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1. :‫اﻟﺻﺣﯾﮫ‬ ‫اﻟﻣﻧظﻣﺎت‬ ‫ﻋﻠﻰ‬ ‫وﺗﺎﺛﯾره‬ ‫اﻟﻔﺳﺎد‬ ‫وأﺷﻛﺎل‬ ‫اﻧواع‬
‫اﻟدﻛﺗور‬ ‫اﺷراف‬
‫اﻟﺣﻛﯾم‬ ‫ﻟﯾث‬
‫اﻋداد‬
‫ﻋﺑد‬ ‫ﺧﻧﺟر‬ ‫اﺣﻣد‬ ‫اﻟطﺎﻟب‬
‫ﻋﺎﻟﻲ‬ ‫دﺑﻠوم‬
‫ﻣﺳﺗﺷﻔﯾﺎت‬ ‫ادارة‬

2. ‫اﻟرﺣﯾم‬ ‫اﻟرﺣﻣن‬ ‫ﷲ‬ ‫ﺑﺳم‬
)‫ظﮭر‬‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫اﻟﺑر‬‫واﻟﺑﺣر‬‫ﺑﻣﺎ‬‫ﻛﺳﺑت‬‫أﯾدي‬‫اﻟﻧﺎس‬‫ﻟﯾذﯾﻘﮭم‬‫ﺑﻌض‬‫اﻟذي‬‫ﻋﻣﻠوا‬‫ﻟﻌﻠﮭم‬‫ﯾرﺟﻌون‬( 41 )‫ﻗل‬‫ﺳﯾروا‬‫ﻓﻲ‬‫اﻷرض‬‫ﻓﺎﻧظروا‬‫ﻛﯾف‬‫ﻛﺎن‬
‫ﻋﺎﻗﺑﺔ‬‫اﻟذﯾن‬‫ﻣن‬‫ﻗﺑل‬‫ﻛﺎن‬‫أﻛﺛرھم‬‫ﻣﺷرﻛﯾن‬( 42 ) )
:‫اﻟﺑﺎﺣث‬ ‫ﻣﻘدﻣﮫ‬
‫ان‬‫اﻟﻔﺳﺎد‬‫وﺗﺧﻠﻔﮭﺎ‬ ‫اﻟﻣﺟﺗﻣﻌﺎت‬ ‫ﺗﺎﺧر‬ ‫ﺳﺑب‬ ‫ھو‬ ‫ﻋﺎﻣﮫ‬ ‫ﺑﺻوره‬‫ھو‬‫اﻓﮫ‬‫ﻗد‬‫ﻓﺗﻛت‬‫ﺑﺎﻏﻠب‬‫ﻣؤﺳﺳﺎت‬‫اﻟدول‬‫اﻟﻧﺎﻣﯾﮫ‬
‫واﻟﻣﺗﻘدﻣﮫ‬‫ﺣﯾث‬‫اﻏﻠب‬‫اﻟﻣﻧظﻣﺎت‬‫وﻻﺳﯾﻣﺎ‬‫اﻟﻣﻧظﻣﺎت‬‫اﻟﺻﺣﯾﮫ‬. ‫ﺧطﯾره‬ ‫ﻣﺷﻛﻠﮫ‬ ‫ﯾﻌﺗﺑر‬‫وﻟﮫ‬‫ﺗﺄﺛﯾر‬‫ﻛﺑﯾر‬‫و‬‫ﻣﺑﺎﺷر‬‫ﻋﻠﻰ‬
‫اﻟ‬‫ﺻﺣﺔ‬‫ﻋن‬‫طرﯾﻖ‬‫ﺧﻔض‬‫ﻧوﻋﯾﺔ‬‫اﻟرﻋﺎﯾﺔ‬‫واﻟﺣﺻول‬‫ﻋﻠﻰ‬،‫اﻟﺧدﻣﺎت‬‫وﺧﺎﺻﺔ‬‫ﺑﺎﻟﻧﺳﺑﺔ‬‫ﻟﻠﻔﻘراء‬‫و‬‫ﻋﻠﻰ‬‫ﻣﺎﯾﻘدم‬‫ﻟﻠﺧدﻣﮫ‬
‫اﻟﺻﺣﯾﮫ‬‫اﻟﺗﻲ‬‫ھﻲ‬‫اﺳﺎﺳﺎ‬‫ﻏﯾر‬‫ﻣﻠﻣوﺳﮫ‬‫ﻓﯾؤدي‬‫ﻻﻧﺣﺎرﻓﮭﺎ‬‫ﻋن‬‫ﻗواﻋدھﺎ‬‫وﺳﻠوﻛﮭﺎ‬‫اﻻﻧﺳﺎﻧﻲ‬‫اﻟطﺑﻲ‬.
‫وھﻧﺎك‬‫اﺳﺑﺎب‬‫واﺷﻛﺎل‬‫ﻋدﯾده‬‫ﻟ‬‫ﻠﻔﺳﺎد‬‫ﻟﯾس‬ ‫ﻣﺣدده‬ ‫ﻻدوﯾﮫ‬ ‫اﻟﺗروﯾﺞ‬ ‫ﻟﻐرض‬ ‫ﺧﺎﺻﮫ‬ ‫ﺻﯾدﻟﯾﺎت‬ ‫ﻣﻊ‬ ‫اﻻطﺑﺎء‬ ‫ﺗﻌﺎﻣﻼت‬ ‫ﻣﻧﮭﺎ‬
‫ﻟﻛﻲ‬ ‫ﻟﻼطﺑﺎء‬ ‫اﻏرات‬ ‫ﻣن‬ ‫اﻟﺷرﻛﺎت‬ ‫وﻣﺎﺗﻘدﻣﮫ‬ ‫اﻻدوﯾﮫ‬ ‫ﺷرﻛﺎت‬ ‫ﻟﺑﻌض‬ ‫اﻟﺗروﯾﺞ‬ ‫طرﯾﻘﺔ‬ ‫وﻛذاﻟك‬ ‫اﻟﻣطﻠوب‬ ‫ﺑﺎﻟﻣﺳﺗوى‬
‫اﻟ‬ ‫وﻛذاﻟك‬ ‫ﻣﻌﯾن‬ ‫ﻋﻼج‬ ‫ﺑﺻرف‬ ‫ﯾﺳﺗﻣر‬‫ﻋن‬ ‫ﺟذرﯾﺎ‬ ‫ﺗﺧﺗﻠف‬ ‫اﻟﺗﻲ‬ ‫اﻟﺧﺎﺻﮫ‬ ‫اﻻﺟﻧﺣﮫ‬ ‫ﻓﻲ‬ ‫ﺧدﻣﮫ‬ ‫ﻣن‬ ‫وﻣﺎﺗﻘدﻣﮫ‬ ‫ﻣﺳﺗﺷﻔﯾﺎت‬
‫ﻣﻧﻔﻌﮫ‬ ‫ﻟﻐرض‬ ‫اﻟﻣﻧﺻب‬ ‫ﯾﺳﺗﻐل‬ ‫ﻻﺟﻠﮭﺎ‬ ‫اﻟﺗﻲ‬ ‫واﻟﺗﺣزﺑﯾﮫ‬ ‫اﻟﻣﺣﺳوﺑﯾﮫ‬ ‫ھو‬ ‫اﯾﺿﺎ‬ ‫اﻟرﺷوه‬ ‫اﺷﻛﺎل‬ ‫وﻣن‬ ‫اﻟﻌﺎﻣﮫ‬ ‫اﻻﺟﻧﺣﮫ‬
‫ﺧﺎص‬ ‫وﻋﻣل‬ ‫ﺷﺧﺻﯾﮫ‬‫ﻓﻲ‬ ‫ﻣﺗداول‬ ‫ﻣﺎھو‬ ‫وھذا‬‫اﻟﻣﺳﺗﺷﻔﯾﺎت‬‫اﻟﻌراﻗﯾﮫ‬‫ﻣﻣﺎ‬‫ادى‬‫اﻟﻰ‬‫ﺳؤ‬‫اﻟﺧدﻣﮫ‬‫اﻟﺻﺣﯾﮫ‬‫اﻟذي‬‫ﺟﻌل‬‫اﻛﺛر‬
‫اﻟﻣرﺿﻰ‬‫ﯾﺗﻌﺎﻟﺟون‬‫ﺧﺎرج‬‫اﻟﺑﻠد‬‫ﻛﺑﯾره‬ ‫اﻗﺗﺻﺎدﯾﮫ‬ ‫ﻣﺷﻛﻠﮫ‬ ‫وھذه‬‫وﻛذاﻟك‬‫ﺳﻠوك‬‫اﻟﻣوظف‬‫او‬‫اﻟطﺑﯾب‬‫اﻟذي‬‫ﯾﺑﺗز‬‫ﺑﮫ‬
‫اﻟﻣرﯾض‬‫واﺳﺗﻐﻼل‬‫ﻣﻧﺻﺑﮫ‬‫وﻣﻛﺎﻧﮫ‬‫ﻟﻐرض‬‫ﻣﻧﻔﻌﮫ‬‫ﺷﺧﺻﯾﮫ‬‫واﺳﺗﻌﻣﺎل‬‫اﺳﺎﻟﯾب‬‫ﺗﺟﺑر‬‫اﻟﻣرﯾض‬‫ﻋﻠﻰ‬‫دﻓﻊ‬‫اﻟرﺷﻰ‬‫)وﻗد‬
(‫اﻟﮭدﯾﺎ‬ ‫ﺑﺎﺳم‬ ‫ﻣﺑطﻧﮫ‬ ‫ﺗﻛون‬‫ﻟﻐرض‬‫اﺳﺗﺣﺻﺎل‬‫اﻟﺧدﻣﮫ‬‫اﻟﺗﻲ‬‫ﯾﻌﺗﻘد‬‫اﻧﮭﺎ‬‫ﺟﯾده‬.
:‫اﻟﻣﻠﺧص‬
،‫اﻟﻔﺳﺎد‬‫ﺣﻘﯾﻘﺔ‬‫ﻻ‬‫ﯾﻣﻛن‬‫إﻧﻛﺎرھﺎ‬‫ﻓﻲ‬‫اﻟﻘطﺎع‬،‫اﻟﺻﺣﻲ‬‫و‬‫ﯾﻣﻛن‬‫اﻟﻘول‬‫إن‬‫اﻷزﻣﺔ‬‫اﻷﺧﻼﻗﯾﺔ‬‫أﺧطر‬‫ﻓﻲ‬‫اﻟطب‬‫اﻟﯾوم‬.‫اﻟﻔﺳﺎد‬
‫ھو‬‫ﻣﺷﻛﻠﺔ‬‫ﻣﺗﻔﺷﯾﺔ‬‫ﺗؤﺛر‬‫ﻋﻠﻰ‬‫اﻟﻘطﺎع‬‫اﻟﺻﺣﻲ‬.‫ﻋﻠﻰ‬‫ﻣﺳﺗوى‬‫اﻷﻓراد‬،‫واﻷﺳر‬‫وھﻧﺎك‬‫أدﻟﺔ‬‫ﻣﺗزاﯾدة‬‫ﻣن‬‫اﻵﺛﺎر‬‫اﻟﺳﻠﺑﯾﺔ‬
‫ﻟﻠﻔﺳﺎد‬‫ﻋﻠﻰ‬‫ﺻﺣﺔ‬‫ورﻓﺎھﯾﺔ‬‫اﻟﻣواطﻧﯾن‬‫.وﻓﻲ‬‫اﻟﺳﻧوات‬‫ال‬١٠،‫اﻟﻣﺎﺿﯾﺔ‬‫اﻛﺗﺳﺑت‬‫اﻟﺟﮭود‬‫اﻟﻣﺑذوﻟﺔ‬‫ﻟﻣﻛﺎﻓﺣﺔ‬‫اﻟﻔﺳﺎد‬‫اﻧﺗﺑﺎه‬
‫اﻟﺣﻛوﻣﺎت‬‫اﻟوطﻧﯾﺔ‬‫وﺷرﻛﺎء‬‫اﻟﺗﻧﻣﯾﺔ‬‫وﻣﻧظﻣﺎت‬‫اﻟﻣﺟﺗﻣﻊ‬‫اﻟﻣدﻧﻲ‬.‫ﺑﯾﻧﻣﺎ‬‫ﻗد‬‫ﺗﻛون‬‫ھﻧﺎك‬‫ﺣﺎﺟﺔ‬‫إﻟﻰ‬‫إﺻﻼﺣﺎت‬‫ﺣﻛوﻣﯾﺔ‬
‫ﺷﺎﻣﻠﺔ‬‫ﻟﻣﻌﺎﻟﺟﺔ‬‫اﻟﻔﺳﺎد‬،‫اﻟﻣﺳﺗﺷري‬‫واﻟﺣﻠول‬‫ﻓﻲ‬‫ﻗطﺎﻋﺎت‬‫ﻣﺣددة‬‫ﯾﻣﻛن‬‫ﻣﺗﺎﺑﻌﺗﮭﺎ‬‫ﻓﻲ‬‫ﻧﻔس‬‫اﻟوﻗت‬‫أو‬‫ﺣﺗﻰ‬‫ﻓﻲ‬‫ﻏﯾﺎب‬
‫اﻹرادة‬‫اﻟﺳﯾﺎﺳﯾﺔ‬‫ﻹﺟراء‬‫ﻣزﯾد‬‫ﻣن‬‫اﻹﺻﻼﺣﺎت‬‫اﻟﺷﺎﻣﻠﺔ‬( Lewis 2006. Rose 2006)
‫و‬‫ﻣوﺿوع‬‫اﻟﻔﺳﺎد‬‫ﯾﻣﻛن‬‫ﻣﻧﺎﻗﺷﺗﮫ‬‫ﻣن‬‫ﻣﺟﻣوﻋﺔ‬‫ﻣﺗﻧوﻋﺔ‬‫ﻣن‬‫وﺟﮭﺎت‬‫اﻟﻧظر‬‫و‬‫ﺑﻣﺎ‬‫ﻣن‬ ‫ﯾﺧﻠف‬‫اﻵﺛﺎر‬،‫اﻻﻗﺗﺻﺎدﯾﺔ‬‫اﻟﺳﯾﺎﺳﯾﺔ‬
‫واﻻﺟﺗﻣﺎﻋﯾﺔ‬.‫اﻟﻔﺳﺎد‬‫ھو‬‫ظﺎھرة‬‫واﺳﻌﺔ‬‫اﻻﻧﺗﺷﺎر‬‫وﻣﻌﻘدة‬‫اﻟﺗﻲ‬‫ﻻ‬‫ﺗﻧﺗﻣﻲ‬‫ﻓﻘط‬‫إﻟﻰ‬‫اﻟﺑﻠدان‬"‫ﻏﯾر‬‫اﻟﻐرﺑﯾﺔ‬."‫اﻟﻔﺳﺎد‬‫ھو‬
‫ﺻﻌب‬‫ﺗﻌرﯾﻔ‬‫ﮫ‬‫وﻟﻛن‬‫ﻣن‬‫اﻟﺳﮭل‬‫اﻟﺗﻌرف‬‫ﻋﻠﯨ‬‫ﮫ‬.،‫ﯾﻣﻛن‬‫اﻟﻔﺳﺎد‬‫ﺗﺿر‬‫اﻟﻣﺟﺗﻣﻌﺎت‬‫واﻗﺗﺻﺎداﺗﮭﺎ‬.‫وﻋﻼوة‬‫ﻋﻠﻰ‬،‫ذﻟك‬
‫اﻟﻔﺳﺎد‬‫اﻟﻌﻣﯾﻖ‬‫اﻟﺟذور‬‫ﯾﺑطﺊ‬"‫اﻟﺗﻧﻣﯾﺔ‬‫اﻻﻗﺗﺻﺎدﯾﺔ‬‫وﯾﻘوض‬،‫اﻟدﯾﻣﻘراطﯾﺔ‬‫واﻷﺿرار‬‫ﻓﻲ‬‫اﻟﻌداﻟﺔ‬‫اﻻﺟﺗﻣﺎﻋﯾﺔ‬‫وﺳﯾﺎدة‬
‫اﻟﻘﺎﻧون‬)"EC 2014،1(‫وﻓﻘﺎ‬‫ﻟﻼﺗﺣﺎد‬‫اﻷوروﺑﻲ‬.‫ﻣﻊ‬‫ﺗﺄﺛﯾرات‬‫ﺳﻠﺑﯾﺔ‬‫ﻋﻠﻰ‬‫اﻟﺣﺎﻟﺔ‬‫اﻟﺻﺣﯾﺔ‬‫واﻟرﻋﺎﯾﺔ‬‫اﻻﺟﺗﻣﺎﻋﯾﺔ‬.

3. ‫وﺗوﺟد‬‫اﻟﻌدﯾد‬‫ﻣن‬‫اﻷدوات‬‫اﻟﻣﺳﺎﻋدة‬‫ﻋﻠﻰ‬‫ﻗﯾﺎس‬‫اﻟﻔﺳﺎد‬‫وﺗﺣدﯾد‬،‫اﻟﻣﺷﻛﻠﺔ‬‫ﺑﻣﺎ‬‫ﻓﻲ‬‫ذﻟك‬‫ﻋﻣﻠﯾﺎت‬‫اﻟﻣﺳﺢ‬‫اﻟﻔﺳﺎد‬،‫اﻟﺗﺻور‬
‫ﻣﺳوﺣﺎت‬،‫اﻹﻧﻔﺎق‬‫وﺟﻣﻊ‬‫اﻟﺑﯾﺎﻧﺎت‬‫اﻟﻧوﻋﯾﺔ‬‫واﺳﺗﻌراض‬‫أﻧظﻣﺔ‬‫اﻟﺗﺣﻛم‬.‫وﯾرد‬‫اﻹطﺎر‬‫اﻟﻧظري‬‫ﻟﺗوﺟﯾﮫ‬‫ﺻﻧﺎع‬‫اﻟﻘرار‬‫ﻓﻲ‬
‫دراﺳﺔ‬‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫اﻟﻘطﺎع‬‫اﻟﺻﺣﻲ‬‫وﺗﺣدﯾد‬‫اﻟﺳﺑل‬‫اﻟﻣﻣﻛﻧﺔ‬‫ﻟﻠﺗدﺧل‬‫ﻟزﯾﺎدة‬‫اﻟﻣﺳﺎءﻟﺔ‬‫واﻟﺷﻔﺎﻓﯾﺔ‬‫وﻣواطن‬‫ﺻوت‬‫واﻟﻛﺷف‬
،‫واﻹﻧﻔﺎذ‬‫واﻟﺳﯾطرة‬‫ﻋﻠﻰ‬‫اﻟﺳﻠطﺔ‬‫اﻟﺗﻘدﯾرﯾﺔ‬‫واﻟﺣد‬‫ﻣن‬‫ﺳﻠطﺔ‬‫اﺣﺗﻛﺎرﯾﺔ‬.
‫وﻗد‬‫ﺷﮭدت‬‫اﻟﺳﻧوات‬‫اﻷﺧﯾرة‬‫ﺗوﺳﻌﺎ‬‫ﻣﻠﺣوظﺎ‬‫ﻓﻲ‬‫ﻗدرة‬‫اﻻﻗﺗﺻﺎدﯾﯾن‬‫ﻟﻘﯾﺎس‬‫اﻟﻔﺳﺎد‬.،‫وھذا‬،‫ﺑدوره‬‫أدى‬‫إﻟﻰ‬‫ﺟﯾل‬‫ﺟدﯾد‬
‫ﻣن‬‫اﻟﺗﻌرف‬،‫ﺟﯾدا‬‫اﻻﻗﺗﺻﺎد‬‫اﻟﺟزﺋﻲ‬‫دراﺳﺎت‬.‫ﻧﺳﺗﻌرض‬‫أدﻟﺔ‬‫ﻋﻠﻰ‬‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫اﻟدول‬‫اﻟﻧﺎﻣﯾﺔ‬‫ﻓﻲ‬‫ﺿوء‬‫ھذه‬‫اﻟﺗطورات‬
،‫اﻟﺣدﯾﺛﺔ‬‫ﻣﻊ‬‫اﻟﺗرﻛﯾز‬‫ﻋﻠﻰ‬‫ﺛﻼﺛﺔ‬‫أﺳﺋﻠﺔ‬:‫ﻛم‬‫اﻟﻔﺳﺎد‬،‫ھﻧﺎك‬‫ﻣﺎ‬‫ھﻲ‬‫ﻋواﻗب‬‫ﻛﻔﺎءة‬،‫اﻟﻔﺳﺎد‬‫وﻣﺎ‬‫ﯾﺣدد‬‫ﻣﺳﺗوى‬‫اﻟﻔﺳﺎد‬.‫ﻧﺣن‬
‫اﻟﻌﺛور‬‫ﻋﻠﻰ‬‫أدﻟﺔ‬‫ﻗوﯾﺔ‬‫ﻋﻠﻰ‬‫أن‬‫اﻟﻔﺳﺎد‬‫ﯾﺳﺗﺟﯾب‬‫ﻟﻣﻌﯾﺎر‬‫ﻧظرﯾﺔ‬‫اﻟﺣواﻓز‬،‫اﻻﻗﺗﺻﺎدﯾﺔ‬‫وﻟﻛن‬‫ﻛﻣﺎ‬‫أن‬‫آﺛﺎر‬‫ﺳﯾﺎﺳﺎت‬‫ﻣﻛﺎﻓﺣﺔ‬
‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫ﻛﺛﯾر‬‫ﻣن‬‫اﻷﺣﯾﺎن‬‫أن‬‫ﯾﺧﻔف‬‫ﻣن‬‫ﺷدة‬‫وﯾﺟد‬‫اﻟﻣﺳؤوﻟون‬‫اﻟﺑدﯾل‬‫اﺳﺗراﺗﯾﺟﯾﺎت‬‫ﻟﻣﺗﺎﺑﻌﺔ‬‫اﻻﯾﺟﺎرات‬.
‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫ﻣﺟﺎل‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫ھو‬‫ﻋﺎﻣل‬‫ﻛﺛﯾرا‬‫ﻣﺎ‬‫ﯾﻐﻔل‬‫ﺗؤﺛر‬‫ﻋﻠﻰ‬‫اﻟﻧﺗﺎﺋﺞ‬‫اﻟﺻﺣﯾﺔ‬‫ﻓﻲ‬‫ﺑﻠد‬.‫وﻗد‬‫أظﮭرت‬‫أﺑﺣﺎث‬
‫ﺳﺎﺑﻘﺔ‬‫أن‬‫ھﻧﺎك‬‫وﺳﺎﺋل‬‫ﻣﺧﺗﻠﻔﺔ‬‫ﻟﻠﻔﺳﺎد‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫و‬‫أن‬‫اﻟﻔﺳﺎد‬‫ﯾﺧﻔض‬‫ﻧوﻋﯾﺔ‬‫وﻛﻣﯾﺔ‬‫ﺧدﻣﺎت‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬.
‫اﺳﺗﻧﺎدا‬‫إﻟﻰ‬‫ﺑﯾﺎﻧﺎت‬‫ﻟوﺣﺔ‬‫ﺗﻘدﯾر‬٣٠‫دوﻟﺔ‬١٩٩٦-٢٠١١،‫اﻟﺗﺎﺛﯾرات‬ ‫وﻣن‬‫ﻣﺗوﺳط‬‫اﻟﻌﻣر‬‫اﻟﻣﺗوﻗﻊ‬)‫ﻋﻧد‬‫اﻟوﻻدة‬(‫و‬‫أﻋﻠﻰ‬
‫ﻣﻌدل‬‫وﻓﯾﺎت‬‫اﻟرﺿﻊ‬)‫ﻟﻛل‬١٠٠٠‫ﻣوﻟود‬‫ﺣﻲ‬.(‫اﻟﻔﺳﺎد‬‫ﻟﮫ‬‫ﺗﺄﺛﯾر‬‫أﻛﺑر‬‫ﻋﻠﻰ‬‫اﻟﺻﺣﺔ‬‫اﻟﻧﺗﺎﺋﺞ‬‫ﻓﻲ‬‫أﻛﺛر‬‫ﻓﻘرا‬‫واﻟدول‬‫اﻷﻛﺛر‬
‫ﺛراء‬‫ﻣﻣﺎ‬‫ﻛﺎن‬‫ﻋﻠﯾﮫ‬،‫ﻓﻲ‬‫اﻟدول‬‫اﻟﻣﺗﻘدﻣﺔ‬.‫اﻟﺣﻛم‬‫اﻟرﺷﯾد‬‫وﺗظﮭر‬‫ﻣﻣﺎرﺳﺎت‬‫وﺳﻛﺎن‬‫اﻟﺣﺿر‬‫أﻛﺑر‬‫ﻟﺗﺣﺳﯾن‬‫اﻟﻧﺗﺎﺋﺞ‬
‫اﻟﺻﺣﯾﺔ‬‫ﻓﻲ‬‫اﻟﺑﻼد‬.‫اﻟﺷﻔﺎﻓﯾﺔ‬‫ﻓﻲ‬‫ﺟﻣﯾﻊ‬‫ﺟواﻧب‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫ﻣﮭﻣﺔ‬‫ﻟﻠﺣد‬‫ﻣن‬‫اﻟﻔﺳﺎد‬‫وﺗﺣﺳﯾن‬‫اﻟﺻﺣﺔ‬‫اﻟﻧﺗﺎﺋﺞ‬.
:‫اﻟﻔﺳﺎد‬ ‫ﻣﺎھو‬
‫ﺗﻌرﯾف‬‫ﻣﻧظﻣﺔ‬‫اﻟﺷﻔﺎﻓﯾﺔ‬‫اﻟدوﻟﯾﺔ‬‫ب‬"‫إﺳﺎءة‬‫اﺳﺗﻌﻣﺎل‬‫اﻟﺳﻠطﺔ‬‫اﻟﻣوﻛﻠﺔ‬‫ﻟﺗﺣﻘﯾﻖ‬‫ﻣﻛﺎﺳب‬‫ﺧﺎﺻﺔ‬"،‫ﯾﺣدث‬‫اﻟﻔﺳﺎد‬‫ﻋﻧدﻣﺎ‬
‫اﻟﻣوظﻔﯾن‬‫اﻟﻌﻣوﻣﯾﯾن‬‫اﻟذﯾن‬‫ﻣﻧﺣوا‬‫اﻟﺳﻠطﺔ‬‫ﻟﺗﻧﻔﯾذ‬‫اﻷھداف‬‫اﻟﺗﻲ‬‫ﺗزﯾد‬‫ﻣن‬‫اﻟﺻﺎﻟﺢ‬،‫اﻟﻌﺎم‬‫ﺑدﻻ‬‫ﻣن‬‫اﺳﺗﺧدام‬‫ﻣوﻗﻔﮭم‬
‫واﻟﻘدرة‬‫ﻋﻠﻰ‬‫اﻻﺳﺗﻔﺎدة‬‫أﻧﻔﺳﮭم‬‫واﻵﺧرﯾن‬‫اﻟﻘرﯾﺑﯾن‬‫ﻣﻧﮭم‬.‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫ﻗطﺎع‬‫اﻟﺻﺣﺔ‬‫ﯾﻣﻛن‬‫اﻻطﻼع‬‫ﻣن‬‫ﺧﻼل‬‫دراﺳﺔ‬
‫اﻷدوار‬‫واﻟﻌﻼﻗﺎت‬‫ﺑﯾن‬‫ﻣﺧﺗﻠف‬‫اﻟﻼﻋﺑﯾن‬‫ﻟﺗﺣدﯾد‬‫اﻻﻧﺗﮭﺎﻛﺎت‬‫اﻟﻣﺣﺗﻣﻠﺔ‬‫اﻟﺗﻲ‬‫ﻣن‬‫اﻟﻣﺣﺗﻣل‬‫أن‬‫ﺗﺣدث‬)Ensor and
Antonio 2002; Savedoff 2006.(‫وﯾظﮭر‬‫ھذا‬‫اﻟرأي‬‫اﻟﺗﻧظﯾﻣﻲ‬‫ﻓﻲ‬‫اﻟﺷﻛل‬١.‫وھﻧﺎك‬‫طرﯾﻘﺔ‬‫أﺧرى‬‫ﻟﻠﻧظر‬‫ﻓﻲ‬
‫أﻧواع‬‫اﻟﻔﺳﺎد‬‫ھو‬‫اﺳﺗﻌراض‬‫ﻣﮭﺎم‬‫ﻋﻣﻠﯾﺔ‬‫ﺗﻘدﯾم‬‫اﻟرﻋﺎﯾﺔ‬،‫اﻟﺻﺣﯾﺔ‬‫وﻓﺣص‬‫اﻻﻧﺗﮭﺎﻛﺎت‬‫اﻟﻣﺣﺗﻣﻠﺔ‬‫اﻟﺗﻲ‬‫ﯾﻣﻛن‬‫أن‬‫ﺗﺣدث‬‫ﻓﻲ‬
‫ﻛل‬‫ﺧطوة‬.‫وﯾظﮭر‬‫ھذا‬‫اﻟﻌرض‬‫ﻓﻲ‬‫اﻟﺟدول‬١.
‫ﻋﻣوﻣﺎ‬‫ﺑﺄﻧﮫ‬"‫إﺳﺎءة‬‫اﺳﺗﻌﻣﺎل‬‫اﻟﺳﻠطﺔ‬‫اﻟﻣوﻛﻠﺔ‬‫ﻟﺗﺣﻘﯾﻖ‬‫ﻣﻛﺎﺳب‬‫ﺧﺎﺻﺔ‬."‫وﯾﻣﻛن‬‫ﺗﺻﻧﯾف‬‫اﻟﻔﺳﺎد‬،‫اﻟﻛﺑرى‬‫ﺗﺎﻓﮫ‬،‫واﻟﺳﯾﺎﺳﯾﺔ‬
‫اﻋﺗﻣﺎدا‬‫ﻋﻠﻰ‬‫ﻛﻣﯾﺎت‬‫ﻣن‬‫اﻷﻣوال‬‫اﻟﻣﻔﻘودة‬‫واﻟﻘطﺎع‬‫ﺣﯾث‬‫ﯾﺣدث‬.
‫ا‬‫ﻟﻔﺳﺎد‬‫ﻣﻧﺗﺷر‬‫ﻋﺑر‬‫اﻟﺛﻘﺎﻓﺎت‬‫واﻟﻣﺗوطﻧﺔ‬‫ﻓﻲ‬،‫اﻟﺑﻠدان‬‫ﺳواء‬‫ﻛﺎﻧت‬‫ﺻﻐﯾرة‬‫أو‬،‫ﻛﺑﯾرة‬‫ﻓﻘﯾرة‬‫أو‬،‫ﻏﻧﯾﺔ‬‫رأﺳﻣﺎﻟﻲ‬‫أو‬
‫اﺷﺗراﻛﻲ‬‫أو‬‫ﻓﻲ‬‫اﻟﺷﻣﺎل‬‫أو‬‫اﻟﺟﻧوب‬)٣.(‫اﻟﺻﺣف‬‫اﻟﺗﻘﺎط‬‫ﻋﻣوﻣﺎ‬‫اﻟﺣﺎﻻت‬‫ﻣذھﻠﺔ‬‫ﻓﻘط‬‫ﻣن‬‫اﻟﻔﺳﺎد‬‫ﻋﻠﻰ‬‫ﻧطﺎق‬‫واﺳﻊ‬.
‫اﻟﻔﺳﺎد‬،‫اﻟﺻﻐﯾر‬‫وﻣﻊ‬،‫ذﻟك‬‫ﻣﻧذ‬‫ﻓﺗرة‬‫طوﯾﻠﺔ‬‫ﺟزءا‬،‫ﻣن‬‫أو‬‫ﺑﺎﻷﺣرى‬‫وﺳﯾﻠﺔ‬،‫ل‬‫ﺣﯾﺎة‬"‫طﺑﯾﻌﯾﺔ‬"‫ﻓﻲ‬‫أﺟزاء‬‫ﻛﺛﯾرة‬‫ﻣن‬
‫اﻟﻌﺎﻟم‬.‫وﻋﻼوة‬‫ﻋﻠﻰ‬،‫ذﻟك‬‫أوﻟﺋك‬‫اﻟذﯾن‬‫ﯾﺄﺧذون‬‫أو‬‫ﺗﻘدﯾم‬‫اﻟرﺷﺎوى‬‫ﻓﻲ‬‫وﺿﻊ‬‫ﻣﻌﯾن‬)‫ﻣﺛل‬‫ﻣﻛﺗب‬‫أو‬‫ﻣﻧزل‬‫ﻣﺳؤول‬(‫أن‬
‫ﯾطﺎﻟب‬‫ﻓﻲ‬‫وﺿﻊ‬‫آﺧر‬)‫ﻣﺛل‬‫اﻟﻣﺣﻛﻣﺔ‬(‫أن‬‫ھذه‬‫ﻛﺎﻧت‬"‫ھداﯾﺎ‬."،‫وھﻛذا‬‫واﻟﺗﻔﺳﯾرات‬‫اﻟﺛﻘﺎﻓﯾﺔ‬‫واﻵﺛﺎر‬‫اﻟﻘﺎﻧوﻧﯾﺔ‬‫اﻟﻣﺗرﺗﺑﺔ‬
‫ﻋﻠﻰ‬‫ﻣﺎ‬‫ﯾﻧظر‬‫إﻟﯾﮫ‬‫ﻣن‬‫ﺣﯾث‬‫اﻟﻔﺳﺎد‬‫ﻗد‬‫ﺗﺧﺗﻠف‬‫أﯾﺿﺎ‬‫ﻣن‬‫ﺳﯾﺎق‬‫إﻟﻰ‬‫آﺧر‬.Pluto Press; 2006.Transparency
International

4. ve key actors in the health systemFi
n Reportand Hussmann, Chapter 1, The causes of corrupƟon in the health sector, in Transparency InternaƟonal (ed.), Global CorrupƟoSource: Savedoff
2006. London: Pluto Press, p. 7
‫ا‬‫ﻟﻔﺳﺎد‬‫ﻓﻲ‬‫ﻗطﺎع‬‫اﻟﺻﺣﺔ‬‫ﯾﻣﻛن‬‫أن‬‫ﯾﻌﻧﻲ‬‫اﻟﻔرق‬‫ﺑﯾن‬‫اﻟﺣﯾﺎة‬‫واﻟﻣوت‬.‫واﻷﻛﺛر‬‫ﺗﺿررا‬‫اﻟﻔﻘراء‬.‫ﯾﻣﻛن‬‫أن‬
‫اﻟطﺎﻗم‬‫اﻟطﺑﻲ‬‫رﺳوﻣﺎ‬‫ﻏﯾر‬‫رﺳﻣﯾﺔ‬‫ﻟﺣﺿور‬‫ﻟﻠﻣرﺿﻰ‬.‫ﻗد‬‫ﯾطﻠﺑون‬‫رﺷﺎوى‬‫ﻟﻸدوﯾﺔ‬‫اﻟﺗﻲ‬‫ﯾﺟب‬‫أن‬‫ﺗﻛون‬
‫ﺣرة‬.‫أو‬‫أﻧﮭﺎ‬‫ﻗد‬‫ﺗﺳﻣﺢ‬‫اﻟﻣرﺿﻰ‬‫اﻟذﯾن‬‫رﺷوة‬‫ﻟﮭم‬‫طﺎﺑور‬‫اﻟﻘﻔز‬.‫ﺗﻛﺎﻟﯾف‬‫اﻟﻔﺳﺎد‬‫أﯾﺿﺎ‬‫ﺣﯾﺎة‬‫ﻋﻧد‬‫ﺑﯾﻊ‬
‫وھﻣﯾﺔ‬‫أو‬‫اﻷدوﯾﺔ‬‫اﻟﻣﻐﺷوﺷﺔ‬‫ﻋﻠﻰ‬‫اﻟﺧدﻣﺎت‬‫اﻟﺻﺣﯾﺔ‬.

5. .‫واﻻﺛﺎر‬ ‫واﻟﺘﺪﺧﻼت‬ ‫واﻷﺳﺎﻟﯿﺐ‬ ‫اﻟﻨﻈﺮﯾﺔ‬ :‫اﻟﺼﺤﺔ‬ ‫ﻗﻄﺎع‬ ‫ﻓﻲ‬ ‫اﻟﻔﺴﺎد‬ ‫اﺳﺘﻌﺮاض‬
١ ‫اﻟﺠﺪول‬
‫اﻟﺼﺤﺔ‬ ‫ﻗﻄﺎع‬ ‫ﻓﻲ‬ ‫اﻟﻔﺴﺎد‬ ‫أﻧﻮاع‬
‫ﻋﻤﻠﯿﺔ‬ ‫أو‬ ‫ﻣﻨﻄﻘﺔ‬ ‫واﻟﻤﺸﺎﻛﻞ‬ ‫اﻟﻔﺴﺎد‬ ‫أﻧﻮاع‬ ‫اﻟﻨﺘﺎﺋﺞ‬
‫اﻟﻤﺮاﻓﻖ‬ ‫ﺗﺄھﯿﻞ‬ ‫وإﻋﺎدة‬ ‫ﺑﻨﺎء‬
‫اﻟﺼﺤﯿﺔ‬
‫ﺗﺆﺛﺮ‬ ‫اﻟﺘﻲ‬ ‫اﻟﺴﯿﺎﺳﯿﺔ‬ ‫واﻻﻋﺘﺒﺎرات‬ ‫واﻟﻌﻤﻮﻻت‬ ‫اﻟﺮﺷﺎوى‬
‫اﻟﺘﻌﺎﻗﺪ‬ ‫ﻋﻤﻠﯿﺔ‬ ‫ﻋﻠﻰ‬
‫ﻟﻠﻤﺴﺎءﻟﺔ‬ ‫وﻟﯿﺲ‬ ‫ﻟﺘﻨﻔﯿﺬ‬ ‫اﻟﻤﻘﺎوﻟﯿﻦ‬ ‫ﻓﺸﻞ‬
‫اﻟﺒﻨﺎء‬ ‫وأﻋﻤﺎل‬ ‫ﻣﻨﺨﻔﻀﺔ‬‫ﺟﻮدة‬ ‫ذات‬ ‫ﻣﺮاﻓﻖ‬‫و‬ ،‫اﻟﻌﺎﻟﯿﺔ‬ ‫اﻟﺘﻜﻠﻔﺔ‬
‫ﻋﺪم‬ ‫إﻟﻰ‬ ‫أدى‬ ‫ﻣﻤﺎ‬،‫ﺣﺎﺟﺔ‬‫ﻣﻊ‬‫ﺗﺘﻮاﻓﻖ‬ ‫ﻻ‬ ‫اﻟﺘﻲ‬ ‫اﻟﻤﺮاﻓﻖ‬ ‫ﻣﻮﻗﻊ‬
‫اﻟﻮﺻﻮل‬ ‫ﻓﻲ‬ ‫اﻟﻤﺴﺎواة‬
‫ﻟﺼﺎﻟﺢ‬ ‫اﻟﺘﺤﺘﯿﺔ‬ ‫ﻟﻠﺒﻨﯿﺔ‬ ‫اﻟﻤﺘﺤﯿﺰ‬ ‫اﻟﺘﻮزﯾﻊ‬ urban- ‫اﻟﻨﺨﺒﺔ‬ ‫ﻣﺎت‬‫واﻟﺨﺪ‬
‫اﻟﻔﺎﺋﻘﺔ‬ ‫واﻟﺘﻜﻨﻮﻟﻮﺟﯿﺎ‬ ،‫ﻋﻠﻰ‬ ‫ﺗﺮﻛﺰ‬ ‫اﻟﺘﻲ‬
‫ﺑﻤﺎ‬ ،‫ﻣﺪادات‬‫واﻹ‬ ‫اﻟﻤﻌﺪات‬ ‫ﺷﺮاء‬
‫اﻷدوﯾﺔ‬ ‫ذﻟﻚ‬ ‫ﻓﻲ‬
‫ﺗﺆﺛﺮ‬ ‫اﻟﺴﯿﺎﺳﯿﺔ‬ ‫واﻻﻋﺘﺒﺎرات‬ ‫واﻟﻌﻤﻮﻻت‬ ‫اﻟﺮﺷﺎوى‬
‫اﻟﻌﻄﺎءات‬ ‫ﻣﻦ‬‫واﻟﻔﺎﺋﺰﯾﻦ‬ ‫ﻣﻮاﺻﻔﺎت‬
‫اﻟﺸﺮاء‬ ‫ﺧﻼل‬ ‫ﺗﺰوﯾﺮ‬ ‫ﻣﺤﺎوﻟﺔ‬‫أو‬ ‫ﺗﻮاطﺆ‬
‫وﻋﺎﻟﯿﺔ‬ ‫اﻟﺘﻜﻠﻔﺔ‬ ‫ﻣﻨﺨﻔﻀﺔ‬‫ﻻﺧﺘﯿﺎر‬ ‫ﺣﻮاﻓﺰ‬‫وﺟﻮد‬ ‫ﻋﺪم‬
‫اﻟﻤﻮردﯾﻦ‬ ‫اﻟﺠﻮدة‬
‫أﺧﻼﻗﻲ‬ ‫ﻏﯿﺮ‬ ‫اﻟﻤﺨﺪرات‬ ‫ﺗﻌﺰﯾﺰ‬
‫ﻣﺴﺎءﻟﺔ‬‫وﻋﺪم‬ ‫ﻟﺘﻘﺪﯾﻢ‬ ‫اﻟﻤﻮردﯾﻦ‬ ‫ﻓﺸﻞ‬
‫ﻣﺰدوﺟﺔ‬‫أو‬ ‫ﻻﺋﻘﺔ‬ ‫ﻏﯿﺮ‬ ‫واﻟﻤﻌﺪات‬ ‫واﻟﻌﻘﺎﻗﯿﺮ‬ ‫ﺗﻜﻠﻔﺔ‬ ‫ارﺗﻔﺎع‬
‫اﻟﺤﻘﯿﻘﯿﺔ‬ ‫اﻟﺤﺎﺟﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻨﻈﺮ‬ ‫دون‬ ‫ﯾﻘﻊ‬ ‫ﻣﻼﺋﻤﺔ‬‫ﻏﯿﺮ‬ ‫ﻣﻌﺪات‬
‫واﻟﻤﺨﺪرات‬ ‫اﻟﻤﺴﺘﻮى‬ ‫دون‬ ‫اﻟﻤﻌﺪات‬
‫ﺟﻤﯿﻊ‬ ‫ﻟﺘﻮﻓﯿﺮ‬ ‫ﻣﻮال‬‫اﻷ‬ ‫ﻛﻔﺎﯾﺔ‬ ‫ﻋﺪم‬ ‫ﺑﺴﺒﺐ‬ ‫اﻹﺟﺤﺎف‬ ‫ﻏﺎدرت‬
‫ﺣﺘﯿﺎﺟﺎت‬‫اﻻ‬
‫اﻷدوﯾﺔ‬ ‫واﺳﺘﺨﺪام‬ ‫ﺗﻮزﯾﻊ‬
‫ﻣﺎت‬‫اﻟﺨﺪ‬ ‫ﺗﻘﺪﯾﻢ‬ ‫ﻓﻲ‬ ‫واﻟﻠﻮازم‬
‫ﺑﯿﻌﮭﺎ‬ ‫)ﻹﻋﺎدة‬ ‫اﻟﺘﺤﻮﯾﻞ‬ ‫أو‬ (‫اﻟﺸﺨﺼﻲ‬ ‫)ﻟﻼﺳﺘﺨﺪام‬ ‫ﺳﺮﻗﺔ‬
‫اﻟﺘﺨﺰﯾﻦ‬ ‫ﻧﻘﺎط‬ ‫ﻓﻲ‬ ‫ﻟﻮازم‬ / ‫اﻟﻤﺨﺪرات‬ ‫ﻣﻦ‬(‫اﻟﺨﺎص‬ ‫اﻟﻘﻄﺎع‬
‫واﻟﺘﻮزﯾﻊ‬
‫أن‬ ‫اﻟﻤﻔﺘﺮض‬ ‫ﻣﻦ‬‫ﻛﺎن‬ ‫اﻟﺘﻲ‬ ‫ﻣﺪادات‬‫اﻹ‬ ‫أو‬ ‫اﻟﻤﺨﺪرات‬ ‫ﺑﯿﻊ‬
‫ﺣﺮا‬‫ﯾﻜﻮن‬
‫اﺳﺘﺨﺪام‬ ‫اﻧﺨﻔﺎض‬
‫اﻟﻤﻨﺎﺳﺐ‬ ‫اﻟﻌﻼج‬ ‫ﻋﻠﻰ‬ ‫ﯾﺤﺼﻠﻮن‬ ‫ﻻ‬ ‫اﻟﻤﺮﺿﻰ‬
‫ﻋﻠﻰ‬ ‫ﻟﻠﺤﺼﻮل‬ ‫اﻟﺮﺳﻤﯿﺔ‬ ‫ﻏﯿﺮ‬ ‫اﻟﻤﺪﻓﻮﻋﺎت‬ ‫ﺟﻌﻞ‬ ‫اﻟﻤﺮﺿﻰ‬ ‫أن‬ ‫ﯾﺠﺐ‬
‫اﻟﻤﺨﺪرات‬
‫ﺗﻄﻮﯾﺮ‬ ‫إﻟﻰ‬ ‫ﯾﺆدي‬ ‫ﻣﻤﺎ‬،‫ﻣﻜﺘﻤﻠﺔ‬‫ﻏﯿﺮ‬ ‫ﻣﻠﺔ‬‫اﻟﻤﻌﺎ‬ ‫أو‬ ‫اﻟﻌﻼج‬ ‫ﻋﻦ‬ ‫اﻟﺘﻮﻗﻒ‬
‫ﻟﻠﻤﯿﻜﺮوﺑﺎت‬ ‫ﻣﻀﺎدة‬‫ﻣﺔ‬‫ﻣﻘﺎو‬
‫اﻟﻤﻨﺘﺠﺎت‬ ‫ﻓﻲ‬ ‫اﻟﺠﻮدة‬ ‫ﺗﻨﻈﯿﻢ‬
‫واﻟﻤﮭﻨﯿﯿﻦ‬ ‫واﻟﻤﺮاﻓﻖ‬ ‫ﻣﺎت‬‫واﻟﺨﺪ‬
‫ﻟﺘﺴﺠﯿﻞ‬ ‫ﻣﻮاﻓﻘﺔ‬‫ﻋﻠﻰ‬ ‫اﻟﺤﺼﻮل‬ ‫أو‬ ‫ﻋﻤﻠﯿﺔ‬ ‫ﻟﺘﺴﺮﯾﻊ‬ ‫رﺷﺎوى‬
‫ﻣﻤﺎرﺳﺎت‬‫ﺷﮭﺎدة‬ ‫أو‬ ،‫اﻟﻤﺨﺪرات‬ ‫اﻟﺠﻮدة‬ ‫وﻓﺤﺺ‬ ،‫اﻷدوﯾﺔ‬
‫اﻟﺠﯿﺪة‬ ‫اﻟﺘﺼﻨﯿﻊ‬
‫ﻋﻤﻠﯿﺎت‬ ‫ﻧﺘﺎﺋﺞ‬ ‫ﺗﺆﺛﺮ‬ ‫اﻟﺴﯿﺎﺳﯿﺔ‬ ‫اﻻﻋﺘﺒﺎرات‬ ‫أو‬ ‫اﻟﺮﺷﺎوى‬
‫اﻟﻨﺘﺎﺋﺞ‬ ‫ﻗﻤﻊ‬ ‫أو‬ ‫اﻟﺘﻔﺘﯿﺶ‬
‫اﻷﻏﺬﯾﺔ‬ ‫وإﻧﺘﺎج‬ ‫ﻟﻠﻤﻄﺎﻋﻢ‬ ‫اﻟﺼﺤﯿﺔ‬ ‫ﻟﻠﻮاﺋﺢ‬ ‫ﻣﻨﺤﺎزة‬‫ﺗﻄﺒﯿﻖ‬
‫اﻟﺘﺠﻤﯿﻞ‬ ‫ﻣﺴﺘﺤﻀﺮات‬‫و‬
‫أو‬ ‫اﻻﻋﺘﻤﺎد‬ ‫ﻣﻌﺎﯾﯿﺮ‬‫و‬ ‫واﻹﺟﺮاءات‬ ‫اﻻﻋﺘﻤﺎد‬ ‫ﻣﻨﺤﺎزة‬‫ﺗﻄﺒﯿﻖ‬
‫اﻟﺘﺮﺧﯿﺺ‬
‫اﻟﺴﻮق‬ ‫ﻋﻠﻰ‬ ‫ﯾﺴﻤﺢ‬ ‫وھﻤﯿﺔ‬ ‫أو‬ ‫ﻋﻼﺟﯿﺔ‬ ‫اﻟﻔﺮﻋﯿﺔ‬ ‫اﻟﻤﺨﺪرات‬
،‫اﻟﻤﻨﺎﻗﺼﺎت‬ ‫ﻓﻲ‬ ‫اﻟﻤﺸﺎرﻛﺔ‬ ‫ﻟﻤﻮاﺻﻠﺔ‬ ‫ﻣﺸﯿﺔ‬‫ھﺎ‬ ‫ﻟﻠﺸﺮﻛﺎت‬ ‫وﯾﺴﻤﺢ‬
‫ﻣﺔ‬‫اﻟﺤﻜﻮ‬ ‫ﻋﻤﻞ‬ ‫ﻋﻠﻰ‬ ‫واﻟﺤﺼﻮل‬
‫اﻟﻐﺬاﺋﻲ‬ ‫اﻟﺘﺴﻤﻢ‬ ‫ﺣﺎﻻت‬‫زﯾﺎدة‬
‫واﻟﺴﺎرﯾﺔ‬ ‫اﻟﻤﻌﺪﯾﺔ‬ ‫ﻣﺮاض‬‫اﻷ‬ ‫اﻧﺘﺸﺎر‬
‫ﻟﻠﻌﻤﻞ‬ ‫ردﯾﺌﺔ‬ ‫ﻧﻮﻋﯿﺔ‬ ‫ذات‬ ‫ﻣﺮاﻓﻖ‬‫ﺗﺴﺘﻤﺮ‬
‫ﻣﻤﺎرﺳﺔ‬‫ﻓﻲ‬ ‫اﻻﺳﺘﻤﺮار‬ ‫وھﻤﯿﺔ‬ ‫أو‬ ‫ﻛﻒء‬ ‫ﻏﯿﺮ‬ ‫اﻟﻤﮭﻨﯿﯿﻦ‬
‫اﻟﺼﺤﯿﯿﻦ‬ ‫اﻟﻤﮭﻨﯿﯿﻦ‬ ‫اﻟﺘﻌﻠﯿﻢ‬
‫أو‬ ‫اﻟﻄﺒﯿﺔ‬ ‫اﻟﻤﺪرﺳﺔ‬ ‫ﻓﻲ‬ ‫ﻣﻜﺎن‬‫ﻋﻠﻰ‬ ‫ﻟﻠﺤﺼﻮل‬ ‫اﻟﺮﺷﺎوى‬
‫ﻣﺔ‬‫اﻟﺨﺪ‬ ‫ﻗﺒﻞ‬ ‫اﻟﺘﺪرﯾﺐ‬ ‫ﻣﻦ‬‫ﻏﯿﺮھﺎ‬
‫اﻟﻨﺠﺎح‬ ‫درﺟﺎت‬ ‫ﻋﻠﻰ‬ ‫ﻟﻠﺤﺼﻮل‬ ‫رﺷﺎوى‬
‫اﻟﻤﺮﺷﺤﯿﻦ‬ ‫اﺧﺘﯿﺎر‬ ‫ﻓﻲ‬ ‫واﻟﻤﺤﺴﻮﺑﯿﺔ‬ ‫اﻟﺴﯿﺎﺳﻲ‬ ‫اﻟﻨﻔﻮذ‬
‫اﻟﺘﺪرﯾﺐ‬ ‫ﻟﻔﺮص‬
‫اﻟﻤﮭﻦ‬ ‫ﻓﻲ‬ ‫ﯾﻌﻤﻠﻮن‬ ‫أو‬ ‫اﻟﻄﺐ‬ ‫ﻣﮭﻨﺔ‬‫ﯾﻤﺎرس‬ ‫ﻛﻒء‬ ‫ﻏﯿﺮ‬ ‫اﻟﻤﮭﻨﯿﯿﻦ‬
‫اﻟﺼﺤﯿﺔ‬
‫ﻋﺎدل‬ ‫ﻏﯿﺮ‬ ‫ﻧﻈﺎم‬ ‫ﺑﺴﺒﺐ‬ ‫واﻟﺤﺮﯾﺔ‬ ‫اﻟﺜﻘﺔ‬ ‫ﻓﻘﺪان‬
‫اﻟﻄﺒﯿﺔ‬ ‫اﻷﺑﺤﺎث‬
‫اﻟﺘﻲ‬ ‫اﻷدوﯾﺔ‬ ‫ﺷﺮﻛﺎت‬ ‫ﺗﻤﻮﻟﮭﺎ‬ ‫اﻟﺘﻲ‬ ‫اﻟﺰاﺋﻔﺔ‬ ‫اﻟﺘﺠﺎرب‬ ‫ﻣﻦ‬
‫ﻟﻠﺘﺴﻮﯾﻖ‬ ‫اﻟﺤﻘﯿﻘﺔ‬ ‫ﻓﻲ‬ ‫ھﻲ‬
‫ذات‬ ‫اﻟﻘﻀﺎﯾﺎ‬ ‫ﻣﻦ‬‫وﻏﯿﺮھﺎ‬ ‫اﻟﻤﺴﺘﻨﯿﺮة‬ ‫اﻟﻤﻮاﻓﻘﺔ‬ ‫اﻟﻔﮭﻢ‬ ‫ﺳﻮء‬
‫ﻣﯿﺔ‬‫اﻟﻨﺎ‬ ‫اﻟﺒﻠﺪان‬ ‫ﻓﻲ‬ ‫ﻛﺎﻓﯿﺔ‬ ‫ﻣﻌﺎﯾﯿﺮ‬
‫اﻟﻔﺮدﯾﺔ‬ ‫ﻟﻠﺤﻘﻮق‬ ‫اﻧﺘﮭﺎك‬
‫اﻟﺒﺤﻮث‬ ‫ﻣﺠﺎل‬‫ﻓﻲ‬ ‫اﻟﻤﺴﺎواة‬ ‫وﻋﺪم‬ ‫اﻟﺘﺤﯿﺰ‬
‫ﻓﻲ‬ ‫ﻣﻠﯿﻦ‬‫اﻟﻌﺎ‬ ‫ﻣﺎت‬‫اﻟﺨﺪ‬ ‫ﺗﻮﻓﯿﺮ‬
‫ﻣﻦ‬‫وﻏﯿﺮھﻢ‬ ‫اﻟﻄﺒﻲ‬ ‫اﻟﻤﺠﺎل‬
‫اﻟﺼﺤﯿﯿﻦ‬ ‫ﻣﻠﯿﻦ‬‫اﻟﻌﺎ‬
‫اﻟﻤﺮﺿﻰ‬ ‫ؤﯾﺔ‬‫ﻟﺮ‬ ‫ﻣﺔ‬‫اﻟﻌﺎ‬ ‫واﻟﻤﻌﺪات‬ ‫اﻟﻤﺮاﻓﻖ‬ ‫اﺳﺘﺨﺪام‬
‫اﻟﺨﺎص‬
‫ﻣﺎت‬‫اﻟﺨﺪ‬ ‫أو‬ ‫ﺧﺎﺻﺔ‬ ‫ﻋﯿﺎدة‬ ‫إﻟﻰ‬ ‫اﻟﻀﺮورﯾﺔ‬ ‫ﻏﯿﺮ‬ ‫ﺣﺎﻻت‬‫اﻹ‬
‫اﻟﺨﺎص‬ ‫ﻟﻠﻘﻄﺎع‬ ‫اﻟﻤﻤﻠﻮﻛﺔ‬ ‫اﻹﺿﺎﻓﯿﺔ‬
‫اﻟﻌﻤﻞ‬ ‫ﻋﻦ‬ ‫اﻟﺘﻐﯿﺐ‬
‫ﻣﺎت‬‫ﻟﻠﺨﺪ‬ ‫اﻟﻤﺮﺿﻰ‬ ‫ﻣﻦ‬‫اﻟﻤﻄﻠﻮﺑﺔ‬ ‫اﻟﺮﺳﻤﯿﺔ‬ ‫ﻏﯿﺮ‬ ‫اﻟﻤﺪﻓﻮﻋﺎت‬
‫ﻣﻦ‬‫آﺧﺮ‬ ‫ﺑﺸﻜﻞ‬ ‫ﺗﺴﺮﯾﺒﮭﺎ‬ ،‫اﻟﻤﺴﺘﺨﺪم‬ ‫رﺳﻮم‬ ‫إﯾﺮادات‬ ‫ﺳﺮﻗﺔ‬
‫اﻟﻤﯿﺰاﻧﯿﺔ‬ ‫ﻣﺨﺼﺼﺎت‬
‫ﻣﻨﺎﺳﺐ‬‫ﺗﻌﻮﯾﺾ‬ ‫دون‬ ‫اﻻﺳﺘﺜﻤﺎرات‬ ‫ﻗﯿﻤﺔ‬ ‫ﻣﺔ‬‫اﻟﺤﻜﻮ‬ ‫ﺗﻔﻘﺪ‬
‫ﺣﺠﻢ‬‫اﻧﺨﻔﺎض‬ ‫إﻟﻰ‬ ‫أدى‬ ‫ﻣﻤﺎ‬،‫اﻟﻤﺮﺿﻰ‬ ‫ﻣﺔ‬‫ﻟﺨﺪ‬ ‫ﺗﺘﻮﻓﺮ‬ ‫ﻻ‬ ‫اﻟﻤﻮظﻔﯿﻦ‬
‫ﻣﺎت‬‫ﻟﻠﺨﺪ‬ ‫ﺣﺪة‬‫و‬ ‫ﺗﻜﺎﻟﯿﻒ‬ ‫وارﺗﻔﺎع‬ ،‫اﻟﻤﻠﺒﺎة‬ ‫ﻏﯿﺮ‬ ‫ﺣﺘﯿﺎﺟﺎت‬‫واﻻ‬ ‫ﻣﺎت‬‫اﻟﺨﺪ‬
‫اﻟﻮاﻗﻊ‬ ‫ﻓﻲ‬ ‫ﻣﺔ‬‫اﻟﻤﻘﺪ‬ ‫اﻟﺼﺤﯿﺔ‬
‫ﻻ‬ ‫اﻟﺬﯾﻦ‬ ‫اﻟﻤﺮﺿﻰ‬ ‫ﻗﺒﻞ‬ ‫ﻣﻦ‬‫ﻣﺎت‬‫ﺧﺪ‬ ‫ﻣﻦ‬‫اﻻﺳﺘﻔﺎدة‬ ‫اﻧﺨﻔﺎض‬
‫دﻓﻊ‬ ‫ﯾﺴﺘﻄﯿﻌﻮن‬
‫ﻟﺴﺪاد‬ ‫أﺻﻮل‬ ‫وﺑﯿﻊ‬ ‫اﻟﺪﺧﻞ‬ ‫ذوي‬ ‫ﻣﻦ‬‫ﻣﻮاطﻨﯿﻦ‬‫ﯾﺴﺘﺨﺪم‬ ‫ﻛﻤﺎ‬ ‫اﻟﻔﻘﺮ‬
‫اﻟﺼﺤﯿﺔ‬ ‫اﻟﺮﻋﺎﯾﺔ‬ ‫ﺗﻜﺎﻟﯿﻒ‬
‫اﻹﯾﺮادات‬ ‫ﻓﻲ‬ ‫ﺧﺴﺎرة‬ ‫ﻣﻦ‬‫اﻟﺮﻋﺎﯾﺔ‬ ‫ﺟﻮدة‬ ‫اﻧﺨﻔﺎض‬
‫اﻟﻤﻮاطﻦ‬ ‫ﻣﺔ‬‫اﻟﺤﻜﻮ‬ ‫ﻓﻲ‬ ‫اﻟﺜﻘﺔ‬ ‫ﻓﻘﺪان‬
T, The sectoral dimensions of corruption: health care, Chapter 4 in Spector BI: VianSource
. Bloomfield, CT: Kumarian Press Inc., 2005,countriesdevelopingincorruptionFighting(ed.).
46-p. 45

6. :‫ﺑﺎﻟﻣﺳﺗﺷﻔﯾﺎت‬ ‫اﻟﻔﺳﺎد‬ ‫اﺷﻛﺎل‬
١-:‫واﻟﻌﻣوﻻت‬ ‫اﻟرﺷﺎوي‬
‫ﻣﯾزھﺎ‬‫وﺿﻊ‬‫اﻟﻌﻼﻣﺎت‬‫ﻣن‬‫اﻟﻔﺳﺎد‬‫واﻟرﺷﺎوى‬‫واﻟﻌﻣوﻻت‬‫ﯾﻣﻛن‬‫أن‬‫ﺗدﻓﻊ‬‫ﻣن‬‫ﻗﺑل‬‫اﻷﻓراد‬‫واﻟﺷرﻛﺎت‬‫إﻟﻰ‬
)‫ا‬(‫ﺷراء‬‫اﻟﻌﻘود‬‫اﻟﺣﻛوﻣﯾﺔ‬‫وﺗﺷرف‬‫ﻋﻠﻰ‬‫ﺗراﺧﯾص‬‫ﻟﺑﻧﺎء‬‫ﻣراﻓﻖ‬‫اﻟرﻋﺎﯾﺔ‬،‫اﻟﺻﺣﯾﺔ‬‫وﺗوﻓﯾر‬‫اﻷدوﯾﺔ‬‫واﻟﺳﻠﻊ‬،‫واﻟﺧدﻣﺎت‬
‫وﻛذﻟك‬‫ﺿﻣﺎن‬‫ﺷروط‬‫ﻋﻘودھم؛‬
)‫ب‬(‫ﺑﺎدﺋﺔ‬‫و‬"‫ﺗﻼﻋب‬"‫ﻋﻣﻠﯾﺔ‬‫ﺗﻘدﯾم‬‫اﻟﻌطﺎءات؛‬
)‫ج‬(‫ﺗﻼﻋب‬‫وﺗزوﯾر‬،‫اﻟﺳﺟﻼت‬‫وﺗﻌدﯾل‬"‫اﻷدﻟﺔ‬"‫ﻹﻋطﺎء‬‫ﻣظﮭر‬‫ﻣن‬‫ﻛوﻧﮭﺎ‬‫ﻓﻲ‬‫اﻻﻣﺗﺛﺎل‬‫ﻟﻣﻌﺎﯾﯾر‬‫اﻟﮭﯾﺋﺎت‬‫اﻟﺗﻧظﯾﻣﯾﺔ‬) .‫د‬(
‫ﺗﺳرﯾﻊ‬‫إﺟراءات‬‫اﻹذن‬‫ﻟﻠﻘﯾﺎم‬‫ﺑﺄﻧﺷطﺔ‬،‫اﻟﻘﺎﻧوﻧﯾﺔ‬‫ﻣﺛل‬‫اﻟﺣﺻول‬‫ﻋﻠﻰ‬‫اﻻﻧﺗﻣﺎء‬،‫اﻟﻣؤﺳﺳﻲ‬‫ﺗﺳﺟﯾل‬‫اﻟﺷرﻛﺔ‬‫أو‬‫ﺗراﺧﯾص‬
‫اﻟﺑﻧﺎء‬.
‫و‬)‫ھــ‬(‫ﺗﺄﺛﯾر‬‫أو‬‫ﺗﻐﯾﯾر‬‫اﻟﻧﺗﺎﺋﺞ‬‫اﻟﻘﺎﻧوﻧﯾﺔ‬‫وذﻟك‬‫ﻟﺗﺟﻧب‬‫اﻟﻌﻘو‬‫ﺑﺔ‬‫ﻋﻠﻰ‬‫اﻻﺛم‬.
٢-‫واﻻﺧﺗﻼس‬ ‫اﻟﺳرﻗﮫ‬:‫ﺗﺣدث‬‫ھذا‬‫ﻋﻠﻰ‬‫ﺳرﻗﺔ‬‫اﻷﺻول‬‫واﻟﻣﻧﺎﻓﻊ‬،‫اﻟﻌﺎﻣﺔ‬‫ﻣﺛل‬‫اﻷدوات‬،‫واﻷدوﯾﺔ‬‫ﻣن‬‫ﻗﺑل‬‫اﻷﻓراد‬،‫ﻟﻠﺑﯾﻊ‬
‫اﺳﺗﺧدام‬‫اﻟﺷﺧﺻﻲ‬‫أو‬‫اﺳﺗﺧداﻣﮭﺎ‬‫ﻓﻲ‬‫ﻟرﺑﺣﯾﺔ‬‫اﻟﻌﯾﺎدات‬‫اﻟﺧﺎﺻﺔ‬.‫ﺳرﻗﺔ‬‫اﻹﯾرادات‬،‫اﻟﺣﻛوﻣﯾﺔ‬‫ﻣﺛل‬‫رﺳوم‬‫ﺗﺳﺟﯾل‬
،‫اﻟﻣرﺿﻰ‬‫ودﻓﻊ‬‫اﻟﻣرﺗﺑﺎت‬‫ﻻﻟﻣﺗوﻓﻰ‬‫أو‬‫اﻟﻌﻣﺎل‬"‫اﻷﺷﺑﺎح‬"‫وﻏﯾر‬‫ذﻟك‬‫ﻣن‬‫أﺷﻛﺎل‬‫اﻟﻔﺳﺎد‬
٣-:‫اﻟﻌﺎﻣﮫ‬ ‫واﻟﻣواد‬ ‫ﺑﺎﻟﺳﻠﻊ‬ ‫اﻟﻣﺗﻌﻣد‬ ‫اﻟﺿرر‬
‫اﻷﺻول‬‫واﻷدوات‬‫اﻟﻌﺎﻣﺔ‬‫ﻓﻲ‬‫اﻟﻣﺳﺗﺷﻔﯾﺎت‬‫اﻟﺣﻛوﻣﯾﺔ‬‫ﯾﻣﻛن‬‫أﯾﺿﺎ‬‫أن‬‫ﺗﺗﺿرر‬‫ﻋﻣدا‬‫وذﻟك‬‫ﻟﺟﻌﻠﮭﺎ‬‫ﻣﺗﺎﺣﺔ‬،‫ﻟﻠﻣرﺿﻰ‬‫ﻣﻊ‬
‫اﻟﮭدف‬‫اﻟﻧﮭﺎﺋﻲ‬‫ﻟطﻠب‬‫اﻟﺧدﻣﺎت‬‫ﻣن‬‫اﻟﻌﯾﺎدات‬‫اﻟﺧﺎﺻﺔ‬‫ﻓﻲ‬‫ﻣﻘﺎﺑل‬‫ﺣواﻓز‬‫ﻣﺎﻟﯾﺔ‬‫أو‬"‫ﻟﺟﻧﺔ‬."
٤-‫اﻟﻌﻣل‬ ‫ﻋن‬ ‫اﻟﺗﻐﯾب‬‫:وھذا‬‫ﺷﻛﻼ‬‫ﻣن‬‫أﺷﻛﺎل‬،‫اﻟﻔﺳﺎد‬‫واﻟﺗﻐﯾب‬)‫ﻻ‬‫ﯾﺣﺿرون‬‫اﻟﻌﻣل‬‫وﻟﻛن‬‫ﯾدﻋﻲ‬‫اﻟراﺗب‬(‫ﻓﻲ‬‫اﻟﻘطﺎع‬
‫اﻟﺻﺣﻲ‬‫ﻣﺻدر‬‫ﻗﻠﻖ‬‫ﻛﺑﯾر‬‫ﻓﻲ‬‫ﺑﻌض‬‫اﻟﺑﻠدان‬‫اﻟﻧﺎﻣﯾﺔ‬
٥-‫رﺳﻣﯾﮫ‬ ‫ﻏﯾر‬ ‫ﻣدﻓوﻋﺎت‬‫:ﻓﻲ‬‫ﺑﻌض‬،‫اﻟﺑﻠدان‬‫اﻟﻣرﺿﻰ‬‫ﺗﺟﻌل‬‫ﻋﺎدة‬‫ﻣدﻓوﻋﺎت‬‫ﻏﯾر‬‫رﺳﻣﯾﺔ‬‫ﻷﺧﺻﺎﺋﯾﻲ‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬
‫ﻟﺗﻘدﯾم‬‫ﺧدﻣﺎت‬‫أﻓﺿل‬.‫ﻓرض‬‫ﻣﺛل‬‫ھذه‬"‫اﻟﺿرﯾﺑﺔ‬"‫ﻋﻠﻰ‬‫ﺧدﻣﺎت‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬"‫اﻟﺣرة‬"‫ﻟﮫ‬‫ﺗﺄﺛﯾر‬‫ﺳﻠﺑﻲ‬‫ﻋﻠﻰ‬
‫اﻟﺣﺻول‬‫ﻋﻠﻰ‬‫اﻟﺧدﻣﺎت‬‫اﻟﺻﺣﯾﺔ‬
٦-‫ﻣﺎﻟﯾﮫ‬ ‫ﻟﻣﻛﺎﺳب‬ ‫اﻟﺑﺷرﯾﮫ‬ ‫اﻟﻣوارد‬ ‫اﺳﺗﺧدام‬‫:اﻟﺑﺎﺣﺛﯾن‬‫اﻟﺳرﯾري‬‫ﻣن‬‫ﻗﺑل‬‫ﺻﻧﺎﻋﺔ‬‫اﻟطب‬‫اﻟﺣﯾوي‬‫ﻟﺗوظﯾف‬‫اﻟﻔﻘراء‬
،‫واﻷﻣﯾﯾن‬‫أي‬،‫اﻟﺿﻌﯾﻔﺔ‬‫واﻟﻣوﺿوﻋﺎت‬‫اﻹﻧﺳﺎن‬‫ﻟﻠﺗﺟﺎرب‬‫اﻟﺳرﯾرﯾﺔ‬.‫وھﻧﺎك‬‫طرﯾﻘﺔ‬‫أﺧرى‬‫ﻓﯾﮭﺎ‬‫اﻟﻣﺳﺗﺷﻔﯾﺎت‬‫واﻷطﺑﺎء‬
‫اﺳﺗﺧدام‬‫اﻟﻣرﺿﻰ‬‫ﯾﺗم‬‫ﻋن‬‫طرﯾﻖ‬‫ﻓرض‬‫اﻟﻣرﺿﻰ‬‫ﻏﯾر‬‫اﻟﻣؤﻣن‬‫ﻋﻠﯾﮭم‬‫واﻟﻣرﺿﻰ‬‫اﻟذﯾن‬‫ﯾﻌﺎﻧون‬‫ﻣن‬‫اﻟﺧطط‬‫اﻟﺻﺣﯾﺔ‬
‫اﻷﺧرى‬‫أﻛﺛر‬‫ﺑﻛﺛﯾر‬‫ﻣن‬‫اﻟﺗﻛﺎﻟﯾف‬‫اﻟﻔﻌﻠﯾﺔ‬‫اﻟﻣﻌﻧﯾﺔ‬‫وﻣﺎ‬‫ﺗدﻓﻊ‬‫ﺷرﻛﺎت‬‫اﻟﺗﺄﻣﯾن‬‫اﻟﺻﺣﻲ‬
٧-‫اﻟﻣؤﺳﺳﺎﺗﻲ‬ ‫اﻟﻣﺣﺗﻣل‬ ‫اﻟﻔﺳﺎد‬‫:ﻓﻲ‬‫ﺑﻌض‬‫اﻟﻣﺳﺗﺷﻔﯾﺎت‬‫ﻟﻠ‬،‫رﺑﺢ‬‫واﻷطﺑﺎء‬‫ﻟدﯾﮭم‬‫اﻟﺗزاﻣﺎت‬‫ﺗﻌﺎﻗدﯾﺔ‬‫ﻧﻌﺗرف‬‫ﻋدد‬‫ﻣﺣدد‬‫ﻣن‬
‫اﻟﻣرﺿﻰ‬‫ﻋﻠﻰ‬‫ﺳرﯾر‬‫اﻟﻣﺧﺻص‬‫ووﺻف‬‫ﻋدد‬‫ﻣن‬‫اﻟﻔﺣوص‬‫اﻟﻣﺧﺗﺑرﯾﺔ‬)‫ﺣﺗﻰ‬‫ﻟو‬‫ﻛﺎن‬‫ﻏﯾر‬‫ﺿروري‬(‫ﻟﺗوﻟﯾد‬
‫اﻹﯾرادات‬.

7. ٨-‫ﻟﻠﺗﺟﺎرب‬ ‫واﻻﻣﯾﯾن‬ ‫اﻟﻔﻘراء‬ ‫اﺳﺗﺧدام‬ ‫اﻟﺳرﯾرﯾﮫ‬ ‫اﻟﺗﺟﺎرب‬.
tUnited Nations DevelopmenProgramme; 2011Oct 31[cited 2013 Jul 4} New York:.[
‫اﻧﻣﺎ‬‫ط‬‫اﻟرﺷوة‬‫ﻓﻲ‬‫ﺗﻘدﯾم‬‫اﻟﺧدﻣﺎت‬‫اﻟطﺑﯾﺔ‬.:
-‫اﻟﻔﺳﺎد‬‫اﻟﺷراء؛‬
-‫اﻟﻌﻼﻗﺎت‬‫اﻟﺗﺳوﯾﻘﯾﺔ‬‫ﻏﯾر‬‫ﻻﺋﻘﺔ‬.
-‫ﺳوء‬‫اﺳﺗﺧدام‬‫ﻟﻠﻣواﻗﻊ‬)‫ارﺗﻔﺎع‬(‫ﻣﺳﺗوى‬.
-‫ﻣطﺎﻟﺑﺎت‬‫اﻟﺳداد‬‫ﻻ‬‫ﻟزوم‬‫ﻟﮭﺎ‬.
-‫اﻻﺣﺗﯾﺎل‬‫واﻻﺧﺗﻼس‬‫ﻣن‬‫اﻷدوﯾﺔ‬‫واﻷﺟﮭزة‬‫اﻟﺻﺣﯾﮫ‬ ‫ﺑﺎﻟﺧدﻣﮫ‬ ‫اﻟﻔﺳﺎد‬ ‫اﻟطﺑﯾﺔ‬:
)Radin 2013(
‫اﻟﻧﺷﺎط‬‫اﻟ‬‫ﻔﺎﺳد‬‫ﻓﻲ‬‫اﻟﻘطﺎع‬‫اﻟﺻﺣﻲ‬‫ﯾﻣﻛن‬‫أن‬‫ﯾﻛون‬‫ﻟﮭﺎ‬‫ﺗداﻋﯾﺎت‬‫ﻓﻲ‬‫ﺛﻼﺛﺔ‬‫ﻣﺟﺎﻻت‬.
١-‫اﻟﺻﺣﯾﺔ‬‫وﻧظﺎم‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬.‫وﻣن‬‫اﻟﻣرﺟﺢ‬‫أن‬‫ﺗﺿر‬‫ﻗدرة‬‫ﻧظﺎم‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫ﻟﺗﻘدﯾم‬‫ﻧوﻋﯾﺔ‬‫ﻋﺎﻟﯾﺔ‬‫واﻟرﻋﺎﯾﺔ‬
‫اﻟﻔﻌﺎﻟﺔ‬‫ﻟﻸﺷﺧﺎص‬‫اﻟذﯾن‬‫ﯾﻣﻛن‬‫أن‬‫ﺗﺳﺗﻔﯾد‬‫أﻛﺛر‬‫ﻧﺷﺎط‬‫اﻟﻔﺎﺳدﯾن‬.‫ھﻧﺎك‬‫أدﻟﺔ‬‫ﻣﺗزاﯾدة‬‫ﻋﻠﻰ‬‫أن‬‫ارﺗﻔﺎع‬‫ﻣﺳﺗوﯾﺎت‬‫اﻟﻔﺳﺎد‬
‫إﻓﻘﺎر‬،‫اﻟﺳﻛﺎن‬‫وزﯾﺎدة‬‫ﻋدم‬،‫اﻟﻣﺳﺎواة‬‫واﻟﺣﺎﻟﺔ‬‫اﻟﺻﺣﯾﺔ‬‫اﻟﺳﺑب‬‫ﻓﻲ‬،‫اﻟﺗدھور‬‫ﺧﺎﺻﺔ‬‫ﺑﯾن‬‫اﻟﻔﺋﺎت‬‫اﻟﺳﻛﺎﻧﯾﺔ‬‫اﻷﻛﺛر‬‫ﺿﻌﻔﺎ‬.
٢-‫اﻟﻧﺷﺎط‬‫اﻟﺗﺟﺎري‬.‫وﺟود‬‫ﻧظﺎم‬‫ﺷﺑﮫ‬‫اﻧﻔراد‬‫اﻟﻛﺑﯾر‬‫اﻟذي‬‫ﯾﻌﻣل‬‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫اﻟﻘطﺎع‬‫اﻟﻌﺎم‬‫ﯾﻣﻛن‬‫أن‬‫ﯾﻛون‬‫ﺿﺎرا‬‫ﻟﺗطوﯾر‬
‫ﻗطﺎع‬‫ﺧﺎص‬‫ﻗوي‬.‫اﻧﮭﺎ‬‫ﻏﺎﻟﺑﺎ‬‫ﻣﺎ‬‫ﺗﻛون‬‫أﻛﺛر‬‫رﺑﺣﺎ‬‫ﻟﻣﻘدﻣﻲ‬‫اﻟﺧﺎص‬‫ﻻﺳﺗﻐﻼل‬‫اﻟﻣراﻓﻖ‬،‫اﻟﻌﺎﻣﺔ‬‫ﻣﻊ‬‫إﻣداداﺗﮭﺎ‬‫ﻣن‬‫اﻟﻣﻌدات‬
‫اﻟطﺑﯾﺔ‬،‫واﻟﻣرﺿﻰ‬‫ﺑدﻻ‬‫ﻣن‬‫إﻧﺷﺎء‬‫ﻋﯾﺎداﺗﮭم‬‫اﻟﺧﺎﺻﺔ‬‫وآﻟﯾﺎت‬‫ﺗﺟﻧﯾد‬‫اﻟﻣرﺿﻰ‬.
٣-‫اﻻﻗﺗﺻﺎد‬‫اﻟﻛﻠﻲ‬.‫ھﻧﺎك‬‫أدﻟﺔ‬‫ﻣﺗزاﯾدة‬‫ﻋﻠﻰ‬‫أن‬‫اﻟﻔﺳﺎد‬‫ﯾﻘﻠل‬‫ﺑﺷﻛل‬‫ﻣﻠﺣوظ‬‫اﻟﻧﻣو‬‫اﻻﻗﺗﺻﺎدي‬‫واﺳﺗﺛﻣﺎرات‬‫اﻟﻘطﺎع‬
‫اﻟﺧﺎص‬.
)European Observatory on Health Care Systems Series. Accessed 7 April 2005(

8. :‫اﻟﺻﺣﯾﮫ‬ ‫اﻟﻣﻧظﻣﮫ‬ ‫ﻓﻲ‬ ‫اﻟﻔﺳﺎد‬ ‫ﻋواﻗب‬
‫اﻟﻌواﻗب‬‫ﯾؤﺛر‬‫اﻟﻔﺳﺎد‬‫اﻟﻧﺗﺎﺋﺞ‬‫اﻟﺻﺣﯾﺔ‬‫ﻋن‬‫طرﯾﻖ‬‫اﻟﺣد‬‫ﻣن‬‫اﻟﺗﻣوﯾل‬‫اﻟﺣﻛوﻣﻲ‬‫اﻟﻣﺗﺎح‬‫ﻟﻠﺧدﻣﺎت‬‫ﺻﺣﯾﺔ‬.‫واﻟ‬‫ﺷرﻛﺎت‬
‫اﻟ‬‫ﺧﺎﺻﺔ‬‫ﺗﺗردد‬‫ﻓﻲ‬‫اﻻﺳﺗﺛﻣﺎر‬‫ﻓﻲ‬‫ﺑﻠدان‬‫ذات‬‫ﻣﺳﺗوﯾﺎت‬‫ﻋﺎﻟﯾﺔ‬‫اﻟﻔﺳﺎد‬‫اﻟذي‬‫ﯾﺧﻔض‬‫اﻟﻧﻣو‬‫اﻻﻗﺗﺻﺎدي‬‫اﻟﻌﺎم‬.‫وھذا‬‫ﺑدوره‬
‫ﯾﻌﻧﻲ‬‫ﺗ‬‫ﻘﻠ‬‫ﯾل‬‫اﻹﯾرادات‬‫اﻟ‬‫ﻣﺗﺎﺣﺔ‬‫ﻟﻠﻘطﺎع‬‫اﻟﺻﺣﻲ‬.‫ﺣﺗﻰ‬‫داﺧل‬‫اﻟﻘطﺎع‬،‫اﻟﺻﺣﻲ‬‫وﺗﺧﺻﯾص‬‫اﻟﻣوارد‬‫ﻗد‬‫ﺗﻛون‬‫ﻣﺷوھﺔ‬
‫اﻟﻘرارات‬‫ﻷﻧﮫ‬‫ﻣن‬‫اﻷﺳﮭل‬‫ﻟﻠﺣﺻول‬‫ﻋﻠﻰ‬‫رﺷوة‬‫ﻛﺑﯾرة‬‫ﻋﻠﻰ‬‫اﻟﻣﺳﺗﺷﻔﻰ‬‫ﻋﻘد‬‫اﻟﺑﻧﺎء‬‫أو‬‫ﻋﻠﻰ‬‫ﺷراء‬‫ﻣﻛﻠﻔﺔ‬‫وﻣﺗطورة‬
‫اﻟطﺑﯾﺔ‬‫اﻟﻣﻌدات‬‫ﻣن‬‫اﻟﺗرﻛﯾز‬‫ﻋﻠﻰ‬‫ﺑراﻣﺞ‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫اﻷوﻟﯾﺔ‬
‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫اﻟﻘطﺎع‬‫اﻟﺻﺣﻲ‬‫ﻟﮫ‬‫ﺗﺄﺛﯾر‬‫ﺳﻠﺑﻲ‬‫ﻋﻠﻰ‬‫وﺻول‬‫ﻟﻠﻣرﯾض‬ ‫ﻧوﻋﯾﺔ‬.‫ﻛﻣﺎ‬‫ﯾﺗم‬‫ﺻرف‬‫اﻟﻣوارد‬‫ﻣن‬‫ﺧﻼل‬‫اﻻﺧﺗﻼس‬
‫واﻻﺣﺗﯾﺎل‬‫ﺑ‬،‫ﺎﻟﻣﺷﺗرﯾﺎت‬‫و‬‫ﺗﻘﻠﯾل‬‫اﻟﻣﺎل‬‫ھو‬‫ﻣﺗﺎح‬‫ﻟدﻓﻊ‬‫اﻟرواﺗب‬‫وﺗﻣوﯾل‬‫اﻟﻌﻣﻠﯾﺎت‬‫واﻟﺻﯾﺎﻧﺔ‬.‫ھذا‬‫ﯾﻣﻛن‬‫ﺗﺣطﯾم‬‫ﻣﻌﻧوﯾﺎت‬
،‫اﻟﻣوظﻔﯾن‬‫واﻧﺧﻔﺎض‬‫ﺟودة‬،‫اﻟرﻋﺎﯾﺔ‬‫واﻟﺣد‬‫ﻣن‬‫ﺗواﻓر‬‫واﺳﺗﺧدام‬‫اﻟﺧدﻣﺎت‬.‫وﻗد‬‫أظﮭرت‬‫اﻟدراﺳﺎت‬‫أن‬‫اﻟﻔﺳﺎد‬‫ﻟﮫ‬‫ﺗﺄﺛﯾر‬
‫ﺳﻠﺑﻲ‬‫ﻋﻠﻰ‬‫اﻟﺻﺣﺔ‬‫ﻣؤﺷرات‬‫ﻣﺛل‬‫ﻣﻌدل‬‫وﻓﯾﺎت‬‫اﻟرﺿﻊ‬،‫واﻷطﻔﺎل‬‫وھﻧﺎك‬‫أدﻟﺔ‬‫ﻋﻠﻰ‬‫أن‬‫اﻟﺣد‬‫اﻟﻔﺳﺎد‬‫ﯾﻣﻛن‬‫ﺗﺣﺳﯾن‬
‫اﻟﻧﺗﺎﺋﺞ‬‫اﻟﺻﺣﯾﺔ‬‫ﻣن‬‫ﺧﻼل‬‫زﯾﺎ‬‫دة‬‫ﻓﻌﺎﻟﯾﺔ‬‫اﻟﺟﻣﮭور‬‫اﻟﻧﻔﻘﺎت‬
‫وﺗﺑﯾن‬‫ﻣن‬‫اﺳﺗﻌراض‬‫اﻷﺑﺣﺎث‬‫ﺣول‬‫اﻟﻣدﻓوﻋﺎت‬‫ﻏﯾر‬‫اﻟرﺳﻣﯾﺔ‬‫دﻟﯾل‬‫ﻋﻠﻰ‬‫أن‬‫اﻟﻣدﻓوﻋﺎت‬‫ﻏﯾر‬‫اﻟرﺳﻣﯾﺔ‬‫ﻟﻠﺣﺻول‬‫ﻋﻠﻰ‬
‫اﻟرﻋﺎﯾﺔ‬‫ﺗﻘﻠﯾل‬‫ﻓرص‬‫اﻟﺣﺻول‬‫ﻋﻠﻰ‬‫اﻟﺧدﻣﺎت‬‫ﻣن‬‫ﺧﻼل‬‫ﺟﻌل‬‫اﻟرﻋﺎﯾﺔ‬‫أﻗل‬‫ﺑﺄﺳﻌﺎر‬،‫ﻣﻌﻘوﻟﺔ‬‫وﺧﺎﺻﺔ‬‫ﺑﺎﻟﻧﺳﺑﺔ‬‫ﻟل‬
‫اﻟﻔﻘراء‬.‫ﻓﻲ‬،‫أذرﺑﯾﺟﺎن‬‫وﻗدرت‬‫إﺣدى‬‫اﻟدراﺳﺎت‬‫أن‬٣٥٪‫ﻣن‬‫اﻟوﻻدات‬‫ﻓﻲ‬‫اﻟﻣﻧﺎطﻖ‬‫اﻟرﯾﻔﯾﺔ‬‫ﺗﺟري‬‫ﻓﻲ‬،‫اﻟﻣﻧزل‬‫وذﻟك‬
‫ﺟزﺋﯾﺎ‬‫ﺑﺳﺑب‬‫رﺳوم‬‫ﻏﯾر‬‫رﺳﻣﯾﺔ‬‫ﻋﺎﻟﯾﺔ‬‫ﻟﻠرﻋﺎﯾﺔ‬‫ﻓﻲ‬،‫ﻣراﻓﻖ‬‫ﺑﯾﻧﻣﺎ‬‫ﻓﻲ‬،‫أرﻣﯾﻧﯾﺎ‬‫ﻋﺎﺋﻼت‬‫ﯾﻔﯾد‬‫اﻻﺿطرار‬‫إﻟﻰ‬‫ﺑﯾﻊ‬
‫ﻣواﺷﯾﮭم‬‫أو‬،‫اﻷﺻول‬‫أو‬‫اﻗﺗراض‬‫اﻟﻣﺎل‬‫ﻣن‬‫ﻣوﺳﻌﺔ‬‫أﻓراد‬‫اﻷﺳرة‬،‫واﻟﻣﺟﺗﻣﻊ‬‫ﻣن‬‫أﺟل‬‫ﺟﻌل‬‫اﻟﻣدﻓوﻋﺎت‬‫ﻏﯾر‬‫اﻟرﺳﻣﯾﺔ‬
‫اﻟﻼزﻣﺔ‬‫ل‬‫ﺗﻠﻘﻲ‬‫اﻟرﻋﺎﯾﺔ‬.
‫اﻟرﺷﺎوى‬‫ﻗﻠﯾﻠﮫ‬ ‫ﺟوده‬ ‫وذات‬ ‫اﻟﻛﻠﻔﮫ‬ ‫ﻗﻠﯾﻠﺔ‬ ‫اﻻدوﯾﮫ‬ ‫اﻟﻰ‬ ‫ﺗﻠﺟﺎء‬ ‫اﻟﻣوؤﺳﺳﺎت‬ ‫ﺟﻌﻠت‬.‫اﻟﺳﻣﺎح‬‫اﻷدوﯾﺔ‬‫ﻣن‬‫ﻗﯾﻣﺔ‬‫اﻟﻔرﻋﯾﺔ‬
‫اﻟﻌﻼﺟﯾﺔ‬‫ﻟﯾﺗم‬‫ﺑﯾﻌﮭﺎ‬‫ﯾﻣﻛن‬‫اﻟﻣﺳﺎھﻣﺔ‬‫ﻓﻲ‬‫ﺗطوﯾر‬‫اﻟﻛﺎﺋﻧﺎت‬‫اﻟﻣﻘﺎوﻣﺔ‬‫ﻟﻠﻌﻘﺎﻗﯾر‬‫وزﯾﺎدة‬‫ﺧطر‬‫اﻷوﺑﺋﺔ‬‫ﻏﯾر‬‫ﻗﺎﺑل‬‫ﻟﻠﻌﻼج‬.
‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫ﺷﻛل‬‫ﻣن‬‫أﺷﻛﺎل‬‫اﻟﺳرﻗﺔ‬‫أو‬‫ﺗﺳرﯾب‬‫اﻻدوﯾﮫ‬‫ﯾﻣﻛن‬‫أن‬‫ﯾؤدي‬‫إﻟﻰ‬‫ﻧﻘص‬‫ﻓﻲ‬‫اﻷدوﯾﺔ‬‫ﻓﻲ‬‫اﻟﻣراﻓﻖ‬،‫اﻟﺣﻛوﻣﯾﺔ‬
‫واﻟﺗﻲ‬‫ﻗد‬‫ﺗﺛﻧﻲ‬‫اﻟﻧﺎس‬‫ﻋن‬‫اﻟﺣﺻول‬‫ﻋﻠﻰ‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟطﺑﯾﺔ‬.‫اﻟﻔﺳﺎد‬‫اﻟﺷراء‬‫ﯾﻣﻛن‬‫أن‬‫ﯾؤدي‬‫إﻟﻰ‬‫اﻟﺑﻧﯾﺔ‬‫اﻟﺗﺣﺗﯾﺔ‬‫اﻟﻌﺎﻣﺔ‬‫ردﯾﺋﺔ‬
‫ﻣﻊ‬‫ارﺗﻔﺎع‬‫أﺳﻌﺎر‬‫ﺟﯾدا‬‫ﻋﺎﻟﯾﺔ‬‫ﻛﻣﺎ‬‫ان‬‫ﺗدﻓﻊ‬‫اﻟﺣﻛوﻣﺔ‬،‫ﻟﻠﻣواد‬‫وﺗرك‬‫أﻗل‬‫ﻣن‬‫اﻟﻣﺎل‬‫ل‬‫ﺗﻘدﯾم‬‫اﻟﺧدﻣﺎت‬.
)Lewis 2006(
١٠‫اﻟﻔﺳﺎد‬ ‫ﻟﻣﻛﺎﻓﺣﺔ‬ ‫اﺗﺑﺎﻋﮭﺎ‬ ‫ﯾﺟب‬ ‫ﺧطوات‬‫ادارﯾﺎ‬:
١-‫اﻟﻔﺳﺎد‬ ‫ﻣﺧﺎطر‬ ‫ﺗﻘﯾم‬
٢-‫اﻟﻔﺳﺎد‬ ‫ﻣﻛﺎﻓﺣﺔ‬ ‫ﺳﯾﺎﺳﺔ‬ ‫ﺗطوﯾر‬
٣-‫اﻟﻣﺧﺎطر‬ ‫اﺳﺎس‬ ‫ﻋﻠﻰ‬ ‫اﻟﻔﺳﺎد‬ ‫ﻣﻛﺎﻓﺣﺔ‬ ‫ﺳﯾﺎﺳﺔ‬ ‫ﺗﻧﻔﯾذ‬
٤-‫اﻟﻔﺳﺎد‬ ‫ﻟﻣﻛﺎﻓﺣﺔ‬ ‫اﻟﻣﺎﻟﯾﮫ‬ ‫اﻟرﻗﺎﺑﮫ‬ ‫ﺗﻧﻔﯾذ‬

9. ٥-‫اﻟﺧﺎرﺟﯾﮫ‬ ‫اﻻطراف‬ ‫وﻣراﻗﺑﺔ‬ ‫ﺗﺣدﯾد‬
٦-‫اﻟﻔﺳﺎد‬ ‫ﻟﻣﻛﺎﻓﺣﺔ‬ ‫اﻻﻣﺛل‬ ‫اﻟﺗدرﯾب‬
٧-‫رﺻد‬‫واﻟﺣﻣﺎﯾﮫ‬ ‫اﻟرﻗﺎﺑﮫ‬ ‫ﺑراﻧﻣﺞ‬
٨-‫اﻟﺗﻧﻔﯾذ‬ ‫ﻟﺳرﻋﺔ‬ ‫اﻻﺟرات‬ ‫ﻣﻊ‬ ‫اﻟﻔﺳﺎد‬ ‫ﻣﻛﺎﻓﺣﺔ‬ ‫اﺟرات‬ ‫دﻣﺞ‬
٩-‫اﻟﻔﺳﺎد‬ ‫ﻻﺧطﺎر‬ ‫اﻟدوري‬ ‫اﻟﺗﻘﯾﯾم‬
١٠-‫اﻟﻔرﯾﻖ‬ ‫ﻋﺑر‬ ‫اﻟوظﯾﻔﻲ‬ ‫اﻻﺷراك‬
‫اﻟﻔﺳﺎد‬ ‫ﻟﻣﻛﺎﻓﺣﺔ‬ ‫ﺧطوات‬‫اﻟﺻﺣﯾﮫ‬ ‫اﻟﻣﻧظﻣﮫ‬ ‫ﻓﻲ‬‫طﺑﯾﺎ‬:
١.‫ﻋدم‬‫اﻟﺗﺳﺎﻣﺢ‬‫ﻣﻊ‬‫اﻟﻣﻣﺎرﺳﺎت‬‫ﻏﯾر‬‫اﻷﺧﻼﻗﯾﺔ‬‫واﻟﻔﺳﺎد‬‫ﻓﻲ‬‫اﻟﺻﺣﺔ‬
‫ﯾﺟب‬‫ﻋﻠﻰ‬‫اﻷطﺑﺎء‬‫واﻟﺟﻣﻌﯾﺎت‬‫اﻟطﺑﯾﺔ‬‫اﻟﻣﮭﻧﯾﺔ‬‫ﻣن‬‫ﻣﺧﺗﻠف‬‫اﻟﺗﺧﺻﺻﺎت‬‫واﻟﻣﺟﺗﻣﻊ‬‫أﺧﻼﻗﯾﺎت‬‫ﻋﻠم‬‫اﻷﺣﯾﺎء‬‫ﻣﻧﺎﻗﺷﺔ‬
‫اﻟﺗداﺑﯾر‬‫اﻟﻣﻣﻛﻧﺔ‬‫ﻟﻣﻛﺎﻓﺣﺔ‬‫اﻟﻔﺳﺎد‬‫وﺗﻧﻔﯾذ‬‫أﻋﻠن‬‫ﻋﻠﻰ‬‫اﻟﻣﻸ‬‫ﺳﯾﺎﺳﺔ‬‫ﻋدم‬‫اﻟﺗﺳﺎﻣﺢ‬‫ﻣﻊ‬‫اﻟﻣﻣﺎرﺳﺎت‬‫ﻏﯾر‬‫اﻷﺧﻼﻗﯾﺔ‬‫وﻓﺳﺎدا‬‫ﻓﻲ‬
‫رﻋﺎﯾﺔ‬‫اﻟﻣرﺿﻰ‬‫واﻟﺑﺣوث‬‫اﻟﺳرﯾرﯾﺔ‬‫واﻟﺗﻌﻠﯾم‬‫اﻟطﺑﻲ‬.‫وھذا‬،‫ﯾﺳﺗﺗﺑﻊ‬‫ﻣن‬‫ﺑﯾن‬‫أﻣور‬،‫أﺧرى‬‫اﺗﺧﺎذ‬‫اﻟﺗداﺑﯾر‬‫اﻟﻣﻧﺎﺳﺑﺔ‬
‫ﻟﻣواﺟﮭﺔ‬‫اﻟﺗﺣﻘﯾﻘﺎت‬‫ﻻ‬‫ﻟزوم‬‫ﻟﮭﺎ‬‫وﺑﺎﻟﻣﻐﺎﻻة‬‫ﻓﻲ‬‫اﻟﻔواﺗﯾر‬‫ﯾﻧﺗﻘد‬‫أﻋﺿﺎء‬‫ﺑﻧزاھﺔ‬‫ﻣﺷﻛوك‬،‫ﻓﯾﮭﺎ‬‫ووﺿﻊ‬‫آﻟﯾﺎت‬‫ﻟﻠﺗﻌﺎﻣل‬‫ﻣﻊ‬
‫ﻣزاﻋم‬‫ﺳوء‬،‫اﻟﺳﻠوك‬‫وﺗﻌزﯾز‬‫اﻟﺷﻔﺎﻓﯾﺔ‬‫واﻟﻣﺳﺎءﻟﺔ‬‫ﻓﻲ‬‫ﺟواﻧب‬‫ﻣﺗﻧوﻋﺔ‬‫ﻣن‬‫اﻷدوﯾﺔ‬.
٢.‫دﻋم‬‫ﺗداﺑﯾر‬‫ﻣﻛﺎﻓﺣﺔ‬‫اﻟﻔﺳﺎد‬
‫ﯾﺟب‬‫ﻋﻠﻰ‬‫اﻷطﺑﺎء‬‫واﻷﺧﻼﻗﯾﺎت‬‫اﻟﺑﯾوﻟوﺟﯾﺔ‬،‫ﺗدﻋم‬‫ﺑﻛل‬‫اﺧﻼص‬‫ودون‬،‫ﺗﺣﻔظ‬‫وﻣﺑﺎدرات‬‫ﻣﻛﺎﻓﺣﺔ‬‫اﻟﻔﺳﺎد‬‫اﻟﺗﻲ‬‫ﺗﻘوم‬‫ﺑﮭﺎ‬
‫ﻗطﺎﻋﺎت‬‫أﺧرى‬‫ﻣن‬‫اﻟﻣﺟﺗﻣﻊ‬،‫واﻟدوﻟﺔ‬‫ﻣﺛل‬‫اﻟﻣﺟﺗﻣﻊ‬‫اﻟﻣدﻧﻲ‬‫وﻣﻧظﻣﺎت‬‫ﺣﻘوق‬‫اﻟﻣرﺿﻰ‬‫واﻟﺟﻣﻌﯾﺎت‬‫اﻟﺗطوﻋﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬
‫واﻟﻣﻧظﻣﺎت‬‫ﻏﯾر‬‫اﻟﺣﻛوﻣﯾﺔ‬)‫اﻟﻣﻧظﻣﺎت‬‫ﻏﯾر‬‫اﻟﺣﻛوﻣﯾﺔ‬(،‫واﻟﺳﻠطﺔ‬،‫اﻟﻘﺿﺎﺋﯾﺔ‬‫ووﺳﺎﺋل‬‫اﻹﻋﻼم‬.‫وھذا‬‫ﻣن‬‫ﺷﺄﻧﮫ‬‫ﻣﺳﺎﻋدة‬
‫ﻓﻲ‬‫ﺑﻧﺎء‬‫اﻟﺣﻛم‬‫اﻟرﺷﯾد‬‫وﻣﺟﺗﻣﻊ‬‫ﻋﺎدل‬.
٣.‫ﺣﻣﺎﯾﺔ‬‫اﻟﻣﺧﺑرﯾن‬
‫ﯾﺟب‬‫ﻋﻠﻰ‬‫اﻷطﺑﺎء‬‫واﻷﺧﻼﻗﯾﺎت‬‫اﻟﺑﯾوﻟوﺟﯾﺔ‬‫ﺗوﻓر‬‫اﻟدﻋم‬‫اﻟﻣﻌﻧوي‬‫واﻟﻣﺳﺎﻋدة‬‫اﻟﻘﺎﻧوﻧﯾﺔ‬‫ﻷﻋﺿﺎء‬‫ﻣﮭﻧﺗﮭم‬‫أو‬‫اﻻﻧﺿﺑﺎط‬
‫اﻟذﯾن‬‫ﺗﺟرأوا‬‫ﻋﻠﻰ‬‫ﻓﺿﺢ‬‫ﺧطﺄ‬‫ﺧطﯾر‬‫ﺑﮫ‬‫ﻓﻲ‬‫أي‬‫ﺟﺎﻧب‬‫ﻣن‬‫ﺟواﻧب‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫واﻟطب‬.‫وھذا‬‫ﺿروري‬‫ﻷن‬
‫اﻟﻣﺧﺑرﯾن‬‫ﺗﺗﻌرض‬‫ﻟﺧطر‬‫ﻣواﺟﮭﺔ‬،‫اﻟﺗﺣرش‬‫إن‬‫ﻟم‬‫ﯾﻛن‬،‫ﺿرر‬‫ﻣن‬‫ﻗﺑل‬‫أﺻﺣﺎب‬‫اﻟﻣﺻﺎﻟﺢ‬‫اﻟﺧﺎﺻﺔ‬.
٤.‫ﺗﺷرﯾﻊ‬
‫ﯾﺟب‬‫ﻋﻠﻰ‬‫اﻷطﺑﺎء‬‫واﻷﺧﻼﻗﯾﺎت‬‫اﻟﺑﯾوﻟوﺟﯾﺔ‬‫ﺗﻠﻌب‬‫دورا‬‫أﻛﺛر‬‫ﻓﺎﻋﻠﯾﺔ‬‫ﻓﻲ‬‫اﻟﺿﻐط‬‫ﻣن‬‫أﺟل‬‫ﺳن‬‫وﺗﻧﻔﯾذ‬‫اﻟﺗﺷرﯾﻌﺎت‬
‫واﻟﺿواﺑط‬‫واﻟﺣﻛم‬‫اﻟرﺷﯾد‬‫واﻟﺷﻔﺎﻓﯾﺔ‬‫واﻟﻣﺳﺎءﻟﺔ‬‫ﻓﻲ‬‫ﻣﺟﺎل‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫واﻟطب‬.‫وﻛﺛﯾرا‬‫ﻣﺎ‬‫اﻧﺗﮭﻛت‬‫ﻗواﻧﯾن‬‫ﻣﻛﺎﻓﺣﺔ‬
‫اﻟﻔﺳﺎد‬‫ﺑﺳﺑب‬‫ﻋدم‬‫ﻛﻔﺎﯾﺔ‬‫اﻟﺗﻧظﯾم‬،‫واﻟﻣراﻗﺑﺔ‬‫أو‬‫ﻟﻌدم‬‫وﺟود‬‫ﻋﻘوﺑﺎت‬‫ﻓﻌﺎﻟﺔ‬.‫ﺣل‬‫واﺣد‬‫ﯾﻣﻛن‬‫أن‬‫ﯾﻛون‬‫ﻻﻧﺷﺎء‬‫ﻣﻛﺗب‬‫أﻣﯾن‬
‫اﻟﻣظﺎﻟم‬‫ﻟﻠﺗﻌﺎﻣل‬‫ﻣﻊ‬‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫ﻛل‬‫ﻋﺎﺻﻣﺔ‬،‫اﻟﻣﻘﺎطﻌﺔ‬‫اﻟﻣﻘﺎطﻌﺔ‬‫واﻟدوﻟﺔ‬.‫ﯾﺟب‬‫أن‬‫ﺗﻛون‬‫ﻣﺟﮭزة‬‫أﻣﯾن‬‫اﻟﻣظﺎﻟم‬‫ﺑﺎﻟﻣوارد‬
‫اﻟﻛﺎﻓﯾﺔ‬‫واﻟﺑﻧﯾﺔ‬‫اﻟﺗﺣﺗﯾﺔ‬‫واﻟﻘوى‬‫اﻟﺣﻘﯾﻘﯾﺔ‬.

10. ٥.‫اﻟﺗﻌﻠﯾم‬
‫ﺑﺎﻟﻛﺎد‬‫ﯾﻣﻛن‬‫اﻟﻣﺑﺎﻟﻐﺔ‬‫ﻓﻲ‬‫أھﻣﯾﺔ‬)‫اﺳﺗﻣرار‬(‫اﻟﺗﻌﻠﯾم‬.‫ﻓﻣن‬‫اﻟﺻﻌب‬‫أن‬‫ﻧﺻدق‬‫أن‬‫ﺟﻣﯾﻊ‬‫اﻟرﺟﺎل‬‫واﻟﻧﺳﺎء‬‫اﻟﺷﺑﺎب‬‫اﻻﻧﺿﻣﺎم‬
‫اﻟطب‬‫ﻓﻘط‬‫ﻟﻛﺳب‬‫اﻟﻣﺎل‬‫ﻣن‬‫ﻣرض‬‫اﻟﻧﺎس‬.‫اﻟﺗﻌﻠﯾم‬‫ﻓﻲ‬‫اﻷﺧﻼق‬‫ﻣن‬‫ﺧﻼل‬‫اﺳﺗﺧدام‬‫ﻧﻣﺎذج‬‫إﯾﺟﺎﺑﯾﺔ‬‫ﻗد‬‫ﺗﻌزز‬‫اﻟﻘﯾم‬
‫اﻷﺧﻼﻗﯾﺔ‬.‫ﻣن‬‫ﺷﺄﻧﮫ‬‫أن‬‫ﯾﺳﺎﻋد‬‫ﻓﻲ‬‫اﻟﺣﺎﺿر‬‫واﻟﻣﺳﺗﻘﺑل‬‫اﻟﻣﺗﺧﺻﺻﯾن‬‫ﻓﻲ‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫ﻟﯾس‬‫ﻓﻘط‬‫ﻟﺗوﺟﯾﮫ‬‫واﺿﺢ‬‫ﻣن‬
‫اﻻﺣﺗﯾﺎل‬‫وإﺳﺎءة‬‫ا‬)Beblavy and Beblava 2014, 7.(،‫ﻟﻣﻌﺎﻣﻠﺔ‬‫وﻟﻛن‬‫أﯾﺿﺎ‬‫ﻟﺧﻠﻖ‬‫ﻣﻧﺎخ‬‫ﻣوات‬‫اﻷﺧﻼﻗﻲ‬‫ﻓﻲ‬
‫اﻟﻣﮭﻧﺔ‬.
‫وزارة‬‫اﻟﻌدل‬‫ﻓﻲ‬‫ﺟﻣﮭورﯾﺔ‬‫ﻛرواﺗﯾﺎ‬‫ﺧطﺔ‬‫ﻋﻣل‬‫ﻣﻊ‬‫إﺳﺗراﺗﯾﺟﯾﺔ‬‫ﻣﻛﺎﻓﺣﺔ‬،‫اﻟﻔﺳﺎد‬‫اﻟﻔﺻل‬١٠.‫اﻟﺻﺣﺔ‬،‫ﻛرواﺗﯾﺎ‬٢٠١٢
‫و‬‫اﻟﺗداﺑﯾر‬‫اﻟﻼزﻣﺔ‬‫ﻟﻣﻧﻊ‬‫اﻟﻔﺳﺎد‬‫ﻓﻲ‬‫اﻟﻧظﺎم‬‫اﻟﺻﺣﻲ‬‫ﻓﻲ‬‫اﻟﻌﻣل‬٢٠١٢
‫ﺧطﺔ‬‫اﺳﺗراﺗﯾﺟﯾﺔ‬‫ﻟﻣﻛﺎﻓﺣﺔ‬،‫اﻟﻔﺳﺎد‬‫واﻟﺗﻲ‬‫ﺗﻐطﻲ‬:
-‫ﻣﻘدﻣﺔ‬‫ﻻﺋﺣﺔ‬‫اﻻﻧﺗظﺎر‬‫اﻟوطﻧﯾﺔ‬
-‫ﻣﻘدﻣﺔ‬‫ﻟﺟدوﻟﺔ‬.
-‫رﺑط‬‫ﺳﺟﻼت‬‫ﻗطﺎع‬‫اﻟرﻋﺎﯾﺔ‬‫اﻟﺻﺣﯾﺔ‬‫وﺗوﺣﯾد‬‫اﻟﺑﯾﺎﻧﺎت؛‬
-‫ﺗوﺣﯾد‬‫اﻟﻣﺷﺗرﯾﺎت‬‫اﻟﻣﺳﺗﺷﻔﻰ‬‫ﻟﻠﻣﺳﺗﺷﻔﯾﺎت‬‫اﻟﻌﺎﻣﺔ؛‬
-‫اﺳﺗﻣرار‬‫اﻋﺗﻣﺎد‬‫اﻟﻣؤﺳﺳﺎت‬‫اﻟﺻﺣﯾﺔ؛‬
-‫ﻣراﻗﺑﺔ‬‫ﺗﻧﻔﯾذ‬‫اﻻﺧﺗﺑﺎرات‬‫اﻟﺳرﯾرﯾﺔ‬‫ﻟﻸدوﯾﺔ‬.
-‫رﺻد‬‫اﻹﻋﻼن‬‫ﻋن‬‫اﻷدوﯾﺔ‬‫واﻟﻣﺳﺎﻋدات‬‫اﻟﻌظﺎم‬)‫اﺗﻔﺎق‬‫اﻷﺧﻼﻗﯾﺔ‬
‫إﻋﻼن‬(‫؛‬
-‫ﻣراﻗﺑﺔ‬‫ﻋﻣﻠﯾﺔ‬‫إدراج‬‫ﻓﻲ‬‫ﻗﺎﺋﻣﺔ‬‫اﻟﻌظﺎم‬‫وﻏﯾره‬‫اﻹﯾدز؛‬
-‫ﻣراﻗﺑﺔ‬‫ﺗﻧﻔﯾذ‬‫اﻟﺗزاﻣﺎت‬‫اﻟﻌﻘد‬‫وﺗﺧﺻﯾص‬‫اﻹﻧﻔﺎق‬‫اﻷﻣوال‬‫ﻟﻠﻧظﺎم‬‫اﻟﺻﺣﻲ‬‫اﻹﻟزاﻣﻲ‬
Indian J Med Ethics. 2013 Jan-Mar;10(1):11-13. integrity in medicine and science)(

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