Analysing health outcomes

被引:10
作者
Dowie, J [1 ]
机构
[1] London Sch Hyg & Trop Med, London WC1, England
关键词
health economics; utility; analysisism; rights; QALY;
D O I
10.1136/jme.27.4.245
中图分类号
B82 [伦理学(道德学)];
学科分类号
摘要
If we cross-classify the absolutist-consequentialist distinction with an intuitive-analytical one we can see that economists probably attract the hostility of those in the other three cells as a result of being analytical consequentialists, as much as because of their concern with "costs". Suggesting that some sources of utility (either "outcome" or "process" in origin) are to be regarded as rights cannot, says the analytical consequentialist, overcome the fact that fulfilling and respecting rights is a resource-consuming activity, one that will inevitably have consequences, in resource-constrained situations, for the fulfilment of the rights of others. Within the analytical consequentialist framework QALY-type measures of health outcome have the unique advantage of allowing technical and allocative efficiency to be addressed simultaneously, while differential weighting of QALYs accruing to different groups means that efficiency and equity can be merged into the necessary single maximand. But what if such key concepts of the analytical consequentialist are not part of the discursive equipment of others? Are they to be disqualified from using them on this ground? Is it ethical for intuition to be privileged in ethical discourse, or is the analyst entitled to "equal opportunities" in the face of "analysisism", the cognitive equivalent of "racism" and "sexism"?
引用
收藏
页码:245 / 250
页数:6
相关论文
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