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A meaningful death can be fostered for a patient and his or her family with the aid of medical treatment, specifically through the alleviation of the patient's suffering and pain. To recognize the dying process is a part of the art of medicine. Compassionate care for dying patients includes a move from a curative model of care to a palliative model of care in defining the primary goal. Hospice volunteer training and practice is sufficient palliative care training to develop these skills. The time has come for incorporating palliative care into the curriculum of medical school.

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Erik N is a morbidly obese male with a long history of Pickwickian syndrome. He has right heart failure due to cor pulmonale and is totally bedbound. His wife is an advertising executive and her company has insurance that offers family coverage, but Erik and his wife decided not to purchase coverage for him so that they could afford to send their daughter to private school. Last year, Erik and his wife divorced and he hired sitters to care for him at home. Unfortunately, he exhausted his funds and dismissed his sitters. He was found on the day of admission by a neighbor in a semicomatose state. He was immobile, in bed, without adequate hygiene and was taken by Emergency Medical Services to the nearest hospital. Erik has been stabilized, but it is obvious he cannot care for himself at home. He will require nursing home care that he cannot afford and lives in a state with strict Medicaid requirements; he currently does not qualify for state assistance. Given that Erik voluntarily decided not to purchase coverage for himself when he could have and cannot afford the health care he needs, the question arises: does society have an obligation to care for him? Discuss the concept of distributive justice.

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