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.
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