Meet Maria.
She’s a hospital administrator who allocates their resources to do the most good for the
patients, for as long as possible.
Now, meet Nicky.
He’s a 13-year old who needs a liver transplant... which is expensive.
It’s pricey to find a matching liver, keep Nicky healthy before the operation, perform
the transplant itself, and to care for Nicky while he recovers.
So Maria faces a very difficult question everyday: What’s the maximum amount of money the hospital
can spend to get Nicky his transplant, and save his life?
Think about it and come up with a number in your head, keeping in mind that any money
spent on saving Nicky is not spent on other patients, hospital equipment, or doctors and
nurses.
Is it a thousand dollars?
Ten thousand?
A million?
If the hospital could spend a billion dollars to save Nicky’s life, but it would have
to shut down the next day, is it worth it?
This sort of question forces us to put a limit on the value of a human life, something that’s
sacred or priceless, and it’s kind of uncomfortable.
Research shows that these decisions make us so uncomfortable we actually resent the people
forced to make them, even if those people are trying to achieve the best possible outcome,
and even if we’re having to make the choice ourselves.
But still these decisions are made everyday.
So what is the value of a life?
From a purely economic and mathematical perspective, we put dollar values on individual lives all
the time – it’s called the value of a statistical human life, or VSL, and US government
agencies currently consider it to be about $8 to $10 million.
Consider the lives lost in the September 11 attacks.
Thousands of people perished, from bankers to firefighters, and a victim compensation
fund was established to assist the families of those who lost their lives.
The amount of compensation received by the families was calculated based on the victim’s
age, income, and personal expenses, and averaged a little over $2 million.
But the families of those killed in the attacks who were making less than $20 thousand a year
at the time, only received about a quarter of a million, while the families of those
making more than $220 thousand received as much as $7.1 million.
This meant, generally speaking, the families of bankers working in the towers received
more compensation than the families of firefighters who ran into the buildings to try and save
those bankers.
The idea is to prevent the families’ loss and hardship from also causing a financial
burden.
We don’t like to think of these payouts as placing a dollar value on our own life,
but that’s precisely what they attempt to do.
There are even plenty of thought problems asking us to price one life in terms of the
lives of other.
Last year I spoke about the Trolley Problem, which asks us to decide whether we would rather
actively kill one innocent person or passively kill several.
Even if we calculated the value of a statistical human life for each person on the tracks,
deciding between one banker and five firefighters doesn’t make the problem easier.
When it comes to ethical choices like this, our valuations aren’t economic.
We value the lives of people we know and care about more than strangers; and we even experience
“citizenship bias”, where we value the lives of our fellow citizens more than those
of foreigners.
But just asking people to make a choice between the lives of others, to consider something
like the trolley problem, can cause the same mental and emotional turmoil we experience
when we’re being asked to set a monetary value on life.
The truth is, we don’t like to think about the value of a life because we don’t like
to think about our own mortality.
But we are more than just our thoughts, feelings, and economic output.
What about the value of what we leave behind when we die?
We’re also biological machines that depend on multiple fragile systems.
And medically, we have value as bags of organs even after we pass.
Post-mortem donation of major organs can be used to save up to eight lives, and improve
the lives of up to fifty people through tissue and cornea transplants.
Obviously the replacement value for any one person, like Nicky, is infinite to the people
who care about them.
There’s nowhere we can go to buy another copy of the people we love.
Recognizing that, and remembering that, well, we are mortal, can help people like Maria
make tough ethical and economic decisions.
And it can help the rest of us understand those choices.
Let me know your thoughts in the comments.