Why It Matters That Some Are Worse Off Than Others: An Argument against the Priority View

Otsuka, Michael; Voorhoeve, Alex

doi:10.1111/j.1088-4963.2009.01154.x

Cited by 85 publications

(71 citation statements)

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“…While the latter can motivate standard Cost-Effectiveness Analysis (CEA) with QALYs, prioritarianism can motivate CEA with the so-called equity-weighted QALYs 5–7. As for divisions within prioritarianism, there is an ongoing debate over the relative virtues of ex ante and ex post prioritarianism 8 9. To sidestep this complex issue, we will assume certainty about outcomes so as to eliminate the distinction between the worse off ex ante and ex post.…”

Section: Introductionmentioning

confidence: 99%

Lifetime QALY prioritarianism in priority setting

Ottersen

2012

J Med Ethics

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Two principles form the basis for much priority setting in health. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. Jointly, these principles accord with so-called prioritarianism. Crucial for its operationalisation is the specification of the worse off. In this paper, we examine how the worse off can be defined as those with the fewer lifetime Quality-Adjusted Life Years (QALYs). We contrast this proposal with several alternative specifications.

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Section: Introductionmentioning

confidence: 99%

Lifetime QALY prioritarianism in priority setting

Ottersen

2012

J Med Ethics

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“…Once a coin has been tossed once, there is then no need to do it again. 3 It is also favorably considered and applied in Meyer and Mookherjee (1987), Harel et al (2005), Otsuka and Voorhoeve (2007), Roemer (2007).…”

mentioning

confidence: 99%

Assessing Risky Social Situations

Fleurbaey¹

2010

Journal of Political Economy

188

148

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This paper re-examines the welfare economics of risk. It singles out a class of criteria, the "expected equally-distributed equivalent", as the unique class which avoids serious drawbacks of existing approaches. Such criteria behave like ex-post criteria when the final statistical distribution of wellbeing is known ex ante, and like ex-ante criteria when risk generates no inequality. The paper also provides a new result on the tension between inequality aversion and respect of individual ex ante preferences, in the vein of Harsanyi's aggregation theorem.

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“…Michael Otsuka and Alex Voorhoeve 19 cite survey evidence that individuals are indifferent to the distribution of costs and benefits when it comes to intra-personal trade-offs; individuals apply what appears to be a 'utilitarian' normative framework: they maximise expected utility. 20 For example, people are indifferent between a treatment that would entirely cure their slight impairment, and treatment that would turn their very severe impairment into a somewhat less severe impairment, given a 50/50 antecedent risk of having either condition.…”

Section: Intra-personal Trade-offsmentioning

confidence: 99%

Rose's Prevention Paradox

Thompson

2016

J Applied Philosophy

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Geoffrey Rose's 'prevention paradox' occurs when a population-based preventative health measure that brings large benefits to the community -such as compulsory seatbelts, a 'fat tax', or mass immunisation -offers little to each participating individual. Although the prevention paradox is not obviously a paradox in the sense in which philosophers understand the term, it does raise important normative questions. In particular, should we implement population-based preventative health measures when the typical individual is not expected to gain from them? After canvassing other attempts to address the paradox, I argue that what is significant about the prevention paradox is that it involves intra-personal trade-offs; the costs and benefits of the choice to implement or not implement a preventative health measure fall on the same individuals. The intra-personal nature of these trade-offs has two implications. First, the solutions to the paradox proposed by other authors are deficient. Second, the policy choice to not implement some preventative health measures can be normatively justified.

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Why It Matters That Some Are Worse Off Than Others: An Argument against the Priority View

Cited by 85 publications

References 0 publications

Lifetime QALY prioritarianism in priority setting

Lifetime QALY prioritarianism in priority setting

Assessing Risky Social Situations

Rose's Prevention Paradox

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