Williams A
Centre for Health Economics, University of York, U.K.
Respir Med. 1991 Sep;85 Suppl B:3-5. doi: 10.1016/s0954-6111(06)80161-7.
With health care resources inevitably limited, we must ensure that they are used where they will do the most good. Doing good means improving people's life expectancy and quality of life, two characteristics which are combined in the Quality-Adjusted-Life-Year, or QALY. Even with effectiveness measured in this humanitarian way some people think it is unethical to let cost-effectiveness notions guide health care priorities. But costs represent sacrifices of health imposed on others, and it cannot be ethical to ignore such sacrifices. Indeed the reverse is true, it is unethical to ignore costs, and not to seek to become more efficient.
由于医疗保健资源必然有限，我们必须确保将它们用于能产生最大益处的地方。产生益处意味着提高人们的预期寿命和生活质量，这两个特征在质量调整生命年（QALY）中得到了综合体现。即使以这种人道主义方式衡量有效性，一些人仍认为让成本效益观念指导医疗保健优先事项是不道德的。但成本代表着强加于他人的健康牺牲，忽视这种牺牲是不道德的。事实上，恰恰相反，忽视成本、不寻求提高效率才是不道德的。
