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In this article, the author comments on the report of reseracher P. Littlejohns and his colleagues on the National Institute for Health and Clinical Excellence (NICE) against charges of ageism. He mentions that Littlejohns entirely miss the requirements of the Equality Act 2010. Further the author focuses on the concept of ageing.

Continues the debate between the author and Peter Singer et al started in the volume 21, number three issue of the `Journal of Medical Ethics,' about the ethical respectability of the use of Quality Adjusted Life Years (QALY) in health care allocation. Calculations of probability; Interests of the rational egoist who must choose from behind a veil of ignorance.

The article discusses the cost effectiveness of health benefits offered in Great Britain. To have an idea on the gains made and the gains forgone, NICE should know accurately which gains have foregone. According to Claxton and Culyer, neither NICE or any decision making entity can know which NHS activities will be under their guidance or if these decisions will forego any specific benefit. It is also noted that NICE is making decisions that is based on the moral evaluation and cost effectiveness of alternative resources.