Ethical Issues Which Have Prevented the U.S. from Maximizing Quality of Life Years

Abstract

The cost of healthcare interventions varies greatly with age, with a significant fraction of cost being spent in the last two years of life. Treating a child can save orders of magnitude more life-years than an octogenarian treated for the same disease, such as cancer. While Quality-Adjusted Life Years (QALYs) can be used to plan a roadmap for how resources should be expended to maximize quality of life the execution of those plans often fail due to societal norms which trump the carefully measured QALYs, resulting in lowered average number and/or quality of years lived. The ethical issues concerning age, sex, lifestyle (smoking, drinking, obesity), cost transparency, and extreme examples (war, population explosion vs. collapse) will be discussed.

Introductory Chapter: The Global Framework for Wellness – Concepts, Theories, Measurements, Interventions and New Directions

“…These measures take into consideration the important issue of morbidity which represents a deficit in health status. Quality adjusted life years (QALY) measurements typically range from 0 to 1 where 0 represents death, 1 represents a year of perfect health and 0.5 represents a significant health deficit such as a patient that is bedridden [18,19]. Although rare, QALY values can be less than zero or greater than one which signify a state worse than death or exceeding perfect health (e.g., euphoria).…”

Perspective Chapter: Quality of Life (QoL) Calculations and Interventions across Divergent Societies

“…With the industrial revolution, living standards became more dependent on the distribution and utilization of technological advances. In modern times, the first big global economic indicator of national well being was Gross Domestic Product (GDP) [1]. The GDP originally was a conceptual proxy that equated economic growth with national well being.…”