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PubMed2000

Uncertain lifetime, life protection, and the value of life saving.

The analytic innovation is treating life's end as uncertain, and life expectancy as partly the product of individuals' efforts to self-protect against mortality and morbidity risks. The demand for self-protection is modeled in a stochastic, life-cycle framework under alternative insurance options. The model helps explain the trend and systematic diversity in life expectancies across different population groups, as well as the wide variability in reported "value of life saving" estimates. The analysis yields a closed-form solution for individuals' value of life saving that is estimable empirically. It reflects the impacts of specific personal characteristics and alternative insurance options on both life expectancy and its valuation.

Humans↗
PubMed1990

[The value of life and limb].

Assessment of the value of life and limbs is a controversial subject, not only emotionally but also theoretically. The economic starting point is based on assessment of the value of reduction or increase of the probability for an event which leads to disability or death. No concern is expressed for the single individual but for the phenomenon of probability where the person or persons who are affected by an event cannot be identified. Assessment of the value is in monetary units. The obvious discrepancy between the expression "value of life and limbs" and the theoretical content of the analysis has involved many misunderstandings. Attempts are made to elucidate and explain these. There is e.g. another method of assessing the value of life and limbs, the human capital method. In this, the disability and the premature death (compared with the current time) by means of loss of occupational income are assessed. The method is criticized and is discarded on the basis of theoretical arguments and consequences, the calculations of which are employed. Unfortunately, it has proved tempting to employ the method because it is relatively easy to make the calculations. Finally, the parts played by some recent questionnaire methods for assessment of alterations of risks are discussed. Assessment of the value of alterations in risks is an important requirement in order to carry out relevant cost-benefit analyses in the health sector. In cases where this is not possible, these analyses are meaningless.

Cost-Benefit Analysis↗
PubMed1983

[Significance of the measurement of placental perfusion by radionuclides in prenatal diagnosis in pregnancies at risk].

The evaluation of placental perfusion measurements in 102 high-risk pregnancies from the 28th to 41st gestational week is described. --Following an injection of In113m-chloride, the half-life value of the rise in activity was determined by computer evaluation according to a single-compartment model. --Mean value of the half-life value of the rise of the placental perfusion curve is 12.55 +/- 2.42 seconds (33 normal test persons). --A half-life value of 20.62 +/- 2.43 seconds was determined in high-risk pregnancies. --In cases of EPH-gestosis a half-life value of 22.55 +/- 3.64 seconds was determined. Individual cases showed values of 50 seconds for gestosis. There was no correlation between the half-life value and the size of the placenta and or gestational age.

Female↗
PubMed1997

The values of life.

In Life's Dominion Dworkin aims at defusing the controversy about abortion and euthanasia by redefining its terms. Basically it is not a dispute about the right to life, but about its value. Liberals should grant that human life has not only a personal, but also an intrinsic value; conservatives should accept the principle of toleration which requires to let people decide for themselves about matters of intrinsic value. Dworkin fails, however, to distinguish between two kinds of personal value: (1) the value of something to a person, when he actually or dispositionally desires it, or finds it pleasant; and (2) the value of something to a person, when it's objectively contributes to his well-being, as defined by reference to his personal point of view, whether or not he ever perceives it as so contributing. He also fails to distinguish between two meanings of the concept of 'intrinsic value': (3) ultimate, i.e. non-instrumental personal value of kind (2); (4) the impersonal value of something which is not good-for-anybody, but simply good, i.e. not a constituent of someone's well-being. Dworkin argues that the human fetus from conception onwards has a value, that it is not a personal value of kind (1), and therefore must be an intrinsic value. But the value of the life of the fetus is not a personal value of kind (2) either and therefore not an intrinsic value of kind (3): it is normally a constituent of the well-being of the pregnant woman, but that doesn't constitute its value, and it is not good 'for' the fetus itself in the relevant sense, because it doesn't have a personal point of view. If, however, the fetus' life is allowed to have an intrinsic value of kind (4), the conservative cannot be refuted by appeal to the principle of toleration, for this only concerns intrinsic value of kind (3). The liberal, indeed, should recognize that the fetus' life has a value, but it is neither a personal value (1) or (2), nor an impersonal value (4), but rather a relational value which gradually develops from some point substantially later than conception.

Abortion, Induced↗
PubMed1982

The economic value of life: linking theory to practice.

Human capital estimates of the economic value of life have been routinely used in the past to perform cost-benefit analyses of health programs. Recently, however, serious questions have been raised concerning the conceptual basis for valuing human life by applying these estimates. Most economists writing on these issues tend to agree that a more conceptually correct method to value risks to human life in cost-benefit analyses would be based on individuals.' "willingness to pay" for small changes in their probability of survival. Attempts to implement the willingness-to-pay approach using survey responses or revealed-preference estimates have produced a confusing array of values fraught with statistical problems and measurement difficulties. As a result, economists have searched for a link between willingness to pay and standard human capital estimates and have found that for most individuals a lower bound for valuing risks to life can be based on their willingness to pay to avoid the expected economic losses associated with death. However, while these studies provide support for using individual's private valuation of forgone income in valuing risks to life, it is also clear that standard human capital estimates cannot be used for this purpose without reformulation. After reviewing the major approaches to valuing risks to life, this paper concludes that estimates based on the human capital approach--reformulated using a willingness-to-pay criterion--produce the only clear, consistent, and objective values for use in cost-benefit analyses of policies affecting risks to life. The paper presents the first empirical estimates of such adjusted willingness-to-pay/human capital values.

Adolescent↗
PubMedDate not supplied

Half-life of oxazaphosphorines in biological fluids.

Plasma AUC and half-life values for cyclophosphamide were determined in rats manipulated to hydroxylate cyclophosphamide at different rates; plasma AUC and apparent half-life values for two pharmacologically important metabolites of cyclophosphamide, viz. 4-hydroxycyclophosphamide/aldophosphamide and phosphoramide mustard, were also determined in these animals. Apparent plasma half-life values for 4-hydroxycyclophosphamide/aldophosphamide and phosphoramide mustard increased with an increase in plasma half-life values for cyclophosphamide. AUC values for cyclophosphamide increased approximately linearly with an increase in its plasma half-life but AUC values for 4-hydroxycyclophosphamide/aldophosphamide and phosphoramide mustard remained approximately constant with an increase in their respective apparent plasma half-life values. Given that the cytotoxic effects of cyclophosphamide are directly proportional to AUC values for 4-hydroxycyclophosphamide/aldophosphamide and/or phosphoramide mustard, we conclude that changes in the rate of cyclophosphamide hydroxylation will not alter the systemic toxic and therapeutic responses to a given dose of cyclophosphamide. Actual half-life values for 4-hydroxycyclophosphamide/aldophosphamide and phosphoramide mustard after the iv infusion of these agents were also determined. A comparison of the actual plasma half-life values for cyclophosphamide (29 min), 4-hydroxycyclophosphamide/aldophosphamide (14 min), and phosphoramide mustard (14 min) with the apparent plasma half-life values obtained for 4-hydroxycyclophosphamide/aldophosphamide (34 min) and phosphoramide mustard (55 min) following cyclophosphamide administration suggests that the major determinant with regard to the apparent plasma half-life of 4-hydroxycyclophosphamide/aldophosphamide is its rate of formation whereas in the case of phosphoramide mustard, an additional determinant, perhaps efflux from the cell, is operative.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

The value of life and accident costing: a willingness-to-pay study amongst motorcyclists in Malaysia.

Motorcyclists constitute a large proportion of total road casualties in Asian countries Unfortunately, studies conducted for the purpose of evaluating the cost of traffic crashes, and cost-benefit analyses of safety interventions, are almost nonexistent in these countries. The loss-of-output approach to valuing life has been used for many years, yet this method has also long been criticised as it results in significant resource misallocation. This study attempts to overcome this problem by estimating the value of a statistical life among motorcyclists using the willingness-to-pay method that is commonly used in developed countries. The study recommends adopting a value of MYR1.1 million (almost five times the previous estimate) per statistical life for public policy analysis involving motorcycle safety.

Accidents, Traffic↗
PubMed2002

Years of potential life lost and valued years of potential life lost in assessing premature mortality in Slovenia.

AIM: To determine the leading causes of death that contribute most to premature mortality in Slovenia; to classify premature mortality according to the cause of death, age, and sex; and to determine the age point before which premature mortality becomes a potential loss to the society. METHOD: Potential economic losses to society were estimated by use of years of potential life lost (YPLL), with a cut-off point at 65 years, and valued years of potential life lost (VYPLL) methods. We calculated the sex-, age-, and underlying causes of death-specific YPLL and VYPLL for residents of Slovenia who died at age younger than 65 years, using Slovene sex-specific life expectancy for 1998/1999 and age-specific weights of investment-producer-consumer model. RESULTS: In 1998, 4,558 YPLL per 100,000 population were lost to Slovenia. We found bimodal age distribution of YPLL, with the first peak in the 20-24 year age group and the second in the 45-49 year age group. Men to women rate ratio was 2.5. The leading causes of YPLL were external causes of death, followed by malignant neoplasms, and cardiovascular diseases. External causes, including suicides and traffic accidents, were the leading causes of death in men, whereas malignant neoplasms, including breast cancer and digestive cancer, were top-ranking causes in women. Among those, only external causes of death produced positive VYPLL, indicating a net loss to the society. CONCLUSION: In Slovenia, YPLL peaked in the 20-24 and 45-49 year age groups. Only external causes of death, most of which were preventable, accounted for the net economic loss to Slovenian society. We believe that YPLL and VYPLL, as specific mortality measures, can be reliably used in the evaluation of leading causes of death before age 65 and potential economic loss to the society caused by those deaths, and that they should be taken into account when setting public health priorities.

Adolescent↗
PubMed1987

Gender, firm size, industry, and estimates of the value-of-life.

Two national probability samples are used to investigate four empirical questions associated with estimating the value-of-life using coefficients from wage regressions. The four questions pertain to whether wage regression coefficients on fatality rate variables are sensitive to (1) including or excluding women from the sample, (2) definitions of the fatality rate which include estimates of either male only or female only deaths, (3) removing the influence of firm size from the fatality rate or the wage rate, (4) respondents' inaccuracies in reporting their three-digit industry. Problems associated with (3) and (4) are found to be minimal. Problems associated with (1) and (2) also appear to be small if the goal is to estimate the value-of-life for men.

Accidents, Occupational↗
PubMed2001

An internalist view on the value of life and some tricky cases relevant to it.

If we understand death as the irreversible loss of the good life, we can give meaning to the idea that for suffering patients in the end stage of their illness, life may become an evil and death no longer a threat. Life may lose its good already in the living person. But what does the good of life consist in, then? I defend an internalist view according to which the goodness of life is intrinsically related to the attitudes, concerns, interests and experiences of the person who is leading the life. This results in the contention that the core of what we understand as the value of the person's life is to be identified with what makes life go well for the person living the particular life. This internalist view does not presuppose (or imply) hedonism or mentalism, nor does it pose an experience requirement. Something may be good for you, because it is valuable as seen from your authentic viewpoint, even if you do not actually experience this goodness, or think otherwise because you are mistaken about your own well-being. To test this position, and the authenticity-requirement it includes, I discuss three cases of patients who are persistent in denying that in their life any value is left and who contend that death is not worse than further living. Internalism acknowledges that in the life of these patients there may be 'functionings' and 'beings' that are worthwhile, where the test of value is at least partially independent of subjective assessment. Still, internalism claims that something truly valuable can only contribute to the good of one's life of it has positive meaning as seen from the attitudinal viewpoint that identifies oneself.

Attitude to Death↗
PubMed1999

The concept of the person and the value of life.

The concept of the person has come to be intimately connected with questions about the value of life. It is applied to those sorts of beings who have some special value or moral importance and where we need to prioritize the needs or claims of different sorts of individuals. "Person" is a concept designating individuals like us in some important respects, but possibly including individuals who are very unlike us in other respects. What are these respects and why are they important? This paper sets out to answer these questions and to develop a coherent and useful concept of the person.

Animal Rights↗
PubMed1983

Placing a value on life and limb: the role of the informed consumer.

What is the value of a human life? As the resources available for medical care are constrained, and as our ability to create new and expensive ways to prolong life grows, this question becomes relevant. By observing decisions to spend money to prolong life, we can estimate what is actually spent per year of life saved. By observing decisions not to spend money, we can see when someone decided it cost too much to save a life. This literature is critically reviewed here. Problems of measurement are considered, and decisions are found to be inconsistent.

Cost-Benefit Analysis↗
PubMed1985

Association of the positive inotropic action of ouabain with a second species of digitalis receptors.

Studies were conducted to determine whether Na-K ATPase or a second species of digitalis receptors in canine cardiac sarcolemma membrane preparations is associated with the positive inotropic action of nontoxic concentrations of ouabain. [3H]ouabain association and dissociation experiments using highly enriched sarcolemma preparations from canine ventricle indicate the presence of two species of ouabain binding receptors. Ouabain binding to Na-K ATPase of the sarcolemma preparation requires supporting ligands and is characterized by fast association and very slow dissociation in vitro. The second species of digitalis receptor does not require supporting ligands for ouabain binding and is characterized by slow association and fast dissociation. To determine which species of digitalis receptor is associated with the positive inotropic action of digitalis, ouabain washout experiments were conducted using various isolated canine myocardial preparations. Washout of the positive inotropic effects of 1.2-2.4 X 10(-7) M ouabain gave half-life values of 1.5-2.0 h for the various myocardial preparations. [3H]ouabain dissociation from the second species of digitalis receptors gave half-life values of 1.7-1.8 h, whereas dissociation from the sarcolemma Na-K ATPase gave half-life values of 8.9-9.3 h for the various sarcolemma preparations utilized. Therefore, based on similarities in half-life values between ouabain inotropy and [3H]ouabain dissociation from the second class of digitalis receptors, it is postulated that the positive inotropic action of digitalis glycosides is associated with the second species of digitalis receptors in the sarcolemma and not with the digitalis inhibitory receptor of Na-K ATPase for nontoxic concentrations of digitalis.

Animals↗
PubMed2001

The value of remaining lifetime is close to estimated values of life.

Workers under 50 on average will spend 10-20% of their future hours working. So, assuming they value leisure time at the wage rate, the value of their lives is 5-10 times their future lifetime earnings. This value is close to values of life estimated by compensating wage differentials or willingness to pay.

Adult↗
PubMed1995

Health policy approaches to measuring and valuing human life: conceptual and ethical issues.

To achieve more cost-effective and equitable use of health resources, improved methods for defining disease burdens and for guiding resource allocations are needed by health care decision makers. Three approaches are discussed that use indicators that combine losses due to disability with losses due to premature mortality as a measure of disease burden. These indicators can also serve as outcome measures for health status in economic analyses. However, their use as tools for measuring and valuing human life raises important questions concerning the measurement of mortality and the multidimensions of morbidity; valuing of life, particularly regarding weighting productivity, dependency, age, and time-preference factors; and conflicts between equity and efficiency that arise in allocation decisions. Further refinement of these tools is needed to (1) incorporate national and local values into weighting; (2) elaborate methods for disaggregating calculations to assess local disease patterns and intervention packages; and (3) develop guidelines for estimating marginal effects and costs of interventions. Of utmost importance are methods that ensure equity while achieving reasonable efficiency.

Cost of Illness↗
PubMed1987

QALYfying the value of life.

This paper argues that the Quality Adjusted Life Year or QALY is fatally flawed as a way of priority setting in health care and of dealing with the problem of scarce resources. In addition to showing why this is so the paper sets out a view of the moral constraints that govern the allocation of health resources and suggests reasons for a new attitude to the health budget.

Ethics, Medical↗