title: Should a criminal receive a heart transplant? Medical justice vs. societal justice.
abstract: Should the nation provide expensive care and scarce organs to convicted felons? We distinguish between two fields of justice: Medical Justice and Societal Justice. Although there is general acceptance within the medical profession that physicians may distribute limited treatments based solely on potential medical benefits without regard to nonmedical factors, that does not mean that society cannot impose limits based on societal factors. If a society considers the convicted felon to be a full member, then that person would be entitled to at least a "decent minimum" level of care--which might include access to scarce life-saving organs. However, if criminals forfeit their entitlement to the same level of medical care afforded to all members of society, they still would be entitled to a kind of "rudimentary decent minimum" granted to all persons on simple humanitarian grounds. Almost certainly this entitlement would not include access to organ transplants.
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California 92093-0622, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Schneiderman
authors.forename: N S
authors.initials: NS
authors.lastname: Jecker
mesh_terms: D000533:Altruism; D026686:Beneficence; D003415:Crime / Q000331:legislation & jurisprudence*; D004992:Ethics, Medical; D005380:Financing, Government / Q000331:legislation & jurisprudence; D015276:Health Care Rationing / Q000191:economics / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence; D016027:Heart Transplantation / Q000191:economics / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D028681:Moral Obligations; D018579:Patient Selection; D011329:Prisoners / Q000331:legislation & jurisprudence*; D040841:Resource Allocation; D012935:Social Justice; D012945:Social Values; D014481:United States; D035862:Vulnerable Populations