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June 2010

Individual Justice or Societal Injustice

Author Affiliations

Author Affiliation: Nationwide Children's Hospital, The Ohio State University, Pediatric Neurology, Columbus, Ohio.

Arch Neurol. 2010;67(6):777-779. doi:10.1001/archneurol.2010.103

The Spanish poet, statesman, and physician Ramón Maríia de las Mercedes Campoamor Campoosorio (1817-1901) wrote a limerick that roughly translates to, “In this treacherous world there are no truths and there are no lies, everything depends on the color of your lens.” In that spirit, I offer this comment of Schiff and colleagues' recent article.1

The authors indicated that their “ . . . ethical motivation was a justice ethic, to overcome the societal neglect syndrome that has plagued [patients in chronic minimally conscious state].” My view of the ethical principle of justice, however, is different. I understand justice, specifically distributive justice, to be a tenet not focused on individuals, but on society at large. In that vein, justice addresses how benefits and burdens are shared by members of a society. That is, balancing the individual patient's needs with the expense to society in staff and monetary cost.2

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