Abstract

KIE: O'Donnell objects to assigning priorities in the allocation of health resources by using the quality adjusted life year (QALY), which gives healthy life expectancy a positive mathematical value and unhealthy life expectancy a negative value. He argues that not everyone prefers a short healthy life to a long disabled one, and that administrators and physicians should not be allowed to choose whom to treat based on their assessment of someone else's quality of life. The QALY, he maintains, is a new version of "old guesses and prejudices," and is an unjust way to bring management efficiency to Britain's National Health Service. O'Donnell agrees with philosopher John Harris that a lottery would be a fairer way to allocate resources.