Justice
The principle of justice means that all similarly situated persons receive their "fair share" of benefits and assume their fair share of burdens. For example, health care is a benefit that should be fairly distributed and taxes are a burden that we also try to share fairly.
There are at least three types of justice that include compensatory, procedural and distributive. Compensatory justice concerns compensation for wrongs that have been done. Physical therapists may be involved in these types of justice issues if you are involved in a lawsuit or even if you are a member of a jury. Procedural justice involves how the laws are procedurally carried out. Physical therapists and physical therapist assistants must obey the laws and rules of the state and federal government or they may experience justice in the application of our laws. Distributive justice involves the fair allotment of benefits or burdens, especially when there is competition for resources. In health care, we often refer to the fairness of resource allocation. Deciding who will receive a liver or a heart for a transplant is an example of a distributive justice issue.
Physical therapists also face distributive justice issues since there are not enough resources to provide full reimbursement for the care that we provide patients. Further, our time is a scarce resource and how we determine the use of our time is a justice issue. Physical therapists and physical therapist assistants face distributive justice issues frequently. Since we work in an era of cost containment, we must determine how we can provide quality care to patients with limited resources. Within our own practices, issues of justice involve patients who should receive their fair share of physical therapy care while they also must assume the burden of paying for it. Patients should be made aware of your clinic's reimbursement policies. They must assume the responsibility for knowing what their insurance or managed care company has allowed before treatment. Patients should understand that it may be their own agreement with their insurance or managed care company that could result in a limitation of care. Establishing these guidelines prior to treatment will help patients understand that you are trying to fairly provide care to them within a system that may set arbitrary guidelines.
Try to identify the justice issues in the following case.