质量调整生命年的提出和应用  

The Proposal and Application of Quality-adjusted Life Years

作　　者：李奕萱 LI Yixuan(School of Health Humanities,Peking University,Beijing 100191,China)

机构地区：[1]北京大学医学人文学院,北京100191

出　　处：《医学与哲学》2025年第3期77-80,F0003,共5页Medicine and Philosophy

基　　金：2023年国家留学基金项目(202306010294)。

摘　　要：质量调整生命年(quality-adjusted life years,QALYs)是整合生命长度和质量的量化健康方法,于20世纪70年代提出,为辅助医疗资源合理分配提供同时满足效率和公平的有效方法。随着生命伦理的发展,个人健康权成为国际准则,QALYs基于社会共识的特征,从数学模型中没能捕捉到人群健康价值差异的技术问题,转变为对个人健康权的冒犯和对特殊人群的歧视的伦理问题。在此转变下,对QALYs的批评表现为依托于政策诞生的量化方法代表并加强政府权力,在政策目标与伦理的争论中,完全站在伦理的对立面。不论是QALYs的提出和应用,还是对该方法的批评,都体现出健康测量对人而非疾病的关注。Quality-adjusted life years(QALYs)is a quantitative health measure that integrates both life expectancy and quality,proposed in the 1970s as an effective tool for aiding the rational allocation of healthcare resources while balancing efficiency and equity.With the development of bioethics,personal health rights became an international standard.Initially,QALYs,based on societal consensus,were seen as a mathematical model that failed to capture the health value differences within populations.This limitation shifted QALYs from a technical issue to an ethical one,as it began to be perceived as an infringement on individual health rights and discriminatory against special populations.As a result,criticism of QALYs has highlighted their role as a government policy-driven quantitative method that reinforces state power,positioning itself opposite to ethical debates surrounding policy goals.Both the acceptance of QALYs and the critics in the later decades reflect that health measures moving to people-centered,rather than disease-centered principles.

关 键 词：质量调整生命年 健康价值 健康测量 生命伦理 

分 类 号：R-09[医药卫生]