Lifetime QALY prioritarianism in priority setting

J Med Ethics. 2013 Mar;39(3):175-80. doi: 10.1136/medethics-2012-100740. Epub 2012 Nov 30.

Abstract

Two principles form the basis for much priority setting in health. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. Jointly, these principles accord with so-called prioritarianism. Crucial for its operationalisation is the specification of the worse off. In this paper, we examine how the worse off can be defined as those with the fewer lifetime Quality-Adjusted Life Years (QALYs). We contrast this proposal with several alternative specifications.

MeSH terms

  • Decision Making
  • Health Care Rationing / methods*
  • Health Care Rationing / trends
  • Health Status Disparities*
  • Humans
  • Life Expectancy*
  • Norway
  • Quality of Life*
  • Quality-Adjusted Life Years*
  • Social Justice*