Citation

Miller TR. J. Forensic Econ. 2000; 13(2): 145-167.

Copyright

(Copyright © 2000, National Association of Forensic Economics)

DOI

unavailable

PMID

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Abstract

Nonfatal injuries and illnesses cause impairment that can result in the loss of functional capacity and reduce quality of life (Nagi, 1991). When impairment is the result of injury or toxic exposure, juries often are asked to place a value on quality of life losses. Their judgments typically are based on gut reactions to anecdotal testimony and to medical forecasts about the losses involved, rather than on available scientific evidence.

This paper describes empirically validated techniques that forensic experts can apply to help guide these jury valuations. Applying them widely may increase the predictability of jury awards for nonfatal injury and illness (Miller, 1988). These techniques require use of a metric that scientifically measures the utility loss associated with health impairment. Health economists regularly employ such a metric, termed "quality-adjusted life years" (QALYs), to evaluate pharmaceutical or clinical protocols that are intended to improve health-related quality of life. QALYs are a systematic, replicable measure of how peoples' utility levels are affected by their health status. Berla et al. (1990) first described a judgmental scaling method for valuing hedonic damages resulting from non-fatal injury. QALYs can serve this role better; because they are systematic and replicable (i.e., verifiable), they meet the dictionary definition of science. They typically are a non-monetary metric indicating the percentage of someone's quality of life lost to an injury or illness. In that form, they have en-tered the mainstream. They are featured in virtually all current health eco-nomics texts that discuss cost-effectiveness analysis, play a critical role in the new drug approval process, are widely measured worldwide by the World Health Organization and collaborating governments (often in the form of disability-adjusted life years or DALYs), and get heavy coverage in leading health economics journals.

QALYs can be monetized, yielding what courts are now calling hedonic damage estimates for personal injuries (Miller et al., 1989).