Ethics raises questions about what kind of society
we ought to be, questions that are at the heart of this
case. Increasingly, inequalities in healthcare fueled by
lack of access, inadequate insurance coverage, and rising
costs are creating dilemmas in the proper distribution
of healthcare resources. Questions of distributing scarce
and valuable resources are fundamentally questions of justice.
The classic definition of justice is the duty to give to
each person what they deserve and can legitimately claim
so that justice is understood as a moral obligation to
help persons exercise their rights. Distributive justice,
i.e., what distribution of resources is fair, equitable,
and appropriate, thus turns on the concept of rights. One
of the key questions in this case is whether and to what
extent this patient has a right to treatment for his heart
disease. In the classic understanding of justice, he must
assert and we as a society must agree that he has a right
to treatment for his heart condition before we are morally
obligated to provide this care. Are there limits to this
patient's right to healthcare? If so, what are they?
The differing principles of distributive justice use different
criteria to rank or weight decisions regarding the proper
and just distribution of healthcare services. In this case,
at least two competing but ethically valid principles can
be identified: the humanitarian principle and the libertarian
principle.