Palliative Care, Good Death, and Social Security System: Concept Clarification and Theoretical Analysis
Several important social issues in an aging society, such as end-of-life suffering, impoverishment due to illness, and the optimization of medical resource allocation, can be mitigated through the establishment of palliative care systems. Palliative care is a holistic medical and nursing approach that respects the autonomy of end-of-life patients, aims to alleviate end-of-life suffering, improves the quality of life for patients, and provides relevant social support for patients and their families. The corresponding social security arrangements can effectively promote the development of palliative care, reduce the likelihood of impoverishment due to illness, and optimize medical resource allocation. This study focuses on the concept with respect to applicability-related conceptual issues, including individual utility, decision-making time, and medical costs. It clarifies and systematically aligns the relevant concepts of palliative care in medical practice based on the assumptions concerning individual utility embedded in theoretical models and analyzes the impact of different care models on patient utility. On this basis, a simplified individual end-of-life medical decision-making model is constructed to explore patients' choices in end-of-life medical decisions and the corresponding social cost-benefit analysis. It demonstrates that providing palliative care options offers potential for improving both individual and societal welfare and proposes policy-based insurance as a financing mechanism to achieve a Pareto improvement at the level of the social security system. Additionally, this study further clarifies the boundaries of palliative care within the social security framework, providing an analytical framework for facilitating preference-consistent choices by patients and their families, as well as the normative implementation of related systems.
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