Bentham's dictum, ‘everybody to count for one, nobody for more than one’, is frequently noted but seldom discussed by commentators. Perhaps it is not thought contentious or exciting because interpreted as merely reminding the utilitarian legislator to make certain that each person's interests are included, that no one is missed, in working the felicific calculus. Since no interests are secure against the maximizing directive of the utility principle, which allows them to be overridden or sacrificed, the dictum is not usually (...) taken to be asserting fundamental rights that afford individuals normative protection against the actions of others or against legislative policies deemed socially expedient. Such non-conventional moral rights seem denied a place in a utilitarian theory so long as the maximization of aggregate happiness remains the ultimate standard and moral goal. (shrink)

Counting QALYs (quality adjusted life years) has been proposed as a way of deciding how resources should be distributed in the health service: put resources where they will produce the most QALYs. This proposal has encountered strong opposition. There has been a disagreement between some economists favouring QALYs and some philosophers opposing them. But the argument has, I think, mostly been at cross-purposes. Those in favour of QALYs point out what they can do, and those against point out what they (...) can't. There need be no disagreement about this. What is needed is to sort out what is the proper domain of QALYs, and it may be possible to do this amicably. Then we may be able to get on with the more useful job of deciding how well QALYs perform within their domain. In this paper I shall try to accomplish the first task (sections II–IV), and make a start on the second (sections V–VIII). (shrink)