The Quality-Adjusted Life Year

On Saturday I watched as rescuers pulled the body of a 22 year old young man from the ocean. It was a beautiful summer day, and the beach was full of visitors, many of whom had no inkling that the rough surf had undercurrents that could kill. I've been upset about this young man's death, mostly because at 22 he had really just begun to live as an adult and he had so much more of life ahead of him. His life, it seems to me, had so much value because of his young age. To me his loss of life is much more tragic than that of someone much older, particularly someone very much older nearing the end of life.

Philosopher Peter Singer, in arguing for health care rationing, comes to the same sort of conclusion about putting different values on different people's lives. Read his article in the New York Times magazine by clicking on the title of this post. One of Singer's topics is the concept of a quality-adjusted life year (QALY), which is a way of placing a value on medical treatments based upon what the they can reasonably accomplish for the patient. QALY can be used to draw the line on paying for treatments that are not cost effective, that don't improve the quality and quantity of life sufficiently considering the cost. Are we headed in this direction in the health care reform debate? I doubt it, at least not yet. But Singer makes some provocative arguments in favor of some form of health care rationing.