A Great Dilemma

While I have said we must bridge the gap between public health and community medicine. This poses a personal, ethical dilemma: When faced with limited resources to improve peoples' health, as a public health practitioner one would believe that you use resources to help improve the health of as many people possible (This is the classical utilitarian view). As a medical practitioner when faced with the same dilemma, ones duty is to his/her patient. The question is at what cost? Is there a cost that would prevent you from treating any one patient knowing that those resources could be distributed to help many more (Peter Singer frames this question more eloquently)?

I welcome comments as this is truly a great ethical dilemma for all of us. It applies to health resources and aid for the poor, health care rationing in this country........etc. I also wonder if there is a different way to frame the issue of limited resources. While in theory, I have posed conflicting views, in practice can't we be utlitarians that are also dedicated to the health and well being of individual patients and vice versa? Under what circumsatnces should we act as one rather then the other?