Ethical considerations in prevention and management of non-communicable diseases: a narrative review

Elnaz  Shahmohamadi; Aryan  Ayati; Yasaman  Sharifi; Pouya  Ebrahimi; Ehsan Shamsi  Gooshki; Shirin  Djalalinia; Mahbube  Ebrahimpur; Moloud  Payab; Bagher  Larijani

doi:10.18502/jmehm.v17i19.18671

Elnaz Shahmohamadi Non-communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Aryan Ayati Non-communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Yasaman Sharifi Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Pouya Ebrahimi Tehran Heart Center Cardiovascular Disease Research Institute, Tehran University of Medical Sciences Tehran Iran.
Ehsan Shamsi Gooshki Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Lecturer, Monash Bioethics Center, Monash University, Melbourne Australia.
Shirin Djalalinia Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
Mahbube Ebrahimpur Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Moloud Payab Non-communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Bagher Larijani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jmehm.v17i19.18671

Keywords: Non-communicable diseases; Prevention; Health services; Gender equity; Management; Healthcare ethics.

Abstract

In recent years, alarming trends in non-communicable diseases (NCDs) have grown into some of the most important health concerns worldwide. The present research attempts to address the controversial approaches to the practical function of medical ethics while critically reviewing the main concepts of ethical considerations in NCD prevention literature. After refining the searched documents, we integrated related concepts and research, particularly emphasizing ethical considerations in NCD management. All four functional areas of NCD prevention (general health policymaking, social interventional, primary prevention, and secondary prevention) are affected by parallel associated factors of health determinants: environmental modification, lifestyle improvement and physiological characteristics, respectively. In addition to the practical aspects of implementing a response to NCDs, a variety of ethical considerations should be taken into account. For instance, general policies, equity in care, interventional programs, and clinical/research data protection. A comprehensive, holistic approach considering all the involved parties can accommodate the wide spectrum of needs and continuum of management for NCDs. Creating an ethical procedure structure in public health systems can provide insight into managing the challenges posed by NCDs to health systems and assist in systematically confronting ethical problems in the management of NCDs.