REEXAMINING HEALTHCARE JUSTICE IN THE LIGHT OF EMPIRICAL DATA ADALBERTO DE HOYOS, YARENI MONTEÓN AND MYRIAM M. ALTAMIRANO-BUSTAMANTE Keywords justice, capability, qualitative research, human flourishing, ethical dilemmas ABSTRACT This article discusses the notion of justice from a capabilities approach. We undertake an empirical analysis of the concepts of justice held by healthcare personnel, gleaned from a qualitative analysis of interviews on the subject of ethical dilemmas in everyday practice. The article states that Justice undoubtedly presents a work in progress, which implicates the link between justice as capability and human dignity. We empirically found a contrast between the views of justice based on the patient’s own perceptions and those based on the perceptions of healthcare personnel. We establish the kind of actions, communication skills and justice required to build a stronger relationship between patients and healthcare professionals, which would improve prognosis, treatment efficiency and therapeutic adhesion. INTRODUCTION One of the challenges of the millennium in terms of global health is posed by the inequalities between rich and poor countries. A child born in Europe has a life expectancy of 90 years, whereas a child born in sub-Saharan Africa will barely live to the age of 35. 1 In its Millennium Develop- ment Goals, the United Nations describes actions taken to improve global health and reduce inequalities. 2 Without a doubt, central questions to be pondered are: Can we aspire to health and justice for all? What kind of justice do we need in order to respond to the health inequalities in the world? In the history of medicine, bioethics and clinical ethics, justice has been greatly emphasized. 3 Beauchamp and Childress consider it to be one of the four principles to ponder in the ethical considerations surrounding health and the environment. 4 This principlism has proven itself to be limited in its practical applications, such that its underlying notions need to be broadened in order to respond to ever more complex debates in biomedical science in a variety of social, political and economic contexts. 5 Here we shall consider two issues: first, we begin with an empirical analysis of perceptions of justice held by Mexican healthcare personnel that have been gleaned from a qualitative analysis of interviews on the subject of ethical dilemmas in everyday practice; secondly, we undertake a theoretical discussion about the notion of justice from a capabilities perspective. Based on the above, we will see in what ways healthcare personnel behave based on their own representations of justice, while at the same time seeing how their discursive prac- tices of justice influence their job performance. 1 Unicef. Levels & trends in child mortality. New York: Unicef; 2011. 2 M. Marmot, et al. WHO European review of social determinants of health and the health divide. Lancet 2012; 380: 1011–1029; L.O. Gostin. A Framework Convention on Global Health: Health for All, Justice for All. J Amer Med Assoc 2012; 307: 2087–2092. 3 G.O. Salaverry. Inequity in health: it’s historical development. Rev Peru Med Exp Salud Public 2013; 30: 709–713. 4 J.F. Beauchamp & T.L. Childress. Principles of Biomedical Ethics. Oxford: Oxford University Press; 2008. 5 M.A. Verkerk, et al. Health-related quality of life research and the capability approach of Amartya Sen. Qual Life Res 2001; 10: 49–55. Address for correspondence: Myriam M. Altamirano-Bustamante, Unidad de Investigación en Enfermedades Metabólicas. Centro Médico Nacional Siglo XXI, IMSS. Cuauhtémoc 330, Doctores, 06720, México, DF, México. Email: myriamab@unam.mx or biocatalisismma@gmail.com Conflict of interest statement: All authors declare no competing interests. Bioethics ISSN 0269-9702 (print); 1467-8519 (online) doi:10.1111/bioe.12188 Volume 29 Number 9 2015 pp 613–621 © 2015 John Wiley & Sons Ltd