This article is a scoping review first step performed according to JBI method (2020) to clarify the “fair care” concept in health. This review is part of an embracing study performed within the “Ethics4Care” Project of the Center of Interdisciplinary Research in Health (CIIS) of the Universidade Católica Portuguesa, which aims to build this concept. The research was made in the Medline and Cinahl’s databases, which resulted in 7 papers. The results revealed two conceptual categories to define the “fair care” concept. The first is related to respect for the principle of justice and, specifically, equity in the health professional actions. The second category refers to respect for people’s right to care. Thus, we found two attributes to define the concept of “fair care” in health that will help in the conceptual construction. In a pandemic moment of COVID-19, when the conflict between the need for care and the possible arises, considering existing resources, these results contribute to a better ethical decision in the search for “fair care” in health.
The concept of “fair care” proposed by Vieira , applies to healthcare in general and nursing care in particular. According to the different scientific approaches, different perspectives in health sciences can be found. Medicine will focus the concept on the search for the most appropriate treatment for the disease and Nursing will consider “fair care” the most appropriate therapeutic intervention according to the human responses to people health-disease situations. In Ethics4Care Project of the Center of Interdisciplinary Research in Health (CIIS) of the Universidade Católica Portuguesa, we are developing a study that seeks to build this “fair care” concept in health care. In this pandemic moment of COVID-19 in which we live, the definition of this concept is essential. Currently, we are experiencing a conflict between what is necessary and what is possible in health care, therefore the search for “fair care” appears to be the greatest ethical challenge for professionals. In this article, we present the preliminary results of a literature review that aimed to synthesize the “the state of art” on the current knowledge in this field.
The study consists of a Scoping Review according to the Joanna Briggs Institute method (2020) . The results presented here are related to the studies described in the papers identified at this method’s first phase when we searched in Medline and Cinahl databases. In this first research, we used the following descriptors gathered in the research equations: “Nursing Care AND Social Justice AND Ethics AND Nursing Ethics” and “Nurs* AND Care AND Fair”. Seven out of eighty-five papers followed the “fair care” concept in health, which were result of studies of different natures [3-9]
In this study, we found that no definitions were given on the “fair care” concept in health. Therefore, we analyzed the 7 papers, searching for the conceptual characteristics presented by the authors. We considered each of these conceptual characteristics as attributes of the “fair care” concept. As the study unfolds, we will group the total attributes found in the literature and build the final “fair care” concept in health. In this scoping review, we found two categories regarding the construction of this concept. These are the category of “justice” and the category of “right to care”. The “justice” category was split into the “equity” subcategory since the studies demonstrate a clear link between these two principles. According to the results of these studies, “fair care” in health is that which is guided by the principle of justice in its Aristotelic  definition of equity. “Fair care” corresponds to the materialization of equity in the relationship between the health professional and the assisted person. “Fair care” incorporates the health professional’s search for an action that responds to the concrete needs of each person and can depart from the general scientific rule. The health professional must seek to give each one what is due, searching for the right balance between different variables in care.
For example, between the safety and effectiveness of care, it is
necessary to look for the justice of professional action to achieve
the “just compromise” of some authors’ approach . The “right
to care” category emerges as a fair care dimension. Fair care in
health must correspond to the satisfaction of the person’s right
to care. The right to health care as a human right that we can find
established for all citizens in the world . The action of the
health professional will be fair, insofar as it respects the content
of this right. In such a way that this fair action corresponds to a
duty of care, as this literature review shows. The duty of care by the
health professional goes beyond the mere obligation to act; it is also
necessary for the health professional to respect the extent of the
person’s right to care. This category presents itself as an important
problematic pandemic moment of COVID-19. Even in the current
reality, there is a conflict between adequate care for each person
according to their needs and the possibility of providing it with
the existing resources. The respect for the person’s right in their
particular situation will be an appropriate measure of fair care. We
found that this study allowed us to identify conceptual categories
for the definition of “fair care” in health.
There are attributes - equity in the provision of care and the right to care – that embrace this definition. The search for a professional action in health that respects the individuality of each person must materialize in an action that responds to their specific care needs. Otherwise, respect for the right to care, by the law, is also a way of acting fair.
This paper revealed the outcome of a study that aims to define the “fair care” concept in health. It presented the results of the scoping review first step in which two conceptual categories emerged: respect for the principle of justice and the right to care in the actions of health professionals. The acting fair must correspond to equitable care in the sense that it respects the special need for care of each person and acting in respect of the right to care that becomes a duty of care for the health professionals. The “fair care” concept has gained two conceptual categories that will allow us to build on its definition. Respect for the principle of justice and the right to care is established as well as two attributes of this concept that contribute to building the final conceptual definition.
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