There is a truly enormous literature on using stated preference information to place a monetary value on environmental amenities. This three volume set provides the key papers for understanding the historical development of contingent valuation, its theoretical and statistical foundations, and the major controversies. It also contains representative papers covering all of the major application areas in environmental valuation.

Abstract: August 1995 - Do funding priorities for health and safety policies reflect irrational fears? the disaster of the month - rather than address more fundamental problems? A thousand people were surveyed to gauge popular feelings about funding choices between environmental and public health programs. In developing and industrial countries alike, there is concern that health and safety policy may respond to irrational fears - to the disaster of the month - rather than address more fundamental problems. In the United States, for example, some policymakers say the public worries about trivial risks while ignoring larger ones and that funding priorities reflect this view. Many public health programs with a low cost per life saved are underfunded, for example, while many environmental regulations with a high cost per life saved are issued each year. Does the existing allocation of resources reflect people's preoccupation with the qualitative aspects of risks, to the exclusion of quantitative factors (lives saved)? Or can observed differences in the cost per life saved of environmental and public health programs be explained by the way the two sets of programs are funded? Cropper and Subramanian examine the preferences of U.S. citizens for health and safety programs. They confronted a random sample of 1,000 U.S. adults with choices between environmental health and public health programs, to see which they would choose. The authors then examined what factors (qualitative and quantitative) seem to influence these choices. Respondents were asked about pairs of programs, among them: smoking education or industrial pollution control programs, industrial pollution control or pneumonia vaccine programs, radon eradication or a program to ban smoking in the workplace, and radon eradication or programs to ban pesticides. The survey results, they feel, have implications beyond the United States. They find that, while qualitative aspects of the life-saving programs are statistically significant in explaining people's choices among them, lives saved matter, too. Indeed, for the median respondent in the survey, the rate of substitution between most qualitative risk characteristics and lives saved is inelastic. But for a sizable minority of respondents, choice among programs appears to be insensitive to lives saved. The interesting question for public policy is what role the latter group plays in the regulatory process. This paper - a joint product of the Environment, Infrastructure, and Agriculture Division, Policy Research Department, and the Environment and Natural Resources Division, Asia Technical Department - is part of a larger effort in the Bank to see what can be learned about efficient environmental policy by examining the U.S. experience with environmental regulation. The authors may be contacted at mcropper@@worldbank.org or usubramanian@@worldbank.org.

There are not enough resources in health care systems around the world to fund all technically feasible and potentially beneficial health care interventions. Difficult choices have to be made, and economic evaluation offers a systematic and transparent process for informing such choices. A key component of economic evaluation is how to value the benefits of health care in a way that permits comparison between health care interventions, such as through costs per quality-adjusted life years (QALY). Measuring and Valuing Health Benefits for Economic Evaluation examines the measurement and valuation of health benefits, reviews the explosion of theoretical and empirical work in the field, and explores an area of research that continues to be a major source of debate. It addresses the key questions in the field including: the definition of health, the techniques of valuation, who should provide the values, techniques for modelling health state values, the appropriateness of tools in children and vulnerable groups, cross cultural issues, and the problem of choosing the right instrument. This new edition contains updated empirical examples and practical applications, which help to clarify the readers understanding of real world contexts. It features a glossary containing the common terms used by practitioners, and has been updated to cover new measures of health and wellbeing, such as ICECAP, ASCOT and AQOL. It takes into account new research into the social weighting of a QALY, the rising use of ordinal valuation techniques, use of the internet to collect data, and the use of health state utility values in cost effectiveness models. This is an ideal resource for anyone wishing to gain a specialised understanding of health benefit measurement in economic evaluation, especially those working in the fields of health economics, public sector economics, pharmacoeconomics, health services research, public health, and quality of life research.

To assist the implementation of benefit-cost analysis, this research report describes issues and techniques related to estimating the human health risk reduction benefits provided by actions that reduce contaminant concentrations in drinking water, and discusses how these benefits should be compared to costs. Material is relevant for evaluating the benefits and costs of federal and state regulatory actions such as setting a Maximum Contaminant Level, instituting treatment requirements, and implementing a guideline or advisory. The report will be of interest to water utility professionals, benefit- cost practitioners, and public policy decision makers. No subject index. Annotation copyrighted by Book News Inc., Portland, OR.

As life expectancy rates continue to increase in many countries around the world, comparative health assessments based on mortality rates alone give an increasingly inadequate picture of public health. This publication addresses a wide range of key issues regarding the measurement of population health using comprehensive indices which combine data on mortality and ill-health. It considers the various uses of such summary measures, as well as an appropriate measurement framework and specific ethical and social value choices involved. The contributors to this book include leading experts in epidemiological methods, ethics, health economics, health status measurement and the valuation of health states.

Budgets of governments and private insurances are limited. Not all drugs and services that appear beneficial to patients or physicians can be covered. Is there a core set of benefits that everyone should be entitled to? If so, how should this set be determined? Are fair decisions just impossible, if we know from the outset than not all needs can be met? While early work in bioethics has focused on clinical issues and a narrow set of principles, in recent years there has been a marked shift towards addressing broader population-level issues, requiring consideration of more demanding theories in philosophy, political science, and economics. At the heart of bioethics' new orientation is the goal of clarity on a complex set of questions in rationing and resource allocation. Rationing and Resource Allocation in Healthcare: Essential Readings provides key excerpts from seminal and pertinent texts and case studies about these topics, contextualized by original introductions. The volume is divided into three broad sections: Conceptual Distinctions and Ethical Theory; Rationing; and Resource Allocation. Containing the most important and classic articles surrounding the theoretical and practical issues related to rationing and how to allocate scare medical resources, this collection aims to assist and inform those who wish to be a part of bioethics' 21st century shift including practitioners and policy-makers, and students and scholars in the health sciences, philosophy, law, and medical ethics.

This volume brings together cutting-edge research from emerging and senior scholars alike representing a variety of disciplines that bears on human preferences for fairness, equity and justice. Despite predictions derived from evolutionary and economic theories that individuals will behave in the service of maximizing their own utility and survival, humans not only behave cooperatively, but in many instances, truly altruistically, giving to unrelated others at a cost to themselves. Humans also seem preoccupied like no other species with issues of fairness, equity and justice. But what exactly is fair and how are norms of fairness maintained? How should we decide, and how do we decide, between equity and efficiency? How does the idea of fairness translate across cultures? What is the relationship between human evolution and the development of morality? The collected chapters shed light on these questions and more to advance our understanding of these uniquely human concerns. Structured on an increasing scale, this volume begins by exploring issues of fairness, equity, and justice in a micro scale, such as the neural basis of fairness, and then progresses by considering these issues in individual, family, and finally cultural and societal arenas. Importantly, contributors are drawn from fields as diverse as anthropology, neuroscience, behavioral economics, bioethics, and psychology. Thus, the chapters provide added value and insights when read collectively, with the ultimate goal of enhancing the distinct disciplines as they investigate similar research questions about prosociality. In addition, particular attention is given to experimental research approaches and policy implications for some of society's most pressing issues, such as allocation of scarce medical resources and moral development of children. Thought-provoking and informative, Interdisciplinary Perspectives on Fairness, Equity, and Justice is a valuable read for public policy makers, anthropologists, ethicists, psychologists, neuroscientists, and all those interested in these questions about the essence of human nature.

This comprehensive textbook analyzes the ethical issues of health and health care in global perspective. Ideal for students of public health, medicine, nursing and allied health professions, public policy, and ethics, the book helps students in all these areas to develop important competencies in their chosen fields. Applying a comparative, or multicultural, approach, the book compares different perspectives on ethical issues in various countries and cultures, such as informed consent, withholding or withdrawing treatment, physician-assisted suicide, reproductive health issues, research with human subjects, the right to health care, rationing of limited resources, and health system reform. Applying a transnational, or cross-border, approach, the book analyzes ethical issues that arise from the movement of patients and health professionals across national borders, such as medical tourism and transplant tourism, ethical obligations to provide care for undocumented aliens, and the “brain drain” of health professionals from developing countries. Comprehensive in scope, the book includes selected readings which provide diverse perspectives of people from different countries and cultures in their own words. Each chapter contains an introductory section centered on a specific topic and explores the different ways in which the topic is viewed around the globe. Ethics in Health Services and Policy is designed to promote student participation and offers methods of activity-based learning, including factual scenarios for analysis and discussion of specific ethical issues.

The gap between a rising demand for health care services on the one side and scarce resources on the other, is leading to a growing pressure on decision-making processes. Hence, prioritization in medicine has become an increasingly important issue for assuring stability of health systems and improving the capability of health care. The present volume addresses normative dimensions of methodological and theoretical approaches, the legal basis behind priority setting as well as international experiences concerning the normative framework and the process of priority setting. It also examines specific criteria for prioritization and discusses economic evaluations. Contributing authors from a broad range of scientific disciplines discuss prioritization within an international dialogue.