The Place of Bioethics within the Complaints Examination System in the Quebec Health and Social Services Network

Abstract

In Quebec, the complaints examination process in the health and social services network contributes to the continuous improvement of care by allowing users to voice their dissatisfaction to an independent body with the authority to make recommendations to institutions. This process fosters the active participation of users and therefore contributes to democratizing care and services. In addition to its obvious connection with this empowerment objective, bioethics is ubiquitous in the work of the bodies responsible for applying the process, namely the complaints commissioners’ offices. This article highlights the implicit use of concepts from bioethics in the day-to-day work of complaints commissioners’ offices. We discuss autonomy from the perspective of self-determination and confidentiality in analyzing the complaints’ admissibility. We discuss justice in terms of fairness in resource allocation and epistemic justice in complaints’ examination. Next, we discuss the similarities in methodologies between bioethics and the complaints examination process, namely clinical ethics grids and narrativity. Finally, we discuss the importance of impartiality, independence, and transparency in the work of complaints commissioners. We conclude by offering some reflections on ways to update the empirical knowledge regarding the objectives of fostering users’ participation in their care and democratizing care.