[Medical justice as a priority for Latin America]. / La Justicia Sanitaria Como Prioridad Para America Latina.

PIP: The need for an ethics of medical justice in Latin America is asserted in the context of a review of concepts of justice throughout history and of changing governmental perspectives on provision of health care in the US and other developed countries. The current view that individuals are primarily human resources is at odds with a long tradition asserting the intrinsic dignity of human beings. English-speaking bioethicists began in the 1960s to stress the principal of autonomy of patients, recognizing their right to make decisions on their own lives and medical care equally with the physician. At the same time, the US has approved no legislation establishing a right to health care, which is rather regarded as a private good. Governments are increasingly inclined to renounce their role as direct providers of health care. The liberal democratic state until recently understood that it fulfilled its ethical commitment to promoting social justice through provision of health care. Nevertheless, societies that stress the importance of the individual in decision-making and that conceive of health as a private good are confronted with the contradiction of apparently irreconcilable visions. With infinite demand for health services and limited health resources, the discourse of autonomy has slowly been replaced by a discourse of distributive justice. The most appropriate version of distributive justice for Latin America is probably that which affirms the duty of assisting those most in need. The prevalence of malnutrition, misery, and premature death in the world is a clear sign of imbalance. If the essential dignity of all human beings and not just of the elite is to be affirmed, medical justice must become the most urgent priority of Latin America.^ieng