Discrimination Against the Elderly Within a Consequentialist Approach to Health Care Resource Allocation

Abstract

In this chapter, I examine the implications for discrimination against the elderly of a consequentialist approach to health care resource allocation. While the moral theory called “consequentialism” may be unfamiliar to many health policy analysts and others, consequentialism supports a familiar form of allocation and prioritization of health care services — cost effectiveness and cost benefit analyses. Explicit and formal resource allocation and prioritization of health care services are increasing both on local and global levels by means of one or another form of cost effectiveness analysis, often employing the concept of a quality adjusted life year (QALY). Thus, the ethical issues raised by resource allocation from a consequentialist moral perspective are essentially the same as those raised by the quite common use of cost effectiveness analysis to make allocation decisions. Consequentialism is not an esoteric moral theory of interest mainly to professional philosophers, but rather a moral theory that supports one of the more common formal and explicit methods and standards for resource allocation decisions in health policy in use today throughout the world.