Justice is one of the four pillars of ethics
– but what exactly does it mean? And how might this come up in your Medical School interview
What is Justice?
Justice – in the context of medical ethics – is the principle that when weighing up if something is ethical or not, we have to think about whether it’s compatible with the law, the patient’s rights, and if it’s fair and balanced.
It also means that we must ensure no one is unfairly disadvantaged when it comes to access to healthcare. Justice is one reason why the NHS has certain entitlements, such as free prescriptions for lower-income individuals.
One of the easiest ways to understand justice is with an example.
Patients suspected of having cancer are prioritised within the NHS, with the maximum waiting time for referral being two weeks (as opposed to 18 weeks for non-urgent referrals). Patients diagnosed with cancer are entitled to a range of treatments including radio- and chemotherapy. These treatments are expensive and treat a small, but significant proportion of patients.
This raises a couple of dilemmas for justice, and it’s important you can think of arguments on both sides of the issue. For example:
- It could be argued that prioritising cancer patients means you’re limiting the ability of other patients to access healthcare
- A counter-argument might be that by referring these patients to specialist oncology centres, you’re actually freeing up other services
- It could also be argued that spending public money on radio- and chemotherapy on a smaller group of people is taking budget away from less expensive treatments that would benefit a greater number of people – for example, an increase in statins for those at risk of cardiovascular disease
- A counter-argument would be that early treatment increases survival rates and actually reduces the cost of cancer treatment
Discussing Justice At Interview
Justice is a factor you need to consider when you’re talking about ethics in your interview. You should think about:
- Is this action legal?
- Does this action unfairly contradict someone’s human rights?
- Does this action prioritise one group over another?
- If it does prioritise one group over another, can that prioritisation be justified in terms of overall net benefit to society or does it agree with moral conventions?
Some questions where you need to consider justice include:
- Does euthanasia have a place in modern medicine?
- Discuss the ethical issues involved if a patient discloses that they haven’t told their partner that they have HIV
- Do you think the NHS should fund treatment for smokers?
Find out how to answer these questions – and see more ethics questions here.
Make sure you’re aware of hot topics where justice applies. These include: