Établir des priorités en soins de santé. Comment passer des besoins vitaux aux taux de remboursement ?

Choice is part of human life, but when it concerns collective goods such as healthcare, and when budgets are restricted, choice is in an important sense irreducibly ethical. We propose an approach which employs the ethical concept of vital need to decisions about the ?health basket?. Vital needs must be met if individuals are to avoid the ?serious harm? of diminished capacity as agents (?agentive power?). We provide a critique of the majority of the key variables used to determine different forms of equity that are proposed in the literature. We then consider the ethical questions raised by healthcare priority-setting. These decisions must take into account social preferences to be legitimated. The procedure through which these preferences are expressed can be improved if what we term ?informational care? is respected.