Ethics And Allocating Healthcare Resources Flashcards
Why should age be considered in resource allocation?
Based on the ‘fair innings argument’ where:
Older people have had a more full life + Younger people have not yet lived a full life, Therefore treatment should be given to younger people.
Older people are less likely to respond positively to treatment, therefore it presents 2 sound arguments.
What is a sound argument?
A sound argument fulfils 2 criteria:
Reasoning is accurate and factual
Reasoning logically leads to a conclusion, therefore it is valid.
What are the characteristics protected by the Equality Act 2010?
There are 9 criteria:
Age
Sex
Sexual orientation
Gender reassignment surgery
Disability
Race
Pregnancy/maternity
Marriage/Civil partnership status
Religion
Why should age not be considered in resource allocation?
It is a form of discrimination and age is a protected characteristic in the law of the Equality Act 2010.
Age alone is not a good prognosis of health and likelihood of disease complications.
What is a direct age discrimination?
Treatment of a person with a protected characteristic such as older person in a less favourable manner than a comparably young person, based solely on age.
What is indirect age discrimination?
Policy which applies to everyone but places people with a protected characteristic at a disadvantage.
What are QALY-based assessments?
Assigning utility value to a state of health in a value between 0 to 1
AND
Multiplying the number of years expected to live in that state.
What are the benefits of QALY-based assessments?
Addresses the primary purpose of healthcare to maximise welfare of patients with life quality and quantity
Widely used in practise by NICE
Maximises the healthcare budget
What are the arguments against QALY-based assessments?
—>Goes against principal of justice because all patients should have equal access to treatment
—>There may be difficulties with measurement and bias
—>Some object QALY assessment measures are unjust
—>Age discrimination because a healthy old person will inherently have less QALYs compared to a young ill person
How can QALY assessment be unjust?
End of life care, where patients with a shorter life expectancy are treated worse
Double jeapordy objection, where those with a pre-existing medical condition are treated worse.
What are the arguments against considering age for resource allocation?
Burden of treating older people is due to the disease itself and the incapacity it causes rather than age
Even if treatment is more costly, society should treat its members equally with respect and compassion
