Table 1.
Justice constructs and illustrative quotes
| ELEMENT OF JUSTICE | DEFINITION ADAPTED (BY RESEARCHERS) TO THE HEALTH CARE CONTEXT | ILLUSTRATIVE QUOTES |
|---|---|---|
| Distributive justice12 | Perceptions of the fairness of the outcomes patients receive (ie, that they believe they need) (eg, timely appointments, medications, and access to care including referrals) | “I can get in to see him pretty much anytime I want.” “I find it great, you can always rely on her and if she doesn’t know what your problem is, she’ll find out.” “I’ve never been helped any time I’ve ever went there. Ever. Not once.” |
| Procedural justice13,14 | Perceptions of the fairness of the decision-making procedures used by the health care provider to diagnose problems and make decisions or recommendations | |
| • Accuracy | Is accurate information collected and used to make decisions? Does the provider use good information and informed opinion? | “He had a routine that [made sure] he didn’t miss anything.” “He doesn’t just speculate ... he’ll send you for tests.” “She tends to … brush things off and not really investigate enough to make sure there is nothing else going on.” |
| • Bias suppression | Does the provider suppress personal biases against the patient (eg, based on race, age, sexual orientation)? | “I told him I was homosexual … it just wasn’t an issue.” “They’re judging you and you know they are. I could just read that from her.” |
| • Consistency | Is there consistency in decision making (over time and across patients)? (Continuity and coordination of care were included in this category) | “It’s just important that all my records are in one place.” “She wants to encourage regular monitoring.” |
| • Correctability | Does the patient have the ability to correct flawed or inaccurate decisions (eg, treatments that the patient does not feel comfortable with or that are not working)? | “I’m not comfortable questioning the doctor.” “The nice thing about [her] is that if something wasn’t working for me I can just go in and say, ‘We need to look at something else.’” “I used it once and I didn’t like the effect … so, I said I’m not going to take this [medicine] … I’m taking it back to [the doctor] and telling him I want something more current.” |
| • Voice or representativeness | Does the provider ensure that the opinions of those affected by the decision have been taken into account? Does the provider ask the patient for input regarding his or her care and consider the patient’s viewpoint? Does the provider give the patient ample opportunity to present his or her case or symptoms? | “I just honestly felt that she cared about what I was talking about.” “The doctor needs to hear my voice.” “I think probably he doesn’t take me seriously.” |
| • Ethicality | Does the provider adhere to prevailing ethical and moral standards? | No quotes were coded with this label |
| Interpersonal justice5,15 | Does the provider treat the patient with dignity, respect, consideration, and sensitivity, and show a general sense of caring about the patient? | “She is not the sort of doctor that will ever say, you know, ‘This is a ridiculous waste of my time. Why are you bothering me with this little thing?’” “There’s always that kind of warm welcome, and ‘How’ve you been?’” “It’s kind of very sterile, like ‘What’s wrong with you? Next!’” |
| Informational justice5,15 | Does the doctor adequately explain courses of treatment and diagnoses? Does the doctor explain how he or she arrived at a course of treatment? Is he or she honest in his or her communications with patients? Does he or she give patients information (eg, about side effects)? | “She is explaining why I need this, why I need that, and what the procedure is like.” “She just signs the paper and goes … ‘This is what work you need done’ … I’d like to know what it’s for … I want to know what each one means and what … they’re testing for. She never tells me.” “I don’t feel like taking a pill just because they say … ‘You have this. Take an antibiotic.’ Like, I need to know why.” |