Health, Equity and Care throught the End of Life

Faced with budget constraints, those working in the health care sector are called to make daily decisions based upon priorities for action. This task emerges as especially challenging in light of the difficulty of reaching a univocal definition of human health, encompassing a physical state of well-being that concerns multiple dimensions of human existence, including the psychological and the spiritual ones. A further significant problem arises when one is called on to decide whether to designate some of those scarce resources towards care at the end of life, when the outcome can no longer be measured in terms of restoration or improvement of physical health. Therefore, from a political economy perspectve, criteria are necessary in order to evaluate whether and how limited resouces can be allocated for the care of dying persons, according to conditions of efficiency and equity. General criteria for the allocation of resources at a macroeconomic and microeconomic level are indicated according to each stanpoint, together with the identification of particular objectives and instruments of econominc policy, and tha anthropological paradigms that may conceivably underlie the distributive variable in each of the four views examined.