[Ethics in times of scarcity]

Healthcare systems face ongoing challenges of resource and staffing shortages, resulting in complex ethical dilemmas. The Franciscus Hospital approaches scarcity as a moral issue, employing structured moral deliberation to support healthcare professionals in navigating difficult decisions. A hospital ethicist fosters open dialogue, courageous speech, and the documentation of moral case studies (moresprudence), creating a foundation for ethical reflection. Two cases highlight these challenges. In one, a geriatric patient in the Emergency Department revealed tensions between individual care needs and collective safety. In another, limited dialysis capacity during the holidays forced difficult prioritization decisions, underscoring the lack of clear guidelines. Both cases demonstrate the necessity of embedding ethical reflection into organizational culture. By integrating ethics into decision-making, the hospital strengthens trust and supports professionals in making fair, morally sound choices. This approach underscores that ethics is not a luxury but a vital component of responsible, equitable healthcare.