Intended for healthcare professionals

Feature Commentary

Risk and equality

BMJ 2010; 340 doi: (Published 18 February 2010) Cite this as: BMJ 2010;340:c642
  1. Julian Sheather, ethics manager
  1. 1BMA, London WC1H 9JP
  1. jsheather{at}

    The provision of health services to members, and former members, of the armed forces raises several challenging and controversial ethical problems. Underlying these are decisions about the way in which a society seeks to distribute risk, which go to its political heart and inevitably involve basic questions of justice. What would a fair distribution of risk look like? Such questions arise in all areas where the state takes an allocative role, and they are properly political questions.

    Take warfare. Most people accept that one of the primary roles of the state is the defence of its borders and that this requires effective armed forces. As we have seen during the recent conflict in Afghanistan, the risks are far from theoretical and combatants can pay with their lives. Although opinions about the justice of individual conflicts will differ, our current system involves a small number of people assuming the risks of defending the physical security of the nation, the benefits of which are distributed among us all. …

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