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AGE-WEIGHTING*

  • Greg Bognar (a1)
Abstract

Some empirical findings seem to show that people value health benefits differently depending on the age of the beneficiary. Health economists and philosophers have offered justifications for these preferences on grounds of both efficiency and equity. In this paper, I examine the most prominent examples of both sorts of justification: the defence of age-weighting in the WHO's global burden of disease studies and the fair innings argument. I argue that neither sort of justification has been worked out in satisfactory form: age should not be taken into account in the framework of the burden of disease measure, and on the most promising formulations of the fair innings argument, it turns out to be merely an indicator of some other factor. I conclude by describing the role of age in theories of justice of healthcare resource allocation.

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Broome J. 1988. Good, Fairness and QALYs. In Philosophy and medical welfare, ed. Bell J. M. and Mendus S., 5773. Cambridge: Cambridge University Press.
Broome J. 1999. Fairness. In Ethics out of economics, 111–22. Cambridge: Cambridge University Press.
Broome J. 2002. Measuring the burden of disease by aggregating well-being. In Summary measures of population health: Concepts, ethics, measurement, and applications, ed. Murray C. J. L., Salomon J. A., Mathers C. D. and Lopez A. D., 91113. Geneva: World Health Organization.
Busschbach J. J. V., Hessing D. J. and de Charro F. Th.. 1993. The utility of health at different stages in life: A quantitative approach. Social Science and Medicine 37, 153–8.
Callahan D. 1987. Setting limits: Medical goals in an aging society. New York: Simon & Schuster.
Cropper M. L., Aydede S. K. and Portney P. R.. 1994. Preferences for life saving programs: How the public discounts time and age. Journal of Risk and Uncertainty 8, 243–65.
Daniels N. 1985. Just health care. Cambridge: Cambridge University Press.
Daniels N. 1988. Am I my parents' keeper? An essay on justice between the young and the old. New York: Oxford University Press.
Daniels N. 1996. Problems with prudence. In Justice and justification: Reflective equilibrium in theory and practice, 284301. Cambridge: Cambridge University Press.
Daniels N., Kennedy B. and Kawachi I.. 2004. Health and inequality, or, why justice is good for our health. In Public Health, Ethics, and Equity, ed. Anand S., Peter F. and Sen A., 6391. Oxford: Oxford University Press.
Goerdt A., Koplan J. P., Robine J.-M., Thuriaux M. C. and van Ginneken J. K.. 1996. Non-fatal health outcomes: Concepts, instruments and indicators. In The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020, ed. Murray C. J. L. and Lopez A. D., 99116. Cambridge, MA: Harvard School of Public Health on behalf of the WHO and the World Bank.
Harris J. 1985. The value of life. London: Routledge & Kegan Paul.
Harris J. 1988. More and better justice. In philosophy and medical welfare, ed. Bell J. M. and Mendus S., 7596. Cambridge: Cambridge University Press.
Hausman D. M. 2007. What's wrong with health inequalities? Journal of Political Philosophy 15, 4666.
Johannesson M. and Johansson P.-O.. 1997. Is the valuation of a QALY gained independent of age? Some empirical evidence. Journal of Health Economics 16, 589–99.
Johri M., Damschroder L. J., Zikmund-Fisher B. J. and Ubel P. A.. 2005. The importance of age in allocating health care resources: Does intervention-type matter? Health Economics 14, 669–78.
Kamm F. M. 1993. Morality, mortality. Volume I: Death and whom to save from it. New York: Oxford University Press.
Kamm F. M. 2002. Health and equity. In Summary measures of population health: Concepts, ethics, measurement, and applications, ed. Murray C. J. L., Salomon J. A., Mathers C. D. and Lopez A. D., 685706. Geneva: World Health Organization.
Kappel K. and Sandøe P.. 1992. QALYs, age and fairness. Bioethics 6, 297316.
Lewis P. A. and Charny M.. 1989. Which of two individuals do you treat when only their ages are different and you can't treat both? Journal of Medical Ethics 15, 2832.
Lockwood M. 1988. Quality of life and resource allocation. In Philosophy and Medical Welfare, ed. Bell J. M. and Mendus S., 3355. Cambridge: Cambridge University Press.
McKie J., Richardson J., Singer P. and Kuhse H.. 1998. The allocation of health care resources: An ethical evaluation of the ‘QALY’ approach. Aldershot: Ashgate.
McMahan J. 2002. The ethics of killing: Problems at the margins of life. Oxford: Oxford University Press.
Murray C. J. L. 1996. Rethinking DALYs. In The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and Projected to 2020, ed. Murray C. J. L., and Lopez A. D., 198. Cambridge, MA: Harvard School of Public Health on behalf of the WHO and the World Bank.
Murray C. J. L. and Acharya A. K.. 1997. Understanding DALYs. Journal of Health Economics 16, 703–30.
Murray C. J. L., Salomon J. A., Mathers C. D. and Lopez A. D.. 2002. Summary measures of population health: Conclusions and recommendations. In Summary measures of population health: concepts, ethics, measurement, and applications, 731–56. Geneva: World Health Organization.
Nord E. 1999. Cost-value analysis in health care: Making sense out of QALYs. Cambridge: Cambridge University Press.
Nord E., Street A., Richardson J., Kuhse H. and Singer P.. 1996. The significance of age and duration of effect in social evaluation of health care. Health Care Analysis 4, 103–11.
Parfit D. 1984. Reasons and persons. Oxford: Clarendon Press.
Rodríguez E., and Pinto J. L.. 2000. The social value of health programs: is age a relevant factor? Health Economics 9, 611–21.
Tsuchiya A. 1999. Age-related preferences and age weighting health benefits. Social Science and Medicine 48, 267–76.
Tsuchiya A., Dolan P. and Shaw R.. 2003. Measuring people's preferences regarding ageism in health: some methodological issues and some fresh evidence. Social Science and Medicine 57, 687–96.
Veatch R. M. 2000. Transplantation ethics. Washington, DC: Georgetown University Press.
Williams A. 1997. Intergenerational equity: an exploration of the ‘Fair Innings’ argument. Health Economics 6, 117–32.
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Economics & Philosophy
  • ISSN: 0266-2671
  • EISSN: 1474-0028
  • URL: /core/journals/economics-and-philosophy
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