What is justice in health care?

In health care, justice refers to fairness. In other words, medical resources must be distributed in a way that is fair, equal, and consistent. The notion of justice in health care is long-time principle of medical ethics and can be traced as far back as the 18th century BCE to the time of Hammurabi’s Code in ancient Mesopotamia.

The field of health care is most concerned with the type of justice known as distributive justice, which requires that goods and services be given out fairly and equitably. When there are more than enough resources to be provided for all patients, distributive justice is less of a concern. But it becomes more of a challenge when resources are limited. Offering limited medical services to one patient means that such services are not being offered to someone else. Under these conditions, the question becomes who receives the resources and how such a determination is made.

Health care professionals must ensure that the distribution of medical resources is done ethically. For example, in a health care environment in which justice is a principle component, a rich person and a poor person or people of different ethnicities should be treated as equals in terms of the quality of care and the treatments made available to them. However, the reality of the situation is often different, and even within a health care system that strives to ensure justice, justice is not always attainable.

Justice in health care is often dependent on outside factors, such as the cost of goods and services. Even if resources are available to a particular patient, that patient might not be able to afford them. For example, medication for certain long-term illnesses, such as human immunodeficiency virus (HIV), can cost thousands of dollars per month, which makes treating a poor person with HIV very difficult. Whereas, a wealthy person who is HIV-positive can afford effective health care and expensive medications and to help manage the disease over many years of an otherwise normal life.

The other guiding principles of medical ethics can usually be accomplished regardless of the resources available at a given health care facility. But the very notion of justice is based on the fact that resources are not always available and must be distributed in a way that is fair.