NEWS STORY: Panel Debates How to Assign Relative Values to Lives

c. 2005 Religion News Service WASHINGTON _ President Bush declared in absolute terms that people such as Terri Schiavo deserve “a presumption in favor of life,” but his budget office is taking a relative approach to valuing life that runs counter to the ethics of the pro-life movement. By Bush’s logic, all life is equally […]

c. 2005 Religion News Service

WASHINGTON _ President Bush declared in absolute terms that people such as Terri Schiavo deserve “a presumption in favor of life,” but his budget office is taking a relative approach to valuing life that runs counter to the ethics of the pro-life movement.

By Bush’s logic, all life is equally valuable and should be treated as such by officials, public policy experts said. At the Office of Management and Budget, however, officials want to use “quality of life” factors such as people’s health and age in making regulations.


Underlying the work of the budget office is a bottom-line moral dilemma: Given limited government resources, how should federal agencies choose whom they try to protect from illness, accident and death?

“We can’t bankrupt ourselves to protect everybody,” said Carl Cranor, a professor of philosophy at the University of California, Riverside, and a member of a panel reviewing federal rule-making.

Following Schiavo’s death Thursday, Bush again called for government to help promote a “culture of life.” But pro-life advocates said this week that the approach favored by Bush’s budget office raises the potential for agencies to undermine his stated goal.

“This business about discrimination based on the quality of people’s lives or based on their age have been concerns of ours,” said Richard Doerflinger, deputy director of pro-life activities at the U.S. Conference of Catholic Bishops. “When they do appear in a specific policy, we have reacted to them negatively and said this is not the way the government should be doing its job.”

Others said they hope the Schiavo case will highlight the gap between presidential rhetoric and administrative action. Advocates for the elderly and the disabled called on Bush and Congress to respond by doing more to safeguard their civil rights.

“The Terri Schiavo situation creates an opportunity for us to shine a light on why we don’t like assessments of efficacy based on assessments of quality of life,” said Andy Imparato, president of the American Association of People With Disabilities. “To me, it invites discrimination based on the general public’s tendency to devalue the quality of a disabled person’s life.”

The White House budget office serves as a gatekeeper of regulations across the federal bureaucracy, setting policies that affect how agencies protect human health and safety, from highway design to industrial air emissions.


For most major rule proposals, agencies compare costs of compliance with the value of benefits. While costs are relatively easy to identify, agencies have a harder time measuring the benefits of preventing premature deaths, especially those of the sick or elderly.

Lacking a better yardstick, many agencies count benefits in dollars. The Environmental Protection Agency, for example, in recent years has chalked up a standard, $6.1 million benefit for every premature death prevented by reductions in air pollution.

Under Bush, the White House budget office has scrutinized whether that approach does the most good for society. And it has raised difficult moral questions: Can a single dollar amount reflect the value of a healthy 40-year-old as well as a 65-year-old with chronic illness?

In 2002, the budget office helped prepare an “alternative analysis” of Bush’s Clear Skies Initiative that assigned benefits per “life year” realized by reduced emissions. The result was a lower value for the lives of older people that critics dubbed “the senior discount.”

A spokesman for the budget office declined to comment for this article. But in previous interviews, top officials have said they had drawn on the work of Richard Zeckhauser, a professor at Harvard University’s Kennedy School of Government and a pioneer in applying quality of life measures to regulations.

In Zeckhauser’s view, most people would agree that it makes intuitive sense to save the lives of younger, healthier people. Many would apply the same logic to their own lives, putting a higher value on their healthy years than those that might be spent in a nursing home near the end of life, he said.


“Most people wouldn’t pay just to save lives, they would pay to promote life quality,” Zeckhauser said. “So of course there are moral values associated with that. It’s giving people what they say they want.”

Currently, the budget office is sponsoring a two-year review of federal agencies’ efforts to value benefits of regulation. A 16-member panel assembled by the National Academies of Science is scheduled to make its report in December.

The panel will focus on what the budget office calls “cost effectiveness.” Ideally, the method would identify efficient ways to save lives or avoid accidents. But it still relies on government officials to make relative judgments about quality of life.

Doerflinger said many in the pro-life movement haven’t recognized the moral questions raised by the regulatory process because they haven’t witnessed a case like Schiavo’s where government action led to a preventable death.

“To a lot of people, it seems like a murkier and more abstract problem,” Doerflinger said.

But Cranor, a member of the panel, said that from a moral standpoint, the stakes are the same. Even if regulators can’t see the faces or know the names of people affected by their choices, they know by statistical inference that they hold real lives in their hands.


“Can you imagine yourself meeting one of these people who could have been protected by regulation, and what do you say? You’re too expensive and it was the right thing to do?” Cranor said.

“Where you have statistics, you have some living, breathing human being with a life and family,” he added. “I think it’s important not to lose sight of that.”

PH/JM END BARNETT

(Jim Barnett writes for the Oregonian of Portland, Ore.)

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