Ethical choices in Long-Term care: What does justice require?

Existing systems of long-term care for people with chronic illnesses and disabilities are not enough to meet the growing demand. Though unpaid family members will continue to play a central role in providing care, states must ensure that resources are available to address growing needs and that those resources are distributed efficiently and equitably. A society invites a dialogue about how best to structure the ethical framework within which equitable, fair rational, and transparent decisions about long-term care can be made when it asks: What long-term care needs exist? What resources are available to provide them? What does justice require? The answers point the way towards systems that are responsible, accessible, efficient, and accountable, and that address the universe of human needs with dignity and respect. The primary goal of this report is to reflect on the moral basis of long-term care and to identify some of the issues that need to be considered as those systems are designed.