In the European debate on equity in health and health care a crucial question has received scant consideration. It concerns the precise specification of a health system's objectives and the manner by which they can be suitably interpreted to permit monitoring of implemented policies. This article is an attempt to review actual and potential contributions to this area of study. It adopts the view that the meaning of equity in the health domain depends crucially on how social justice is defined and that this in turn depends on value judgements or the views of society held by individuals, groups or governments. Such an approach allows one to choose principles of distribution which are in agreement with a society's value set and subsequently to apply them as the correct yardstick for measuring the success of policy. Following an initial exposition of the approach, the main body of the article discusses the question of competing theories of society - Libertarian, Liberal and Democratic Socialist - and appraises the various distribution principles, to be found in the economic and philosophical literature, which they imply. The final section offers some brief conclusions and avenues for further research.
