Articles
DOI DOI: 10.62441/actainnovations.v63i.1093

PHILOSOPHICAL FOUNDATIONS OF HEALTH ADMINISTRATION: TOWARD AN ONTOLOGICALLY PLURALIST, EPISTEMOLOGICALLY INCLUSIVE, AND ETHICALLY SYSTEMIC GOVERNANCE FRAMEWORK

Muhammad Idris Patarai1
  1. 1 Graduate Program, Universitas Megaresky

Abstract

Contemporary health administration increasingly confronts governance failures that cannot be attributed solely to resource deficits or managerial inefficiencies. This article argues that such failures are rooted in unresolved philosophical misalignments, specifically the absence of explicit ontological, epistemological, and ethical foundations in health system design. This study aims to systematically map the interrelationships among ontology, epistemology, ethics, and governance within health administration, and to identify the structural breaks in this chain that produce predictable policy failures. A narrative synthesis of Scopus-indexed literature published between 2015 and 2024 was conducted, encompassing studies on health philosophy, clinical epistemology, bioethics, digital health governance, and learning health systems across diverse global contexts. Four critical findings emerge. First, ontological incoherence, particularly the unreflective adoption of biomedical reductionism distorts quality measurement by optimizing for what is measurable rather than what is genuinely valuable. Second, epistemological monism in health professional education produces practitioners ill-equipped to integrate empirical, normative, and experiential knowledge, a deficit intensified by the advent of AI-based clinical decision support systems. Third, classical bioethics, while normatively valid, is architecturally insufficient to manage moral responsibility in distributed, technology-mediated, and systemically complex health organizations. Fourth, existing health governance evaluation tools lack the philosophical depth necessary to assess governance quality in its full normative and contextual dimensions. Health administration must be reconceptualized as a discipline explicitly grounded in philosophical foundations. A unified framework that is ontologically pluralist, epistemologically inclusive, ethically systemic, and adaptively governed is proposed. This framework is not a universal prescription but a normative structure enabling contextual adaptation while maintaining moral coherence. Implications are drawn for policy design, health professional education, AI ethics in healthcare, and governance reform in transitioning health systems, with particular relevance for Indonesia and the Southeast Asian context.

How to Cite

Patarai, M. I. (2026). PHILOSOPHICAL FOUNDATIONS OF HEALTH ADMINISTRATION: TOWARD AN ONTOLOGICALLY PLURALIST, EPISTEMOLOGICALLY INCLUSIVE, AND ETHICALLY SYSTEMIC GOVERNANCE FRAMEWORK. ACTA INNOVATIONS, 63, 218–229. https://doi.org/10.62441/actainnovations.v63i.1093
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