Palliative care for the terminally ill in America: the consideration of QALYs, costs, and ethical issues

Medicine, Health Care and Philosophy 15 (4):411-416 (2012)
  Copy   BIBTEX

Abstract

The drive for cost-effective use of medical interventions has advantages, but can also be challenging in the context of end-of-life palliative treatments. A quality-adjusted life-year (QALY) provides a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health-related quality of life and survival for the patient. However, since it is in the nature of end-of-life palliative care that the benefits it brings to its patients are of short duration, it fares poorly under a policy of QALY-maximization. Nevertheless, we argue that the goals of palliative care and QALY are not incompatible, and optimal integration of palliative care into the calculation of QALY may reveal a mechanism to modify considerations of how optimal quality of life can be achieved, even in the face of terminal illness. The use of QALYs in resource allocation means that palliative care will always compete with alternative uses of the same money. More research should be conducted to evaluate choices between palliative care and more aggressive therapies for the terminally ill. However, current limited data show that investing in palliative care makes more sense not only ethically, but also financially

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 92,168

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

The ethics of palliative care: European perspectives.Henk ten Have & David Clark (eds.) - 2002 - Phildelphia, PA: Open University Press.
Palliative care ethics: a good companion.Fiona Randall - 1996 - New York: Oxford University Press. Edited by R. S. Downie.
The philosophy of palliative care: critique and reconstruction.Fiona Randall - 2006 - New York: Oxford University Press. Edited by R. S. Downie.
Physicians Should “Assist in Suicide” When It Is Appropriate.Timothy E. Quill - 2012 - Journal of Law, Medicine and Ethics 40 (1):57-65.
The concept of disease in palliative medicine.Joachim Widder & Monika Glawischnig-Goschnik - 2002 - Medicine, Health Care and Philosophy 5 (2):191-197.
On the notion of home and the goals of palliative care.Wim Dekkers - 2009 - Theoretical Medicine and Bioethics 30 (5):335-349.

Analytics

Added to PP
2011-11-10

Downloads
67 (#243,899)

6 months
15 (#170,094)

Historical graph of downloads
How can I increase my downloads?

Author's Profile

Yw Yang
University of London

Citations of this work

No citations found.

Add more citations

References found in this work

Palliative Care and the QALY Problem.Jonathan Hughes - 2005 - Health Care Analysis 13 (4):289-301.

Add more references