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Bursting Bubbles? QALYs and Discrimination

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  • DAVIES, BEN

Abstract

The use of Quality-Adjusted Life Years (QALYs) in healthcare allocation has been criticized as discriminatory against people with disabilities. This article considers a response to this criticism from Nick Beckstead and Toby Ord. They say that even if QALYs are discriminatory, attempting to avoid discrimination – when coupled with other central principles that an allocation system should favour – sometimes leads to irrationality in the form of cyclic preferences. I suggest that while Beckstead and Ord have identified a problem, it is a misdiagnosis to lay it at the feet of an anti-discrimination principle. The problem in fact comes from a basic tension between respecting reasonable patient preferences and other ways of ranking treatment options. As such, adopting a QALY system does not solve the problem they identify.

Suggested Citation

  • Davies, Ben, 2019. "Bursting Bubbles? QALYs and Discrimination," Utilitas, Cambridge University Press, vol. 31(2), pages 191-202, June.
    • Handle: RePEc:cup:utilit:v:31:y:2019:i:02:p:191-202_00
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