QALYs, age and fairness

Abstract

... We can therefore conclude that either we should go for equality; and in that case QALYs are unfair because they haven't got enough of an ageist bias. Or we should accept consequentialism; and in that case QALYs have just the right sort of ageist bias. No plausible case can, however, be made for the claim that QALYs have an unfair bias against old people. Other things being equal we ought when distributing resources essential for survival favour the young. This ethical claim can be supported both by reference to equality (the life-time-view) and by reference to consequentialism (and the premises that resources generally will be more useful when given to young people).