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Logo of jmedethJournal of Medical EthicsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Med Ethics. Mar 1993; 19(1): 37–42.
PMCID: PMC1376167

The relevance of health state after treatment in prioritising between different patients.


In QALY-thinking, an activity that takes N people from a bad state (including 'dying') to the state of healthy for X years should have priority over an activity that takes N other people from the same bad state to a state of moderate illness for the same number of years (given equal costs). An empirical study indicates that this view may not be shared by the general public in Norway. Subjects tended to emphasise equality in value of life and in entitlement to treatment rather than level of health after treatment. The relevance of costs per QALY in prioritising between different health care programmes in Norway is thereby brought in to doubt. While the sample in the study is too small to support firm policy conclusions, the results should contribute to an increased interest among health economists in actually measuring people's ethical preferences in matters of prioritising, rather than taking it for granted that their own values are shared by the general public.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Williams A. Who is to live? A question for the economist or the doctor? World Hosp. 1987 Oct;23(3-4):34–36. [PubMed]
  • Harris J. QALYfying the value of life. J Med Ethics. 1987 Sep;13(3):117–123. [PMC free article] [PubMed]
  • Patrick DL, Bush JW, Chen MM. Methods for measuring levels of well-being for a health status index. Health Serv Res. 1973 Fall;8(3):228–245. [PMC free article] [PubMed]
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