The relevance of justice for the current debate on long-term care is explored on the basis of demographic and economic data, especially in the U.S. and Germany. There is a justice question concerning the quality and availability of long-term care for different groups within society. Mapping the justice debate by discussing the two main opponents, John Rawls and Robert Nozick, the article identifies fundamental assumptions in both theories. An exploration of the biblical concept of the “option for the poor” and (...) its influence on a new “ecumenical social teaching from below” leads to the conclusion that a Christian ethical account of long-term care will argue for a system that guarantees decent care to every citizen. The German model of Soziale Pflegeversicherung is presented as one possible option for putting this ethical guideline into political practice. In a final reflection, the role of religious affiliation for long-term care is discussed by looking at empirical data and by naming seven dimensions of faith-driven long-term care. (shrink)