"Commitment to a just distribution of finite resources. While meeting the needs of individual patients, physicians are required to provide health care that is based on the wise and cost-effective management of limited clinical resources."

 Further in the same section of the paper physician are admonished to work to "minimize overuse of health care resources"

So under the rubric of " social justice" the authors instruct physicians  to provided health care that is wise,cost-effective and fair.The Charter was silent,however, in regard to how would the practicing make operation the principle of social justice . Later ACP and ABIMF would give instructions in that regard. Spoiler alert-it relates to following guidelines based on cost effectiveness criteria.

Since the Charter was proposing a sea change in medical ethics,voices were raised in opposition.
A particularly articulate critique was made by Dr. Richard Fogoros, who was blogging under the name DrRich  on the blog  The Covert Ratoning Blog . Quoting from his January 18,2010 blog commentary:

"The New Medical Ethics,...(Annals of Internal Medicine, February 5, 2002, vol. 136, pages 243-246), is deficient in the following ways:
  • it undermines the foundation of the doctor-patient relationship,
  • it threatens to fundamentally destroy medicine as a legitimate profession, and
  • it places patients at grave personal risk whenever they encounter the healthcare system"