Quality-adjusted life years and the ethical values of health care.

This paper defines the QALY, the quality-adjusted life year, and examines the ethical dimensions of its potential uses in health care, with special reference to rehabilitation. The implications of QALYs are analyzed with respect to three central ethical values in health care: freedom, happiness and fairness. QALYs may be useful in expanding patient freedom and in securing greater social happiness in the allocation of resources. However, QALYs raise important problems of fairness and have a bias toward curative interventions.