The wellbeing approach offers a clear solution to the basic questions in political philosophy and moral philosophy. Crucially, it provides a single overarching goal. Coherent decisions require an overarching goal, for if you have multiple goals, they may point in different directions. Aristotle recognised this but modern ’utilitarianism’ dates back to Jeremy Bentham. According to the Benthamite approach, decisions should aim to maximise the discounted sum of future wellbeing.

This is already the approach of many health policy-makers. However others believe that it is especially important to raise the wellbeing of those whose wellbeing is low. This ’prioritarian’ approach suggests looking for new policies especially in those areas which account for the most misery (on which evidence exists), and giving especial weight to the reduction of misery.

There have been many criticisms of the wellbeing approach, which the chapter discusses and tries to answer – consequentialism and rights, the experience machine, adaptation, and the nanny state. Readers who accept those criticisms are challenged to come up with an alternative philosophy that is operational.