The groundwork for health care rationing in Switzerland has been laid. Health care costs are rising and personnel is at a premium in Switzerland, a situation unlikely to improve and leading to questions whether treatments should be rationed. In addition, a judge recently ruled to limit the money that could be spent on a patient’s care. The judgment, criticized as arbitrary, has forced health care specialists to consider how best to evaluate the benefits of their patients’ treatment. The answer could come with the possible implementation of a “Quality of Life Adjusted Life Years” (QALY) criteria. This evaluation process is what bioethicist Wesley J. Smith calls the “discriminatory form of withholding treatment based on subjective quality of life judgmentalism.”

 

QALY criteria assumes that one year of life in perfect health has a value of one. Any health problem shifts that value below one. A treatment could be denied even if it increases life expectancy because the patient’s quality of life is considered low. Included in the evaluation  are so-called “social” values. “In other words,” Smith warns, “popular prejudices become incorporated into healthcare policy.”