Centre for Philosophy, Justice and Health

Evaluation and Measurement of Health and Wellbeing

The evaluation and measurement of health and wellbeing is a key theme of CPJH. A number of our recent conferences addressed it, including The Ethics and Economics of the Global Response to HIV/AIDS (2012), How Can We Set Priorities in Health Fairly? (2012) and NICE, age discrimination, and end of life treatments (2010). Some recent projects, reports, and publications include:

Social Values and Health Priority Setting

Jointly led by UCL's School of Public Policy, King's College London Medical School and NICE international and in collaboration with a host of international partners, this research project aims to compare the decisions made about resource allocation in health care by different countries, and to explore the differing social values that shape those choices. In the light of these analyses, the researchers aim to develop a set of principles to guide policy makers in any country when facing the ‘values challenge’ of health care prioritisation.  A seminar series on Social Values and Health Priority Setting is running in Autumn 2012. For more on the project, see http://www.ucl.ac.uk/socialvalues.

Priority Setting and Value Based Pricing

Shepley Orr, Steve Morris and Jo Wolff were commissioned by Pfizer to consider the question of what values could be included in a health priority allocation method under the new proposed system of value based pricing. The resulting report (2011) examines a number of potential values, and ranks them on a traffic light system for inclusion or exclusion, and can be downloaded here.

Preference, Experience and Capability Measures of Health

How should health should be measured for public policy purposes? Current measures use the quality adjusted life year (QALY) or disability adjusted life year (DALY). The QALY bases valuations of health on public preferences. But is it right to consult the public rather than professionals or patients? And should be base valuations on preferences, rather than 'experience' or 'capability' measures? And what difference does it make? In this project, a number of members of CPJH proposed a reconciliatory approach to evaluating healthcare interventions. For the output, see Wolff, J and Edwards, S and Richmond, S and Orr, S and Rees, G (2011) Evaluating Interventions In Health: A Reconciliatory Approach. Bioethics 10.1111/j.1467-8519.2011.01888.x.

Value of Life and Health

Jonathan Wolff and Shepley Orr were asked by the Inter-Departmental Group on the Value of Life and Health, which includes the Treasury, the Department of Health, the Department of Transport, NICE, and around ten other government departments, to provide a report on the value of life and health for the purposes of public policy decision-making. The central questions addressed concern how the quality adjusted life-year (QALY), used in health decision making relates to the value of preventing a fatality (VPF) uses in transport, and when it is, and is not, appropriate to use this values. Further issues discussed include the question of how questions of equity can be taken account of in public policy decision-making. The resulting report (2009) can be downloaded here.