The Competition for Limited Resources

The competition for limited health care resources is intensifying. We urgently need an acceptable method for deciding how they should be allocated.

The Diversity of Health Care Achievements

But the goods that health care produces are of very different kinds. Health care can extend the lives of children and of older people. It can make it possible for a person to walk, when without health care that person would be permanently bedridden; and it can reduce the pain and distress of people who are terminally ill.

The Need for a Common Measure

How can we possibly decide which of these - and many more - diverse achievements of health care are more deserving than others? We need a common unit by which we might be able to measure these very different goods. The Quality-Adjusted Life Year, or QALY, is the most developed proposal for such a unit of measure.

The Core of the QALY Proposal

In this book a distinguished team of ethicists and economists defend the core of the QALY proposal: that health care resources should be used so as to produce more years of life, of the highest possible quality.

Fundamental Ethical Questions

This leads to a discussion of such fundamental questions as whether all lives are of equal value, whether health care should be allocated on the basis of need and whether the QALY approach incorporates an adequate account of fairness or justice.

Conclusion

The result is the most thorough account yet of the ethical issues raised by the use of the QALY as a basis for allocating health care resources.