Public Valuation of Lifesaving: The Controllability Issue

点击翻译按钮获取中文摘要

Public Valuation of Lifesaving: The Controllability IssueAbstractRisk analysts frequently use cost-effectiveness analysis to make decisions about the relative value of different policy options. Embedded in these analyses is the assumption that one life saved is equal to any other. Research has shown, however, that people think about the value of lives as affected by other qualitative factors, such as the risks people take and whether those risks are controllable by the individual or undertaken voluntarily. This project will explore how controllability and voluntariness influence peoples' valuation of lives in policy contexts.Specifically, an instrument will be developed to measure people's preferences for the valuation of lives. Like values or beliefs, preferences are challenging to measure because people can be unsure of or reluctant to reveal their preferences, and hence unable to answer survey questions. Previous researchers have devised a variety of techniques to overcome these difficulties, with varying success. Focus groups, cognitive interviews and survey pre-testing will be used to explore different methods for measuring preferences, and to develop an approach that produces stable and unbiased results of peoples' valuation of lives that are exposed to controllable or uncontrollable, and voluntary or involuntary risks.Three real-world, lifesaving scenarios will be used to elicit preferences: (1) airbag design to preferentially protect belted versus unbelted drivers, (2) liver transplant in persons with liver damage secondary to alcohol use versus other causes, (3) and regulatory priority for indoor versus outdoor sources of air pollution. Real-world topics that are well-defined and compelling offer the best opportunity to develop appropriate tools because they are familiar and interesting to people. The final product of this research will be a survey instrument that can measure how much the controllability and voluntary nature of risk-taking affects how people value lives saved by risk prevention and risk reduction policies. Once collected, this measurement could be directly incorporated into policy analyses that inform decisions about which policies are most desired by the public. This may allow policy decisions to be adjusted for people's preferences about the nature of lives that are saved by risk prevention and risk reduction policies.