Where Now for Saving Lives?

Many of the most pressing decisions of society directly or indirectly involve the saving or expenditure of lives. Energy planning, national health insurance, and occupational health and safety regulation, indeed national defense policy, represent major issues that invariably bring us back to the question: Which lives should be saved? Or, to reflect the process of lifesaving more accurately, the question might be rephrased: Where should we spend whose money to undertake what programs to save which lives with what probability?1 Ten years ago, merely asking this question explicitly would have seemed unethical or at least repugnant to many, though its central issues, of course, were addressed implicitly in a whole range of individual and collective decisions. Today variants of this question are studied by theologians and sociologists, as well as economists and policy makers. The question of how lives should be valued is now an acceptable one for intellectual discourse, though it is true that for some the answer cannot come through academic discovery