Justice and Health Care

Bioethics is a discipline still not fully explored in spite of its rather remark­ able expansion and sophistication during the past two decades. The prolifer­ ation of courses in bioethics at educational institutions of every description gives testimony to an intense academic interest in its concerns. The media have catapulted the dilemmas of bioethics out of the laboratory and library into public view arid discussion with a steady report of the so-called 'mira­ cles of modern medicine' and the moral perplexities which frequently accom­ pany them. The published work of philosophers, theologians, lawyers and others represents a substantial and growing body of literature which explores relevant concepts and issues. Commitments have been made by existing in­ stitutions, and new institutions have been chartered to further the discussion of the strategic moral concerns that attend recent scientific and medical progress. This volume focuses attention on one of the numerous topics of interest within bioethics. Specifically, an examination is made of the implications of the principle of justice for health care. Apart from four essays in Ethics and Health Policy edited by Robert Veatch and Roy Branson [4] the dis­ cussion of justice and health care has been occasional, almost non-existent, and scattered. The paucity of literature in this area is regrettable but perhaps understandable. On the one hand, Joseph Fletcher, one of the contemporary pioneers in bioethics, can hold that "distributive justice is the core or key question for biomedical ethics" ([1], p. 102).