Telling a 39-year-old woman with stage four bowel cancer that her life is “less valuable” than that of a healthier person was insensitive, ill-timed and ultimately unhelpful for sensible public debate. But those condemning Lord Sumption most loudly for his comments on the BBC’s The Big Questions must also accept their fair share of responsibility for infantilising politics. There isn’t a health service manager, senior civil servant, undergraduate economist or a politician, other than those whose only aspiration is empty populism, who doesn’t recognise that it is often necessary to place a value on human life in public policymaking.
Healthcare and transport are two of areas in which the need to value human life is most evident. We see this in the news every month when there are reports of new drugs which NICE (the National Institute for Clinical Excellence) has approved and those which they have not. As Julian Jessop has written on this site, the idea of QALYs (quality adjusted life years) is critical to health care decision-making. The cost of any treatment needs to be justified against the benefit, measured in terms of number of extra years of life in good health for an individual, reportedly around £30,000 per year. The same logic applies to assessing whether to proceed with road improvement schemes which are predicted to save a certain number of lives, although different parts of government seem to attribute slightly different values to human life (with the Department of Transport using a value of £1.8 million per saved life).
If it was genuinely not possible to put a finite value on human life none of us would ever take even the slightest risk, governments would never deploy armed forces and healthcare and public transport would have infinite budgets driven by the need to try to save every life, however low the chance. The reality of life proves every day that we do perceive human life to have a finite value, and that governments all over the world act on this basis.
One of Lord Sumption’s biggest errors, in being drawn to comment on the value of an individual life, was to ignore the concept of the ‘Veil of Ignorance’, first developed by the political philosopher John Rawls. He hypothesised that if human beings were asked to structure a society without knowing the consequences of their decisions for specific individuals – including themselves – they would make rational choices maximising the benefits to that society as a whole.
But this logic is neither understood nor accepted by the wider populace, and most politicians would rather gnaw their arm off than explain and justify it. It is far too easy to repeat the mantra that life is invaluable. What this means is that there is no real democratic consent for a key aspect of the way in which governments, of all stripes, take decisions.
That’s particularly troubling for those of us on the centre-right, because it contributes to the emerging narrative that it’s sufficient for a policy idea or spending programme simply to have a positive effect, rather than needing to demonstrate its value compared to alternatives. This ultimately leads to an upwards-only ratchet on public expenditure.
Modern Conservative politicians often try to avoid the need to make choices. But in taking the path of least resistance they have made it almost impossible to resist the successive demands for more and more money to be spent. Consistent with this, they have also abdicated the responsibility of explaining that public expenditure requires wealth creation to sustain it, and that requires limits on taxation and the size of government. This is dangerous at a time when younger voters have no memory of an era when the bloated state stifled economic growth, ultimately reducing possible levels of spending.
We may be living through a period of political polarisation, but the basic concept of cost-benefit analysis is universally accepted by policymakers. Attaching a monetary value to human life is, in fact, a relatively neutral tool and if more people understood that it might help us have more grown-up debate.
I’ve often heard commentators state their belief in the ultimate wisdom of the British electorate, whatever day-to-day opinion polling might suggest. If Margaret Thatcher could find a way of communicating complicated and difficult choices in the 1970s and 1980s, today’s Conservative politicians should find some strength of character and do the same. They could start by admitting that much of government decision making requires weighing the value of a human life against other factors, and that the Labour Party has also consistently governed on this principle. Otherwise they will be helping to promulgate further what is, in reality, an economic fairytale.
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