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Provision of Healthcare Services for Children in Iran: Common Ethical Principles and Obstacles to Successful Implementation



Bathaie FS1 ; Ardeshir Larijani B2 ; Farzadfar F3 ; Nedjat S4 ; Emamirazavi SH5 ; Kadivar M6 ; Anaraki FZ3 ; Zinati P7 ; Roshanfekr P8 ; Olyaeimanesh A9 ; Nezamoleslami D1
Authors
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Authors Affiliations
  1. 1. Department of Medical Ethics, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Medical Ethics and History of Medicine Research Center, Endocrinology and Metabolism Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
  5. 5. Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Pediatrics Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Social Planning, University of Tehran, Tehran, Iran
  8. 8. Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation, Tehran, Iran
  9. 9. Social Development and Health Promotion Center, Tehran University of Medical Science, Tehran, Iran

Source: Acta Medica Iranica Published:2018

Abstract

Ethics is an essential element in the provision of healthcare services. Fundamental ethical values determine the manner in which the professional behavior is implemented in the healthcare area. These ethical principles find meaning in time and place and in the social context of ethical values and among children as vulnerable groups. So, this study examined the ethical principles of providing health care services for children and barriers to their application in Iran from key informants’ perspective. Therefore, qualitative content analysis method was used by means of semi-structured questionnaire to theoretical saturation scale with the participation of 20 key informants. Each interview underwent the process of implementation, evaluation, coding, and analysis, and then its findings were presented in two dimensions: desirable principles and barriers for its application, including 15 classes. Desirable principles include autonomy, beneficence, non-maleficence, justice, confidentiality, accent, consent, and participation. Obstacles to their compliance also included weakness of the policy landscape, weakness of the judicial system, cultural conservatism, socio-economic inequality, services commodification with unequal distribution, resource mismanagement (limitation), weakness of the professional education system, and the emergence of complex situations. From the key informants’ point of view, codes of ethics do not differ significantly from international principles, but their application is faced with difficulties, and they are likely to be improved through evidence-based policies according to the results of scientific studies. © 2018 Tehran University of Medical Sciences.