title: Public preferences for responsibility versus public preferences for reducing inequalities.
abstract: In cost-utility analysis, the numbers of quality-adjusted life years (QALYs) gained are aggregated by placing the same weight on each QALY. Deviations from this rubric have been proposed on a number of grounds, including the degree to which persons might be deemed responsible for the illness faced, and inequality in lifetime health between groups. Most research has looked at these factors in isolation. This paper analyses public preferences about the relative importance of these factors. Over 500 members of the general public in the UK are interviewed in their homes. Where "blameworthy" groups experience a moderate drop in quality of life due to their behaviour, they appear to receive higher priority than an otherwise "trustworthy" group if they also experience poorer health prospects because the latter is weighted more heavily than the former.
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK. r.p.edlin@leeds.ac.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Edlin
authors.forename: Aki
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: Paul
authors.initials: P
authors.lastname: Dolan
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003362:Cost-Benefit Analysis; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011639:Public Opinion; D019057:Quality-Adjusted Life Years; D012941:Social Responsibility; D012959:Socioeconomic Factors; D006113:United Kingdom