How should different life expectancies be valued?

BMJ 1998;317:1155 ( 24 October )

Letters

How should different life expectancies be valued?

Existential model may be better than scale that uses quality adjusted life years

Diminishing marginal utility and discounting future effects have similar consequences

Existential model may be better than scale that uses quality adjusted life years

The first 150 words of the full text of this article appear below.

EDITOR $---$ Problems with the valuation of life expectancy and quality adjusted life years¹ can be traced to the underlyingphilosophical paradigm. The quality adjusted life year paradigmis based on 19th century classical utilitarianism. The greatestgood is perfect health, which is valued at 1; being dead (andthe event of death) has the value of 0. Other states are givenvalues of <1; states judged worse than death may be given negativevalues.²

This century, philosophers such as Martin Heidegger and Sir Karl Popper have put forward ideas that differ from those of theutilitarians and suggest an alternative model of how to valuehealth. Heidegger's premise is that we are unaware of things whenthey are normal; our conscious concern is with the abnormal. Forexample, we are not aware of using a door handle when we entera room unless it is broken.³ We are not consciously . . . [Full text of this article]

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

How should different life expectancies be valued?: Norman Waugh and David Scott
BMJ 1998 316: 1316. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Cucherat, M. (2007). Quantitative relationship between resting heart rate reduction and magnitude of clinical benefits in post-myocardial infarction: a meta-regression of randomized clinical trials. Eur Heart J 28: 3012-3019 [Abstract] [Full text]
Katz, K. A. (2006). The (relative) risks of using odds ratios.. Arch Dermatol 142: 761-764 [Abstract] [Full text]
EPSTEIN, D. H. (2003). Problems With Odds Ratios. Am. J. Psychiatry 160: 190-191 [Full text]
Feihl, F., Melot, C., Brimioulle, S., Her, C., Ho, K. M., Patel, S. R., Harris, R. S., Malhotra, A., Yoon, T. S., Kupfer, Y., Tessler, S., Nuckton, T. J., Eisner, M. D., Matthay, M. A. (2002). Pulmonary Dead Space and Survival. NEJM 347: 850-852 [Full text]
Ray, J.G., O'brien, T.E., Chan, W.S. (2001). Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysis. QJM 94: 435-444 [Abstract] [Full text]
Akins, P. T., Schneweis, S., Tirschwell, D., Furlan, A., Wechsler, L., Gent, M., Higashida, R., Roberts, R. (2000). Intra-arterial Prourokinase for Acute Ischemic Stroke. JAMA 283: 2102-2104 [Full text]
Altman, D. G, Deeks, J. J, Sackett, D. L (1998). Odds ratios should be avoided when events are common. BMJ 317: 1318-1318 [Full text]