Theoretical Medicine

, Volume 8, Issue 1, pp 47–59 | Cite as

Robin hoods and good samaritans: The role of patients in health care distribution

  • John Hardwig


There are good reasons — both medical and moral — for wanting to redistribute health care resources, and American hospitals and physicians are already involved in the practice of redistribution. However, such redistribution compromises both patient autonomy and the fiduciary relationship essential to medicine. These important values would be most completely preserved by a system in which patients themselves would be the agents of redistribution, by sharing their medical resources. Consequently, we should see whether patients would be willing to share before we resort to surreptitiously redistributing their resources or denying medical care to some who want and need it. We should change our health care payments systems to allow patients to donate their medical benefits to those in need.

Key words

Allocation of resources Altruism Autonomy Cost-shifting Patient ethics 


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Copyright information

© D. Reidel Publishing Company 1987

Authors and Affiliations

  • John Hardwig
    • 1
  1. 1.Program in Medical Ethics Quillen-Dishner College of MedicineEast Tennessee State UniversityJohnson CityUSA

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