Monday, October 22, 2012

Value of a Human Life

What is the value of a human life?  Though this may seem like a philosophical or theoretical question, it becomes a very practical, but rarely considered one, especially when laws are proposed or proponents for change use the argument “if only one life is saved, it’s worth it.”  These choices imply a value, often without admitting it and without considering the impact of changes.  (This posting expands on the question from last time about how much society owes certain classes of victims.)

Many would argue that a life is priceless, that the value can’t be determined.  It is a gift from God not to be degraded by setting a price.  Though this may be true from a religious or philosophical viewpoint, we are often faced with the question of how much of our limited resources we are willing to spend to save a life.  Is it practical to spend a trillion dollars on a particular gadget or medical research to save one life – or a dozen, how about 100 or 1,000?  Could that money be better spent to save ten thousand or more?  Resources are not unlimited.  Someone must decide.  Is this best done on a case-by-case basis as so often happens today?

Recently the Supreme Court ruled that states have the option to enact more-inclusive Medicaid standards.  To do so will cost taxpayers.  A study completed at Harvard suggests that expanding Medicaid could reduce deaths among non-elderly Medicaid recipients by about 96,500 per year.  They compared data from states with expanded programs to data from nearby states without.  The head researcher admits, ‘‘I can’t tell you for sure that this is a cause-and-effect relationship, that the Medicaid expansion caused fewer nonelderly adults to die,” but the study was well designed using the best available data.  Now the question becomes, is it worth the investment?  Should states make the change?  Reviewing several sources, I found that there would be 17 million additional recipients at an annual cost from $77.4 billion to $112 billion (estimates vary).  That would be an expenditure of $802,000 to $1,160,000 per life saved.  By making (or not making) this decision they implicitly put a value on a human life.

Since 2001 the federal government requires that all passenger cars have a trunk release handle.  This became an issue after 11 children died in locked car trunks in 1998.  Although this was not a typical year for such incidents, it started a groundswell of support led by an advocacy group called the Trunk Releases Urgently Needed Coalition.  At a government-estimated cost of $2.00 per passenger car, that comes to around $14 million annually.  This cost was treated as irrelevant because “if it saves just one child, it’s worth it.”  Even using the unusually high rate of 1998, that’s an implied value of about $1.3 million per child's life or more.

Earlier this year the State of Indiana along with other parties involved with entertainment at the 2011 State Fair offered $13.2 million to the victims of the stage collapse.  Five were killed and over 50 injured.  The proposed distribution of the payout was not made public, but somehow that amount was reached.  Again, it implied a value to the 5 lives lost.  The FAA is more forthcoming and generous, assigning a value of $6.2 million per life when evaluating the cost/benefit of new rules for airlines.

I think you can see what I’m getting at.  It’s always tempting to spend great gobs of money, our money, on safety devices, legal settlements and regulations.  Although it may seem cold and unfeeling, we cannot pass laws or make social decisions on the basis of “if it just saves one life, it’s worth it.”  We don’t have unlimited resources.  This is the hard edge, but necessary application, of critical thinking.  Why should we leave these ever-more-frequent decisions to bureaucrats, politicians, judges, juries, appeals courts and big business risk management departments to make on a piecemeal and arbitrary basis with no guidelines and no controls?  Unfortunately that's exactly what will happen, because in an America with so few critical thinkers, the if-it-saves-one-life advocates will always win the hearts and souls of the public, while politicians will always shrink from making these necessary, but unpopular decisions.

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