{"title":"QALY 的伦理缺陷:公共卫生中对少数民族的歧视。","authors":"Gabriel Andrade","doi":"10.1017/S0963180123000580","DOIUrl":null,"url":null,"abstract":"<p><p>Despite progress, discrimination in public health remains a problem. A significant aspect of this problem relates to how medical resources are allocated. The paradigm of quality-adjusted-life-year (QALY) dictates that medical resources should be allocated on the basis of units measured as length of life and quality of life that are expected after the implementation of a treatment. In this article, I discuss some of the ethical shortcomings of QALY, by focusing on some of its flawed moral aspects, as well as the way it relates to discrimination on the basis of age, race, and disability status. I argue that while this approach seeks to maximize efficiency, it does not place sufficient value on the preservation of life itself. Even more concerning is the fact that the use of QALY disproportionately harms minorities. While QALY is a well-intentioned approach to the allocation of scarce healthcare resources, new alternatives must be sought.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-8"},"PeriodicalIF":1.5000,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ethical Shortcomings of QALY: Discrimination Against Minorities in Public Health.\",\"authors\":\"Gabriel Andrade\",\"doi\":\"10.1017/S0963180123000580\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Despite progress, discrimination in public health remains a problem. A significant aspect of this problem relates to how medical resources are allocated. The paradigm of quality-adjusted-life-year (QALY) dictates that medical resources should be allocated on the basis of units measured as length of life and quality of life that are expected after the implementation of a treatment. In this article, I discuss some of the ethical shortcomings of QALY, by focusing on some of its flawed moral aspects, as well as the way it relates to discrimination on the basis of age, race, and disability status. I argue that while this approach seeks to maximize efficiency, it does not place sufficient value on the preservation of life itself. Even more concerning is the fact that the use of QALY disproportionately harms minorities. While QALY is a well-intentioned approach to the allocation of scarce healthcare resources, new alternatives must be sought.</p>\",\"PeriodicalId\":55300,\"journal\":{\"name\":\"Cambridge Quarterly of Healthcare Ethics\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-01-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cambridge Quarterly of Healthcare Ethics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/S0963180123000580\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cambridge Quarterly of Healthcare Ethics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/S0963180123000580","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Ethical Shortcomings of QALY: Discrimination Against Minorities in Public Health.
Despite progress, discrimination in public health remains a problem. A significant aspect of this problem relates to how medical resources are allocated. The paradigm of quality-adjusted-life-year (QALY) dictates that medical resources should be allocated on the basis of units measured as length of life and quality of life that are expected after the implementation of a treatment. In this article, I discuss some of the ethical shortcomings of QALY, by focusing on some of its flawed moral aspects, as well as the way it relates to discrimination on the basis of age, race, and disability status. I argue that while this approach seeks to maximize efficiency, it does not place sufficient value on the preservation of life itself. Even more concerning is the fact that the use of QALY disproportionately harms minorities. While QALY is a well-intentioned approach to the allocation of scarce healthcare resources, new alternatives must be sought.
期刊介绍:
The Cambridge Quarterly of Healthcare Ethics is designed to address the challenges of biology, medicine and healthcare and to meet the needs of professionals serving on healthcare ethics committees in hospitals, nursing homes, hospices and rehabilitation centres. The aim of the journal is to serve as the international forum for the wide range of serious and urgent issues faced by members of healthcare ethics committees, physicians, nurses, social workers, clergy, lawyers and community representatives.