Palliative care for the terminally ill in America: the consideration of QALYs, costs, and ethical issues [Book Review]
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Medicine, Health Care and Philosophy 15 (4):411-416 (2012)
The drive for cost-effective use of medical interventions has advantages, but can also be challenging in the context of end-of-life palliative treatments. A quality-adjusted life-year (QALY) provides a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health-related quality of life and survival for the patient. However, since it is in the nature of end-of-life palliative care that the benefits it brings to its patients are of short duration, it fares poorly under a policy of QALY-maximization. Nevertheless, we argue that the goals of palliative care and QALY are not incompatible, and optimal integration of palliative care into the calculation of QALY may reveal a mechanism to modify considerations of how optimal quality of life can be achieved, even in the face of terminal illness. The use of QALYs in resource allocation means that palliative care will always compete with alternative uses of the same money. More research should be conducted to evaluate choices between palliative care and more aggressive therapies for the terminally ill. However, current limited data show that investing in palliative care makes more sense not only ethically, but also financially
|Keywords||Palliative care End-of-life care Health policy QALY Costs Ethics|
|Categories||categorize this paper)|
|Through your library||Configure|
References found in this work BETA
Nathan E. Goldstein & Joanne Lynn (2006). Trajectory of End-Stage Heart Failure: The Influence of Technology and Implications for Policy Change. Perspectives in Biology and Medicine 49 (1):10-18.
Jonathan Hughes (2005). Palliative Care and the QALY Problem. Health Care Analysis 13 (4):289-301.
Margaret M. Mahon & Jeanne M. Sorrell (2008). Palliative Care for People with Alzheimer's Disease. Nursing Philosophy 9 (2):110-120.
Citations of this work BETA
No citations found.
Similar books and articles
H. ten Have & David Clark (eds.) (2002). The Ethics of Palliative Care: European Perspectives. Open University Press.
Fiona Randall (1996). Palliative Care Ethics: A Good Companion. Oxford University Press.
H. Colby William, John Lantos Constance Dahlin & Myra Christopher John Carney (forthcoming). The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines Domain 8: Ethical and Legal Aspects of Care. HEC Forum.
William Colby, Constance Dahlin, John Lantos, John Carney & Myra Christopher (2010). The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines Domain 8: Ethical and Legal Aspects of Care. [REVIEW] HEC Forum 22 (2):117-131.
Eve Garrard & Anthony Wrigley (2009). Hope and Terminal Illness: False Hope Versus Absolute Hope. Clinical Ethics 4 (1):38-43.
Fiona Randall (2006). The Philosophy of Palliative Care: Critique and Reconstruction. Oxford University Press.
Timothy E. Quill (2012). Physicians Should “Assist in Suicide” When It Is Appropriate. Journal of Law, Medicine and Ethics 40 (1):57-65.
Maaike A. Hermsen & Henk A. M. J. ten Have (2003). Moral Problems in Palliative Care Practice: A Qualitative Study. Medicine, Health Care and Philosophy 6 (3):263-272.
Daniel S. Brenner (ed.) (2002). Embracing Life & Facing Death: A Jewish Guide to Palliative Care. Clal.
Gert Olthuis & Wim Dekkers (2005). Quality of Life Considered as Well-Being: Views From Philosophy and Palliative Care Practice. Theoretical Medicine and Bioethics 26 (4):307-337.
Craig Blinderman (2009). Palliative Care, Public Health and Justice: Setting Priorities in Resource Poor Countries. Developing World Bioethics 9 (3):105-110.
T. W. Kirk (2011). The Meaning, Limitations and Possibilities of Making Palliative Care a Public Health Priority by Declaring It a Human Right. Public Health Ethics 4 (1):84-92.
Joachim Widder & Monika Glawischnig-Goschnik (2002). The Concept of Disease in Palliative Medicine. Medicine, Health Care and Philosophy 5 (2):191-197.
Bert Gordijn & Rien Janssens (2004). Euthanasia and Palliative Care in the Netherlands: An Analysis of the Latest Developments. Health Care Analysis 12 (3):195-207.
Wim Dekkers (2009). On the Notion of Home and the Goals of Palliative Care. Theoretical Medicine and Bioethics 30 (5):335-349.
Added to index2011-11-10
Total downloads8 ( #138,621 of 1,089,047 )
Recent downloads (6 months)1 ( #69,722 of 1,089,047 )
How can I increase my downloads?