Title: Health policy approaches to measuring and valuing human life: conceptual and ethical issues.

POPLINE Document Number: 108667

Author(s):

Morrow RH
Bryant JH

Source citation:

AMERICAN JOURNAL OF PUBLIC HEALTH, 1995 Oct;85(10):1356-60.

Abstract:

In order to achieve the most cost-effective and equitable use of health resources, health care decision makers need better ways to define disease burdens and guide resource allocations. Resource allocation decisions in sectors other than health are based upon benefits obtained per dollar expended. During the last two decades, composite indicators which combine losses due to disability and premature mortality have been developed as a measure of disease burden and as an outcome indicator for health status in economic analyses. With the increasing use of these indicators, it is timely to examine potential conceptual and ethical issues related to the measuring and valuing of human life. The authors review the healthy life approach of the Ghana Health Assessment Team, the quality-adjusted life year approach, and the World Development Report disability-adjusted life year approach. The review covers conceptual and ethical issues generic to the use of composite indicators for measuring and valuing life, highlights issues specific to the methods used in the World Development Report, and provides suggestions to refine the approach for developing tools to assist in more rational resource allocation decisions. Further refinement of the tools is needed to incorporate national and local values into weighting, elaborate methods for disaggregating calculations to assess local disease patterns and intervention packages, and develop guidelines for estimating the marginal effects and costs of interventions. It is of the utmost importance that equity be ensured during the attempt to achieve reasonable efficiency.

Keywords:

Social Policy
Measurement
Value Orientation
Ethics
Delivery of Health Care
Policy
Research Methodology
Psychological Factors
Behavior
Health