Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 12 08 1112 1112 EN Najmeh Bahmanziari PhD Candidate in Health Policy, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mehrdad Mohammadi Affiliated Lecturer, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Chair of Public Health Law Group, The Institute for Legal Innovations, Tehran, Iran Amirhossein Takian Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.Chair, Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Chief Research Officer, Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran. Mohammad Arab Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Iraj Harirchi Professor, Department of General Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2021 09 13 2021 12 29 The policies of health systems are inspired by ethical priorities. A critical review of policies can reveal the ethical theories/justice schools behind them. This study aimed to identify the ethical theory(ies) underpinning the Iranian health system governance over the past 50 years. This was a qualitative study conducted in two stages during 2019. First, we identified and constructed the key concepts and distinctive notions of prominent ethical theories/justice schools. Then, we spotted and selected 24 strategic laws and policy documents in the Iranian health system governance during the past 50 years and analyzed their content to surmise their underlying ethical theory. The results showed that the dominant theory affecting the policies of the Iranian health system governance over the past 50 years was egalitarian liberalism and then objective utilitarianism and relativist communitarianism. Retrospective empirical application of ethical theories to health system governance is methodologically doable, and this application reveals the mood or priorities of the politics. Also, highlighting the underpinning ethical theories of health system governance as well as the gap between ambitions versus realization are insightful and may prospectively empower and strengthen egalitarianism   https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1112 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1112/385