> So defrauding millions to accrue QALYs (for whom?) is morally acceptable? Under most utilitarian theories of ethics, I think it's morally required, if you ca

> So defrauding millions to accrue QALYs (for whom?) is morally acceptable? Under most utilitarian theories of ethics, I think it's morally required, if you can show the fraud really does yield a significantly higher QALY count. The best out I can see to argue the fraud is not required is to show that another course of action will yield even more QALYs. Then you'd be obligated you do that instead. That, of course, comes to another fundamental flaws of utilitarianism, namely the belief that you can know what the results of your actions will be with any meaningful completeness or certitude. You can't. Without that it's all just excuses that justify whatever you want to do.