Essay The Economic Argument for a Policy of Suicide Prevention

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1 Essay The Economc Argument for a Polcy of Sucde Preventon Darrel P. Doessel, BEcon, MPolEcon, DpEd, PhD 1 Ruth F.G. Wllams, BA, BEcon, MEconSt, DpEd, PhD 2, 1 Australan Insttute for Sucde Research and Preventon, Grffth Unversty, Australa 2 Regonal School of Busness, La Trobe Unversty, and Australan Insttute for Sucde Research and Preventon, Grffth Unversty, Australa Submtted to SOL: 24 th Aprl 2010; accepted: 18 th August 2010; publshed: 22 nd August 2010 Abstract: The purpose of ths paper s to demonstrate, usng some conventonal concepts and procedures from the dscplne of economcs, the economc ratonale for governments to have sucde preventon polces. Ths s a conceptual paper, whch proceeds n a theoretcal fashon. The part of the economcs lterature that s relevant to ths task s welfare or normatve) economcs, not postve or emprcal economcs. Welfare economcs s that part of economcs whch s concerned wth evaluatng whether some change n the human envronment economc, socal, poltcal etc) has ncreased socal welfare. The motvaton of ths paper s to show that a sucde preventon polcy nvolves a legtmate role of government, gven the conventonal framework of welfare economcs. It may seem puzzlng to sucdologsts that t s necessary to argue an economc case for sucde preventon, gven that sucde preventon seems establshed n contemporary cvl socety. That t s wellestablshed s a vew that does not always apply outsde the crcle of sucdology. The case for polcy s dubous amongst some wth a contemporary concern for envronmental degradaton. Ths argument s that a lassez-fare approach to sucde s approprate n order to protect the planet. Ths paper shows that there s no economc case for a no polcy stance wth respect to sucde preventon. Copyrghts belong to the Authors). Sucdology Onlne SOL) s a peer-revewed open-access journal publshed under the Creatve Commons Lcense 3.0. *It s well-known that sucde rates n varous western countres have, n the recent past, been rsng, and that governments n a number of countres have developed sucde preventon polces n response. Furthermore t has been ponted out by, nter ala, Cutler, Glaeser, & Norberg 2001) that these ncreases have been concentrated among the young. Detals of governmental concerns have been outlned n varous publcatons, for example, Department of Health 2000) for England, Commonwealth Department of Human Servces and Health 1995) * Ruth F.G. Wllams, BA, BEcon, MEconSt, DpEd, PhD Senor Lecturer Regonal School of Busness La Trobe Unversty and Adjunct Senor Lecturer Australan Insttute for Sucde Research and Preventon Grffth Unversty PO Box 199, Bendgo Vc 3550 Australa Tel: Fax: e-mal: ruth.wllams@latrobe.edu.au for Australa, US Publc Health Servce 1999) for the Unted States, etc. At a 2006 Health Economcs conference n London, some jont-authored work on sucde Doessel, Wllams, & Robertson, 2010), was subject to some heated crtcsm on conservaton grounds by a conference partcpant. Although the paper was concerned wth sucde measurement ssues, partcularly dscusson of two measures of sucde enumeraton and the calculaton of tmeseres statstcs on the dstrbuton of sucde per se), there were some prefatory remarks about sucde preventon polces. It was brefly argued that such polces were approprate and justfed n terms of general economc theory. It was ths general argument justfyng a sucde preventon polcy that the conference partcpant found objectonable. By mplcaton, ths same argument can be levelled aganst the actvtes of all clncans who work n the feld of sucde preventon and selfharm. For such clncans the am s clearly 66

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3 the capabltes approach of Sen 1985), Nussbaum & Sen 1993) and the more recent human flourshng approach of Ruger 2009). The lterature on preventon, and the more general economcs and health-related lteratures, are relevant to wthn-polcy choces that arse once t s establshed that there wll be a polcy. Such lteratures as those just mentoned can gude polcy content. But ths paper addresses the pror economc queston: should there be a polcy on sucde preventon? The lteratures just mentoned are not germane to ths dscrete queston. In ths context t s relevant to clarfy the part of economc theory that s beng consdered here: economc analyses can be separated nto two types, emprcal or descrptve analyses, and normatve or prescrptve work. The frst category s often referred to as postve economcs and the latter category as welfare economcs.) In other words, economc analyss can descrbe the economc world or prescrbe for t. Although postve economcs can provde an mportant component for normatve analyss, work wth a focus on polcy generally fts wthn the second category. In ths context t s useful to recall Mshan s statement on the role of welfare economcs: normatve or welfare economcs can be defned as the study of crtera for rankng alternatve economc stuatons on the scale of better or worse Mshan, 1981, p. 3). Smlarly another much-quoted defnton also hghlghts polcy choce as the central characterstc of normatve economcs: Welfare economcs s the theory of how and by what crtera economsts and polcy makers make or ought to make ther choces between alternatve polces Arrow & Sctovsky, 1969, p. 1). The alternatve economc stuatons or alternatve polces that are relevant to ths paper are to have a sucde preventon polcy thus usng publc or prvate resources for ths objectve), or not to have such a polcy, and havng no resources allocated to the objectve. Ths paper wll employ the conventonal analytc and algebrac tools of welfare economcs Baumol & Wlson, 2001) n order to demonstrate that effectve sucde preventon rases socal welfare, and hence such a polcy s justfed. It wll be argued below that ths s an ssue that nvokes, not emprcal economcs, but that branch of economcs whch s concerned wth what should be done by government,.e. normatve or welfare economcs. An Analyss from Welfare Economcs It s useful to observe that there are some areas of study, e.g. astronomy, physcs etc, where the concern s to understand the phenomena n queston, n part to predct events. Thus, a normatve branch of the relevant dscplne does not exst. Ths does not mply that ethcal crtques do not exst: see Prngle & Spegelman 1982) for a crtcal account of the nuclear ndustry, a byproduct of theoretcal physcs. But the pont s that such a crtque s not wthn physcs.) But economcs s not lke that: n the hstory of the dscplne, ssues of what should be done were central to the concerns of the foundng fathers, not smply n the Englsh-language lterature but also n lteratures from contnental Europe. See, n partcular, the Scandnavan and Italan contrbutons to publc fnance Musgrave & Peacock, 1958) and the Italan lterature on publc happness pubblca felcta) and cvc vrtues, such as publc trust fede pubblca). See Brun 2006) for detals. Some examples of hstorcal polcy ssues were free trade vs protecton, the desrablty of accumulatng and preservng stocks of a country s precous metals, e.g. gold and slver, as a polcy objectve as advocated by the Mercantalsts; a dsproportonate emphass on a sngle ndustry, agrculture, a polcy prescrpton of the Physocrats; the German romantcs, e.g. Muller, argung for the exempton of land and ts produce from taxaton, etc. The hstorcal term for these early contrbutons to economcs s poltcal economy. The part of contemporary economcs that contnues these polcy concerns about what should be done s now called welfare, or normatve, economcs. The state of postve economcs,.e. testng hypotheses or economc models of economc behavour etc, was at that tme embryonc.) However, contemporary economc problems are somewhat dfferent from those mentoned above. Some that come to mnd are as follows: whether government should subsdse the producton of cars wth hybrd engnes; whether country X should jon the customs unon, now called the European Unon; whether nvestment n a new ralway lne s economcally vable; whether we should conserve places of natural beauty, and how much should be preserved, etc. These are ultmately poltcal questons, but nsofar as they are subjected to economc analyss, the relevant lterature that s applcable s welfare economcs. Attenton s drected here to applyng some relevant parts of welfare economcs to the topc whch s under examnaton here,.e. s a sucde preventon program a legtmate functon of government polcy? Let us recognse that not all people share a concern for sucde preventon: some admre the sucdes of honour, love, dealsm, eptomsed hstorcally by the acts of Cleomenes, Hppo, 68

4 Seneca, Lucreta, Brutus, Pythagoras etc Mnos, 1999). Yet agan, there s the concept of the absurd n exstentalst thought that, for some exstentalst wrters, leads to sucde beng regarded as qute understandable: as there s no purpose, value or meanng n the world or to lfe, sucde s an understandable response. See Orbach 2007). But, for Camus, although sucde was the one truly serous phlosophcal problem Camus, 1955 p. 3-4), hs dsposton was to struggle and revolt aganst the absurd Camus, 1960). Rebellon, for Camus, mples dssatsfacton wth the human condton,.e. one needs to face the absurd, and make a decson n favour of lfe. See Lengers 1994) for a dscusson of Camus perspectve for the role of health professonals. Camus, t must be sad, was n conflct wth some of the major French wrters ncludng Sartre, who at the tme was justfyng Stalnsm), followng the publcaton of The Rebel wth ts ant-totaltaran theme. In fact, Camus had been ostracsed by the left-bank ntellectuals of Pars. Lenzn, a recent bographer of Camus, wrtes as follows: He would reman an outsder n ths world of letters, confned to exstental purgatory He was not part of t. He never would be. And they would never mss the chance to let hm know that Lenzn, 2009, p. 76). But ths s a dgresson: publc polcy, n large part, s oblvous to these types of arguments. Let us now begn by restatng the central ponts of the frst paragraph of ths paper. Sucde as a cause of death s ncreasng n many countres and s beng dentfed by many governments as a socal problem. In response, some governments have adopted polces concerned wth addressng sucde through preventve acton. Ths mples an nverse relatonshp between communty welfare and sucde. The mpact of sucde upon socety can be measured by the reducton n the length of lfe, or longevty, that results from an act of sucde. Furthermore, poltcans and bureaucrats say that t s a greater tragedy when young people take ther own lves. Thus communty welfare falls even more when the young take ther own lves. One way of descrbng the ponts made n the paragraph above s to say that the partal) socal welfare functon W 1 ) has two arguments, vz. the total socal loss from sucde, and the dstrbuton of age-at-death from sucde. Thus, W f SLfS, I s E ) 1) 1 s where SLfS s the socal loss from sucde, and I s E s s the notaton for nequalty/equalty n the dstrbuton of age-at-death from sucde. We work wth a partal socal welfare functon,.e. abstractng from goods and servces consumed for the moment), as well as the non-economc determnants of welfare as outlned by Bergson 1938), as these varables wll smply clutter the exposton.) Goods and servces wll be ncorporated below. Also, t wll be shown that equaton 1) s partal n that t takes no account of tme. Before proceedng to ssues of measurement of the two varables n 1), as outlned n Doessel et al. 2010), t s relevant to place these concerns n the wder framework of welfare economcs. A conventonal approach n welfare economcs s to specfy socal welfare W) as an undefned) functon of the utlty levels of the n ndvduals who comprse the communty. Thus we may wrte: W f U, U,..., U ) 2) 1 2 n where U s the utlty level of person, where = 1,2,,n. It s not necessary n ths context to specfy any relatonshp, say the addtve form of the Cambrdge School, between the U n equaton 1).) There are some very mportant value judgements assocated wth equaton 2), as elaborated by Nath 1969). However, these value judgements are not central to ths paper and wll not be consdered. Dssatsfacton wth such a socal welfare functon, equaton 2), arose durng the debate on welfare crtera ntated by Kaldor 1939), and was quckly followed by contrbutons from Hcks 1940) and Sctovsky 1941). Some parts of ths lterature are qute abstract and employ some standard welfare concepts such as commodty space, utlty space, the communty ndfference map, the stuaton utlty-possblty curve etc: thus some of the arguments requre some techncal understandng of welfare economcs). Gven the abstract nature of some of the content, t s useful to gve some examples of what the lterature was consderng. At the very begnnng of the welfare crtera debate, the polcy ssue of repeal of the Brtsh) Corn Laws by the Peel government n 1846 was consdered. Ths ssue s a manfestaton of the free trade vs protecton debate. Abolton of the tax a tarff) on gran mports to Brtan would have the effect of makng some people worse off the owners of Brtsh agrcultural land, who had been recevng super-normal profts because the tarff had ncreased domestc gran prces.) On the other hand, abolton would make another group better off,.e. Brtsh consumers of grans bread etc) who would beneft from lower prces. Ths s a straghtforward case of welfare changes between 69

5 producers and consumers. The ultmate polcy queston was as follows: was repeal of the Corn Laws decreasng tarffs on mports of grans to Brtan) a good thng? However t may be helpful to menton some more contemporary polcy changes. Consder a government contemplatng the constructon of a new freeway from the central busness dstrct of a well-establshed cty to outlyng suburbs. Such a change n the economc envronment wll make some people better off commuters etc) and some worse off, e.g. people whose propertes are resumed often at less than market prces because of the emnent doman power of government), as well as the remanng resdents who are now subject to nose polluton. A lttle reflecton ndcates that there are lkely to be few changes such that no one n socety s made worse off. The welfare crtera debate started wth Kaldor s argument that a polcy change on tarffs, a freeway etc) was desrable on economc effcency grounds) f some of the gans to the ganers could be used to compensate the losers for ther losses, and hence everyone could be made better off. For Kaldor, ths compensaton test also called the compensaton prncple or crteron ) was an objectve test of economc effcency, and polcy prescrptons based on t were scentfc, n that they were devod of any value judgement. It should be emphassed that Kaldor dd not requre that compensaton be pad: whether hypothetcal compensaton became actual compensaton was a poltcal queston, not an economc queston. What Kaldor, and later Hcks 1940), were dong was usng compensaton as a conceptual wedge or a sharp conceptual dstncton) between effcency and dstrbuton, whch effectvely swept dstrbuton out of vew. Leavng asde Sctovsky s 1941) paradox paper, whch s not relevant n ths present context, the next contrbuton was from Lttle 1949), whose arguments were subsequently elaborated n Lttle 1957). Lttle argued forcefully that value judgements partcularly about dstrbuton) are central to welfare economcs and cannot be avoded or swept out of sght. Furthermore those value judgements should not be hdden or suppressed, but should be stated explctly, and arguments gven for ther adopton. But f the value judgements underlyng the compensaton test are clearly stated, the polcy may fnd lttle publc support. As compensaton does not have to be pad, the test s consstent wth makng the poor poorer. It was Lttle s argument that Kaldor, Hcks et al. were beng msleadng by ther use of persuasve terms e.g. ncrease n wealth, economc effcency etc). They had separated effcency and dstrbuton only by gnorng the latter. The search for a value-free crteron of an mprovement n economc welfare was futle. Ths tortuous debate, to use Mshan s 1969) phrase, n the theoretcal lterature culmnated n what s now called Lttle s crteron. Lttle s poston was that dstrbuton must be recognsed as a relevant varable: s there a better dstrbuton assocated wth the post-polcy outcome compared wth the dstrbutve poston of the pre-polcy poston? Clearly, the answer to ths queston nvolves a normatve judgement. Thus, followng Lttle, we may wrte W f U, U,..., U ; I E ) 3) 1 2 n U U where equaton 2) s augmented by I U EU, some measure of the dstrbuton of utlty or welfare) between the members of the communty, the pont that had been so forcefully made by Lttle. Dstrbutonal effects of any economc change must be ncorporated nto the analyss. These theoretcal dstrbutonal matters receved some consderable attenton n the appled lterature on socal nvestment apprasal, where a number of dfferent emprcal approaches were developed to ncorporate ncome or wealth dstrbuton n cost-beneft analyses. The Lttle crteron nvolves both the provson of effcency nformaton and dstrbutonal nformaton to decson-makers. Margln 1962) then suggested that planners/economsts should am to present nformaton to decson-makers whch maxmses a weghted sum of redstrbuton and effcency. Wesbrod devsed a way of mplementng Margln s suggeston by nferrng dstrbutonal weghts from prevous governmental decsons: hs procedure nvolves the smultaneous soluton to a system of equatons Wesbrod, 1968). Neenan 1971) then appled ths technque n hs analyss of an X-ray screenng programme to detect tuberculoss. Another approach to ntegratng effcency and equty, frst suggested by Ecksten 1961), s to nfer dstrbutonal weghts from a stuaton n whch redstrbutonal ssues are at the forefront of attenton: the personal ncome tax legslaton n western countres) s such a case. Mera 1969) devsed a procedure to do ths and Nwaner 1970) appled the technque n re-workng the Roskll analyss of the then proposed) Thrd London Arport. Usng the Australan ncome tax schedule, Doessel 1978) appled ths procedure n hs costbeneft study of four alternatve methods of treatng end-stage renal dsease. 70

6 It s now not atypcal to see welfare functons such as that ndcated n equaton 3) n the theoretcal lterature. Graaff s argument s that there s a need to dspense wth the tme-honoured devce of drawng a dstncton between the sze and the dstrbuton of natonal ncome and sayng that welfare depends on them both Graaff, 1967). Ths statement s remnscent of Lttle s crtque of Kaldor: [Kaldor] suggested not a test, but a defnton, whch certanly separated out ncome dstrbuton, but only by gnorng t We do not beleve that any defnton of an ncrease n wealth, welfare, effcency, or real socal ncome whch excludes ncome dstrbuton s acceptable Lttle, 1957, p. 92). See also Fscher 1956), Sheshnsk 1972) and Felds 1979). More recently, Sen 1976) has re-argued the case for ncorporatng dstrbuton n generally) standard-of-lvng comparsons. He argues that the welfare theory of real natonal ncome comparsons s defcent partcularly wth respect to ncome dstrbuton. Hs procedure s to weght goods to dfferent people by dstrbutonal judgements. Thus, a concern for I E U U n the welfare functon now has many precedents. As yet we have not specfed the content of the utlty functon, U, the components of equatons 2) and 3). It s conventonal to say that the arguments n U are goods/servces consumed. Thus U f X, Y ) 4) where X s the amount good x consumed by person, and Y s the amount of good y consumed by person, and gven that, X X and Y Y, where X and Y are the totals of goods x and y for the communty. Thus, equaton 3) can be rewrtten as W f X, Y ; I E U ) 3a) U Note that equatons 3) and 3a) are tmeless. Although the mportance of tme has been recognsed n economcs n the context of nvestment apprasal snce Fsher 1930), t was not untl 1965, wth the publcaton of A Theory of the Allocaton of Tme by Becker 1965), that tme was ncorporated nto the body of mcroeconomcs. One of Becker s key ponts was that the consumpton of goods actually takes tme: ths s clearly recognsed n the context of attendng the theatre for a muscal concert, a play or a flm, havng a restaurant meal etc: recognton of the jontness of consumpton of goods and tme leads quckly to the concept of a tme-prce assocated wth the money-prce of the consumpton of a good. In the health sector ths has led to the calculaton of tme-prces assocated wth the consumpton of health care servces, the frst study beng that of Acton 1975). It s relevant to observe that ths jontness between the consumpton of goods and tme s not smply restrcted to partcular consumpton goods, but s applcable to all consumpton goods. If we consder the conventonal utlty functon n equaton 4), t s clear that ths functon takes no account of the jontness dscussed above. One way to recognse ths s to re-wrte equaton 4) as follows: U f X, Y ; t, t ) 5) x y where t x and t y are the tme perods assocated wth the consumpton of X andy. It s mportant to note that ths equaton s exactly the same as Becker s 1965) equaton 4), wth the excepton of notaton. In equaton 5), t s recognsed that tme assocated wth consumpton) s an argument n the utlty functon for person. Summng across n persons, we have total tme T) as follows: n T t, t 1 x y It s also useful to state the followng dentty: n T t 1 where t s the length of lfe of person. Gven that tme enters the utlty functon, there s but a small step to recognse that tme also enters the socal welfare functon W). Thus we may re-wrte equaton 3a) as follows: W f X, Y; IU EU ; T ) 3b) It s conventonally, and uncontroversally, assumed that W s ncreasng n X and Y: gven that T s jontly nvolved wth X and Y, t follows that W s also ncreasng n T. Thus the perod of tme durng whch consumpton s avalable,.e. the total perod of lfe of the members of the communty, s also an argument n the socal welfare functon and 71

7 ncreases W. Thus, the longevty of the communty s members s a varable whch contrbutes to socal welfare. It follows from equaton 3b) that death from any cause ncludng sucde) wll decrease the value of the socal welfare functon W). Gven that nequalty/equalty assocated wth goods) s an argument n the welfare functon, and that people jontly combne goods and tme, t follows that the dstrbuton of tme s also a component of W. Thus we may wrte: W f X, Y; I E ; T; I E ) 3c) U U T T Let us now return to equaton 1), a statement of government concern for the socal loss from sucde and ts dstrbuton. Ths equaton was descrbed as a partal socal welfare functon. Gven that tme and ts dstrbuton), have now been shown, as n equaton 3c), to be arguments n the general socal welfare functon, the statement of W 1 n equaton 1), can be seen to be a part of W n equaton 3c). In other words, a concern for sucde and ts dstrbuton) can be regarded as part of the general body of welfare economcs. Thus, extensons of modern welfare economcs provde a justfcaton for tme,.e. length of lfe or longevty, to enter the socal welfare functon. The approach for detectng whether a socetal nterventon such as a preventon polcy) has had an mpact on sucde nvolves examnng sucde data. It has been argued elsewhere Doessel, Wllams & Whteford, 2009a; Doessel, Wllams & Whteford 2009b) that the approprate measure for detectng the effcacy of a socetal nterventon s not headcount measures conventonal mortalty data), but the years of unlved lfetme due to sucde, as measured by the Potental Years of Lfe Lost PYLL), a measure frst advocated by Dempsey 1947). Such data n tme-seres form provde the materal that allows analyses of the statstcal locaton, or quantty, of sucde and ts dstrbuton Doessel, Wllams & Robertson, 2010). The result of ths welfare economc analyss s that a concern for sucde and ts preventon can be ncorporated nto the conventonal/tradtonal dscourse of welfare economcs. Ths result s of partcular relevance and mportance n ths present era: arguments based on the contemporary concern for envronmental degradaton) proposng that a lassez-fare approach to sucde s approprate, are shown here to have no bass n conventonal welfare economcs. Debatng and developng effectve sucde preventon polcy s an mportant step n the formaton of polcy that prevents sucde. Varous assumptons n terms of socal welfare that underle emprcal economc research are relevant to such debates. These assumptons are made explct by a methodologcal type of study such as ths. The study therefore advances the usefulness of the emprcal nformaton, whch can be made avalable to polcy makers, for effectve sucde preventon polcy. Effectve polcy wll rase socal communty) welfare, both n terms of the quantty of lfe lved n a naton, and the dstrbuton of that lfe lved. Dscusson Approbaton or condemnaton of sucde, also called at varous tmes self-murder and voluntary death, has a long hstory n human affars, from at least) the classcal hertage of Greece and Rome Mnos, 1999). However, governmentfunded sucde preventon polces are of much more recent orgn. Ths paper s a reacton, or response, to an argument, not for sucde per se, but aganst governments havng a polcy to prevent sucde. The argument presented here s that the applcaton of concepts central to conventonal welfare economcs provdes a clear economc justfcaton for governments to adopt sucde preventon programs. It has been ponted out prevously that ths paper, qute delberately, does not even allude to ssues that can be consdered wthn sucde preventon programs. Researchers who tll the feld of sucde research and preventon may even be surprsed at the content of ths paper, and mplctly may have assumed that fundng research nto effectve sucde preventon s a good thng, and thus an obvous case for publc fnancng. Ths mplct assumpton also apples to the provson of sucde-related clncal servces: for servce provders, there may seem no need to justfy ther exstence and/or actvty. Whlst, for some, the need for ths paper may seem surprsng or even unnecessary, ths paper ndcates that such a vew s too sangune n the current clmate of communty atttudes. There are those for whom fnancng sucde preventon servces and research nto effectve practce and polcy s not obvous; there are those for whom the place for such a polcy s not uncontroversal. Thus, ths paper may fll a gap n the sucdology lterature n that t addresses an ssue that many sucdologsts may not even have realsed exsted. Note that ths argument aganst government-funded preventon strateges s equally applcable to the preventve role of clncans who work wth sucdal and self-harmng people. Ths ant-sucde preventon argument has been 72

8 motvated, not by any argument about abrogatng people s rght to make choces over all ther lfe decsons ncludng ther own exstence), but by relatvely contemporary concerns about envronmental degradaton arsng from human actons of varous knds. Those concerns, t has been argued, lead to the concluson that sucde should not be prevented, n pursung the cause of the long-term survval of the planet. Sucde preventon polcy can be approached along a spectrum of no government acton towards ncreasng levels of government preventve strateges. Varous groups n socety beneft from the poston adopted along ths spectrum, and dfferng polces affect groups of people to varyng degrees.e. groups charactersed by age, gender, dagnoss etc). There are mportant welfare mplcatons behnd trends n sucde, and also behnd strateges desgned to reduce sucde. However, ths paper has not been concerned wth these mportant ssues: rather our concern has been to address the ssue of whether economc resources for a preventon program and clncal servces for at-rsk people) are justfably appled by government. In ths context, t s valuable to employ the analytcal tools of welfare economcs n order to demonstrate that effectve sucde preventon rases socal welfare. It has been shown here that resources spent on sucde preventon strateges should rase socal welfare, and thus a sucde preventon polcy s approprate for government. That concluson has been reached by recourse to conceptual arguments at the core of modern welfare economcs. Ths concluson s mportant, as t s contrary to a currently fashonable concern for allevatng envronmental degradaton. Although t can be argued that the number of sucdes, beng relatvely low, wll have a neglgble mpact on the planet s envronmental status, we have delberately chosen not to argue on such an emprcal bass. Rather, we have chosen to address ths challenge to sucde preventon at a conceptual level, usng the tools of modern welfare economcs: t s clear that there s a conflct between ths concluson derved from conventonal welfare economcs and the Gaanspred envronmental conservaton concluson. The envronmental conservaton arguments outlned at the begnnng of ths paper, whch propose that there s no place for such a polcy, do not even allude to the concepts from conventonal welfare economcs appled here. We note n passng that welfare economcs s people-focussed,.e. the concern s for the people who comprse the communty, as manfested n equaton 2) etc. It s not unreasonable to expect that proponents of conservatonst vews, should they wsh to argue aganst the use of resources for sucde preventon, do so by addressng the evdence for sucde preventon that conventonal welfare economcs produces. Thus, the purpose of ths paper has been served, by outlnng the case whch refutes the vew that governments should not allocate taxpayers resources to the preventon of sucde. Although envronmental concerns are currently popular, and poltcally correct, when the envronmental argument aganst sucde preventon s placed n the framework of conventonal welfare economcs, that argument s shown to be defcent. In other words, ths Gaa-derved argument s at odds wth conventonal welfare economcs. Acknowledgements We wsh to acknowledge the assstance of Urska Arnautovska, who has kndly made our task easer. Also addressng the helpful comments of two anonymous referees has consderably mproved ths paper. Needless to say, any remanng errors are our responsblty. References Acton, J. 1975). Nonmonetary factors n the demand for medcal servces: Some emprcal evdence. Journal of Poltcal Economy, 83, Arrow, K., & Sctovsky, T. 1969). General ntroducton. In K. Arrow& T. Sctovsky Eds), Readngs n welfare economcs pp. 1-3.). London: George Allen and Unwn. Australan Department of Health and Ageng 2008). Lvng Is For Everyone LIFE) framework. Canberra: Australan Department of Health and Ageng. Baumol, W., & Wlson, C. 2001). Welfare economcs. 3 vols. Northampton, MA: Edward Elgar. Becker, G. 1965). A theory of the allocaton of tme. Economc Journal, LXXV, Bergson, A. 1938). A reformulaton of certan aspects of welfare economcs. Quarterly Journal of Economcs, 52, Brun, L. 2006). Cvl happness: Economcs and human flourshng n human perspectve. Abngdon: Routledge. Camus, A. 1955). The myth of Ssyphus and other essays. Translated by J. O Bren. London: Hamsh Hamlton. Camus, A. 1960). The plague. Translated by Stuart Glbert. Harmondsworth: Pengun. 73

9 Chambers, N., Smmons, C., & Wackernagel, M. 2000). Sharng nature's nterest: Ecologcal footprnts as an ndcator of sustanablty. London: Earthscan. Commonwealth Department of Human Servces and Health 1995). Here for lfe: A natonal plan for youth n dstress. Canberra: AGPS. Cutler, D., Glaeser, E., & Norberg K. 2001). Explanng the rse n youth sucde. Cambrdge, Mass: Harvard Insttute of Economc Research. Dawkns, R. 1982). The extended phenotype: The gene as a unt of selecton. Oxford: W.H. Freeman. Dempsey, M. 1947). Declne n tuberculoss: The death rate fals to tell the entre story. Amercan Revew of Tuberculoss, 56, Department of Health. 2000). Natonal sucde preventon strategy for England. London: Department of Health. Doessel, D. 1978). An economc analyss of endstage renal dsease. Canberra: Hosptals and Health Servces Commsson. Doessel, D., Wllams, R. & Whteford, H. 2009a). The approprate measure of sucde for polcy analyss: a comparson of headcount and PYLL rates n Australa Archves of Sucde Research, 13, Doessel, D., Wllams, R., & Whteford, H. 2009b). A Re-Assessment of Sucde Measurement: Some Comparatve PYLL- Based Trends, Queensland, Crss, 30, Doessel, D., Wllams, R., & Robertson, J. 2010). Changes n the nequalty of mental health: Sucde n Australa. Health Economcs, Polcy and Law, n press). Ecksten, O. 1961). A survey of the theory of publc expendture crtera. In R.W. Houghton Ed.), Publc fnance: Selected readngs pp ). Harmondsworth: Pengun. Felds, G. 1979). A welfare economc approach to growth and dstrbuton n the dual economy. Quarterly Journal of Economcs, XCIII, Fscher, F. 1956). Income dstrbuton, value judgements and welfare. Quarterly Journal of Economcs, 70, Fsher, I. 1930). The theory of nterest: As determned by mpatence to spend ncome and opportunty to nvest t. New York: MacMllan. Gordon, R. 1983). An operatonal classfcaton of dsease preventon. Publc Health Reports, 98, Gould, S. 1997). Kropotkn was no crackpot. Natural Hstory, 106, Graaff, J. de V. 1967). Theoretcal welfare economcs. Cambrdge: Cambrdge Unversty Press. Hcks, J. 1940). The valuaton of socal ncome. Economca, VII, Joner, T. 2005). Why people de by sucde. Cambrdge, Mass: Harvard Unversty Press. Kaldor, N. 1939). Welfare propostons of economcs and nterpersonal comparsons of utlty. Economc Journal, XLIX, Lengers, F. 1994). The dea of the absurd and the moral decson: Possbltes and lmts of a physcan's actons n the vew of the absurd. Theoretcal Medcne & Boethcs, 15, Lenzn, J 2009). Quoted n The Economst, 394, 9 January, Lttle, I. 1949). The foundatons of welfare economcs. Oxford Economc Papers, 1, new seres, Lttle, I. 1957). A crtque of welfare economcs. London: Oxford Unversty Press. Lovelock, J. 1995). Gaa: A new look at lfe on earth. 3 nd ed. Oxford: Oxford Unversty Press. Lovelock, J. 2006). The revenge of Gaa: Why the earth s fghtng back-and how we can stll save humanty. London: Allen Lane. Margln, S. 1962). Objectves of water-resource development: A general statement. In A. Maass, M. Hufschmdt, R. Dorfman, H.Thomas, S. Margln, & G. Far Eds.), Desgn of water-resource systems: New technques for relatng economc objectves, engneerng analyss and governmental plannng. pp ). Cambrdge, Mass: Harvard Unversty Press. Mera, K. 1969). Expermental determnaton of relatve margnal utltes. Quarterly Journal of Economcs, 83, Mnos, G. 1999). Hstory of sucde: Voluntary death n western culture. Baltmore: The Johns Hopkns Unversty Press. Mshan, E. 1969). Welfare economcs: An assessment. Amsterdam: North Holland. Mshan, E. 1981). Introducton to normatve economcs. New York: Oxford Unversty Press. Mrazek, P. & Haggerty, R.I. 1994). Summary. In P. Mrazek & R. Haggerty Eds), Reducng rsks for mental dsorders: Fronters for preventve nterventon research. pp. 1-67). Washngton, DC: Natonal Academy Press. Musgrave, R., & Peacock, A. 1958). Classcs n the theory of publc fnance. London: Macmllan. 74

10 Nath, S. 1969). A reapprasal of welfare economcs. London: Routledge and Kegan Paul. Neenan, W. 1971). Dstrbuton and effcency n beneft-cost analyss. Canadan Journal of Economcs, 4, Nussbaum, M., & Sen, A. 1993). The qualty of lfe. Oxford: Clarendon Press. Nwaner, V. 1970). Equty n cost-beneft analyss: A case study of the thrd London arport. Journal of Transport Economcs and Polcy, 4, Orbach, I. 2007). Exstentalsm and sucde. In A. Tomer, G. Eleason, & P. Wong Eds.), Exstental and sprtual ssues n death atttudes pp ). New York: Lawrence Erlbaum Assocates. Prngle, P., & Spgelman, J. 1982) The nuclear barons. London: Joseph. Raphael, B. 2000). A populaton health model for the provson of mental health care. Canberra: Commonwealth of Australa. Ruger, J.P. 2009). Health and socal justce. Oxford: Clarendon Press. Sctovsky, T. 1941). A note on welfare propostons n economcs. Revew of Economc Studes, IX, Sen, A. 1976). Real natonal ncome. Revew of Economc Studes, XLIII, Sen. A. 1985). Commodtes and capabltes. Oxford: Oxford Unversty Press. Sheshnsk, E. 1972). Relaton between a socal welfare functon and the Gn ndex of ncome nequalty. Journal of Economc Theory, 4, Shnedman, E. 1996). The sucdal mnd. New York: Oxford Unversty Press. US Publc Health Servce 1999). The Surgeon General's call to acton to prevent sucde. Washngton, DC: Department of Health and Human Servces. Wackernagel, M., & Rees, W. 1996). Our ecologcal footprnt: Reducng human mpact on the earth. Phladelpha, Pa.: New Socety Publshers. Wackernagel, M., Schulz, N., Deumlng, D., Lnares, A., Jenkns, M., Kapos, V., Monfreda, C.,... Randers, J. 2002). Trackng the ecologcal overshoot of the human economy. Proceedngs of the Natonal Academy of Scences, 9 July, Wesbrod, B. 1968). Income redstrbuton effects and beneft-cost analyss. In S. Chase Ed.), Problems n Publc Expendture Analyss: Papers Presented at a Conference of Experts pp ). Washngton, DC: Brookngs. 75

11 Edtoral Offce Dr. Nestor Kapusta Medcal Unversty of Venna Department of Psychoanalyss and Psychotherapy Waehrnger Guertel Venna, Austra Sucdology Onlne s publshed under the followng Creatve Commons Lcense: Attrbuton-Noncommercal-No Dervatve Works 3.0 Austra. Ths lcense regulates that artcles from Sucdology Onlne are free to be Shared to be coped, dstrbuted and transmtted under the followng condtons: Attrbuton You must attrbute the work n the manner that t's source Sucdology Onlne s mentoned. The most approprate way to do ths s by followng scentfc ctaton rules. But not n any way that suggests that Sucdology Onlne or the authors endorse you or your use of the work). Noncommercal You may not use ths work for commercal purposes. No Dervatve Works You may not alter, transform, or buld upon ths work.