John Hemming's Web Log John's Reference Website
Saturday, June 04, 2005
  NICE supports age discrimination
From the National Institute for Health and Clinical Excellence (see link)

Draft proposals for health rationing.
Recommendation 6
With respect to age (section 5.1):
• however, where age is an indicator of benefit or risk, age discrimination
is appropriate.

Recommendation 7
When setting priorities there is no case for discrimination on the basis of
gender or sexual orientation unless these are risk factors for benefits, risks, or
both (section 5.2).

Recommendation 14
Priority for patients with conditions associated with social stigma should only
be considered if the additional psychological burdens have not been
adequately taken into account in the cost–utility analyses (section 6.5).


The above recommendations raise a number of issues, not least the question as to exactly when "age discrimination is appropriate". I can understand the risk issue, but the benefit issue is not clear.

What I have difficulty understanding is what "risk factors for benefits, risks or both" exist for gender or sexual orientation discrimination.

Perhaps the most significant is, however:
Recommendation 5
NICE guidance should explain, explicitly, reasons for recommending – as cost
effective – those interventions with an incremental cost-effectiveness ratio
over £20,000 to £30,000 per QALY (section 4.3).


(A QALY is a Quality Adjusted Life Year).
 
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