Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T19:55:11.636Z Has data issue: false hasContentIssue false
  • English
  • Français

Which values should be built into economic measures?

Published online by Cambridge University Press:  28 February 2019

S. Andrew Schroeder Open the ORCID record for S. Andrew Schroeder [Opens in a new window]
S. Andrew Schroeder*
Affiliation:
Department of Philosophy, Claremont McKenna College, 850 Columbia Ave, Claremont, CA 91711, USA
*
Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Many economic measures are structured to reflect ethical values. I describe three attitudes towards this: maximalism, according to which we should aim to build all relevant values into measures; minimalism, according to which we should aim to keep values out of measures; and an intermediate view. I argue the intermediate view is likely correct, but existing versions are inadequate. In particular, economists have strong reason to structure measures to reflect fixed, as opposed to user-assessable, values. This implies that, despite disagreement about precisely how to do so, economists should standardly adjust QALYs and DALYs to reflect egalitarian values.

Keywords

values in economicsmeasurementinequalityDALYQALY
Type
Article
Information
Economics & Philosophy , Volume 35 , Issue 3 , November 2019 , pp. 521 - 536
Check for updates
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adler, M. 2012. Well-Being and Fair Distribution. Oxford: Oxford University Press.Google Scholar
Anand, S. and Hanson, K. 1997. Disability-adjusted life years: a critical review. Journal of Health Economics 16, 685–702.CrossRefGoogle ScholarPubMed
Anand, S. and Hanson, K. 1998. DALYs: efficiency versus equity. World Development 26, 307–310.CrossRefGoogle Scholar
Anand, S., Diderichsen, F., Evans, T., Shkolnikov, V. M. and Wirth, M. 2001. Measuring disparities in health: methods and indicators. In Evans, T., Whitehead, M., Diderichsen, F., Bhuiya, A. and Wirth, M. (eds), Challenging Inequities in Health: From Ethics to Action. Oxford: Oxford University Press, pp. 49–67.Google Scholar
Arnesen, T. and Kapiriri, L. 2004. Can the value choices in DALYs influence global priority-setting? Health Policy 70, 137–149.CrossRefGoogle ScholarPubMed
Barendregt, J. J., Bonneux, L. and Van der Maas, P. J. 1996. DALYs: the age-weights on balance. Bulletin of the World Health Organization 74, 439–443.Google ScholarPubMed
Bognar, G. 2008. Age-weighting. Economics and Philosophy 24, 167–189.CrossRefGoogle Scholar
Douglas, H. 2009. Science, Policy, and the Value-Free Ideal. Pittsburgh, PA: University of Pittsburgh Press.CrossRefGoogle Scholar
Elliott, K. 2006. An ethics of expertise based on informed consent. Science and Engineering Ethics 12, 637–661.CrossRefGoogle ScholarPubMed
Eyal, N., Hurst, S. A., Norheim, O. F. and Wikler, D. (eds) 2013. Inequalities in Health: Concepts, Measures, and Ethics. Oxford: Oxford University Press.CrossRefGoogle Scholar
Gakidou, E., Murray, C. J. and Frenk, J. 2000. Defining and measuring health inequality: an approach based on the distribution of health expectancy. Bulletin of the World Health Organization 78, 42–54.Google ScholarPubMed
Lyttkens, C. H. 2003. Time to disable DALYs? European Journal of Health Economics 4, 195–202.CrossRefGoogle ScholarPubMed
McKaughan, D. J. and Elliott, K. C. 2013. Backtracking and the ethics of framing: lessons from voles and vasopressin. Accountability in Research 20, 206–226.CrossRefGoogle ScholarPubMed
McKaughan, D. J. and Elliott, K. C. 2018. Just the facts or expert opinion? The backtracking approach to socially responsible science communication. In Priest, S., Goodwin, J. and Dahlstrom, M. F. (eds), Ethics and Practice in Science Communication. Chicago, IL: University of Chicago Press, pp. 197–213.Google Scholar
Menzel, P., Gold, M., Nord, E., Pinto-Prades, J., Richardson, J. and Ubel, P. 1999. Toward a broader view of values in cost-effectiveness analysis of health. Hastings Center Report 29, 7–15.CrossRefGoogle Scholar
Murray, C. 1996. Rethinking DALYs. In Murray, C. and Lopez, A. (eds), The Global Burden of Disease. Geneva: World Health Organization, pp. 1–98.Google ScholarPubMed
Murray, C. and Acharya, A. 1997. Understanding DALYs. Journal of Health Economics 16, 703–730.CrossRefGoogle ScholarPubMed
Murray, C., et al. 2012. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet 380, 2197–2223.CrossRefGoogle ScholarPubMed
Nord, E. 1999. Cost-Value Analysis in Health Care. Cambridge: Cambridge University Press.CrossRefGoogle ScholarPubMed
Polinder, S., Haagsma, J. A., Stein, C. and Havelaar, A. H. 2012. Systematic review of general burden of disease studies using disability-adjusted life years. Population Health Metrics 10, 21.CrossRefGoogle ScholarPubMed
Reiss, J. 2013. Philosophy of Economics: A Contemporary Introduction. London: Routledge.CrossRefGoogle Scholar
Reiss, J. 2017. Fact-value entanglement in positive economics. Journal of Economic Methodology 24, 134–149.CrossRefGoogle Scholar
Schokkaert, E. 2015. How to introduce more (or better) ethical arguments into HTA? International Journal of Technology Assessment in Health Care 31, 1–2.CrossRefGoogle ScholarPubMed
Schroeder, S. A. 2017a. Value choices in summary measures of population health. Public Health Ethics 10, 176–187.Google Scholar
Schroeder, S. A. 2017b. Using democratic values in science: an objection and (partial) response. Philosophy of Science 84, 1044–1054.CrossRefGoogle Scholar
Schroeder, S. A. 2017c. Consequentializing and its consequences. Philosophical Studies 174, 1475–1497.CrossRefGoogle Scholar
Sen, A. 1992. Inequality Reexamined. Cambridge, MA: Harvard University Press.Google Scholar
Stiglitz, J. E., Sen, A. and Fitoussi, J.-P. 2010. Mis-measuring Our Lives: Why GDP Doesn’t Add Up. New York, NY: The New Press.Google Scholar
Temkin, L. 1996. Inequality. Oxford: Oxford University Press.Google Scholar
Tsuchiya, A. 2000. QALYs and ageism: philosophical theories and age weighting. Health Economics 9, 57–68.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Verguet, S., Kim, J. J. and Jamison, D. T. 2016. Extended cost-effectiveness analysis for health policy assessment: a tutorial. PharmacoEconomics 34, 913–923.CrossRefGoogle ScholarPubMed
Voigt, K. 2012. Measuring global health. In Lenard, P. and Straehle, C. (eds), Global Justice and Health Inequalities. Edinburgh: Edinburgh University Press, pp. 139–156.CrossRefGoogle Scholar
Vos, T. 2002. Shifting the goalpost– normative survivorship goals in health gap measures. In Murray, C., Salomon, J., Mathers, C. and Lopez, A. (eds), Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications. Geneva: World Health Organization, pp. 267–272.Google Scholar
World Health Organization. 2000. The World Health Report 2000: Health Systems: Improving Performance. Geneva: World Health Organization.Google Scholar
World Health Organization. 2014. Making Fair Choices on the Path to Universal Health Coverage. Geneva: World Health Organization.Google Scholar
Williams, A. 1997. Intergenerational equity: an exploration of the ‘fair innings’ argument. Health Economics 6, 117–132.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Williams, A. 1999. Calculating the global burden of disease: time for a strategic reappraisal? Health Economics 8, 1–8.3.0.CO;2-B>CrossRefGoogle ScholarPubMed