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Critical-Level Utilitarianism  

Critical-Level Utilitarianism  

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This article examines several families of population principles in the light of a set of axioms. In addition to the critical-level utilitarian, number-sensitive critical-level utilitarian, and number-dampened utilitarian families and their generalized counterparts, we consider the restricted number-dampened family and introduce two new ones: the re...

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... Building upon the work of Dalton (1920) and others (Arrow, 1965;Pratt, 1964), Atkinson's research showed how the concavity of a utility function provides not only a basis for illustration of how the 'principle of transfers' holds, but also allows for quantification of the degree of inequality in an income distribution. Subsequently, strictly concave transformation has been employed in a diverse range of settings including behavioural economics (Cox & Sadiraj, 2006), health economics (Blackorby et al., 2003;Broome, 1993), the economics of education (Ooghe, 2021), and the economics of climate change (Adler & Treich, 2015). ...
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Health spillovers arise when an individual's serious illness affects those close to them emotionally, psychologically, and/or physically. As a result, healthcare interventions that improve the lives of patients may also confer wider health benefits. However, contrary to widespread calls for health spillovers to be included in health economic evaluation, others have argued this could have adverse distributional consequences and equity implications. This paper presents a novel approach to spillover inclusion in health economic evaluation using a ‘prioritarian transformation’ of health gains that allows these equity concerns to be addressed. Affording greater weight to the incremental change in patient outcomes when incorporating carer/family health spillovers into resource allocation decisions, the method provides a feasible means of moderating the distributional impact of spillover inclusion. It also introduces a normative, theoretical perspective to a largely empirical extant literature and, as such, its axiomatic basis is examined. Finally, an illustrative example of the approach is presented to demonstrate its application.
... Classical or total utilitarianism says we should choose the option that maximizes the sum of (expected) utilities [3]. The options are eligible world histories, the sum runs over all possible individuals (i e. individuals who exist in at least one eligible world history) and the (expected) utility of an individual in a world history is a real-valued number that measures the (expected) personal value of the life of that individual in that world history. ...
... The options are eligible world histories, the sum runs over all possible individuals (i e. individuals who exist in at least one eligible world history) and the (expected) utility of an individual in a world history is a real-valued number that measures the (expected) personal value of the life of that individual in that world history. The utility can be a concave function of welfare or lifetime well-being, in which case we have a prioritarian or generalized utilitarian theory [3]: we have to improve everyone's lifetime well-being, giving priority to the worst-off people who have the lowest levels of lifetime well-being [5,19]. If the option involves uncertain outcomes (different world histories having certain probabilities), the utility can be represented as an expected value over the possible outcomes. ...
... Finally, such preferences do not satisfy the axiom of "existence Independence of unconcerned Individuals," so that rankings of alternatives may depend on the utilities of unaffected people such as the long dead. See Blackorby, Bossert, and Donaldson (2001). For other approaches, see, for example, Lagerlöf (2015). ...
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... This difficulty extends beyond CU and CLU. Blackorby, Bossert, and Donaldson (2003) propose a list of reasonable properties and show that there is no welfarist social choice rule which satisfies all of these properties. 1 Ng (1989) and Arrhenius (2000) report similarly negative results. The present paper provides a new perspective on this conundrum. ...
... At the very least, the strength or weakness of these restrictions could provide some insight into how serious the problem is. Blackorby et al. (2002b and 2003) show that, of 13 welfarist social choice rules examined, only classical generalized utilitarianism and critical-level generalized utilitarianism satisfy a truncated version of their list of desirable properties . 2 Therefore, it seems reasonable to focus attention on these two rules. At the same time, Blackorby and Donaldson (1982) demonstrate the severe restrictions on the generalized form which result from the need to accommodate negative utilities in an informational environment where the origin is socially meaningful. ...
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... If all critical levels exist, all same-number generalized-utilitarian principles with some negative critical levels are similarly ruled out. These include the number-dampened utilitarian principles (Ng [1986]) other than classical utilitarianism and their generalized counterparts (see Blackorby, Bossert and Donaldson [2003]). ...
... However, all of the others that do necessarily violate existence independence. Because space constraints prevent us from examining them here, we refer the interested reader to Blackorby, Bossert and Donaldson [2003]. ...
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... There are principles that are closely related to the critical-level generalized-utilitarian principles with positive critical levels. They are the restricted critical-level generalizedutilitarian principles (Blackorby, Bossert and Donaldson [2001]) and they satisfy anonymity, strong Pareto, continuity and weak existence of critical levels and, furthermore, they avoid both the repugnant conclusion and the strong sadistic conclusion. The positive critical level for a critical-level generalized-utilitarian principle becomes the critical-level parameter for the corresponding restricted principle. ...
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