title: [Vulnerability and National Health Service].
abstract: Safegarding health has been an objective of every learned civilization, ancient and modern. In modern times, at least in the western world, the increase in longevity associated with social isolation has created further vu1nerability for the older individua1. Today, healthcare is a social burden of extremely high cost. Among us this service is provided by the National Health Service in accordance to the Constituição da República Portuguesa (Constitution of the Portuguese Republic). Despite the constitutional guarantees of equa1ity in health there are obvious discrepancies in access to health care and the conditions that promote health such as education and wealth. In a poor country, even with limited resources, inequa1ity can be minimized via policies and practical measures founded in equa1ity and social responsibility, not only the principles of economic efficiency. Only in this way can we guarantee equa1 access to health and the distribution of available resources in accordance to health care necessities. Yet, the investment in high technology among us seems out of fase with the investment in the area concerning functional recovery from high morta1ity illness, such as stroke. In Portugal the problem is extremely bad. Life expectancy has been extended but qua1ity of life is still very low. Victims of the social order, the elderly live alone without family who can care for them; on the other hand, the lack of investment in recovery and social integration of individua1s with disabling scars, Turns the ends of their life's into a nightmare for themselves and their kin. It follows stating the necessity to analyse and define the criteria to be used when allocating resources in order to guarantee equality in health and relief from suffering and also to stop discrimination of vu1nerable populations in access to healthcare. Whatever the criteria, it must be pre-defined and its principles widely discussed, reiterating, only that longevity cannot be an acceptable criteria to value life. The article concludes drawing attention to the need to invest in health education, which is just as important as the fair distribution of precious health care resources in reducing harmful risks to the most vulnerable patients.
authors.affiliation: Serviço de Medicina I, Hospital de Curry Cabral, Lisboa, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lima
mesh_terms: D000368:Aged; D006297:Health Services Accessibility / Q000941:ethics* / Q000592:standards; D006299:Health Services for the Aged / Q000941:ethics* / Q000592:standards / Q000600:supply & distribution; D006806:Human Rights; D006801:Humans; D009313:National Health Programs / Q000941:ethics* / Q000592:standards; D011174:Portugal; D012934:Social Isolation