Kinghorn, Philip (2011). "Comparing Two Interpretations of the Capability Approach which have Emerged within the Health Literature" Paper presented at the 8th annual conference of the HDCA, 6-8 September 2011, the Hague, the Netherlands.

Resources used to produce healthcare are finite; the framework used to inform decisions regarding rationing is economic evaluation. One common form of economic evaluation used by health economists is cost-utility analysis, and in turn this is commonly operationalized using quality-adjusted life years (QALYs). However, there are a number of weaknesses with the QALY, arising from its narrow focus on health functionings. The capability approach is being explored as an alternative to the QALY. But, given the incomplete nature of the capability approach, it is unclear whether we should (i) assess the relative (or absolute) well-being of different individuals in terms of functionings or capability, health or broader quality of life; and (ii) how we should allocate scarce healthcare resources between them. This paper reports and compares two interpretations/applications of the capability approach which have emerged within the health literature. One is a more practical application of the approach, whereas the other, as yet, is largely conceptual. Both highlight the amount of compromise which may be needed in order to actually use such a vague and yet ambitious concept as capability. Each contains a particular strength, and I suggest that further research could involve matching together these differing strengths.