PMID: 8961422Dec 1, 1996Paper

QALYS and ethics: a health economist's perspective

Social Science & Medicine
A Williams

Abstract

Objectors on ethical grounds to the use of QALYs in priority-setting in public health care systems are here categorised as (1) those who reject all collective priority-setting as unethical; (2) those who accept the need for collective priority-setting but believe that it is contrary to medical ethics; (3) those who accept the need for collective priority-setting and do not believe that it is contrary to medical ethics, but reject the role of QALYs in it on other ethical grounds; and (4) those who accept the need for collective priority-setting in principle, but are unwilling to specify how it should be done in practice. It is argued that the first two groups of objectors are simply wrong, if distributive justice is a proper ethical concern in this context. The third group is of more interest, as this group appears to believe that QALYs are unethical because it is unethical to regard QALY maximisation as the sole objective of the health care system. This paper argues that QALYs are relevant to a much wider range of objectives than QALY maximisation, and that they can accommodate a wide variety of health dimensions and sources of valuation. They can also accommodate the differential weighting of benefits according to who gets the...Continue Reading

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Citations

Sep 23, 1998·Health Economics·M Blaug
Jan 1, 1996·European Psychiatry : the Journal of the Association of European Psychiatrists·M Knapp
Jul 13, 2002·Social Science & Medicine·Gavin MooneyVirginia Wiseman
May 14, 2003·Social Science & Medicine·John McKie, Jeff Richardson
May 14, 2003·Social Science & Medicine·Lydia KapiririKristian Heggenhougen
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Aug 2, 2001·Journal of Medical Ethics·A Williams
Aug 16, 2008·American Journal of Public Health·Jennifer Prah Ruger
Jun 1, 2001·PharmacoEconomics·B Liljas, B Lindgren
Mar 3, 2007·Journal of Health Economics·Jeff Richardson, John McKie
Aug 20, 2005·Journal of Nursing Management·Hannah-Rose Douglas, Charles Normand
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Sep 14, 2018·Biometrical Journal. Biometrische Zeitschrift·Lucio De Capitani, Daniele De Martini
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Nov 11, 2016·Applied Health Economics and Health Policy·James D ChambersPeter J Neumann
Apr 16, 2020·Journal of General Internal Medicine·James D ChambersPeter J Neumann

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