The following questions describe the scope of this paper. When decision trees are used to analyze optimal decisions, should end nodes be evaluated on the basis of QALYs or on the basis of healthy-years equivalents? Which measures should be used in communications with others, e.g., patients? Which of these measures incorporate nsk attitudes, and which do not? It is demonstrated that the healthy-years equivalent measure does not stand scrutiny. Key words: utility; QALY; quality of life; healthy-years equivalent; standard gamble. (Med Decis Making 1996;16:207-214)