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From reason to practice in bioethicsAn anthology dedicated to the works of John Harris$
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John Coggon, Sarah Chan, Soren Holme, and Thomasine Kushner

Print publication date: 2015

Print ISBN-13: 9780719096235

Published to Manchester Scholarship Online: January 2016

DOI: 10.7228/manchester/9780719096235.001.0001

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Eqalyty revisited

Eqalyty revisited

(p.152) 14 Eqalyty revisited
From reason to practice in bioethics

Andrew Edgar

Manchester University Press

This chapter looks anew at John Harris’s critical discussions of the Quality Adjusted Life Year (QALY) and its use determining the just allocation of health care resources. It is argued that Harris presupposes that the QALY is grounded in subjective evaluations of the experience of health and illness, and that the justice of its application may be assessed by examining how individual subjects would be differentiated through QALY calculations. It is argued that this misconstrues the intended use of QALYs, and fails to reflect recent developments in QALY research. If a subjective interpretation is replaced by an intersubjective interpretation, such that the values and meanings expressed by a QALY matrix are understood to be the results of communication and negotiation between human subjects, then the QALY may be defended as an important resource for facilitating reflection on the moral challenges of health care allocation.

Keywords:   QALYs, Allocation of health care resources, Intersubjective, Health, Justice

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