In defence of societal sovereignty: a comment on Nyman 'the inclusion of survivor consumption in CUA'.

Whether to include or exclude consumption costs and costs of unrelated illnesses in economic evaluation is not a technical issue which may be answered by reference to individuals alone and the consistency of the treatment of individual costs and benefits. In the context of a publicly funded health service the relevant costs and benefits may differ from those normally included in evaluation studies. Specifically, the social welfare function is likely to exclude benefits which would result in preferential care for wealthier members of society. But this conclusion must be established by analysis of social, not individual, values.