Fairness is a key social value. It is important instrumentally: People are more likely to support public policies that seem fair. It is also valued intrinsically. Fairness is a basic element of justice, embodying reciprocity, proportionality, and impartiality that are central to conceptions of just behavior. Sensitivity to fairness may even be instinctive. As philosopher D. D. Raphael pointed out, “Fairness is a notion that is acquired at an early stage of life: young children are quick to complain that action which discriminates in favor of one child or one group is unfair, and they do not confine this complaint to thought of their own advantage but are ready to speak up for the claim of others.”

Medical malpractice is one public realm that has undergone a great deal of reassessment lately. Much of the rhetoric concerns fairness. In urging major malpractice reform, President Bush stated, for example: “If you get hurt, you ought to be able to go to your court, the courthouse and be treated; you ought to get fair compensation for your economic damages. But we cannot have unlimited, non-economic damages and punitive damages drive health care away from the people. So I strongly support, and I urge Congress to have reasonable federal limits on non-economic damages – $250,000 is reasonable.” But the president does not tell us why he thinks $250,000 is fair compensation.