The Principle of Justice
'Into the discussion of human affairs, the questions of justice enters only where the pressure of necessity is equal, and that the powerful exact what they can, and the weak grant what they must.'
Thucydides (471-401 BC)
In Chapters 4 and 5, we concentrated on principles that have their central application within the sphere of the care of the individual. Now we shall be looking at a principle which is used in health care decisions which go beyond the particular individual. The Principle of Justice , that equals ought to be considered equally 1,is applicable in two areas of health care decisions. First, to decide what treatments should be made available within allocated resources. Second, who should receive treatments if there are not enough available for those who need them (see 15.3.1, 15.4, 17.4)? If a particular course of treatment is the most beneficial for that individual, it does not follow that the individual will be able to receive that treatment given limited resources. A principle of justice needs to be designed to provide a just way of distributing benefits between individuals.
The following example provides an illustration of the relevance of the Principle of Justice in allocating resources between individuals.