Abstract:One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the 'QALY trap': we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and argues that all are problematic. Instead, we argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination.
Consequentialism is thought to be in significant conflict with animal rights theory because it does not regard activities such as confinement, killing, and exploitation as in principle morally wrong. Proponents of the “Logic of the Larder” argue that consequentialism results in an implausibly pro-exploitation stance, permitting us to eat farmed animals with positive well-being to ensure future such animals exist. Proponents of the “Logic of the Logger” argue that consequentialism results in an implausibly anti-conservationist stance, permitting us to exterminate wild animals with negative well-being to ensure future such animals do not exist. We argue that this conflict is overstated. Once we have properly accounted for indirect effects, such as the role that our policies play in shaping moral attitudes and behavior and the importance of accepting policies that are robust against deviation, we can see that consequentialism may converge with animal rights theory significantly, even if not entirely.
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