{"id":{"repo_id":"uwtsd","oai_identifier":"oai:repository.uwtsd.ac.uk:454"},"canonical_url":"https://search.dev.ndltd.org/etd/uwtsd/oai:repository.uwtsd.ac.uk:454","repository":{"repo_id":"uwtsd","name":"University of Wales Trinity Saint David","base_url":"https://repository.uwtsd.ac.uk/cgi/oai2"},"display":{"title":"\"Can religious treatment choices justify additional healthcare expenditure and, if so, are there limits to this?\"","abstract":"Access to healthcare is generally regarded as a supportive right to the right to life. Freedom to hold a religious belief and to practice that religion is also held to be a right. The practicing of a religion includes the freedom to live in accordance with the tenets of that religion, but this may entail refusing certain healthcare treatments. Where such a refusal leads to a lower share of healthcare resources being consumed, there is no adverse impact on other people who might also require a share of those healthcare resources. However, where that refusal leads to a more expensive treatment being requested in place of the proscribed treatment, Individual Funding Request (IFR) Panels within the NHS have to decide how to balance individual rights with the fair allocation of resources. This paper considers religious perspectives on healthcare treatments and whether, in respecting these, additional expenditure can be justified. Included within this assessment is a case with extreme characteristics that helps to illustrate the type of problem that such cases present. The solution proposed is built upon Quality Adjusted Life Years (QALYs) as a tool for assessing the cost-effectiveness of treatments and introduces the concepts of ‘individualised QALYs’ and ‘personalised QALYs’, concepts that potentially have much wider applications in individual treatment funding decisions than those for which religious treatment preferences have significance. The use of personalised QALYs allows limits to be set on the acceptable costs of religiously-preferred treatments. These proposals are then tested from a variety of perspectives, including considering the legal implications, to demonstrate that they could be practically applied by IFR Panels in decision making in these difficult and sensitive cases.","abstract_html":"Access to healthcare is generally regarded as a supportive right to the right to life. Freedom to hold a religious belief and to practice that religion is also held to be a right. The practicing of a religion includes the freedom to live in accordance with the tenets of that religion, but this may entail refusing certain healthcare treatments. Where such a refusal leads to a lower share of healthcare resources being consumed, there is no adverse impact on other people who might also require a share of those healthcare resources. However, where that refusal leads to a more expensive treatment being requested in place of the proscribed treatment, Individual Funding Request (IFR) Panels within the NHS have to decide how to balance individual rights with the fair allocation of resources. This paper considers religious perspectives on healthcare treatments and whether, in respecting these, additional expenditure can be justified. Included within this assessment is a case with extreme characteristics that helps to illustrate the type of problem that such cases present. The solution proposed is built upon Quality Adjusted Life Years (QALYs) as a tool for assessing the cost-effectiveness of treatments and introduces the concepts of ‘individualised QALYs’ and ‘personalised QALYs’, concepts that potentially have much wider applications in individual treatment funding decisions than those for which religious treatment preferences have significance. The use of personalised QALYs allows limits to be set on the acceptable costs of religiously-preferred treatments. 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The solution proposed is built upon Quality Adjusted Life Years (QALYs) as a tool for assessing the cost-effectiveness of treatments and introduces the concepts of ‘individualised QALYs’ and ‘personalised QALYs’, concepts that potentially have much wider applications in individual treatment funding decisions than those for which religious treatment preferences have significance. The use of personalised QALYs allows limits to be set on the acceptable costs of religiously-preferred treatments. 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