 This may be granted, but it remains true that bioethicists who rely on the notion of “quality of life” in this context tend to assume, usually without argument, that quality of life is an objective phenomenon that incorporates autonomy, accomplishments and a reasonable array of opportunities to live a full life (see, e.g., Brock 1995, 2005). It is, of course, this objective sense that QALYs was intended to quantify by means of evaluations of health states, either by population or expert ranking, or by means of preference elicitation techniques. Invariably these ranking exercises show that quality of life decreases directly with the severity of the disabling condition.