Social values in health priority setting: a conceptual framework.

PURPOSE

It is commonly recognized that the setting of health priorities requires value judgements and that these judgements are social. Justifying social value judgements is an important element in any public justification of how priorities are set. The purpose of this paper is to review a number of social values relating both to the process and content of priority-setting decisions.

DESIGN/METHODOLOGY/APPROACH: A set of key process and content values basic to health priority setting is outlined, and normative analysis applied to those values to identify their key features, possible interpretations in different cultural and institutional contexts, and interactions with other values.

FINDINGS

Process values are found to be closely linked, such that success in increasing, for example, transparency may depend on increasing participation or accountability, and "content" values are found often to be hidden in technical criteria. There is a complex interplay between value and technical components of priority setting, and between process and content values. Levels of economic development, culture and need will all play a part in determining how different systems balance the values in their decisions.

ORIGINALITY/VALUE: Technical analyses of health priority setting are commonplace, but approaching the issues from the perspective of social values is a more recent approach and one which this paper seeks to refine and develop.