Ethics and values in welfarism and extra-welfarism

Abstract

This chapter focuses on the ethical values that underpin different types of economic evaluation. Welfarism, the standard health maximization approach to extra-welfarism, and a capability approach to extra-welfarism are all discussed in terms of the different values incorporated. Alternative decision rules around maximization and sufficiency are also examined. These theoretical discussions are then supplemented by two case studies related to mental health. The first considers the relative priority that might be given to depression treatment relative to a variety of physical health conditions, using both forms of extra-welfarism. The second explores the use of health and capability measures in interventions for drug addiction. The evidence presented indicates that interventions for mental health conditions will receive different priorities where different value judgements form the basis for the economic evaluation. This underlines the importance of these ethical decisions.