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Unformatted text preview: Bioethics Study Guide February 24 Trude Arneson and Erik Nord, “The value of DALY life: problems with ethics and validity of disability adjusted life years.” BMJ 1999;319:1423–5. • DALYs (disability adjusted life years) have been launched by the World Bank and the World Health Organization as a combined measure of morbidity and mortality • The DALY approach explicitly presupposes that the lives of disabled people have less value than those of people without disabilities • The method assumes that disabled people are less entitled to scarce health resources for interventions that would extend their lives • These assumptions are in contrast with basic principles of the WHO • Forced consistency between questions that address different issues produces disability weightings that are basically artifacts; this affects the validity of the global burden of disease report • The ongoing revision of the DALY protocol should address these problems Conclusions: DALY approach currently in use presupposes that life years of disabled people are worth less than life years of people without disabilities; thus, because of consistency impositions, people participating in evaluation panels are forced to be discriminatory toward the value of life of disabled people. Revision of DALY protocol should deal with methodological problems appropriately and in particular, the use of disability weightings in the valuation of gained life years should be abandoned. Frances Kamm, “Deciding Whom to Help, Health-Adjusted Life Years and Disabilities.” In S. Anand, F. Peter, and A. Sen, eds., Public Health, Ethics, and Equity, Chapter 11 Summary: Kamm discusses the allocation of scarce resources related to health with a particular...
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- Spring '11
- World Health Organization, Disability adjusted life, Frances Kamm