Abstract

In health care systems where access to resources is limited, priorities must be set. The Canadian health care system relies on physicians as clinical or micro-level gatekeepers to health care access. Several studies have indicated that physicians do not tend to consider distributive justice concerns when making clinical-level resource allocation decisions. This is concerning, given that the normative literature on micro-level rationing has featured justice considerations as a necessary condition for fair decision-making. I will first discuss the basics of bedside rationing and some studies which identify a possible justice “value deficit.” I will then analyze the relevant normative frameworks in the rationing literature to identify if and where decision-making may be falling short. Finally, I will use Beauchamp and Childress’ fifth and sixth editions of Principles of Biomedical Ethics to examine whether justice in micro-level rationing is best conceptualized as a principle or a virtue