QALYs—A Threat to our Quality of Life?

ABSTRACT QALY calcuations are currently being considered in the UK as a way of showing how the National Health Service (NHS) can do the most good with its resources. After providing a brief summary of how QALY calculations work and the most common arguments for and against using them to set NHS priorities, I suggest that they are an inadequate measure of the good done by the NHS because they refer only to its effects on what will be defined as the 'patient community'. The benefit of the NHS to the wider community is best regarded as a public good—everyone benefits from the general belief that the NHS is there to provide care for those who fall into a state of medical need. QALY ideology threatens this belief because it gives efficiency a higher priority than caring in response to need. It is a fallacy that a QALY maximising health service will be a greater good to society, because this sort of quest for efficiency threatens the caring basis of the Welfare State as such.     

Couples' Concurrent Cognitions The Influence of Relational Satisfaction on the Thoughts Couples Have as They Converse

Studies of cognition in relationships show that people's thoughts about their partners shape and reflect the quality of relationships. Some research further suggests that women's cognitions are more relationship-centered than men's. The data supporting these arguments, however, often are based on partners' retrospective reports or responses to hypothetical scenarios. This study examined partners' concurrent cognitions—the thoughts they have during the course of interaction. Data were collected using a modification of “protocol analysis.” Partners conversed over networked computers and also voiced what they were thinking. Results indicated that those who were dissatisfied with their relationship expressed significantly more negative thoughts about their partner, fewer positive thoughts about their partner, and fewer positive thoughts about their relationship than did those who were satisfied. Dissatisfied men vocalized fewer negative thoughts about themselves than did those who were satisfied. ‘Women's thoughts were not more focused on relationship-oriented issues than were men's; men expressed more negative cognitions about relationships. The findings confirm that there are distinctions between the concurrent cognitions of satisfied and dissatisfied partners. Researchers should continue questioning the influence of gender on the ways partners evaluate their relationships.     

THE CONCEPTUAL DOMAIN OF INTERPERSONAL COMMUNICATION BEHAVIOR: A FACTOR-ANALYTIC STUDY

A provisional taxonomy of interpersonal behavior, ordered as a circumplex, was empirically derived from both the phenomenological and public communication ratings of subjects. At both levels, ratings were most prominently influenced by a Control dimension, made up of the perceptions of socially undesirable behaviors. The circular arrangements of the variables showed that a gap existed in the active and passive affective quadrants. It was suggested that revision of the IBI incorporate the affective dimensions associated with the findings of interpersonal competence research and that communication researchers give appropriate emphasis to the affective domain of interpersonal behavior.