Investigating Conceptual Frameworks of Justice in the Field of Healthcare


avatar Elham Jaberi 1 , * , avatar Roksana Mirkazemi 1

Hooman Hamrahane Danesh Institute, Shiraz, Iran

how to cite: Jaberi E, Mirkazemi R. Investigating Conceptual Frameworks of Justice in the Field of Healthcare. Shiraz E-Med J. 2017;18(Suppl):e58666. doi: 10.5812/semj.58666.



Background: Despite the remarkable breakthroughs that characterize health improvement and medical care services, countries worldwide differ in terms of recognizing health as a right that every individual can enjoy. Although over the past years specific attention has been given to this problem, practicing justice in healthcare still represents a serious challenge in all societies, even in those with a high healthcare index. One of the reasons for this situation could be attributed to the inefficiency of the conceptual framework and principles underlying practical measures. The purpose of this study is to (a) conduct a critical case study on the notion of justice in healthcare; (b) explicate the conceptual and intellectual foundations in this area; and (c) criticize the functionality of justice in response to the needs of modern societies.

Methods: All of the papers indexed in the scientific database PubMed concerning justice in medical care, published between 1997 and 2016, were filtered. The keywords used in this search included “Equity”, “Justice”, “Equality”, and “Health”, which appeared in the papers’ titles and/or abstracts. To select a paper for further investigation, its contribution to fundamentals and conceptions of justice in healthcare was considered. As a result, case studies and empirical research into indexes and contexts were excluded from the primary screening.

Results: A total number of 12177 papers corresponding to the keywords used in this study were found in the PubMed database, although considering the criteria for paper selection, 200 papers were finally marked for investigation. Results of papers review suggested that the four Modem central schools (viz. Liberalism, Utilitarianism, Conventionalism and Egalitarianism) justifying justice in medical care could not satisfactorily solve the problem of justice in healthcare. The inefficiency of the existing approaches to address human nature and identity has led to a situation in which no comprehensive framework is there to subsume justice and health, as well as the interaction between them, within a holistic system. The common philosophical definition, which emphasizes the full realization of legitimate rights, demands reaching a new compromise and proposing a profound insight into human rights, which is a notion interwoven with human nature and identity.

Another challenge is lack of sufficient understanding of collaboration in improving health at individual and social levels, and of the collaborative role of the society in empowering individuals, communities and institutions responsible for health. The present conceptual challenge is how to define justice in healthcare, considering accessibility to and use of medical services, along with issues such as the quality of health in every society. In fact, serious and profound notions, such as social/individual collaboration in sustaining health and use of medical services, have not been substantially dealt with by scholars in the field.

Conclusions: The observations of the study suggested that there were fundamental challenges to conceptualizing and formulating precepts in justice and healthcare. This study scrutinized the foundations of justice and medical care, as well as the challenges complicating the topic, from a new perspective.


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