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Showing 11 results for Justice
Moral responsibility of the physician in response to the patient’s request for assisted reproductive technology
Fatemeh Doomanlo, Amirhosin Khodaparast,
Volume 6, Issue 1 (4-2013)
Abstract
Professionals who provide assisted reproductive technology (ART) services may be approached by patients who have no chance of success of treatment, or can even be harmed during the requested futile treatment. In such cases, what is the moral duty of those who provide treatment services, in particular the physicians? Does the mere request on the part of the patient free the doctor from his/her professional moral responsibilities? On the one hand, principles of individual autonomy and beneficence require the doctor to provide the patient with necessary treatments regardless of the results and consequences. On the other hand, the principle of non-maleficence requires the physician not to impose any harm on the patient. In addition, due to the limitation of resources, doctors are obliged to allocate them to those patients who have a better chance of recovery and use them in cases in which the probability of resource waste is low. However, does this sit well with the principle of justice, especially where the patient is willing to pay all the costs of his/her treatment? Whose interest does the doctor have to prioritize, the patient’s, that of the child resulting from ART, or the society’s? Given the above points, moral training of the team providing treatment services seems necessary so that they acquire the essential skills to make the right decisions in difficult situations such as those mentioned above.
Relationship between organizational justice and job stress among hospital personnel
Marjan Mardani Hamooleh, Ehteram Ebrahimi, Mehrdad Mostaghasi, Taraneh Taghavi Larijani,
Volume 6, Issue 3 (8-2013)
Abstract
Organizational justice is of great importance particularly for hospital personnel, and job stress has the potential to put their health at risk. The purpose of this study was to determine the relationship between organizational justice and job stress among the personnel of a hospital in Isfahan. In this correlation study, the samples consisted of 150 personnel that were working in a governmental hospital in Isfahan. Samples were selected through convenience sampling in 2012. Data were gathered by personal data questionnaire, Niehoff organizational justice questionnaire and job stress questionnaire. Data were analyzed by descriptive and analytical statistics. Results showed that job stress among hospital personnel varied from 48.6% (moderate) to 39.4% (mild) and 12% (severe). Moreover, findings showed there was a relationship between organizational justice in the domain of interactional justice and job stress among hospital personnel (r = - 0.18, P = 0.03). According to the findings, it is essential to pay attention to the concept of organizational justice in hospitals in order to decrease job stress among the personnel.
Justice in the healthcare system: payment and reimbursement policies in Iran
Hannan Hajimahmoudi, Farzaneh Zahedi,
Volume 6, Issue 3 (8-2013)
Abstract
Justice is one of the main principles of ethics in the healthcare system, and its establishment at macro level depends on formulation of appropriate policies by policy-makers and healthcare providers. Health care policies and payment and reimbursement systems have a significant impact on health systems’ efficiency and cost control. In this paper, payment and reimbursement policies and their impact on financial incentives will be reviewed moreover, financial policies in the national health care in Iran and related challenges will be mentioned in brief. There is no doubt that none of the payment and reimbursement policies is perfect and each of them has the potential to put caregivers or health care providers financially at risk. Therefore, policy-makers should select a combination of the best approaches, considering socioeconomic factors, in order to provide a maximum coverage of health services and ensure fairness in the health system. Efficient payment and reimbursement approaches should undoubtedly preserve the rights of all parties in a fair and logical manner. Current national policy shows that a high percent of health care expenditures are financed through out-of-pocket payments, and therefore appropriate policies should be adopted to lighten this burden. Considering the accelerated trend toward the Family Doctor Plan in big cities in Iran, the present paper would be helpful for many health care providers, physicians and other health care professionals.
The relationship between perceived organizational justice and quality of work life among the personnel of a selected hospital in Ahvaz
Ali Akbar Aminbeidokhti, Ebrahim Mardani,
Volume 7, Issue 2 (7-2014)
Abstract
Organizational justice can dramatically impact the personnel’s attitudes and behaviors and is therefore considered to be of great importance. Moreover, high quality of work life is known as the basic prerequisite to empower human resources in healthcare systems. The aim of this study was to determine the relationship between perceived organizational justice and quality of work life among hospital personnel.In this descriptive correlational study, the samples consisted of 268 staff members of a public hospital in Ahvaz. Samples were selected through census. Data were gathered by a demographic information questionnaire, Niehoff and Moorman Organizational Justice Scale, and Quality of Work Life Questionnaire. Data analysis was performed using descriptive and analytical statistics.Results showed that quality of work life among the hospital personnel in this study was moderate (64.2 %), relatively good (16%), poor (13 %) and good (6.8%). Dimensions of organizational justice including distributive and procedural justice had a significant relationship with quality of work life.Since there is a direct relationship between perceived organizational justice and quality of work life, hospital managers should pay attention to this issue, which will lead to enhanced quality of work life in personnel.
Eugenics and Ethical Considerations Regarding the Violation of Justice
Hosein Fasihi, Seyyed Mohammad Hoseini Souraki,
Volume 14, Issue 0 (3-2021)
Abstract
It is clear that technologies related to medicine and genetics, especially genetic engineering and eugenics, have grown significantly in recent decades. These advances have led to prevention of abnormalities and treatment of diseases. However, it seems the use of genetic engineering and eugenics and the possibility of irresponsible and profitable use of these technologies it's worrying. Hence, some moral philosophers say that to use eugenics’ methods it is morally wrong. Because the result of eugenics is injustice. In this study, while referring to the meaning and types of eugenics and related ethical issues, moral considerations to eugenics are explained and analyzed with emphasis and focus on the violation of justice and with analysis and explanation, it becomes clear that with some wise decisions, injustice caused to eugenic can be prevented or reduced.

Ethical Challenges in Precision Medicine from the Perspective of Health Equity
Mojtaba Norouzi , Ali Akbar Haghdoost , Mina Mobasher,
Volume 16, Issue 1 (3-2023)
Abstract
Scientists now believe that precision medicine, which employs complicated technology and information derived from omics, can treat complex diseases and provide justice in health. Implementation of precision medicine will face new ethical challenges, considering the principles of medical ethics. With respect to philosophical principles, this study addressed the issue of justice and some ethical challenges of precision medicine. Because, in order to gain the benefits of precision medicine, a proper ethical framework must be developed while considering the challenges. The manner in which precision medicine information is shared and accessed can have an impact on people’s future careers, marriage choices, and type of health insurance. Furthermore, preserving people’s privacy and autonomy are important ethical concerns in precision medicine since there will be no perfect guarantee about data security and access. Although in the short and medium term, due to the design of studies and expensive and complex technologies, precision medicine will be limited to certain groups and will intensify the inequality in justice, in the long run, with the easy access and inexpensive cost of precision medicine technologies, the accumulation of medical expenses will decrease throughout life, and justice will be established between and within countries.

Ethical Challenges in Admission and Resource Allocation for Patients in Need of Rehabilitation Services
Mohammadjavad Hosseinabadi Farahani,
Volume 17, Issue 0 (12-2024)
Abstract
Ethical challenges and concerns have long been a part of healthcare, primarily focusing on acute care or end-of-life decisions. However, with the growing elderly population and society's emphasis on restoring patients to the highest possible level of functioning, ethical dilemmas in rehabilitation care have garnered increasing attention. Ethical decisions are a routine part of rehabilitation care. While some are straightforward, such as obtaining informed consent for therapeutic and rehabilitation procedures, others are far more complex. Among the most significant challenges are resource allocation and the selection of patients for rehabilitation services. The process of selecting patients for admission to rehabilitation centers is typically carried out by specialist physicians. However, many centers face demand that exceeds their capacity, necessitating difficult decisions about patient prioritization. Although some centers may have clear guidelines, patient selection is often subjective, involving multiple factors such as:
  • Clinical considerations: Diagnosis, prognosis, secondary complications, and learning ability.
  • Non-clinical factors: Social, occupational, personal, and financial circumstances.
This subjectivity in patient selection raises several ethical concerns. The rights, duties, and responsibilities of both patients and physicians must be carefully weighed. The potential for injustice exists when decisions become overly subjective, leading to possible inequities in resource allocation. Balancing the ethical principles of beneficence (acting in the patient’s best interest) and justice (fair distribution of resources) is essential but can be challenging, as these principles may occasionally conflict. To address these issues, members of the rehabilitation team, particularly physicians, must strive to minimize subjectivity in their decisions. Additionally, it is important to implement follow-up mechanisms for patients initially denied admission, ensuring that any changes in their condition are reevaluated. Medical and rehabilitation ethicists should prioritize the development of clear, evidence-based guidelines for patient selection and admission. These guidelines should be made accessible to the rehabilitation team to promote fairness, transparency, and consistency in decision-making, ultimately ensuring that resources are allocated equitably to those in need.

Ethical Considerations in Post-Crisis and Disaster Rehabilitation
Mohammad Javad Hosseinabadi Farahani,
Volume 17, Issue 0 (12-2024)
Abstract
Rehabilitation in disaster contexts, as part of the overall medical response, faces unique challenges, particularly during the early stages of post-disaster intervention. This is largely due to the relatively new integration of rehabilitation into disaster management. The four principles of bioethics—autonomy, beneficence, non-maleficence, and justice—are essential considerations in immediate post-disaster relief efforts and in the subsequent long-term rehabilitation processes. This review study involved a purposeful search of reliable databases using predetermined keywords, covering the period from 2000 to 2024. The reviewed studies highlight several ethical dilemmas in delivering rehabilitation services after crises and disasters. These challenges arise due to factors such as:
· Resource limitations,
· Insufficient focus on rehabilitation within health systems,
· Shortages of rehabilitation specialists,
· Inadequate follow-up cares post-discharge,
· Limited awareness of the significance of rehabilitation, and
· Stigma associated with disability.
Despite these challenges, it is critical to uphold the four principles of biomedical ethics even in crisis situations. Adhering to these principles ensures that rehabilitation services align with professional norms, ethical standards, and the medical aspects of the local culture. Furthermore, policies aimed at enhancing the status and importance of rehabilitation immediately after crises and disasters must emphasize the equitable distribution of resources.

Ethical Considerations in Post-Crisis and Disaster Rehabilitation
Mohammad Javad Hosseinabadi Farahani,
Volume 17, Issue 0 (12-2024)
Abstract
Rehabilitation in disaster contexts, as part of the overall medical response, faces unique challenges, particularly during the early stages of post-disaster intervention. This is largely due to the relatively new integration of rehabilitation into disaster management. The four principles of bioethics—autonomy, beneficence, non-maleficence, and justice—are essential considerations in immediate post-disaster relief efforts and in the subsequent long-term rehabilitation processes. This review study involved a purposeful search of reliable databases using predetermined keywords, covering the period from 2000 to 2024. The reviewed studies highlight several ethical dilemmas in delivering rehabilitation services after crises and disasters. These challenges arise due to factors such as:
· Resource limitations,
· Insufficient focus on rehabilitation within health systems,
· Shortages of rehabilitation specialists,
· Inadequate follow-up cares post-discharge,
· Limited awareness of the significance of rehabilitation, and
· Stigma associated with disability.
Despite these challenges, it is critical to uphold the four principles of biomedical ethics even in crisis situations. Adhering to these principles ensures that rehabilitation services align with professional norms, ethical standards, and the medical aspects of the local culture. Furthermore, policies aimed at enhancing the status and importance of rehabilitation immediately after crises and disasters must emphasize the equitable distribution of resources.

Challenges of Human Resource Allocation in the Health System
Kourosh Delpasand,
Volume 17, Issue 0 (12-2024)
Abstract
All health systems face the dual challenge of resource shortages, which prevent them from providing all the services needed by society, while also striving to enhance justice in access to health services and care. The prioritization and allocation of resources are critical issues in the health sector, and ensuring fairness in these processes requires consideration of various criteria. This study aims to examine the methods of allocating human resources in the health sector and explain the challenges associated with allocating skilled human resources in the country. This qualitative study involved faculty members and individuals with a history of responsibility in the university. Data collection was conducted through interviews, which were arranged based on mutual agreement with participants. Interviews continued until saturation was reached, meaning they concluded when participants had no further information to provide and the interviewer had no additional questions aligned with the research objectives. The findings were categorized as follows:
  • Prioritization Issues: The prioritization of resources is often directed towards newly established departments and hospitals, and personnel are allocated to new branches to launch new fields. The definition of processes important to the Ministry of Health is based on specific provincial conditions, which may not be included in standard lists. Prioritization should, therefore, be determined based on relevant indicators and the performance of personnel.
  • Organizational Challenges: Organizational charts are outdated, and organizational structures are often unresponsive. Recruitment is based on obsolete charts, and there are discrepancies between created positions and the personnel recruited to fill them. Political influences, such as deception and hypocrisy, also complicate the allocation process.
Population Considerations: The floating population of each province must be considered in resource allocation. The periodic involvement of some individuals as companions and contract personnel in advisory roles alongside university presidents poses challenges. A gradual approach with well-defined management and realistic goals should be implemented over a five-year period.
  • Management and Decision-Making: Human resource managers in universities lack decision-making authority. A national team of managers, specialists, and experts should be formed to address human resources needs. Human resources should be identified based on the estimated needs of existing fields. It is also essential to establish efficiency measurement frameworks grounded in relationships, but the Ministry of Health lacks specific notifications regarding these matters. Efficiency should be measured based on personnel performance and appropriately defined indicators.
  • Emerging Challenges: The migration of specialists in various fields, combined with reluctance among doctors to pursue specialist-level studies in areas such as emergency medicine and pediatrics, further exacerbates human resource allocation challenges. Adding specialist experts and evaluating personnel before hiring are essential measures to address this issue. Additionally, consideration should be given to restructuring the Ministry of Health by dividing it into separate sub-units with distinct financial and management mechanisms.
This study identifies and extracts the criteria used for prioritizing and allocating resources within the health system. According to experts and policymakers in health and medical organizations, additional criteria should be considered beyond traditional metrics when prioritizing and allocating human resources.

A Critical Review of the Ethical Aspects of the Electronic Health Record System (SPAS in Iran)
Shiva Khaleghparast, Saied Bagheri Faradanbeh, Samaneh Karimian, Fahimeh Khosrobeigi Bozchaloei, Seyed Ebrahim Hoseini Zargaz, Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
The electronic health record system (SPAS in Iran) records information related to the health of individuals in an electronic format. It is the center for collecting health information and data on outpatients and inpatients. This system records information such as the patient's full name, marital status, gender, date of admission, level of education, occupation, type of admission, and other relevant medical data. The core values and ethical requirements of SPAS include safeguarding citizens' rights, respecting individuals, observing justice and fairness, transparency, encouraging participation, and accountability. In this study, the ethical aspects of SPAS were evaluated using the model proposed by the World Health Organization (WHO) for ethical evaluation. This model emphasizes fundamental ethical principles such as human well-being and health, respecting individuals and communities, justice, and fairness. Concerning human well-being and health, SPAS can prevent unnecessary and redundant interventions and provide physicians with quick access to an accurate patient history. Furthermore, the system ensures the confidentiality of information, which is essential to respect individuals and communities. Regarding justice and fairness, the system can improve access to health services for disadvantaged and remote areas. Moreover, SPAS adheres to procedural ethical principles such as solidarity, transparency, participation, and accountability. Therefore, by critically examining the ethical dimensions of the electronic health record system (SPAS), the findings of the present study provide valuable insights for policymakers, health professionals, and regulatory organizations to ensure the ethical and efficient performance of electronic health record systems in Iran.

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