In a case where a patient in need of a liver transplant lacks resources, which principle should guide the discussion about ethics?

• A. Autonomy
• B. Beneficence
• C. Justice
• D. Fidelity

Answer: (C)

Fair distribution of scarce medical resources is the main idea here. When a patient needs a liver transplant but lacks resources, the ethical focus is on justice—the fair allocation of limited organs. Justice requires policies that ensure equal consideration and non-discrimination, guiding decisions based on clinical need, urgency, and the likelihood of benefit so that one patient isn’t favored merely by wealth or status. Autonomy is still important because patients should be involved in decisions about their care, but it doesn’t by itself determine how scarce organs are allocated. Beneficence seeks to do good for the individual patient, yet with a shortage of organs, the obligation expands to fairness across all patients who could benefit. Fidelity concerns trust and keeping promises, which supports honest communication but isn’t the framework for distributing scarce resources. So, justice best guides discussions about ethics in this resource-limited situation.