One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the 'QALY trap': we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and argues that all are problematic. Instead, we argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination.

If group members aim to fulfil a collective obligation, they must act in such a way that the composition of their individual actions amounts to a group action that fulfils the collective obligation. We study a strong sense of joint action in which the members of a group design and then publicly adopt a group plan that coordinates the individual actions of the group members. We characterize the conditions under which a group plan successfully coordinates the group members’ individual actions, and study how the public adoption of a plan changes the context in which individual agents make a decision about what to do.

According to the priority view, or prioritarianism, it matters more to benefit people the worse off they are. But how exactly should the priority view be defined? This article argues for a highly general characterization which essentially involves risk, but makes no use of evaluative measurements or the expected utility axioms. A representation theorem is provided, and when further assumptions are added, common accounts of the priority view are recovered. A defence of the key idea behind the priority view, the priority principle, is provided. But it is argued that the priority view fails on both ethical and conceptual grounds.

The value of health states is often understood to depend on their impact on the goodness of people's lives. As such, prominent health states metrics are grounded in particular conceptions of wellbeing – e.g. hedonism or preference satisfaction. In this paper, I consider how liberals committed to the public justification requirement – the requirement that public officials choose laws and policies that are justifiable to their citizens – should evaluate health states. Since the public justification requirement prohibits public officials from appealing to controversial conceptions of the good life, liberals committed to this principle face a significant puzzle.

According to Wlodek Rabinowicz's (2008) fitting-attitude analysis of value relations, two items are on a par if and only if it is both permissible to strictly prefer one to the other and permissible to have the opposite strict preference. Rabinowicz's account is subject, however, to one important objection: if strict preferences involve betterness judgements, then his analysis contrasts with the intuitive understanding of parity. In this paper, I examine Rabinowicz's three responses to this objection and argue that they do not succeed. I then propose an alternative solution. I argue that the objection can be avoided if we ‘relativize’ Rabinowicz's account and define parity in terms of opposite strict preferences between two items that are only relatively permissible, rather than permissible simpliciter. I argue that this account of parity can be defended if we take seriously the distinction between sufficient and decisive reason for a preference relation. I also show that, on the basis of this distinction, we can arrive at a more extensive taxonomy of value relations than the one proposed by Rabinowicz.