Case 12A Mrs. Johns is 92 years old. For her age, she is in relatively good health. She has a heart condition that is treated medically. Two years ago, she declined a surgical fix to her heart blockage, cit- ing concerns and risks about how surgery could affect her overall cont. case 12A cont quality of health. She is now wheelchair bound and lives in an assisted-living facility where she requires moderate to full assis- tance with her activities of daily living. Though in relatively good health compared to others her age, she has told her children and caregivers that she knows her health is steadily declining and that she does not have long to live. She can communicate effectively and participates in her health care decision making. For the past year, she has lived with a rare blood disorder that requires frequent blood transfusions (three-five times per week) and regular doses (two-four per day) of an additional synthetic blood product that helps her blood to clot properly. This blood product is manufactured in California, shipped to the East Coast where Mrs. Johns lives, and costs $5,000 per dose. This treat- ment regimen has gone on for one year and, given the nature of the blood disorder, it is likely that she will require this synthetic blood product more frequently over time. The company that produces the product called the hospital where Mrs. Johns gets her treatment to let it know that the entire Southeastern region of the country where Mrs. Johns lives is facing a dire shortage in the supply of this product, which is the only one that has demonstrated any benefit for Mrs. Johns. The company makes it clear that many other patients in the region who could benefit from the blood product are going without it and that the short supply for the entire region is at risk for as long as Mrs. Johns will require the therapy. The company is limited in how much of the product it can produce because, though synthetic, it requires natural blood properties to make it-the supply of the dural blood properties rise and fall depending on the overall supply of blood. nar- aions Discussion questions. Examine the ethical implications, par- ticularly as they relate to human dignity and justice, of limit- ing Mrs. Johns’s beneficial treatment. What process would you develop to ensure that the short supply of this resource could be balanced fairly? How would you apply this process in Mrs. Johns’s case? How would the five different views of justice address the conflicts raised by this case?