Key words: Health care innovation, exnovation, empirical ethics, integrated care, patient-centered care, nudging

"Connected at the joints; Calibrating knowledge, morals and health care"

To contain rising health care costs, care professionals have come up with a diversity of new forms of care delivery. In the development and assessment of such new forms of care, values such as health, efficiency and quality of care typically play a decisive role. Yet, if patients and doctors consider care to be unfair, such care delivery will not be sustainable. With the empirical ethical method developed during the PhD research, this study tracked in detail how doctors and patients establish justified health care during consultations and management meetings of such a new form of care delivery, specifically Primary Care Plus. The method combines ethnographic insights into the complex moralities implicit in care practices and the normative perspective of ethicists. People are evaluative, that is normative, beings who navigate practices while observing, reflecting and judging (aspects of) small and larger decisions made in the process. Making these actions explicit in dialogue with patients and professionals, offers a rich source of learning about justice in sustainable care.

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