Disability, Epistemic Harms, and the Quality-Adjusted Life Year

Health economists use a conceptual tool called the quality-adjusted life year (QALY) in resource allocation decisions. Despite claims that the values of disabled people are distorted by adaptive preference, I argue that their testimony is in fact more reliable than that of nondisabled third parties. Epistemic injustice in this context harms disabled people and people with chronic illnesses. It also prevents us from challenging the current hegemonic and ableist formulation of the problem of just resource allocation. Community-based participatory research that gives disabled people greater agency in the research process would allow the reframing of the research problem.