Journal of Law, Medicine and Ethics 47 (2):294-303 (2019)

Authors
Govind Persad
University of Denver
Abstract
This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life.
Keywords QALYs  cost-effectiveness analysis  disability  quality-adjusted life-years  discrimination  priority-setting  QALY  disability-adjusted life-years  DALY
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DOI 10.1177/1073110519857285
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References found in this work BETA

Rescuing Justice and Equality.G. Cohen (ed.) - 2008 - Harvard University Press.
The Complicated Relationship of Disability and Well-Being.Stephen M. Campbell & Joseph A. Stramondo - 2017 - Kennedy Institute of Ethics Journal 27 (2):151-184.
Dignity, Disability, and Lifespan.Samuel J. Kerstein - 2017 - Journal of Applied Philosophy.

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Citations of this work BETA

Why the Coming Debate Over the QALY and Disability Will Be Different.Steven D. Pearson - 2019 - Journal of Law, Medicine and Ethics 47 (2):304-307.
Toward Fair and Humane Pain Policy.Daniel S. Goldberg - 2020 - Hastings Center Report 50 (4):33-36.

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