Patient Favoritism as a Barrier to Justice in Health Care: A Qualitative Study

Justice is one of the basic principles of medical ethics which indicates rightful, fair, impartial, and equitable care. The present study aimed to introduce patient favoritism, a phenomenon that undermines justice.

The present qualitative study was conducted based on some data derived from another qualitative study titled “Investigating the process of achieving justice in nursing care delivery” using content analysis. The data were extracted from semi-structured interviews with 22 participants (i.e., 16 clinical nurses and nurse managers from all over the country and 6 healthcare policymakers). The interviews were in-depth, semi structured, and face-to-face, with open-ended questions.

Based on the data, the concept of patient favoritism can be divided into three themes in the healthcare system of Iran. These themes are as follows: 1) types of patient favoritism with three sub-themes of prioritized patients, patients who receive high-quality services, and those who are exempt of the hospital rules and regulations, 2) reasons for accepting patient favoritism with three sub-themes of the lack of trust in the healthcare system, misuse of public services, and scarce medical resources, and 3) reasons for receiving favored patients with four sub-themes of the sense of entitlement among healthcare workers, inability to defy the commands of superiors, inability to refuse the request of colleagues, and a win-win deal.

The phenomenon of patient favoritism, irrespective of its type, is a barrier to justice in health care and threatens medical ethics. Accordingly, this issue can seriously harm the healthcare system.