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Area of Science:

  • Bioethics
  • Health Economics
  • Disability Studies

Background:

  • Morally justified healthcare rationing requires non-discrimination and cost-effectiveness.
  • Conventional cost-effectiveness analysis (CEA) may inherently discriminate against disabled populations.
  • This discrimination is partly due to how health-related quality of life (HRQoL) is measured.

Purpose of the Study:

  • To address the disability discrimination problem in healthcare rationing.
  • To propose and defend a patient-sensitive account of HRQoL.
  • To enhance the moral justification of CEA by reducing discrimination against disabled individuals.

Main Methods:

  • Conceptual analysis of cost-effectiveness principles.
  • Development of a patient-sensitive framework for measuring HRQoL.
  • Ethical argumentation for the proposed HRQoL account.

Main Results:

  • Identified the 'disability discrimination problem' within standard CEA.
  • Proposed a novel patient-sensitive HRQoL framework.
  • Argued that this framework can mitigate discrimination in CEA.

Conclusions:

  • Standard CEA faces a disability discrimination problem due to HRQoL measurement.
  • A patient-sensitive HRQoL account offers a more equitable approach.
  • This revised approach can lead to more morally justified healthcare rationing decisions.