Suppose the following DB migration in Ruby:
create_table :question_votes do |t|
t.integer :user_id
t.integer :question_id
t.integer :vote
The best way is to use both, since rails isn't 100% reliable when uniqueness validation come thru.
You can use:
validates :user_id, uniqueness: { scope: :question_id }
and to be 100% on the safe side, add this validation on your db (MySQL ex)
add_index :question_votes, [:user_id, :question_id], unique: true
and then you can handle in your controller using:
rescue ActiveRecord::RecordNotUnique
So now you are 100% secure that you won't have a duplicated value :)