Medical Humanities 29 (2):81-86 (2003)

The “Time trade-off” (TTO), is the most widely used method to “quality adjust” life years for “QALYs” in cost utility analysis. In this paper we ask if it is theoretically likely that the TTO is valid for this use. The TTO consists in a trade off between longevity and quality of life. Firstly, we argue that it is impossible to control for all factors that may influence one’s willingness to sacrifice lifetime. Secondly, that longevity and quality of life are too closely interrelated for the hypothetical trade off to reveal real preferences. Thirdly, that the TTO handles the value of a life year inconsistently because it simultaneously assumes that it changes (as an outcome measure) and that it doesn’t change (as a currency unit). Lastly, we ask whether the difficulties stem from an inherent contradiction in trying to quantify quality of life. The problems of theoretical validity and internal consistency, contrast the use of the results as exact measurements. We conclude that cost utility analysis based on TTO cannot be trusted as a tool for setting priorities in health
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/mh.29.2.81
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 56,949
Through your library

References found in this work BETA

No references found.

Add more references

Citations of this work BETA

Add more citations

Similar books and articles

Time, the Familiar Stranger.J. T. Fraser - 1987 - University of Massachusetts Press.
Weak Quantum Theory and the Emergence of Time.Hartmann Romer - 2004 - Mind and Matter 2 (2):105-125.
Metaphors and Time Reversibility and Irreversibility in Economic Systems.Rod Cross - 1995 - Journal of Economic Methodology 2 (1):123-134.
Equilibrium and Time: Marshall's Dilemma.Neil Hart - 1996 - Journal of Economic Methodology 3 (2):285-306.
Time.Eva Hoffman - 2009 - Profile Books.
Recent Work: Time.Jonathan Tallant - 2013 - Analysis 73 (2):369-379.
Economic Policy and World Organization.Asaf Bar-Tura - 2011 - Perspectives on Global Development and Technology 10 (1):194-212.
Education and the Concept of Time.Leena Kakkori - 2013 - Educational Philosophy and Theory 45 (5):571-583.
Trends Toward Part-Time Employment: Ethical Issues. [REVIEW]Julia J. Bartkowiak - 1993 - Journal of Business Ethics 12 (10):811 - 815.


Added to PP index

Total views
12 ( #755,216 of 2,409,982 )

Recent downloads (6 months)
3 ( #245,858 of 2,409,982 )

How can I increase my downloads?


My notes