希少医療資源である移植用臓器の配分問題に関する研究―QALYの効用と限界を中心として―

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  • Limitations of the Quality Adjusted Life Years (QALY) Method for Allocation of Organs for Transplantation
  • キショウ イリョウ シゲン デ アル イショクヨウ ゾウキ ノ ハイブン モンダイ ニ カンスル ケンキュウ : QALY ノ コウヨウ ト ゲンカイ オ チュウシン ト シテ

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This study addresses some of the shortcomings of Quality Adjusted Life Years (QALY), the method used to determine organ allocation for transplants in the USA. A psychological quantitative approach reveals that the young generation (age X-Y) prefers their donations to go to young recipients even if the prospective life expectancy is shorter than that of older patients. The younger generation also prioritizes the immediate treatment of critically ill patients with potentially expensive procedures (like heart transplants) over longer-term, possibly more economical preventive care that would cut down on disease in the general population. As a result, the numerical values provided by QALY only appear to be a scientifically quantitative reflection of public values. In reality, they conflict with the actual desires of an important segment of the donor pool. Additional work is necessary to make organ allocation methods more closely reflect the wishes of the donors.

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