{"id":303,"date":"2025-10-07T12:03:45","date_gmt":"2025-10-07T16:03:45","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/?post_type=chapter&#038;p=303"},"modified":"2026-05-26T18:19:33","modified_gmt":"2026-05-26T22:19:33","slug":"limitations-existing-approaches","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/chapter\/limitations-existing-approaches\/","title":{"raw":"10.10 Limitations of existing approaches","rendered":"10.10 Limitations of existing approaches"},"content":{"raw":"Synthetic indices, which are the end-product of ROI, Cost-Benefit and Cost-Utility analyses, have an appealing aesthetic quality and present a seductive format for decision-makers. However, they hide many methodological decisions in a domain where no perfect methods exist. For example, in Cost-Utility analysis, the estimation of utility varies according to the method used and whether they are measured directly or estimated using a classification system (Brousselle et al., 2011c; Brousselle &amp; Lessard, 2011). Utility scores also vary according to the participants (Brousselle et al., 2011c; Brousselle &amp; Lessard, 2011). Another example is the use of discounting and discount rates that are the subject of many ethical and methodological debates.\r\n\r\nFurthermore, the rationale and methods used for giving a monetary value to life, as well as to social and environmental impacts, remain highly contested (Brousselle et al., 2016). For instance, giving a monetary value to all interventions\u2019 results rests on the principle that everything can be valued, including intangible elements, and nothing has an intrinsic value that is incommensurable. Many economists attribute a monetary value to life, for example, but how would you value your own life if you were asked to give it a price?\r\n\r\nEconomic evaluations are aimed at making decision-making more rational. However, to facilitate those processes, we rely on elegant synthetic indicators; these can hide many ethically and methodologically controversial choices which, in the end, make the criterion used for decision-making problematic.","rendered":"<p>Synthetic indices, which are the end-product of ROI, Cost-Benefit and Cost-Utility analyses, have an appealing aesthetic quality and present a seductive format for decision-makers. However, they hide many methodological decisions in a domain where no perfect methods exist. For example, in Cost-Utility analysis, the estimation of utility varies according to the method used and whether they are measured directly or estimated using a classification system (Brousselle et al., 2011c; Brousselle &amp; Lessard, 2011). Utility scores also vary according to the participants (Brousselle et al., 2011c; Brousselle &amp; Lessard, 2011). Another example is the use of discounting and discount rates that are the subject of many ethical and methodological debates.<\/p>\n<p>Furthermore, the rationale and methods used for giving a monetary value to life, as well as to social and environmental impacts, remain highly contested (Brousselle et al., 2016). For instance, giving a monetary value to all interventions\u2019 results rests on the principle that everything can be valued, including intangible elements, and nothing has an intrinsic value that is incommensurable. Many economists attribute a monetary value to life, for example, but how would you value your own life if you were asked to give it a price?<\/p>\n<p>Economic evaluations are aimed at making decision-making more rational. However, to facilitate those processes, we rely on elegant synthetic indicators; these can hide many ethically and methodologically controversial choices which, in the end, make the criterion used for decision-making problematic.<\/p>\n","protected":false},"author":20,"menu_order":10,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[49],"contributor":[],"license":[],"class_list":["post-303","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":273,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/pressbooks\/v2\/chapters\/303","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/wp\/v2\/users\/20"}],"version-history":[{"count":2,"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/pressbooks\/v2\/chapters\/303\/revisions"}],"predecessor-version":[{"id":673,"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/pressbooks\/v2\/chapters\/303\/revisions\/673"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/pressbooks\/v2\/parts\/273"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/pressbooks\/v2\/chapters\/303\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/wp\/v2\/media?parent=303"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/pressbooks\/v2\/chapter-type?post=303"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/wp\/v2\/contributor?post=303"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/foundationsofevaluation\/wp-json\/wp\/v2\/license?post=303"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}