Scarcity is an increasingly pressing problem currently in health care. To help address growing waiting lists, some hospitals in the Netherlands have begun applying triage of referrals for specialist care by primary care physicians: Which patients must be seen in the hospital, and which patients may just as well be treated in primary care settings? Does this new practice of more stringent triage fall within the scope of normal good care provision, or is something else - such as implicit rationing - at play? This paper analyses decision-making about care from an ethical perspective, using various justice theories, including utilitarianism, egalitarianism, sufficientarianism, and prioritarianism.