No—not necessarily. In the case of, say, a hypothetical plane crash in a desert, with two thirsty survivors and one cup of water, resource allocation may also be a profound ethical dilemma. The article’s author (and hospital administrators) encourage us to see the situation in this light.

But in our vastly wealthy, highly-productive 21st-century society, this situation need not be not zero-sum; production can be scaled up on demand, priorities can be shifted, costs can be absorbed. What’s constrained in this case is not supply of the life-saving resource, but political and economic will over inertia.

In this case, calling this an “ethical dilemma” stretches both the definitions of “ethics” and “dilemma” to the breaking point. There is a clear right answer here—but the insistence on choosing the wrong answer over and over, to keep costs down and avoid long-delayed reforms to medical staffing and supply chains, leads to tragic outcomes in which a patient’s survival is determined by institutional bureaucracy. That would be a much more useful framing!