Age and the Disvalue of Death

Abstract

Summary measures of health or well-being must assign a value to averting death and relate it to the value of preventing or curing morbidity. The authors address two key questions about how to value the prevention of death: (1) how the age at which someone dies affects how bad their death is and (2) at what age death starts to be bad for the decedent. Current practice includes, by default, views about both questions that the authors think are mistaken. Regarding (1), the authors argue in favor of gradualism: the value assigned to preventing mortality should gradually increase during early cognitive development, so that the prevention of perinatal deaths is assigned a lower value than the prevention of the deaths of older children. Regarding (2), value should be assigned to preventing deaths from the point of the onset of sentience—at around 28 weeks gestational age—so that the prevention of stillbirths is also valued. The authors tentatively suggest a function for calculating the disvalue of death at different ages and apply this and alternative functions to South African data on interventions to prevent stillbirths and neonatal deaths.