The Allocation of Health Care Resources: An Ethical Evaluation of the "QALY" Approach

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Editorial Reviews

Booknews
A team of ethicists and economists defend the core tenets of the Quality-Adjusted Life Year as a unit of measure by which to decide who gets scarce health-care resources, which proposes that health care resources should be used to produce as many years of life, of the highest possible quality. They juggle with questions such as whether all lives are of equal value, the basis of need, and adequate fairness and justice. Annotation c. by Book News, Inc., Portland, Or.
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Product Details

  • ISBN-13: 9781855219533
  • Publisher: Ashgate Publishing, Limited
  • Publication date: 5/1/1998
  • Series: Medico-Legal Series
  • Pages: 164
  • Product dimensions: 9.21 (w) x 6.14 (h) x 0.71 (d)

Table of Contents

List of Tables and Figures
Acknowledgments
1 Introduction 1
2 The Background to the QALY 15
The Nature of Economic Evaluation 15
Three Types of Economic Evaluation 17
Including Quality of Life 24
Measuring QALYs 25
Types of QALYs 30
Whose Preferences? 32
Ethical Underpinning 38
3 Age Discrimination 47
The 'Fair Innings' Argument 48
Eliminating Ageism? 51
Maximizing QALYs and Maximizing Utility 52
The Prudential Lifespan Approach 55
Four Problems for the QALY Approach 59
Saving Lives versus Maximizing QALYs 64
4 Quality of Life 73
QALY Levels and QALY Gains 74
Money for the Rich 75
The Compensation Objection 79
The Equity Objection 81
The Need Objection 83
The 'Safety Net' Objection 91
5 Double Jeopardy 99
Random Allocation 101
The Equal Value of Lives 103
The Veil of Ignorance 104
Rational Choice and Likelihood 109
6 Public Opinion 117
An Australian Survey 118
Public Opinion, Ethics and Economic Evaluation 127
A Role for the Expert Committee 128
7 Conclusion 133
Bibliography 135
Index 147
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