The Principle of Distributive Justice

Abstract

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.

Differences in advance care planning among nursing home care staff

“…41,42 Such allocation of staff’s time to ACP involves a distributive injustice (unfair or inequitable distribution of finite resources). 43,44 Defining clear responsibilities among staff, or assigning an ACP facilitator are among two strategies relevant to ACP that might help overcome this injustice. 44 Because ACP and developing related care plans in advance is personal, ethically sensitive, complex and nuanced, it requires sufficient knowledge – especially in the ethical and legal aspects of such documents – and timely and skilful communication that is reliable and trustworthy.…”

“You Might Lose Him Through the Cracks”: Clinicians’ Views on Discharge from Assertive Community Treatment

“…Many of these MHICM clinicians express a conflict about the ethical principle of distributive justice: the need to allocate scarce resources in a fair manner in order to serve a group of patients, but without harming their own specific patients (Baumrucker et al 2012;Holmvall et al 2012). Clinicians describe MHICM as a cherished intervention for a highly vulnerable group.…”

Ethics of cost analyses in medical education

“…However, cost analyses are rarely so straightforward and rarely lead to clear-cut conclusions. Occasionally they do lead to clear conclusions but even when that happens, some stakeholders will ask difficult but valid questions about what to do following cost analyses–specifically about distributive justice in the allocation of resources [ 3 ]. These and other questions must be answered.…”