primary healthcare; Ethics; Management; Surveillance; Strategic planning
