Thanks for your comment! I would basically distinguish three questions:
Can we address critiques of the DALY framework by turning a big dial that says âdisability weightâ on it and constantly looking back at the audience for approval like a contestant on The Price is Right? - Probably not.
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.
Is the disability advocacy community a monolith that will be 100% united in approval or disapproval for a particular methodology? - Definitely not.
In general, I agree that we should be trying to have true/âgood evaluation systems, not systems that are optimized for PR. I just think that right now weâre not on the Pareto frontier of that tradeoff.
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.
Iâm pretty sure the answer is âNo, we canâtâ. 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 canât change the waits around for different interventions.
Sorry if my comment was unclear. I donât 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 weâre trying to quantify the impacts of different interventions on health outcomes, the post-2010 DALY scale might be reasonable. If weâre 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. GiveWellâs moral weighting scheme) might make sense.
Iâll return to the RP Moral Weights Project as an example of what Iâm critiquing (the Moral Weight Project is fantastic in lots of ways, I donât 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 animalsâ changes in hedonic wellbeing in terms of human DALYs. But itâs not clear that DALYs are a coherent unit for what theyâre trying to measure. The give trying to âestimate the welfare gain from, say, moving layer hens from cages to a cage-free systemâ as an example of the kind of application theyâre looking at. But locking a human in a cage wouldnât 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. Thatâs the kind of thing Iâm 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!
Thanks for your comment! I would basically distinguish three questions:
Can we address critiques of the DALY framework by turning a big dial that says âdisability weightâ on it and constantly looking back at the audience for approval like a contestant on The Price is Right? - Probably not.
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.
Is the disability advocacy community a monolith that will be 100% united in approval or disapproval for a particular methodology? - Definitely not.
In general, I agree that we should be trying to have true/âgood evaluation systems, not systems that are optimized for PR. I just think that right now weâre not on the Pareto frontier of that tradeoff.
Iâm pretty sure the answer is âNo, we canâtâ. 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 canât change the waits around for different interventions.
Sorry if my comment was unclear. I donât 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 weâre trying to quantify the impacts of different interventions on health outcomes, the post-2010 DALY scale might be reasonable. If weâre 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. GiveWellâs moral weighting scheme) might make sense.
Iâll return to the RP Moral Weights Project as an example of what Iâm critiquing (the Moral Weight Project is fantastic in lots of ways, I donât 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 animalsâ changes in hedonic wellbeing in terms of human DALYs. But itâs not clear that DALYs are a coherent unit for what theyâre trying to measure. The give trying to âestimate the welfare gain from, say, moving layer hens from cages to a cage-free systemâ as an example of the kind of application theyâre looking at. But locking a human in a cage wouldnât 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. Thatâs the kind of thing Iâm 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!