Cost-Effectiveness and the Distinction Between Quantitative and Qualitative Disability Discrimination

Since standard measures of health effect ascribe negative value to disabilities, it is commonly believed that a cost-effective scheme for allocation of healthcare resources discriminates against people with disabilities. It is still a question for discussion, however, when and why such discrimination is justified. In this paper I account for the central normative substance of this disability discrimination problem, and I defend the claim that it is more justifiable to discriminate against disabled people based on lifespan considerations than on assessments of their reduced quality of life. I term this the asymmetry intuition. Based on some prior attempts to explain the asymmetry intuition, I offer the Reasonable Impartial Interest Argument as the best possible way to defend it. If my argument is sound, this moves us a step further towards a cost-effective priority setting that does not unjustly discriminate against people with disabilities.