Priority setting in healthcare: from arbitrariness to societal values

International audienceThis paper develops an account of the normative basis of priority settingin health care as combining the values which a given society holds for thecommon good of its members, with the universal provided by a principle ofcommon humanity. We discuss national differences in health basket in Europeand argue that health care decision-making in complex social and moralframeworks is best thought of as anchored in such a principle by drawing on thephilosophy of need. We show that health care needs are ethically ‘thick’ needswhose psychological and social construction can best be understood in terms ofDavid Wiggins’s notion of vital need: a person’s need is vital when failure to meetit leads to their harm and suffering. The moral dimension of priority setting whichoperates across different societies’ health care systems is located in the demandsboth of and on any society to avoid harm to its members