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1 results

  • The Quality Adjusted Life Year: A Total-Utility Perspective

  • STEVEN J. FIRTH
  • Journal:
    Cambridge Quarterly of Healthcare Ethics / Volume 27 / Issue 2 / April 2018
    Published online by Cambridge University Press:
    06 March 2018, pp. 284-294

  • Given that a properly formed utilitarian response to healthcare distribution issues should evaluate cost effectiveness against the total utility increase, it follows that any utilitarian cost-effectiveness metric should be sensitive to increases in both individual and social utility afforded by a given intervention. Quality adjusted life year (QALY) based decisionmaking in healthcare cannot track increases in social utility, and as a result, the QALY cannot be considered a strict utilitarian response to issues of healthcare distribution. This article considers arguments against, and a possible defence of, the QALY as a utilitarian concept; in response, the article offers a similar — but properly formed — utilitarian metric called the (IALY). This article also advances a tool called the ‘glee factor’ (GF) on which the IALY may lean in a similar way to which the QALY leans on the Rosser Index.