Suppose you have a single pill at your disposal and that pill will extend any person\u2019s life by 10 years. You have to choose to give it to one of the following tow individuals:<\/p>\n
a 20\u2010year\u2010old patient, who will live for 10 more years if she gets the drug, and then she dies;a 70\u2010year\u2010old patient, who will live for 10 more years if she gets the drug, and then she dies.<\/p>\n
The person who does not get the drug will die immediately. Who would you give it to? <\/p>\n
Under a QALY-based framework, you would be indifferent between giving it to either individual; in both cases, life extension is 10 years and (assuming identical quality of life) there would be now difference in how QALYs gained are valued. <\/p>\n
Many people, however, will prefer to give it to the 20 year old. The 20 year old has only lived a short life whereas the 70-year old already has lived a life near the average life expectancy. People who make this argument are making a \u201cFair Innings\u201d argument. <\/p>\n
Adler et al. (2021)<\/a>\u2013building on Bognar 2008<\/a> and Bognar 2015<\/a>\u2013use the following definition:<\/p>\n as between a policy that produces a given gain in expected lifetime well\u2010being for a younger person, and an otherwise\u2010identical policy that produces the same gain in expected lifetime well\u2010being for an older person, it is ethically better for society to undertake the first policy.<\/p>\n The Fair Innings approach is justified theoretically using a prioritarian social welfare function approach, whereby an increasing, concave, and continuous transformation is applied to individual lifetime utilities. <\/p>\n Another question is, do individuals actually believe in the \u201cFair Innings\u201d rationale? fair<\/p>\n