PhD: Our values or mine? A philosophical and empirical critique of deliberative and stated preference elicitation techniques in health economics

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The thesis evaluates to what extent health economic stated preference methods and deliberative approaches towards health preference elicitation allow participants to express normative considerations that are related to the well-being of others, register preferences that take the social status of beneficiaries into account, and express normative evaluations that go beyond a consequentialist focus on outcomes. In addition, the thesis assesses to what degree participants are afforded the opportunity for peer interaction and peer discussion, evaluates the sensitivity of elicitation methods towards participants undergoing preference transformation, and assesses to what degree health economic preference elicitation methods are compatible with the concept of collective moral authorship.

For the assessment, the thesis combines a philosophical analysis of the theoretical paradigms of neoclassical health economics and deliberative democratic theory with an evaluation of how both approaches relate to the practice of health preference elicitation. To the latter end, the thesis presents the findings of a literature review of health-related stated preference studies and discusses the results of qualitative interviews with the participants of two deliberative Community Juries on the topic of disinvestment in breast cancer screening.

Outcome and Translation

The thesis argues for the increased utilization of deliberative methods in health economic preference research alongside preference elicitation methods. 

PhD Student: Ruben Sakowsky

Supervisors: Mandy Ryan (HERU) and V. Entwistle (Health Services Research Unit, University of Aberdeen)


Degeling, C., Barratt, A., Aranda, S., Bell, R., Doust, J., Houssami, N., Hersch, J., Sakowsky, R., Entwistle, V. and Carter, S.M. (2018) 'Should women aged 70–74 be invited to participate in screening mammography? A report on two Australian community juries', BMJ Open, 8(6).

Sakowsky, R. (2020) 'Our values or mine? A philosophical and empirical critique of deliberative and stated preference elicitation techniques in health economics', PhD Thesis, HERU, University of Aberdeen.


Sakowsky, R., Ryan, M. and Entwistle, V. (2016) 'The Citizen's View: looking beyond patient preferences', Medicine, Markets and Morals Network, Meeting Three. Bringing it All Together: Reconfiguring Public Sector Provision of Health and Social Care: Policy and Practical Implications, London, England, 26-27 May 2016.

Sakowsky, R., Ryan, M. and Entwistle, V. (2016) 'The citizen's view: looking beyond patient preferences in health care valuation research', Institute of Applied Health Sciences (IAHS) Postgraduate Research Student Symposium, University of Aberdeen, Aberdeen, 24 June 2016.

Sakowsky, R., Ryan, M. and Entwistle, V. (2016) 'Normative frameworks of health care valuation: democratic deliberation as an alternative to individual preference elicitation', Nordic Health Economists' Study Group Meeting, Centre of Health Economics Research (COHERE), University of Southern Denmark, Odense, Denmark, 17-19 August 2016.

Sakowsky, R., Ryan, M. and Entwistle, V.A. (2017) 'What's good in health and health care?', Centre for Values, Ethics, and the Law in Medicine, University of Sydney, Sydney, Australia.

Sakowsky, R.Ryan, M. and Entwistle, V. (2018) 'Learning what people want in health: the status quo and what deliberation can bring to the table', Global Health Economics Seminar Series, Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Germany, 20 December 2018.

Sakowsky, R.Ryan, M., Entwistle, V., Degeling, C. and Carter, S. (2020) 'Expanding the valuation space of health preference elicitation: what range of normative considerations are deliberative approaches sensitive to?', 15th World Congress of Bioethics, University of Pennsylvania, Philadelphia, USA [Online], 19-21 June 2020.