During medical school, future physicians learn of the four pillars of medicine, the ethical foundation upon which we should strive to build our work in the field. The first three, beneficence (provide good care), nonmaleficence (do no harm), and respect for autonomy (of both patient and physician) are oft-cited in the medical literature and emphasized in our current healthcare system. The fourth pillar, justice, is sometimes forgotten. Webster‘s defines justice as “the quality of being just, impartial, or fair”. In simple terms, then, all physicians have been given the ethical obligation to treat all patients in a fair and impartial way. On a societal level, the fourth pillar of medicine provides the foundation for us to say that all persons have the right to quality health care. We are not living up to to this obligation. Very real disparities still exist in our health care system. Continue reading →