- The text on this page is taken from an equivalent page of the IEHIAS-project.
All assessments involve value judgements. The choice of what issues to assess represents a value judgement, as do the decisions about what to include in the assessment, what to exclude, and how to represent the outcomes of the assessment (i.e. what indicators to use). Crucially, also, value judgements are involved in interpreting the results of an assessment, and deciding what actions to take in response.
Many attempts have been made over the years to categorise the value systems that underpin human attitudes and behaviours, and thus influence the policy process. A range of different systems have been identified - e.g. utilitarianism, libertarianism, communitarianism and prioritarianism. Some of these emphasise the outcomes of any situation; others focus on the processes involved. They also tend to give different emphasis to individual versus collective rights or entitlements and to material (or objective) versus subjective goods.
At the issue-framing stage, it may be helpful to try to classify stakeholders in terms of these different value systems, in order to ensure that their specific interests and expectations are recognised. More important, however, is to take account of the range of value systems that exist in designing the assessment, and especially in developing the relevant indicators, in order to ensure that the assessment will be relevant to the various users it is meant to serve. Exactly what value systems might be involved, and how these need to be catered for, will depend on the context: they may vary, for example, between assessment of a local and a trans-national issue, or between one that mainly affects children and one that affects adults. It also needs to be recognised that a range of different, overlapping, and sometimes contradictory value systems may be at work in any group of people - and even within an individual, under different circumstances. The table below, however, outlines some of the values that may be at work, and some of their implications for designing an assessment.
|Value construct||Optimisation strategy||Implications for indicators||Generic examples|
|Utility maximisation||Maximising overall public good, irrespective of cost and distribution across he population||Should measure sum impacts across target population as whole||Total burden of disease (e.g. DALYs)|
|Cost-effectiveness||Maximising (or achieving acceptable) overall benefit, at minimal (or acceptable) cost||Should show ratio of benefit to cost||Cost per unit benefit (e.g. per DALY); total cost of achieving target benefit (e.g. per 10 000 lives saved)|
|Normative||Achieving policy or social objectives||Should reflect degree to which norms or targets are achieved||Compliance level or distance from target (e.g. % of population above pollution standard)|
|Equity||Maximising benefit within constraint of also minimising differences between individuals/population sub-groups||Should measure distribution impacts across target population||Burden of disease (e.g. DALYs) by socio-economic group|
|Positive discrimination||Reducing or removing disadvantage by targeting action at specific (priority) groups||Should enable comparison of impacts (positive and negative) between priority and non-prioity groups||Change in overall disease burden (e.g. DALYs) by socio-economic group|
|Communitarian||Maximising local preferences of communities /population sub-groups||Should reflect preferences of stakeholders||Satisfaction score (e.g. % satisfied) by geographic or social group|