Can we address critiques of the DALY framework by selecting moral weighting frameworks that are appropriate for our particular applications, addressing methodological critiques when they get raised, and taking care to contextualize our usage of a particular framework? - Maybe.
I’m pretty sure the answer is “No, we can’t”. The whole point of DALY is that it lets us compare completely different interventions. If you replace it with something that is different in each context, you have not replaced it.
I think the best we can do is to calibrate it better, buy asking actual disabled people about their life quality. I think the answer will be very different depending on the disability, and also surrounding support and culture. This can be baked in, but you can’t change the waits around for different interventions.
Sorry if my comment was unclear. I don’t mean that we should use a different set of weights when looking at different interventions, I mean that we should use different weighting frameworks depending on the types of questions we are trying to ask. If we’re trying to quantify the impacts of different interventions on health outcomes, the post-2010 DALY scale might be reasonable. If we’re trying to quantify the impacts of different interventions on wellbeing, then WELLBYs might be reasonable. If we value improvements in health outcomes independent of their impact on subjective wellbeing, then some type of blended framework (e.g. GiveWell’s moral weighting scheme) might make sense.
I’ll return to the RP Moral Weights Project as an example of what I’m critiquing (the Moral Weight Project is fantastic in lots of ways, I don’t mean to say the whole project is bad because of this one critique). For the project, the authors are trying to develop weights that express animals’ changes in hedonic wellbeing in terms of human DALYs. But it’s not clear that DALYs are a coherent unit for what they’re trying to measure. The give trying to “estimate the welfare gain from, say, moving layer hens from cages to a cage-free system” as an example of the kind of application they’re looking at. But locking a human in a cage wouldn’t obviously change the number of DALYs gained in the world, at least under the post-2010 definition. For that application, a unit that included subjective wellbeing would make a lot more sense. That’s the kind of thing I’m trying to get at.
But I do agree with you that asking disabled people about their experiences and incorporating those results into whatever weighting scale we use is a very valuable step!
I’m pretty sure the answer is “No, we can’t”. The whole point of DALY is that it lets us compare completely different interventions. If you replace it with something that is different in each context, you have not replaced it.
I think the best we can do is to calibrate it better, buy asking actual disabled people about their life quality. I think the answer will be very different depending on the disability, and also surrounding support and culture. This can be baked in, but you can’t change the waits around for different interventions.
Sorry if my comment was unclear. I don’t mean that we should use a different set of weights when looking at different interventions, I mean that we should use different weighting frameworks depending on the types of questions we are trying to ask. If we’re trying to quantify the impacts of different interventions on health outcomes, the post-2010 DALY scale might be reasonable. If we’re trying to quantify the impacts of different interventions on wellbeing, then WELLBYs might be reasonable. If we value improvements in health outcomes independent of their impact on subjective wellbeing, then some type of blended framework (e.g. GiveWell’s moral weighting scheme) might make sense.
I’ll return to the RP Moral Weights Project as an example of what I’m critiquing (the Moral Weight Project is fantastic in lots of ways, I don’t mean to say the whole project is bad because of this one critique). For the project, the authors are trying to develop weights that express animals’ changes in hedonic wellbeing in terms of human DALYs. But it’s not clear that DALYs are a coherent unit for what they’re trying to measure. The give trying to “estimate the welfare gain from, say, moving layer hens from cages to a cage-free system” as an example of the kind of application they’re looking at. But locking a human in a cage wouldn’t obviously change the number of DALYs gained in the world, at least under the post-2010 definition. For that application, a unit that included subjective wellbeing would make a lot more sense. That’s the kind of thing I’m trying to get at.
But I do agree with you that asking disabled people about their experiences and incorporating those results into whatever weighting scale we use is a very valuable step!