When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don’t discount the value of future health, there is a sense in which the choice of calculation method is a mere question of accounting. Such questions can be important, but they don’t raise deep theoretical concerns. If we do discount, however, choice of calculation method can change the relative burden attributed to different conditions over time. I conclude by recommending that studies involving disability-adjusted life years be explicit in noting what calculation method is being employed and in explaining why that calculation method has been chosen.

There is a growing consensus among philosophers of science that core parts of the scientific process involve non-epistemic values. This undermines the traditional foundation for public trust in science. In this article I consider two proposals for justifying public trust in value-laden science. According to the first, scientists can promote trust by being transparent about their value choices. On the second, trust requires that the values of a scientist align with the values of an individual member of the public. I argue that neither of these proposals work and suggest an alternative that does better. When scientists must appeal to values in the course of their research, they should appeal to democratic values: the values of the public or its representatives. 1Introduction2Trust and the Value-Free Ideal3What Kind of Trust?4Grounding Trust in Transparency5Grounding Trust in an Alignment of Values6Grounding Trust in Democratic Values7Science, Values, and Democracy8Grounding Science in Democratic Values

Many philosophers of science have argued that social and ethical values have a significant role to play in core parts of the scientific process. A question that naturally arises is: when such value choices need to be made, which or whose values should be used? A common answer to this question turns to political values -i.e. the values of the public or its representatives. In this paper, I argue that this imposes a morally significant burden on certain scientists, effectively requiring them to advocate for policy positions they strongly disagree with. I conclude by discussing under what conditions this burden might be justified.

measures of health, such as the QALY and DALY, have long been known to incorporate a number of value choices. In this paper, though, I show that the value choices in the construction of such measures extend far beyond what is generally recognized. In showing this, I hope both to improve the understanding of those measures by epidemiologists, health economists, and policy-makers, and also to contribute to the general debate about the extent to which such measures should be adjusted to reflect ethical values.

This chapter suggests that descriptive epidemiological studies like the Global Burden of Disease Study can usefully be divided into four tasks: describing individuals’ health states over time, assessing their health states under a range of counterfactual scenarios, summarizing the information collected, and then packaging it for presentation. The authors show that each of these tasks raises important and challenging ethical questions. They comment on some of the philosophical issues involved in measuring health states, attributing causes to health outcomes, choosing the counterfactual against which to assess causes, aggregating and summarizing complex information across multiple domains, discounting, age-weighting, handling fetal deaths, measuring health inequalities, representing uncertainty, and assessing personal responsibility for health outcomes.