ABSTRACT
This chapter presents medical ethical considerations to a more social dimension, asking when, if ever, people duties should include promoting the welfare of others or fulfilling duties to others. Medicine must confront the issues of allocating scarce medical resources, providing health insurance, distributing transplantable organs, and conducting research on human subjects. In each of these areas the goal is benefiting members of a community of people who often have conflicting interests. The chapter examines these issues and also what ethical principles can be brought to bear on them. The area of medical ethics that poses social ethical questions most dramatically is the allocation of health care resources. There will always be more demands for health care services than there are resources. In such a world rationing is morally necessary. The different ethical principles discussed here offer very different ethical responses to the dilemma of pressures for cost containment.
