ABSTRACT
Attempts to assess the quality of life of any individual are beset with difficulty. It is, however, reasonably argued that some rationing of healthcare provision is unavoidable for financial reasons and that a sensible approach to decision-making about spending should involve assessment of the duration of prolongation of life offered by a given treatment and the quality of that life enjoyed by the recipient. Put simply, quality of life is ascribed a number, continuous pain and disability being at the lower end of the scale, and complete normality at the upper end. The number attributed is then multiplied by the average number of years of extra life provided to produce the ‘qualy’. The number of added years can conveniently be calculated as 50% actuarial survival (see below).
