Healthy, Wealthy, and Wise: The Ethics of Benefit-Cost Analysis

February 23, 2023 -
11:00am to 12:00pm

Chair: Sally Davies, Editor, Aeon magazine

In conversation with:

Matthew Adler, JD (Richard A. Horvitz Professor of Law and Professor of Economics, Philosophy and Public Policy, Duke University)

Christian Krekel, PhD (Assistant Professor in Behavioural Science, London School of Economics)

Ole F. Norheim, MD, PhD (Professor of Medical Ethics, University of Bergen)

Lisa A. Robinson, MPP (Deputy Director, Center for Health Decision Science, and Senior Research Scientist, Harvard TH Chan School of Public Health)

Abstract: Conventional benefit-cost analysis is well-established and widely used to assess policy options that profoundly affect public health globally. It is based on strong normative assumptions, however. These include measuring changes in individual welfare based on peoples’ preferences for exchanging their own money for changes in their own wellbeing, and measuring changes in societal welfare by summing these values across individuals. These assumptions are often challenged on ethical grounds. One set of questions relates to how welfare is defined. For example, should we focus on satisfying individual preferences? On maximizing other measures of wellbeing? Give priority to health over other attributes of welfare? In addition, there are worries that conventional benefit-cost analysis underweights benefits that accrue to the poor, ignores distributional impacts, relies on self-regarding rather than other-regarding (e.g., altruistic) values, and does not adequately distinguish between morally-desirable and undesirable preferences. Outcomes that are difficult to quantify or to value in monetary terms, such as respect for human dignity, also cannot be easily accommodated within this framework.

This Brocher Meetup will explore the ethical dimensions of conventional benefit-cost analysis and alternatives, focusing on approaches that compare harms and improvements using the same metric. These alternatives include the use of subjective wellbeing (“happiness”) units and social welfare functions. It will also discuss pragmatic issues related to applying these approaches to evaluate and prioritize risk reduction policies.

Sponsored by the Brocher Foundation

Location and Address

Online