Table 4 Qualitative Themes and Illustrative Quotes
From: Trading people versus trading time: What is the difference?
Themes consistent with QALY-maximization considerations: | ||
|---|---|---|
Quality of life | References to the condition's impact on quality of life. Could be a positive or negative comment on a societal or individual level. | TTO – "...it sounds to me like Mrs. Adams has ... the more severe symptoms, and I would ... think that...it might impact her quality of life more." |
|  |  | PTO – "I would choose to cure the people who are severely short of breath because ... I think it so affects the quality of life, every move they make. ...People don't have to walk up hill, they can avoid doing that, they can drive, they can find some other means. ...I don't see that as being something that's completely disabling, whereas I see the severe shortness of breath as completely disabling." |
Years of life | Expresses the importance of choosing the option that maximizes the length of life. | TTO – "Probably the one that lives longer is in better shape..." |
Non-health benefits | Consideration of the choice that would result in the most benefit in terms of non-health dimensions such as contribution to society, economic contribution, employment, etc. | TTO – "Even though he might have less years to live, he's really capable of doing a lot more." |
|  |  | PTO – "I guess if you wanted to look at it really, really coldly you could say this group is consuming fewer resources ..." |
Themes consistent with equity considerations: | ||
Fair Chance | Consideration of giving someone who is worse-off a fair chance even though the benefit may be less than the alternative. | ... if ... the non-paraplegic versus the paraplegic, have same length of life span ... probably the quality of life would be a little better for the non-paraplegic. So therefore...I would cure...the paraplegics. |
Equality of life | Consideration of equal value of lives as a basis of moral judgement or to be fair. | If they're both living, it doesn't mean one's life is more valuable over the other. |
Prejudice | Specific mention of wanting to avoid prejudice or discrimination. | Now I feel like I'm going to be prejudiced by picking this individual over that one. |
Self-Perspective | Comments about self (or close-others) who have experienced the condition or projecting self into having the condition. | TTO – "...I would rather have pain on the leg than not be able to breathe properly." |
|  |  | PTO – "I think I would have to try to choose the ones with the shortness of breath. ... my son had asthma pretty bad, ... I could live with the leg pain but I don't think I could live with the shortness of breath." |