Harsanyi, Sen, or Bentham : From Which Perspective Should We Assess Wellbeing in Health?

Résumé 0

Health economists oppose two views of the normative foundations of economic evaluation: a welfarist view, which defines social welfare as a function of individual utilities only, and an extra-welfarist view grounded on Sen’s capability approach. In this paper, we contribute to this debate by investigating the ability of three theories of individual wellbeing (well-being as the satisfaction of preferences, as reported happiness or according to the capability approach) to value individual autonomy and to deal in a satisfactory way with the moral consequences of psychological adaptation. Our analysis underlines the failure of theories of well-being as decision or experienced utility to meet these requirements. We present and discuss possible theoretical and operational solutions using measures of individual well-being relying on Sen’s capability notion and using experienced utility as a valuable functioning. Classification JEL: I10, I31, D61