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There are no universal standards that are likely to be accepted by a majority of the population, or even by enough people to consider QALY assessments moral and ethical practices in healthcare (Drotar, 1998). Many also argue that healthcare authorities may favor certain populations including the young adult or pediatric population, based on the theory this group has the greatest chances for survival; this however is often not the case, as there are many older adults that have powerful enough beliefs and mature immune systems so that with proper treatment they might have just as much chance for survival than doctors may assess on first glance (Drotar, 1998).
There are cases where a patient is likely to survive even under dire circumstances, which should favor the arguments made by the opposition. However, proponents provide equally compelling arguments.
Conclusions
Kerr, Asch, Hamilton & Mcglynn (2000) suggest that healthcare professionals must decide how to distribute resources using several approaches outlined in "general medical literature" (p.22). These indicators may include the nature of the disease, the age of the patient, the family medical history, the patient's prognosis and other facets that help doctors and the healthcare team assesses the likelihood that a patient will survive or not following quality care treatment (Kerr, Asch, Hamilton, et al. 2000). The subject of quality adjusted life years is one that will remain controversial for some time. What is positive is the controversy surrounding QALY continues, and as it does more so now than ever before healthcare professionals are looking to establish ethical guidelines for the use of healthcare recommendations. It seems logical that healthcare providers would need to allocate resources sensibly in times when resources are not readily available. This does not suggest however, that people will suffer or not receive proper care as a result of QALY measures when used to allocate resources.
Opponents want to establish a formal tool that is not subjective that would ensure individual autonomy and the rights of patients are not taken away. To achieve this goal all opponents will have to provide evidence that QALY outcomes result in less benefit than good. Thus far based on the research gathered,...
Ethical and moral guidelines are not to be taken lightly. The use of QALY is not something that officials or agents can decide overnight. Further research is necessary to help decide how QALY can be best utilized so all patients benefit and all resources are intelligently allocated. Ultimately for QALY to work the final decision must be one that is made through the collaborative efforts of patients, community members, family, doctors, nurses and healthcare administrators.
References
Bergner, M., Bobbitt, R.A., Carter, W.B., & Gilson, B.S. (1981) the sickness impact profile: Development and final revision of a health status measure. Medical Care, 19: 787-805.
Drotar, D. (1998) Measuring health-related quality of life in children and adolescents:
Implications for research and practice. Mahwah: Lawrence Erlbaum Associates.
Kaplan, R.M., Bush, J.W. & Berrgy, C.C. (1976) Health status: Types of validity and the index of well being. Health Services Research, 11(1): 478-507.
Puma, J.L. & Lawlor, E.F. (1990) Quality-adjusted life-years. Ethical implications for physicians and policymakers. JAMA, 263(21). Online, Retrieved November 20, 2007: http://jama-ama-assn-org/
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