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Abstract:This paper develops an account of the normative basis of priority setting in health care as combining the values which a given society holds for the common good of its members, with the universal provided by a principle of common humanity. We discuss national differences in health basket in Europe and argue that health care decision-making in complex social and moral frameworks is best thought of as anchored in such a principle by drawing on the philosophy of need. We show that health care needs are ethically 'thick' needs whose psychological and social construction can best be understood in terms of David Wiggins's notion of vital need: a person's need is vital when failure to meet it leads to their harm and suffering. The moral dimension of priority setting which operates across different societies' health care systems is located in the demands both of and on any society to avoid harm to its members.

International audience ; Patients suffering from "lifestyle" conditions are most often viewed as responsible for their illness, and so not considered to be a priority for healthcare resources. Instead, their treatment is financed on instrumental grounds: it is better to treat the condition now than to incur higher costs later of not doing so. An alternative register of justification at work in public healthcare policies is not motivated by instrumental considerations. Instead, it seeks to articulate an ethical case for prioritizing lifestyle conditions. Within this framework, we draw on the notion of vital need within the tradition of humanistic philosophy to argue that solidarity justifies the treatment of such conditions, exemplified here by obesity. We use the theoretical framework of economics of convention to present these two registers of justification at work in public healthcare policies. The importance of humanistic criticism prevents instrumental logic from being completely dominant.

International audience ; Patients suffering from "lifestyle" conditions are most often viewed as responsible for their illness, and so not considered to be a priority for healthcare resources. Instead, their treatment is financed on instrumental grounds: it is better to treat the condition now than to incur higher costs later of not doing so. An alternative register of justification at work in public healthcare policies is not motivated by instrumental considerations. Instead, it seeks to articulate an ethical case for prioritizing lifestyle conditions. Within this framework, we draw on the notion of vital need within the tradition of humanistic philosophy to argue that solidarity justifies the treatment of such conditions, exemplified here by obesity. We use the theoretical framework of economics of convention to present these two registers of justification at work in public healthcare policies. The importance of humanistic criticism prevents instrumental logic from being completely dominant.

International audience ; Patients suffering from "lifestyle" conditions are most often viewed as responsible for their illness, and so not considered to be a priority for healthcare resources. Instead, their treatment is financed on instrumental grounds: it is better to treat the condition now than to incur higher costs later of not doing so. An alternative register of justification at work in public healthcare policies is not motivated by instrumental considerations. Instead, it seeks to articulate an ethical case for prioritizing lifestyle conditions. Within this framework, we draw on the notion of vital need within the tradition of humanistic philosophy to argue that solidarity justifies the treatment of such conditions, exemplified here by obesity. We use the theoretical framework of economics of convention to present these two registers of justification at work in public healthcare policies. The importance of humanistic criticism prevents instrumental logic from being completely dominant.

International audience ; Patients suffering from "lifestyle" conditions are most often viewed as responsible for their illness, and so not considered to be a priority for healthcare resources. Instead, their treatment is financed on instrumental grounds: it is better to treat the condition now than to incur higher costs later of not doing so. An alternative register of justification at work in public healthcare policies is not motivated by instrumental considerations. Instead, it seeks to articulate an ethical case for prioritizing lifestyle conditions. Within this framework, we draw on the notion of vital need within the tradition of humanistic philosophy to argue that solidarity justifies the treatment of such conditions, exemplified here by obesity. We use the theoretical framework of economics of convention to present these two registers of justification at work in public healthcare policies. The importance of humanistic criticism prevents instrumental logic from being completely dominant.

Patients suffering from "lifestyle" conditions are most often viewed as responsible for their illness, and so not considered to be a priority for healthcare resources. Instead, their treatment is financed on instrumental grounds: it is better to treat the condition now than to incur higher costs later of not doing so. An alternative register of justification at work in public healthcare policies is not motivated by instrumental considerations. Instead, it seeks to articulate an ethical case for prioritizing lifestyle conditions. Within this framework, we draw on the notion of vital need within the tradition of humanistic philosophy to argue that solidarity justifies the treatment of such conditions, exemplified here by obesity. We use the theoretical framework of economics of convention to present these two registers of justification at work in public healthcare policies. The importance of humanistic criticism prevents instrumental logic from being completely dominant.