PPE Speaker Series: “Modified Years of Life Lost Metrics” with Govind Persad (University of Denver)

This event is an open, public lecture co-sponsored by the Department of Public Policy, to be followed by Q&A. This event satisfies a CLE credit. Pizza will be available after the talk, so stick around!

Abstract:

Years of life lost (YLL) is a commonly used metric in health policy. However, YLL alone do not adequately account for the fact that unfair disadvantage often shortens people’s life expectancies. Some have complained that this can lead to unjust resource allocation, with disadvantaged groups receiving fewer resources. Such complaints have led to YLL being removed from allocation policies used to distribute scarce medical resources such as vaccines and ICU beds, often in favor of less detailed alternatives such as deaths averted. These complaints could also potentially be directed at the use of YLL in health policy  outside of scarce resource allocation. 

Rather than shifting from YLL to deaths averted, there is a better alternative. Modified YLL approaches, such as potential years of life lost (PYLL) and standard expected years of life lost (SEYLL), can address concerns about unfairness by replacing actual life expectancy with potential life expectancy. This ensures that individuals whose lifespans are shortened by injustice are not thereby disadvantaged on that basis. Modified YLL approaches are also better for harm prevention than deaths averted metrics. This is because they give more weight to preventing deaths earlier in the lifespan, when people have more years left to live.

One question for modified approaches is whether to use a single potential lifespan for everyone, or to use different potential lifespans for different groups. This is an ethical question without a univocal answer. However, modified YLL approaches offer a promising way to incorporate justice into health policy while still recognizing relevant differences in magnitude of expected benefit among patients.

Speaker Bio:

Govind Persad is an Associate Professor at the University of Denver Sturm College of Law. His research focuses on distributive justice problems at the intersection of applied ethics and health law, including pharmaceutical pricing, health insurance design, and the allocation of scarce medical resources. His research is published or forthcoming in medical journals including JAMA and The Lancet, bioethics journals including Bioethics and the Journal of Medical Ethics, philosophy journals including the Journal of Political Philosophy and Social Philosophy and Policy, and law journals including the Michigan Law Review, Iowa Law Review, and Yale Law Journal Forum. He has also co-authored op-eds in the New York Times and Washington Post. Professor Persad was a 2018-21 Greenwall Foundation Faculty Scholar in Bioethics and received the 2022 Baruch A. Brody Award in Bioethics for important theoretical contributions to the field of bioethics. He holds a JD and a PhD in Philosophy from Stanford University.