When we consider just distribution of health care, the criterion we usually encounter is need. We must treat patients proportionally to their needs. In this paper, we examine the meaning and limits of this criterion. As soon as we go into the details, we encounter serious difficulties in its application. Those difficulties are conceptual (need has various meanings) and substantial (need is not
... [Show full abstract] enough as a criterion). We conclude that justice requires a partial renunciation to a top-down approach (application of a criterion to particular cases) on behalf of a bottom-up one, giving more weight to the patient, as an authority of choice.