Chapter 2 Professional Ethics 29 Copyright Goodheart-Willcox Co., Inc. JPC-PROD/Shutterstock.com Figure 2.8 Sometimes physicians need to make ethical judgments regarding treatment for some older patients, or other patients who may not benefit from surgery. 4. The principle of justice concerns the allocation of scarce health resources and decisions involving who gets what treatment (fairness and equality). For example, organ transplantation is an area in which issues of justice commonly arise, especially when there are long waiting lists for organs. Should a newly available donated heart be used to save the life of a 72-year-old man or a 23-year-old woman? Who decides? What criteria are used to make the decision? Patients are often placed on the United Network for Organ Sharing (UNOS) list, which is operated under contract from the federal government. UNOS applies the same criteria to all potential transplant recipients. Factors affecting ranking may include tissue match, blood type, length of time on the waiting list, immune status, and the distance between the potential recipient and the donor. For transplants involving the heart, liver, lungs, or intestines, the potential recipient’s degree of medical urgency is also considered. The values of autonomy, beneficence, non-malfeasance, and justice are embedded in various ways throughout the entire field of professional ethics. Some lists of ethical principles include additional values, such as honesty, truthfulness, and dignity. It is possible, however, to consider these values subsets of respecting patient autonomy. justice the principle that requires giving others what is due to them, including the fair distribution of benefits, risks, and costs