The value of health states is often understood to depend on their impact on the goodness of people's lives. As such, prominent health states metrics are grounded in particular conceptions of wellbeing – e.g. hedonism or preference satisfaction. In this paper, I consider how liberals committed to the public justification requirement – the requirement that public officials choose laws and policies that are justifiable to their citizens – should evaluate health states. Since the public justification requirement prohibits public officials from (...) appealing to controversial conceptions of the good life, liberals committed to this principle face a significant puzzle. (shrink)

Policy-makers must allocate scarce resources to support constituents’ health needs. This requires policy-makers to be able to evaluate health states and allocate resources according to some principle of allocation. The most prominent approach to evaluating health states is to appeal to the strength of people’s preferences to avoid occupying them, which we refer to as decision utility metrics. Another approach, experienced utility metrics, evaluates health states based on their hedonic quality. In this article, we argue that although decision utility metrics (...) face a number of significant problems, the appropriate response to these problems is not to replace them with experienced utility metrics. Rather, decision utility metrics should be employed in conjunction with experienced utility metrics. Specifically, respondents to decision utility surveys should be provided with the results of experienced utility metrics in an effort to make their decisions better informed and more robust to the deficiencies of decision utility metrics. Ultimately, this approach would improve quality-adjusted life year calculations and enhance the decision-making of policy-makers in allocating resources to support constituents’ health needs. (shrink)

Desire theories of well-being claim that how well someone’s life goes for them is entirely determined by the fulfilment and frustration of their desires. This thesis considers the viability of theories of this sort. It examines a series of objections that threaten to undermine these views. These objections claim that desire theories of well-being are incorrect because they have implausible implications. I consider four main objections over the course of this thesis. The first claims that these theories are incorrect because (...) they implausibly entail that self-sacrifice does not exist. The second claims that these theories are incorrect because they implausibly entail that severe depression does not diminish the well-being of those afflicted by this condition. The third claims that these theories are incorrect because they have implausible implications about the relative importance of fleeting desires, long-standing desires, and fluctuations in desire strength to well-being. The fourth claims that these theories are incorrect because they fail to capture the intuition that desire fulfilments which leave us disappointed and bereft of feelings of satisfaction do not improve well-being. In each of these cases, I find that desire theories of well-being have sufficient resources to refute these objections. The primary finding of this thesis is that many of the arguments against desire theories of well-being are unsuccessful. A secondary set of findings concern observations about the structure of human psychology. (shrink)