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Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in reflexive governance operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics.

Ce compte-rendu synthétise les échanges tenus lors du 3ème Café de bioéthique de 2019 à Québec, qui ont porté sur le thème : « Le citoyen comme acteur de santé publique : défis et opportunités ». Trois panélistes – Yan Kestens, Allison Marchildon et Karine Lefeuvre – ont enrichi cette rencontre de leur expertise en santé publique et en éthique. Cet échange a fait ressortir la valeur de la participation citoyenne en santé publique et l’importance d’en nuancer sa compréhension et sa mise en application. Il est prioritaire de considérer les relations entre les différentes parties prenantes, les facteurs contextuels pouvant affecter ce processus et les stratégies éthiques permettant de renforcir de « bonnes » participations citoyennes. Cette rencontre s’inscrit dans une série de Cafés de bioéthique tenus à Montréal et à Québec sur le sujet de l’éthique, de la santé et des données.

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