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  1. added 2020-04-03
    Allocation of Scarce Biospecimens for Use in Research.Leah Pierson, Sophia Gibert, Benjamin Berkman, Marion Danis & Joseph Millum - forthcoming - Journal of Medical Ethics:medethics-2019-105766.
    Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of the research enterprise (...)
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  2. added 2020-02-25
    The Fifth Face of Fair Subject Selection: Population Grouping.Tomasz Żuradzki - 2020 - American Journal of Bioethics 20 (2):41-43.
    The article by MacKay and Saylor (2020) claims that the principle of fair subject selection yields conflicting imperatives (e.g. in the case of pregnant women) and should be understood as “a bundle of four distinct sub-principles” (i.e. fair inclusion, burden sharing, opportunity, distribution of third-party risks), each having conflicting normative recommendations (MacKay and Saylor 2020). The authors also offer guidance as to how we should navigate between subprinciples that may conflict with each other. The problem is a crucial one since (...)
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  3. added 2019-12-13
    The Case for Valuing Non-Health and Indirect Benefits.Govind Persad & Jessica du Toit - 2020 - In Ole F. Norheim, Ezekiel J. Emanuel & Joseph Millum (eds.), Global Health Priority-Setting: Beyond Cost-Effectiveness. New York, NY, USA: pp. 207-222.
    Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...)
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  4. added 2019-10-10
    Is Efficiency Ethical? Resource Issues in Health Care.Donna Dickenson - 1995 - In Brenda Almond (ed.), Introducing Applied Ethics. Oxford: Blackwell. pp. 229-246.
    How can we allocate scarce health care resources justly? In particular, are markets the most efficient way to deliver health services? Much blood, sweat and ink has been shed over this issue, but rarely has either faction challenged the unspoken assumption behind the claim made by advocates of markets: that efficiency advances the interests of both individuals and society. Whether markets actually do increase efficiency is arguably a matter for economists, but the deeper ethical question is whether efficiency is the (...)
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  5. added 2019-10-10
    Nurse Time as a Scarce Healthcare Resource.Donna Dickenson - 1994 - In Geoffrey Hunt (ed.), Ethical issues in nursing. London: Routledge. pp. 207-217.
    For a long time, discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. This narrow focus on medical resource prevents us from seeing that there are many cases-- perhaps even the majority--in which time is the real scarce resource, particularly nurse time. What ethical principles should apply to nurse time as a scarce health care resource?
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  6. added 2019-09-27
    Medical Crowdfunding, Political Marginalization, and Government Responsiveness: A Reply to Larry Temkin.Alida Liberman - 2019 - Journal of Practical Ethics 7 (1):40-48.
    Larry Temkin draws on the work of Angus Deaton to argue that countries with poor governance sometimes rely on charitable giving and foreign aid in ways that enable them to avoid relying on their own citizens; this can cause them to be unresponsive to their citizens’ needs and thus prevent the long-term alleviation of poverty and other social problems. I argue that the implications of this “lack of government responsiveness argument” (or LOGRA) are both broader and narrower than they might (...)
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  7. added 2019-07-16
    Considering Quality of Life While Repudiating Disability Injustice: A Pathways Approach to Setting Priorities.Govind Persad - 2019 - Journal of Law, Medicine and Ethics 47 (2):294-303.
    This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or (...)
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  8. added 2019-06-25
    First Come, First Served?Tyler M. John & Joseph Millum - 2019 - Ethics 130 (2):179-207.
    Waiting time is widely used in health and social policy to make resource allocation decisions, yet no general account of the moral significance of waiting time exists. We provide such an account. We argue that waiting time is not intrinsically morally significant, and that the first person in a queue for a resource does not ipso facto have a right to receive that resource first. However, waiting time can and sometimes should play a role in justifying allocation decisions. First, there (...)
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  9. added 2019-06-12
    Sufficiency, Comprehensiveness of Health Care Coverage, and Cost-Sharing Arrangements in the Realpolitik of Health Policy.Govind Persad & Harald Schmidt - 2016 - In Carina Fourie & Annette Rid (eds.), What is Enough?: Sufficiency, Justice, and Health. New York: Oxford University Press. pp. 267-280.
    This chapter explores two questions in detail: How should we determine the threshold for costs that individuals are asked to bear through insurance premiums or care-related out-of-pocket costs, including user fees and copayments? and What is an adequate relationship between costs and benefits? This chapter argues that preventing impoverishment is a morally more urgent priority than protecting households against income fluctuations, and that many health insurance plans may not adequately protect individuals from health care costs that threaten to drop their (...)
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  10. added 2019-06-06
    Justified Commitments? Considering Resource Allocation and Fairness in Médecins Sans Frontières‐Holland.Lisa Fuller - 2006 - Developing World Bioethics 6 (2):59-70.
    Non‐governmental aid programs are an important source of health care for many people in the developing world. Despite the central role non‐governmental organizations play in the delivery of these vital services, for the most part they either lack formal systems of accountability to their recipients altogether, or have only very weak requirements in this regard. This is because most NGOs are both self‐mandating and self‐regulating. What is needed in terms of accountability is some means by which all the relevant stakeholders (...)
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  11. added 2019-06-05
    The Political Ethics of Health.Daniel Weinstock - 2010 - Les Ateliers de L’Ethique 5 (1):105-118.
    This paper seeks to provide an overview of some of the main areas of debate that have emerged in recent years at the interface between theories of justice and health care. First, the paper consi- ders various positions as to what the index of justice with respect to health ought to be. It warns on practical and principled grounds against conceptual inflation of the notion of "health" as it appears in theories of distributive justice. Second, it considers how various standards (...)
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  12. added 2019-04-25
    Will More Organs Save More Lives? Cost‐Effectiveness and the Ethics of Expanding Organ Procurement.Govind Persad - 2019 - Bioethics 33 (6):684-690.
    The assumption that procuring more organs will save more lives has inspired increasingly forceful calls to increase organ procurement. This project, in contrast, directly questions the premise that more organ transplantation means more lives saved. Its argument begins with the fact that resources are limited and medical procedures have opportunity costs. Because many other lifesaving interventions are more cost‐effective than transplantation and compete with transplantation for a limited budget, spending on organ transplantation consumes resources that could have been used to (...)
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  13. added 2019-03-11
    Transparency Trade-Offs: Priority Setting, Scarcity, and Health Fairness.Govind Persad - 2019 - In I. Glenn Cohen, Barbara Evans, Holly Lynch & Carmel Shachar (eds.), Transparency in Health and Health Care. New York: Cambridge UP.
    This chapter argues that rather than viewing transparency as a right, we should regard it as a finite resource whose allocation involves tradeoffs. It then argues that those tradeoffs should be resolved by using a multi-principle approach to distributive justice. The relevant principles include maximizing welfare, maximizing autonomy, and giving priority to the worst off. Finally, it examines some of the implications for law of recognizing the tradeoffs presented by transparency proposals.
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  14. added 2019-01-11
    Pharmacogenomic Inequalities: Strategies for Justice in Biomedical Research and Healthcare.Giovanni De Grandis - 2017 - Diametros 51:153-172.
    The paper discusses the possibility that the benefits of pharmacogenomics will not be distributed equally and will create orphan populations. I argue that since these inequalities are not substantially different from those produced by ‘traditional’ drugs and are not generated with the intention to discriminate, their production needs not be unethical. Still, the final result is going against deep-seated moral feelings and intuitions, as well as broadly accepted principles of just distribution of health outcomes and healthcare. I thus propose two (...)
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  15. added 2018-10-08
    Bursting Bubbles? QALYs and Discrimination.Ben Davies - 2019 - Utilitas 31 (2):191-202.
    The use of Quality-Adjusted Life Years (QALYs) in healthcare allocation has been criticized as discriminatory against people with disabilities. This article considers a response to this criticism from Nick Beckstead and Toby Ord. They say that even if QALYs are discriminatory, attempting to avoid discrimination – when coupled with other central principles that an allocation system should favour – sometimes leads to irrationality in the form of cyclic preferences. I suggest that while Beckstead and Ord have identified a problem, it (...)
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  16. added 2018-09-05
    Calibrating QALYs to Respect Equality of Persons.Franklin Donald - 2016 - Utilitas (1):1-23.
    Comparative valuation of different policy interventions often requires interpersonal comparability of benefit. In the field of health economics, the metric commonly used for such comparison, quality adjusted life years (QALYs) gained, has been criticized for failing to respect the equality of all persons’ intrinsic worth, including particularly those with disabilities. A methodology is proposed that interprets ‘full quality of life’ as the best health prospect that is achievable for the particular individual within the relevant budget constraint. This calibration is challenging (...)
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  17. added 2018-08-30
    Animal Experimentation and the Argument From Limited Resources.Charles K. Fink - 1991 - Between the Species 7 (2):90-95.
    Animal rights activists are often accused of caring more about animals than about human beings. How, it is asked, can activists condemn the use of animals in biomedical research—research that improves human health and saves human lives? In this article, I argue that even if animal experimentation might eventually provide cures for many serious diseases, given the present state of the world, we are not justified supporting this research; rather, we ought to devote our limited resources to other forms of (...)
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  18. added 2018-08-16
    Which Values Should Be Built Into Economic Measures?S. Andrew Schroeder - 2019 - Economics and Philosophy 35 (3):521-536.
    Many economic measures are structured to reflect ethical values. I describe three attitudes towards this: maximalism, according to which we should aim to build all relevant values into measures; minimalism, according to which we should aim to keep values out of measures; and an intermediate view. I argue the intermediate view is likely correct, but existing versions are inadequate. In particular, economists have strong reason to structure measures to reflect fixed, as opposed to user-assessable, values. This implies that, despite disagreement (...)
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  19. added 2018-08-16
    How to Allocate Scarce Health Resources Without Discriminating Against People with Disabilities.Tyler M. John, Joseph Millum & David Wasserman - 2017 - Economics and Philosophy 33 (2):161-186.
    One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and argues that all (...)
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  20. added 2017-12-21
    Why Sore Throats Don't Aggregate Against a Life, but Arms Do.Alex Voorhoeve - 2015 - Journal of Medical Ethics 41 (6):492-493.
    When do claims to be saved of a small or moderate harm aggregate against a competing claim to be saved from an early death? In this short response to Kamm's Bioethical Prescriptions, I argue for the following answer: aggregation of weaker claims against a life is permitted just in case, in a one-to-one contest, a person with a weaker claim would have a personal prerogative to prioritize her claim over a stranger’s competing claim to life.
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  21. added 2017-12-21
    Making Fair Choices on the Path to Universal Health Coverage.Ole Frithjof Norheim, Trygve Ottersen, Bona Chitah, Richard Cookson, Norman Daniels, Nir Eyal, Walter Flores, Axel Gosseries, Daniel Hausman, Samia Hurst, Lydia Kapiriri, Toby Ord, Shlomi Segall, Frehiwot Defaye, Alex Voorhoeve & Alicia Yamin - 2014 - World Health Organisation.
    This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.
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  22. added 2017-12-21
    Human Enhancement: A New Issue in Philosophical Agenda.Marco Azevedo - 2013 - Princípios. Revista de Filosofía 20 (33):265-303.
    Since before we can remember, humanity aims to overcome its biological limitations; such a goal has certainly played a key role in the advent of technique. However, despite the benefits that technique may bring, the people who make use of it will inevitably be under risk of harm. Even though human technical wisdom consists in attaining the best result without compromising anybody’s safety, misuses are always a possibility in the horizon. Nowadays, technology can be used for more than just improving (...)
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  23. added 2017-12-21
    Prioriteit voor patienten met een lagere levenskwaliteit.Alex Voorhoeve - 2010 - Filosofie En Praktijk 31:40-51.
    This paper critically analyses the priority-setting rules used by the National Institute for Health and Clinical Excellence (NICE) in the UK and proposed by the Netherlands' Council on Public Health and Health Care (RVZ). It argues that neither gives proper weight to improving the lot of those who are worse off than others.
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  24. added 2017-12-21
    Egészségpolitika és etika (Health Policy and Ethics).Attila Tanyi & Zsofia Kollanyi - 2008 - DEMOS Studies, DEMOS Hungary.
    This book provides a survey of the ethical aspects of health care resources distribution. It first distinguishes health from health care in an effort to clear up the ethical landscape. After this, still with the same purpose, it makes a distinction between problems of macro-allocation and micro-allocation. In the rest of the book two questions of macro-allocation are treated in some detail. First, several approaches – in particular: utilitarian, egalitarian, communitarian, and libertarian – to the question whether we have a (...)
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  25. added 2017-12-18
    Biotechnology, Justice and Health.Ruth Faden & Madison Powers - 2013 - Journal of Practical Ethics 1 (1):49-61.
    New biotechnologies have the potential to both dramatically improve human well-being and dramatically widen inequalities in well-being. This paper addresses a question that lies squarely on the fault line of these two claims: When as a matter of justice are societies obligated to include a new biotechnology in a national healthcare system? This question is approached from the standpoint of a twin aim theory of justice, in which social structures, including nation-states, have double-barreled theoretical objectives with regard to human well-being. (...)
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  26. added 2017-12-13
    How (Not) to Argue for the Rule of Rescue. Claims of Individuals Versus Group Solidarity.Marcel Verweij - 2015 - In Gohen Glen, Daniels Norman & Eyal Nir (eds.), Identified versus Statistical Victims. An Interdisciplinary Perspective. Oxford University Press. pp. 137-149.
    The rule of rescue holds that special weight should be given to protecting the lives of assignable individuals in need, implying that less weight is given to considerations of cost-effectiveness. This is sometimes invoked as an argument for funding or reimbursing life-saving treatment in public healthcare even if the costs of such treatment are extreme. At first sight one might assume that an individualist approach to ethics—such as Scanlon’s contractualism—would offer a promising route to justification of the rule of rescue. (...)
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  27. added 2017-12-12
    The Post-2015 Development Agenda: Keeping Our Focus On the Worst Off.D. Sharp - 2015 - American Journal of Tropical Medicine and Hygiene 92 (6):1087-89.
    Non-communicable diseases now account for the majority of the global burden of disease and an international campaign has emerged to raise their priority on the post-2015 development agenda. We argue, to the contrary, that there remain strong reasons to prioritize maternal and child health. Policy-makers ought to assign highest priority to the health conditions that afflict the worst off. In virtue of how little healthy life they have had, children who die young are among the globally worst off. Moreover, many (...)
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  28. added 2017-10-02
    Public Preferences About Fairness and the Ethics of Allocating Scarce Medical Interventions.Govind Persad - 2017 - In Meng Li & David Tracer (eds.), Interdisciplinary Perspectives on Fairness, Equity, and Justice. pp. 51-65.
    This chapter examines how social- scientific research on public preferences bears on the ethical question of how those resources should in fact be allocated, and explain how social-scientific researchers might find an understanding of work in ethics useful as they design mechanisms for data collection and analysis. I proceed by first distinguishing the methodologies of social science and ethics. I then provide an overview of different approaches to the ethics of allocating scarce medical interventions, including an approach—the complete lives system—which (...)
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  29. added 2017-09-11
    Why One Should Count Only Claims with Which One Can Sympathize.Alex Voorhoeve - 2017 - Public Health Ethics 10 (2):148-156.
    When one faces competing claims of varying strength on public resources for health, which claims count? This paper proposes the following answer. One should count, or aggregate, a person’s claim just in case one could sympathize with her desire to prioritize her own claim over the strongest competing claim. It argues that this principle yields appealing case judgments and has a plausible grounding in both sympathetic identification with each person, taken separately, and respect for the person for whom most is (...)
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  30. added 2017-09-04
    Are Indirect Benefits Relevant to Health Care Allocation Decisions?Jessica Du Toit & Joseph Millum - 2016 - Journal of Medicine and Philosophy 41 (5):540-557.
    When allocating scarce healthcare resources, the expected benefits of alternative allocations matter. But, there are different kinds of benefits. Some are direct benefits to the recipient of the resource such as the health improvements of receiving treatment. Others are indirect benefits to third parties such as the economic gains from having a healthier workforce. This article considers whether only the direct benefits of alternative healthcare resource allocations are relevant to allocation decisions, or whether indirect benefits are relevant too. First, we (...)
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  31. added 2017-08-21
    Balancing Small Against Large Burdens.Alex Voorhoeve - 2018 - Behavioural Public Policy 2 (1):125-142.
    Common principles for resource allocation in health care can prioritize the alleviation of small health burdens over lifesaving treatment. I argue that there is some evidence that these principles are at odds with a sizable share of public opinion, which holds that saving a life should take priority over any number of cures for minor ailments. I propose two possible explanations for this opinion, one debunking and one vindicatory. I also outline how well-designed surveys and moral inquiry could help decide (...)
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  32. added 2017-04-28
    Health Inequalities and Relational Egalitarianism.J. Paul Kelleher - 2016 - In Rebecca L. Walker Mara Buchbinder & Michele Rivkin-Fish (eds.), Understanding Health Inequalities and Justice: New Conversations across the Disciplines. University of North Carolina Press.
    Much of the philosophical literature on health inequalities seeks to establish the superiority of one or another conception of luck egalitarianism. In recent years, however, an increasing number of self-avowed egalitarian philosophers have proposed replacing luck egalitarianism with alternatives that stress the moral relevance of distinct relationships, rather than the moral relevance of good or bad luck. After briefly explaining why I am not attracted to luck egalitarianism, I seek in this chapter to distinguish and clarify three views that have (...)
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  33. added 2017-03-11
    Dilemmas in Access to Medicines: A Humanitarian Perspective – Authors' Reply.Ezekiel J. Emanuel & Govind Persad - 2017 - Lancet 387 (10073):1008-1009.
    Our Viewpoint argues that expanding access to less effective or more toxic treatments is supported not only by utilitarian ethical reasoning but also by two other ethical frameworks: those that emphasise equality and those that emphasise giving priority to the patients who are worst off. The inadequate resources available for global health reflect not only natural constraints but also unwise social and political choices. However, pitting efforts to reduce inequality and better fund global health against efforts to put available resources (...)
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  34. added 2016-09-23
    Pandemics - Background Paper.Giovanni De Grandis & Jasper Littmann - 2011 - Forward Look Archive.
    The background paper provides an introduction to the concept of pandemics and to the ethical and political issues related with pandemic preparedness.
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  35. added 2016-08-27
    The Ethics of Expanding Access to Cheaper, Less Effective Treatments.Govind C. Persad & Ezekiel J. Emanuel - 2016 - The Lancet:S0140-6736(15)01025-9.
    This article examines a fundamental question of justice in global health. Is it ethically preferable to provide a larger number of people with cheaper treatments that are less effective (or more toxic), or to restrict treatments to a smaller group to provide a more expensive but more effective or less toxic alternative? We argue that choosing to provide less effective or more toxic interventions to a larger number of people is favored by the principles of utility, equality, and priority for (...)
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  36. added 2016-08-25
    Global Bioethics and Political Theory.Joseph Millum - 2012 - In Joseph Millum & Ezekiel J. Emanuel (eds.), Global Justice and bioethics. Oxford University Press. pp. 17-42.
    Most bioethicists who address questions to which global justice matters have not considered the significance of the disputes over the correct theory of global justice. Consequently, the significance of the differences between theories of global justice for bioethics has been obscured. In this paper, I consider when and how these differences are important. I argue that certain bioethical problems can be resolved without addressing disagreements about global justice. People with very different views about global justice can converge on the existence (...)
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  37. added 2016-08-18
    Should Research Ethics Encourage the Production of Cost-Effective Interventions?Govind Persad - 2016 - In Daniel Strech & Marcel Mertz (eds.), Ethics and Governance of Biomedical Research: Theory and Practice. Springer. pp. 13-28.
    This project considers whether and how research ethics can contribute to the provision of cost-effective medical interventions. Clinical research ethics represents an underexplored context for the promotion of cost-effectiveness. In particular, although scholars have recently argued that research on less-expensive, less-effective interventions can be ethical, there has been little or no discussion of whether ethical considerations justify curtailing research on more expensive, more effective interventions. Yet considering cost-effectiveness at the research stage can help ensure that scarce resources such as tissue (...)
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  38. added 2016-08-18
    Expanding Deliberation in Critical-Care Policy Design.Govind C. Persad - 2016 - American Journal of Bioethics 16 (1):60-63.
    In this commentary, I suggest expanding the deliberative aspects of critical care policy development in two ways. First, critical-care policy development should expand the scope of deliberation by leaving fewer issues up to expertise or private choice. For instance. it should allow deliberation about the relevance of age, disability, social position, and psychological well-being to allocation decisions. Second, it should broaden both the set of costs considered and the set of stakeholders represented in the deliberative process. In particular, it should (...)
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  39. added 2015-10-05
    Priority Setting, Cost-Effectiveness, and the Affordable Care Act.Govind Persad - 2015 - American Journal of Law and Medicine 41 (1):119-166.
    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA’s provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither (...)
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  40. added 2015-10-05
    Principles for Allocation of Scarce Medical Interventions.Govind Persad, Alan Wertheimer & Ezekiel J. Emanuel - 2009 - The Lancet 373 (9661):423--431.
    Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and (...)
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  41. added 2015-10-05
    Are Physicians Willing to Ration Health Care? Conflicting Findings in a Systematic Review of Survey Research.Daniel Strech, Govind Persad, Georg Marckmann & Marion Danis - 2009 - Health Policy 90 (2):113-124.
    Several quantitative surveys have been conducted internationally to gather empirical information about physicians’ general attitudes towards health care rationing. Are physicians ready to accept and implement rationing, or are they rather reluctant? Do they prefer implicit bedside rationing that allows the physician–patient relationship broad leeway in individual decisions? Or do physicians prefer strategies that apply explicit criteria and rules?
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  42. added 2015-10-04
    Standing by Our Principles: Meaningful Guidance, Moral Foundations, and Multi-Principle Methodology in Medical Scarcity.Govind C. Persad, Alan Wertheimer & Ezekiel J. Emanuel - 2010 - American Journal of Bioethics 10 (4):46 – 48.
    In this short response to Kerstein and Bognar, we clarify three aspects of the complete lives system, which we propose as a system of allocating scarce medical interventions. We argue that the complete lives system provides meaningful guidance even though it does not provide an algorithm. We also defend the investment modification to the complete lives system, which prioritizes adolescents and older children over younger children; argue that sickest-first allocation remains flawed when scarcity is absolute and ongoing; and argue that (...)
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  43. added 2014-10-19
    Incidence, Prevalence, and Hybrid Approaches to Calculating DALYs.S. Andrew Schroeder - 2012 - Population Health Metrics 10 (19).
    When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don’t discount the value of future health, there is a sense in which the choice of calculation method is a mere question (...)
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