Is this the way freedom dies? Or: Jonathan Sumption: prophet or neurotic?
This is based on Sumption's* article in the Spectator which is a distillation of his speech to the 2020 Cambridge Freshfields Lecture entitled "Government by decree - Covid-19 and the Constitution".
I think he's on the money. I hope people at least listen to the speech even if this thread drops like a stone.
His concern is about the way the Government is ruling by decree, sometimes even by press-conference, side-lining parliament and enlisting the police not only to enforce the law but even thing that are breaking no law (like the 2m rule) often with violence. This to enact the greatest restriction on personal liberty ever (i.e. not even in war times) in the UK.
One of the many interesting facts he raised, and the only one I will quote, is:
He (like BJ) is astonished at how easily people give up there liberty, once you scare the shit out of them. I really think most people don't care about freedom if they feel threatened. But I think that the path we are on is not good at all. Does this concern you? And is concern for freedom becoming only a right-of-centre concern? Because it seems the only real opposition to rule by diktat is coming from Boris' own party.
*For not UK Shipmates JS is a distinguished lawyer, being a retired Supreme Court judge, and has been a constant critic of the UK Government's actions in response to COVID.
I think he's on the money. I hope people at least listen to the speech even if this thread drops like a stone.
His concern is about the way the Government is ruling by decree, sometimes even by press-conference, side-lining parliament and enlisting the police not only to enforce the law but even thing that are breaking no law (like the 2m rule) often with violence. This to enact the greatest restriction on personal liberty ever (i.e. not even in war times) in the UK.
One of the many interesting facts he raised, and the only one I will quote, is:
So much for following the Science.The minutes of the meetings of SAGE, its panel of expert scientific advisers, record that shortly before the lockdown was announced the behavioural scientists advised against the use of coercive powers. 'Citizens should be treated as rational actors, capable of taking decisions for themselves and managing personal risk,' they had said. The government did not act on this advice.
He (like BJ) is astonished at how easily people give up there liberty, once you scare the shit out of them. I really think most people don't care about freedom if they feel threatened. But I think that the path we are on is not good at all. Does this concern you? And is concern for freedom becoming only a right-of-centre concern? Because it seems the only real opposition to rule by diktat is coming from Boris' own party.
*For not UK Shipmates JS is a distinguished lawyer, being a retired Supreme Court judge, and has been a constant critic of the UK Government's actions in response to COVID.
Comments
Had due processes been followed it does not, of course, mean that we might not find ourselves in exactly the same place, only more "legally" than we do at present.
I'll admit I've been mildly perturbed when reading about, eg. a group of anti-racism demonstrators refering to a nearby anti-social distancing protest as "a white-supremacist rally", with the article presenting no evidence that that was the ideological bent of the rally.
I mean, sure, if I was betting money, I would bet that there is probably at least a 50% overlap between anti-SDers and white supremacists, based on everything I've seen. I still think it's dangerously lazy to make that an automatic assumption about anyone questioning masks or 2m rules.
And while I do think that enforcing distance during a pandemic is a legitimate function of government, I am a bit uncomfortable if the "rules" in question are not actual laws, but rather just informal guidelines that police have the power to enforce as if they were laws. Seems a little open to abuse.
I am less concerned about the government ignoring "scientists". Behavioural science is definitely one of the "soft sciences" in my books, and the mentioned recommendations strike me as basically just truisms, open to a zillion exceptions in practice: I'm sure even these psychologists preaching about "rational actors managing personal risk" would agree that someone coughing up tubercular blood should be kept away from seniors' homes, if needs be via force.
As to right/left wing, certainly some right wing pundits have opposed lockdown, and dispute the statistics; I assume they are libertarians.
Or possibly just right-wingers adopting a libertarian stance on this one particular issue for the sake of convenience, as many right-wingers are wont to do. True libertarianism(even in the American sense of the term) is a respectable philosophy, but it's also pretty rare.
And while I basically agree with the rest of what you wrote, I'll also say that the concept of a "dire emergency" is somewhat subjective. X number of people die of the flu every year, but we don't consider that a justification to enfore social distancing on a wide scale. So at what numerical point do the deaths become sufficient to justify mass bankruptcy and unemployment?
I thought that with covid, there is no numerical point. I mean if there are a 1000 deaths a day, this is not static, and they talk of doubling every few days. Well, it would be a brave politician who risks that.
By decanting the elderly from hospitals and turning care homes into charnel houses.
Morris Manning, the lawyer most responsible for Canada having the most liberal(ie. none) abortion laws in the world, was a libertarian whose other crusades involved trying to make compulsory union dues illegal(he failed on that one). Apparently, his anti-union activities made him somewhat unpopular with the more left-leaning members of the pro-choice movement, but in any case, he saw the job through.
On the other hand, this other Morris was also a libertarian, who campaigned for abortion to remain illegal in Canada. It was explained to me by one of his admirers that be he regarded fetuses as individuals deserving the same protection as born people.
But yes, abortion and its questions of personhood aside, any true libertarian should oppose all laws seeking to regulate sexual behaviour between consenting adults. If a self-proclaimed Republican libertarian does not defend the right of willing customers to smoke crystal meth while watching gay porn videos, he's nothing more than a fraud.
I think in the way Sumption argues against. In my view, Covid is a major crisis, akin to WW2. In these times, the executive government comes into its own. It needs to act fast, and it needs to impose whatever restrictions are necessary to protect the public.
As Sumption details, legislative warrant for such action exists, and I think he argues that the Government in the UK went beyond what those statutes authorise. He puts that as a matter of legislative interpretation general authorising words in a statute do not override fundamental rights. Legislatures have to do that specifically. I disagree with him. These sorts of Acts are designed to be used in emergency situations, where extraordinary action is required. That must include the violation of civil liberties where necessary to meet the crisis, or the purpose of the legislation is frustrated. I think Sumption is wrong, but I don't know that he's wrong, because I haven't had a good look at the whole of the relevant legislation. So I just reckon he might be wrong.
So I think all of the UK Government's pathetic attempts to contain Covid are probably authorised by law. But Parliament also inquires into the actions of the Executive Government, and oversee its actions. The Executive is responsible to the British people through the Parliament. This is where Sumption has a point. When this issue came up in Victoria there was a dispute as to whether Parliament should continue as normal, with the necessary Covid restictions. At the time, I thought that Parliament should not sit, because I wanted the executive to be focused on the day to day management of the crisis and not distracted by political considerations. I wanted Parliament's supervisory role suspended, as it were, and to have the rights and wrongs of the Executive's actions determined once the immediate crisis was over.
As things turned out in Victoria, there was a problem with our Hotel Quarantine system that resulted in a second wave in Melbourne. The city is just now coming out of a 12 week hard lockdown, and we look to have our testing and tracing system working so that the virus is virtually contained (touch wood). So the Premier called an inquiry off his own bat, and while it tried to suspend Parliament, it didn't have the numbers in the upper house. The inquiry resulted in a senior public servant and the Health Minister losing their jobs, and will report shortly.
So, on the issue of the restriction on civil rights, that's fine. Its authorised by legislation in a crisis, and because it is in a genuine ridgy didge crisis it is temporary only. We will shortly see whether my view is right in Australia, as there is an avalanche of law suits against the Government.
I would consider being conscripted to fight in the trenches and the widespread rationing of food and clothing to constitute a bigger impact on personal freedom. Likewise the evacuation of children from cities. And then there was the blackout. Also, Northern Ireland would probably like a word from back in “the troubles”. (I am excluding here the myriad abuses perpetrated by the British empire, and the facilitation of the slave trade - because I think you are basically talking only about the domestic population in Britain.)
Not to say he might not have a point about the contempt in which the current government holds parliament - but I think that seeing this as out of kilter with other crisis restrictions is over claiming.
I think part of issue is that there are those of us who see the pandemic as major crisis on a par with a world war and likely to last 2 to 3 years, and those who think it is a much more minor problem that they thought would be over by Christmas. Your view of how serious it is profoundly effects how much disruption you feel is justified to contain it.
I guess that's a variation on the question 'This safety feature will cost x million pounds to implement and will save y lives - at what value of x/y is it no longer worthwhile?' Which is the sort of question that people have to answer but don't admit to answering ...
We know it isn't. Well, as much as we know anything. "It's just flu" is right up there with anti-vax and climate change denial. The death rates are higher. The symptoms are different.
Sumption never denies that we could have gotten to where we are in a way fully legal and in line with the UK constitution. It's just Boris chose not to because he wanted to avoid giving Parliament any say. So he believes as a matter of opinion that all the current legislation would be viewed as illegal if it came to judicial review. Because, to make life easy for himself (aka removing any influence from the MPs he and Cummings hold in such low esteem), he chose to use "Part IIA of the Public Health (Control of Disease) Act 1984, as amended in 2008", which in his view does not contain the power to order a general lockdown. He could have used an Act which does confer those powers, but precisely because of the strength of those powers, has parliamentary scrutiny built in.
The main fear of the Sumptions of this world is that people will take the attitude "so it's not all that . . . meh", which is a slippery slope.
I don't dispute that "various restrictions are necessary" but it's another thing to say "so let the Government have free reign to rule by diktat and not bother too much about fine points like legality".
But when all is said and done, there are plenty of people in all countries who like the idea of authoritarian government. One of Sumption's main beliefs is, just that, a belief, which is that, contrary to popular ideas, democratic processes are more efficient that dictatorial ones. I believe that, but I can't prove it.
PS.
Do you agree that Victoria is as good a test case as we will get as to whether elimination of COVID as opposed to long term co-existence, is the strategy to go for?
I'd argue they aren't. For any kind of mitigation to work over mid to long periods of time there needs to be an end state that can be clearly articulated, and it should be evident that how each rule builds towards that and/or there needs to be a large amount of trust in government (another thing the Sweden fetishists often miss)
It isn't as simple as that, the assumption is that mass bankruptcy and unemployment can be avoided by opening up, without factoring in the economic impact when the death toll goes up along with the generalised effects of covid (simplistically; families aren't likely to continue to spend when granny dies and their breadwinners are suffering from long Covid).
You can see this play out in a different way and at a smaller scale at the levels of business; a large number of whom pushed for 100% home working even when they did not need to, because the disruptive effects of having people off sick for weeks at a time were likely to be greater than the ensuing loss of productivity.
Surely New Zealand is a better bet there?
I agree with Doublethink. This was also true of the First World War. There are 81 names on our war memorial, from a rural village / parish. That doesn't include those who returned home injured, or shell-shocked. The newspaper reports of the "Exemption Boards" which decided if someone could claim exemption from conscription make appalling reading. For example, the farmer who was told to tell his adult daughter to give up her job in the city, and return home to work on the farm, to release her brother for service. The Post Office / shop which was told that it could be run by a single person - if a telegram came in, one of the older pupils in the nearby school could be pulled out of lessons to deliver it. I assume this included the telegrams informing families of deaths at the front. Academic lessons reduced so that pupils could knit socks for the troops in school. Endless collections - eggs for the military hospital, cigarettes for the troops, money for the Red Cross. Some of my church's communion linen went to be turned into bandages. Our church windows were too big for black-out blinds, so no evening services. There didn't seem to be any aspect of life unaffected.
I'm all for masking, but if it became illegal for someone to start a blog pushing scientific or even pseudo-scientific theories about the alleged uselessness of masks, that would be crossing a pretty major line.
1. The Role of the Executive in Crisis Management
If the Executive acts in accordance with the law: with legislation previously passed to deal with emergencies like this Covid crisis, like wartime, like massive bushfires or floods, it is not acting in an authoritarian matter at all. It is acting lawfully in accordance with legislation previously passed by Parliament. My understanding from the Sumption article is that Boris has, in accordance with his usual practice, pulled a swiftie. So whether he has acted lawfully or not will probably be dealt with in the Courts in due course.
The Executive does need to take action that it believes necessary quickly in a crisis. That's why legislation granting the Govt emergency powers exists. I don't want to tell you how to suck eggs, but it is highly relevant that the executive is comprised of persons who are members of Parliament appointed by the queen as advised by the PM, the PM having the confidence of the lower house to form an executive govt. It is in no way an authoritarian institution when it exercises its powers lawfully under emergency powers legislation.
2. Oversight of the Executive during Crisis Management
Even if Parliament is not in session, the Executive must justify itself in the public square. Our Premier holds a Press Conference daily. He instituted an inquiry into how the virus got out into the community. The opposition held press conferences each day. The idea that in our democratic countries, Government actions are not subject to scrutiny if Parliament is not in session is wrong. Further, the Parliament's supervisory functions do not have to happen in real time, and rarely if ever do. Instead, what tends to happen is that questions are asked in Parliament well after the offending conduct has occurred and there might then be a subsequent formal inquiry. A Parliamentary Committee might decide to inquire into a matter, but it is mostly after the fact.
Here, Parliament doesn't draft rules, as distinct from laws. They are drafted by public servants working within the executive. There is usually a publication requirement like in the Government Gazette. Some rules need to be validated by Parliament after a certain time or they lapse, but I don't think that would apply to rules like who can go to work and when you can leave your home and for what reason. They expire either when superseded or when the State of Emergency under which they were made lapses.
3. The Goal of Crisis Management in addressing Covid.
The strategy in Victoria is suppression, not elimination. The purpose of the lockdown is to both limit the spread so that hospitals and other health infrastructure can cope, and to improve/refine your testing and tracing systems so that when an outbreak happens it can be jumped on, and the people infected, their close contacts and the close contacts of close contacts can be put into isolation so that the rest of the community can continue to act in a covid safe way. My understanding from British radio comedy is that Boris screwed up the testing and tracing prep when you guys first went into lockdown.
Before replying to your excellently constructed post (really! - although it's schmooze as well) I would like to make one general comment about Sumption's view which is easily missed and makes it primarily a British (maybe English) point of view. It is all about the entrenched attitude, certainly of the English establishment, that it is a good thing that English law and practice is governed by unwritten conventions which "good chaps" adhere to. Famously we have no written constitution, and many aspects of parliament are governed by conventions rather than explicit rules. It is Boris' undermining of all this which he is so against, and he has no criticism at all, of say Macron who uses extensive powers, because they are properly given to him by the French Constitution. In fact, although he personally is against it, you could take Sumption's whole lecture as an argument for a written constitution.
I do not know what sort of arrangement applies to Australia, or even whether it is consistent for all states. Sorry for the ignorance. As to your points:
Section 1 Para 1 (I don't like reproducing the text which people can easily read)
Totally agree.
Para 2: I have always though of the Executive Branch as the Civil Service and organisations like the Criminal Justice system, so that there is a separation of powers. The political branch does not enforce law, and the executive branch does not make it. I think the US is like that. I thought Australia was. Specifically: Totally agree, and Boris had that option if he had used the Civil Contingencies Act and yet chose not to use it, in order to avoid parliament having any involvement in the application of those powers or any power to revoke them.
Section 2 para 1: Yes . .but. S's contention is that (a bit like Trump) Boris believes his legitimacy to govern rests directly on the fact that he won the election (populism almost by definition) but this is not the case. The Government governs by consent of Parliament. Boris can, and does, use ruses to make sure parliament is "not around", so to whom is he accountable?
And here is a real problem. As S points out, the nice thing about appealing to "the people, not the derided MPs" is that there are no institutions in existence to channel public opinion in a way which The Leader can't control. Yes, Boris has news conferences but he can and does select those who may attend. There is a veil of secrecy over all that is being done (is this true also where you are?) where refuge is taken in scientific advice which is kept secret even despite repeated requests. So it is hard for the public to take an informed view, which suits Boris fine. It allows them to issue "scary scenarios" whilst making sure that nobody has the information to judge whether they are real.
para 2: Here the main distinction is between those which are classed as recommendation as opposed to those that have the force of law. And S's complaint is that the Police are being used to enforce recommendations that have no force of law, and it is a dangerous situation where the Police are authorised to stop you exercising your legal rights even if the Government thinks them unwise. There have been several attempts to see how well the police are informed about what is against the law (hence within their remit) as against what is a recommendation. Where the recommendations are insidious is that often even the police do not know, as in the 2 metre recommendation. I quote that, but it is far from being the only one.
para 3: Well, not just test and tracing, for which the UK Gov has spent an eye watering £18 Billion. I jest not, as it is not remotely funny. And having sacked the first guy who tried it, they put in place a mate of Matt Hancock which a track record of major data breaches, with no selection process. You're strictures on the UK Government are maybe softened on the basis that politeness requires at least some measure of respect for foreign heads of state. But feel free as far as I am concerned.
In the end different folk go for different solutions where there is no good one. I hope you all succeed, but I would not be tempted to move to your neck of the woods, and probably vice versa. I think you're level of lockdown is more intolerable than our chaos, although it a case of the least of evils.
Sure - I don't mean that x and y are completely independent variables. In the same way, if your product kills too many people because you didn't implement the safety feature, you could end up losing more in sales than you saved by not implementing it.
I'd be very surprised if this was not the case in the UK, but I'm not certain. If Sumption is right about the powers Boris is exercising, then the Crown could have a problem. I can't remember what remedies are available under this type of action, specifically whether a person can claim damages.
I don't follow British politics closely at all. I am saturated in the tradition of Irish Catholic antipathy to all things English, and I am always afraid that I am going to break into Fenian insults on the Ship, so better I keep away. Also, the cricket is a fertile ground for abuse. I was attracted to the thread because I liked the title. I'm interested in the question of freedom and its limits.
On moving to the UK, I'd love to, for a few years anyway, on the basis that I could use England as a base to make an intense study of Europe in a series of focused trips. I have the right to residency as my Grandfather was English, so prior to Brexit I could have used that to get British citizenship and the right to live anywhere in the EU. My Irish ancestors have been in Australia too long for me to use Ireland for that purpose.
So I really hate Brexit for totally selfish reasons.
Some people here have been calling Daniel Andrews 'Dictator Dan', encouraged by sections of the Murdoch press. But if this was actually a dictatorship they would be killed or locked up in jail or a reeducation camp for making comments like that in the media and online. I know quite a number of people who were locked up, tortured or forced to flee their countries for being critical or being perceived to be in opposition to their dictatorial governments. One man worked with people with disabilities and wrote a letter to his government respectfully advocating that the government spend more on disability services. This landed him in jail for being critical of the government. I have full faith in this not happening in Australia in the near future or even in my lifetime without much greater societal changes or catastrophes.*
*Just wanted to add that Australia does have other policies that break human rights, but they are against non-citizens like asylum seekers coming to Australia by boat. Indigenous people are protected by law, but are still jailed and die in custody in much larger numbers than other Australians, for lesser crimes. There's definitely room for improvement here too. Sadly many Australians can't cope with 12 weeks of lock down, but see no problem with locking up asylum seekers, including children indefinitely. Boris Johnson seems to be looking to our government in some of his migration policies, I'm sorry to say.
That balance seems to me to be impossible to strike correctly if statistics on deaths attributed to covid are high-profile and published daily whilst statistics on deaths related to lockdown (such as increases in suicides, or people dying of cancer because their anti-cancer treatment was suspended so as to make room in the hospital for covid patients) are not published at all.
Yes, such statistics are difficult (in that it's arguable in each case whether lockdown was entirely responsible, or whether they would have died anyway, or something in between).
But such difficulties also apply to covid statistics. I'm told that if you're knocked down by a bus after testing positive then that goes into the statistics as a covid-related death.
We're being told a biased story, as part of talking-up the crisis.
Just not necessarily for any sinister reason relating to grabbing power...
If there were large numbers of deaths due to lockdown they would show up in excess death statistics. Importantly, though, you have to compare such deaths not with the covid deaths that happened but with what would have happened without lockdown, a larger but much less certain figure.
However, the latest rumours in the UK press are that the latest figures used to panic Boris (not a difficult task it seems) went back to the 60 days basis. Also that the "killer" graph is based on research done at Cambridge but there is a later version from the same team that is not nearly so pessimistic. But Whitty/Valance preferred to use the out of date report as it was scarier.
Now is this all lockdown-skeptic fake-rumour? Well of course it may be, since I am unable to offer proof. However it highlights the main complaint of most lockdown skeptics: the secrecy behind it all. A skeptic is a skeptic not a denier, and skepticism is, in my view, the right response to the withholding of information. Various people are calling for the evidence behind the (totally incomprehensible) scary slides to be made public. But I think it will be kept under wraps, because it will not hold up to scrutiny.
I was never a Boris voter (admittedly because I'm anti-Brexit so the last election was a no brainer, and sadly a no hoper). But it is beyond me to see how he imagines anyone can take him seriously after yet another U-turn, without giving current regional lockdowns a chance to work, even with stricter rules. He really does not seem to have the slightest capacity for coherent thought, or maintaining a strategy for more that a week. Could his attention span actually be shorter than Trump's?
So what has he left? His moral integrity? Quite.
I hope we have a meaningful debate in Parliament on Wednesday.
From what I can gather some figures were this crude some months ago. Since when things have become more sophisticated.
And almost by definition, if you base everything on Worst Case (say 99%-ile probability) you will make it seem worse than it is.
The other thing is that people have a vested interest in keeping up their reputation. So if you start pessimistic, you have to maintain that it really is as bad as you first feared.
I think you're right, which I find depressing because it means nobody will be called to account for the harm they have done. Sad but true.
The science advisors were working off the consensus when they started advising that a lockdown was necessary before the Cambridge report. Even the consensus, with which the revised Cambridge projection is in line, has it that the NHS would be overwhelmed in December without a lockdown.
Even omitting the first alarmist version of the Cambridge projection, the scientific consensus was that the three tier system was never going to work.
The takeaway from all this is that Johnson has no ulterior motive to lockdown and every ulterior motive not to lock down. As you say, it makes him "not seem to have the slightest capacity for coherent thought, or maintaining a strategy for more that a week". (Although many of us thought that of him long before now.) It makes his backbench MPs who have been consistently lobbying for less stringent measures annoyed. It means he picked a fight with Burnham for nothing. It hands Starmer the chance to say if you'd locked down when I told you it would have saved lives and hit the economy less hard. There is absolutely nothing in it for Johnson, other than that it really is necessary and well past overdue.
1. Lockdown is the wrong response and/or the consequences of not locking down have been exaggerated;
2. The decision to lock down was made with inadequate Parliamentary scrutiny.
Most Shipmates (myself included) are unlikely to agree with (1) as written, but I think there is nevertheless universal common ground that bad decisions have been made.
Would those decisions have been any better with more Parliamentary scrutiny? My democratic instincts would like to say Yes. OTOH, the record of the 2017-19 Parliament on Brexit is atrocious; regardless of the merits of individual MPs, collectively they acted like utter morons when presented with a problem more complicated than 'Shall we support the Cabinet or not?' But it is really depressing to think the answer would be No.
1. LS contend that guiding policy by models with no hard evidence to be even in the right ballpark, is mistaken. Referring of course, but not solely to the IC model. Now you may believe it's a lie that the existing track record of this modelling team is wildly out. The code quality is abysmal and a lot of the data needed to critique the model is not being revealed. This could be a whole thread in itself, which given a narrow focus could get somewhere. So LS really believes that the idea of hundreds of thousands of deaths is pure fantasy, not an acceptable option. The whole validity of modelling is worth discussing.
2. "To save the economy" is not a remotely fair statement to describe what I think is the missing side of the lockdown cost/benefit equation. Nobody denies that severe economic damage costs lives. Most LS believe that at the end of the day, lockdown will cause as many or more deaths than it saves, but this a a totally unprovable claim, as is it's converse, namely lockdown saved more lives than it cost. But why is it unreasonable to ask for a lockdown justification that gives both sides of the equation, and from the appearance of W/V at the select committee, they agree, and mentioned a report giving a figure of 200,000 collateral deaths without trashing it. SAGE has no economists (is this wise?), but somebody should be doing this work. Why was the work previously being done stopped, if it was.
3. "Mainly of old people". This is where I can see why some think: lockdown skeptic = total bastard, just like abortion clinic = extermination camp. I intensely dislike emotion in argument, but I know that I am an outlier in this and where the lives of the perceived undefended are in play most people are not going to think that emotion is out of place.
It is perfectly true that a lot of sceptic arguments much prefer to use QALYs rather than simple deaths, when assessing the benefits of lockdown and this leads to a lowering of the tragedy-scale when the person is already close to death (aka OLD). If you believe it is fundamentally immoral to attach money values to lives in order to assess the cost-benefit of a treatment (as I believe NICE does) there is probably no room for discussion. Just like if you view a foetus as a child desperately in need of protection you are probably not emotionally capable of discussing abortion rights. And to be honest, I can't see any way forward on this.
Sometime we just flat out disagree. And, of course, we haven't even raised the issue of civil rights.
W/V is Chris Whitty and Sir Patrick Vallance - expert advisers on SAGE
QALY is Quality Adjusted Life Years
OLD is just aged written in capitals
QALY stands for quality-adjusted life years. The idea is that if you're a health organisation with limited resources and you want to prioritise your spending so it's most effective you need to have some way of putting a number on how much good you're doing so you can compare a hip replacement for a seventy year old with a cataract operation for a twenty year old with a heart transplant for a fifty five year old and decide which ones are giving best value for money.
The idea behind a QALY is that you survey lots of people to see how many years of life they'd trade for being blind. Then having worked out that people value a year of being blind at 80% of a year of full sight you say that the cataract operation gives you QALYs equal to a fifth of the life expectancy of the person who gets it.
There are some people, who call their movement effective altruism, who build that into a general theory of ethical giving: I think there are too many problems in the assumptions behind the methodology to justify that.
But that's really not very relevant to the question whether or not it is ethically justifiable to consider the actual achieved life extension coupled with the quality of life, which is the basis of the QALY approach. I once heard a pop-singer turned campaigner (Billy Bragg) when pressed, saying that a spend of £1m to prolong the life of a old person by one week was ethically necessary "because you cannot make cost judgements about life". Now he's maybe extreme, but I would guess that the majority of people on this Ship believe it is ethically wrong to factor the age profile of COVID deaths into any discussion of the cost-benefit of an intervention. I disagree but this type of conviction is very deeply held.
Apologies. I'll avoid abbreviations which can be annoying.