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Justice In Medical Ethics (Simply Explained)

Justice In Medical Ethics (Simply Explained)

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

The medical ethics pillar of justice is a fundamental principle that plays a crucial role in governing modern medicine.

Justice, in the context of medical ethics, revolves around fairness, balance, and compatibility with the law and patients’ rights.

It ensures equitable treatment of all patients and demands that no individual is unfairly disadvantaged when it comes to accessing healthcare.

What Is Justice In Medical Ethics?

The medical ethics pillar of justice refers to one of the four main principles that guide ethical decision-making in healthcare.

It plays a crucial role in ensuring fairness, balance, and adherence to legal and patient rights. In the context of medical ethics, the concept of justice encompasses several key dimensions.

One aspect involves distributive justice, which is concerned with the fair allocation of medical resources and benefits among patients and society.

This includes considerations around, for example, prioritising treatment and distribution of scarce resources during emergencies or pandemics (think ICU beds during the height of COVID).

Another facet is the equal treatment of patients, ensuring that healthcare providers do not exhibit biases or preferences in delivering care and treatment.

This aspect aims to create a healthcare system where every patient receives equal consideration, irrespective of any personal attributes or societal influences.

Furthermore, the pillar of justice embodies the importance of adhering to legal and regulatory requirements in the medical field.

It emphasises that healthcare professionals must remain in compliance with the law and consider patient rights while making clinical decisions.

LEARN MORE: My comprehensive guide to the four pillars of medical ethics

Why Is Justice Important?

The pillar of justice plays a crucial role in medical ethics, as it ensures fairness and equal treatment for all patients, regardless of their background, circumstances, or needs.

The principle of justice is intertwined with the law, patient rights, and a balanced approach to healthcare.

One of the primary reasons why justice is so important in medical ethics is that it promotes equal access to healthcare for everyone.

In an ideal scenario, every individual should have the same opportunities and resources to receive healthcare services.

This was in fact one of the founding principles of the NHS.

By adhering to the principle of justice, healthcare providers can ensure that their practices are not biased or discriminatory and that they treat all patients fairly.

Moreover, the pillar of justice serves to protect patients’ rights, for instance, the right to informed consent, confidentiality, and truth-telling.

By respecting these rights, medical professionals ensure that their actions towards patients are fair, legal, and ethically sound.

Furthermore, the pillar of justice helps healthcare providers navigate ethical dilemmas that involve conflicting interests, resource allocation, and decision-making.

When healthcare professionals encounter complex situations, the principle of justice acts as a guiding framework to determine the most appropriate and fair course of action.

Justice Interview Question Examples

Medical school interviewers love to throw ethical scenarios at candidates to see how they reason through these often extremely complex dilemmas.

Distributing Scarce Resources

Consider two patients who both require a kidney transplant. One is a 65-year-old grandmother and the other is a 30-year-old single male. Only one kidney is available. How would you use the pillar of justice to help decide which patient would receive the single kidney?

One common interview question related to justice may involve discussing a scenario where resources are limited and there are multiple eligible patients.

This could be a scenario regarding organ donation as above, bed spaces in ICU or even seats on a lifeboat from a sinking ship.

A decision must be made based on criteria such as medical need and the likelihood of success to ensure a just outcome- but never privileging factors like race, age or financial status.

If you do find yourself answering a question like the one above in your medical school interview, make sure you think out loud so that your interviewer understands your thought process, as there are rarely any singly correct answers.

Access To Healthcare

Patients awaiting a hip replacement through the NHS may have to wait for up to 18 months in pain while awaiting their surgery. A patient paying for a private hip replacement could have this procedure done within 2 months. Do you think this is fair?

Another possible justice-related interview question is about handling situations where a patient’s access to healthcare may be compromised due to socioeconomic factors.

Candidates can discuss the importance of advocating for equal access to healthcare and addressing barriers faced by patients.

A doctor stops to speak to a patient in a wheelchair
A doctor speaking with a patient as they leave hospital

You can emphasise the responsibility of healthcare providers in ensuring justice by working to eliminate disparities in healthcare access and identifying ways to support patients who face such challenges.

Blending Ethical Principles

During a consultation, a patient admits to you that they rolled their ankle while running away from a  security guard at a shopping centre. They were being chased as they’d stolen an item of clothing from a high street store. The security guard never caught them. What are the ethical dilemmas for you as the treating clinician in this scenario?

Sometimes, justice in medical ethics questions may be blended with other ethical pillars, such as autonomy or confidentiality.

For example, you may be asked how you’d handle a situation where treating a patient could lead to the disclosure of a crime, and if that would be a breach of confidentiality.

This issue touches upon both justice and the principle of patient confidentiality.

As a candidate, you should weigh the importance of confidential patient information against potential harm to others resulting from nondisclosure and evaluate the situation based on these ethical considerations.

Balancing Justice With Other Ethical Principles

In practising medicine, the ethical principle of justice needs to be balanced with other pillars of medical ethics.

Non-Maleficence

Non-maleficence, meaning to do no harm, is a crucial ethical principle in medicine. However, when balancing it with justice, healthcare professionals might face dilemmas.

For example, allocating limited resources to a larger population may result in overlooking the individual’s potential harm.

In such cases, practitioners need to consider how to allocate resources fairly while minimising harm to individual patients.

Beneficence

Beneficence, or the principle of doing good for patients, can sometimes conflict with the principle of justice.

For instance, providing the best possible care for an individual might mean using expensive or scarce resources that could benefit multiple patients.

To strike a balance, healthcare providers should aim for an approach that maximises the overall benefit to the entire patient population while taking into account individual needs and circumstances.

Autonomy

Autonomy, the principle of respecting a patient’s freedom to make informed decisions about their care, can also pose challenges when weighed against justice.

For example, a patient’s decision to receive a costly treatment may limit the availability of resources for others.

Healthcare professionals must consider the ethical implications of respecting patient autonomy while ensuring equitable distribution of resources and access to care for all patients.

Challenges In Implementing Justice

While it’s easy to agree that healthcare professionals should adhere to the principle of justice at all times, there are of course challenges in implementing this in real life.

Political And Social Influences

Political and social influences may occasionally hinder the proper implementation of justice as a principle.

For instance, healthcare policies can be influenced by political agendas, leading to unequal access to resources and treatments among different populations.

In addition to this, societal values and beliefs may also shape the way healthcare providers approach justice in their practice.

Cultural biases or stigmatisation of certain conditions may lead to reluctance in providing equal care and support to all patients, regardless of their circumstances (think the legal issues surrounding abortion, especially in America).

Addressing these challenges requires a concerted effort from healthcare professionals, policymakers, and society as a whole to promote a more just and equitable healthcare system.

Emerging Technologies

The rapid development of new technologies in medicine brings significant benefits and also challenges to the implementation of the principle of justice.

For example, new diagnostic tools, treatment methods, and digital health applications may not be readily available or affordable for all patients.

As a result, individuals with more resources may have access to better care, thus widening healthcare disparities.

Furthermore, issues around data privacy and the ethical use of health-related information gathered by emerging technologies require careful consideration.

Final Thoughts

The pillar of justice brings together various factors that a healthcare professional must consider while making decisions regarding a patient’s care and treatment.

From, the allocation of resources, prioritisation of patients, and accessibility of healthcare.

The objective is to create an environment that promotes equity and impartiality among the diverse population being served.

To fully comprehend the significance of justice in medical ethics, it is important to examine it alongside the other three pillars, as together these principles provide a solid foundation for ethical decision-making in modern medical practice.

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.