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]

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

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