ABSTRACT
The economic evaluation of counselling in the health service involves utilising information about the costs and effects of counselling and making decisions about the allocation of resources to finance counselling. The ethical issues associated with the economic evaluation of counselling and resource allocation are often raised by counsellors and doctors aware of potential conflict between the quality and cost of care. This chapter examines arguments for the rational allocation of resources based on cost-effectiveness criteria and the opposing ‘slippery slope of compromised ethics’ view. While medical ethics is currently conceived in terms of the individualistic ethics of duty and virtue, economics embraces a concept of social as well as individual ethics. One measure of effectiveness developed by health economists to overcome the objection that survival rates pay no regard to quality of life is by adopting the quality adjusted life year.
