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   <subfield code="a">The ethical poverty of cost-benefit methods: Autonomy, efficiency and public policy choice</subfield>
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   <subfield code="c">[John Gillroy]</subfield>
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   <subfield code="a">The principle of efficiency holds as the basic standard of market decision-making. Routinely however, it has been applied as a standard of judgement to public choices as well. This essay proceeds on the basis of four assumptions. First, that efficiency, outside the market context, has two manifestations (Cost-Effectiveness Analysis and Cost-Benefit Methods) which are made distinct by one's concentration on judging the most cost-effective means to policy ends otherwise arrived at, and the other's use of efficiency to judge both the means and end of policy choice. Second, that although efficiency is a fit primary decision standard within a competitive market a principle with more distinctly ‘moral weight' is needed to judge ends outside of markets. Third, that one possible source of this ‘moral weight' is individual autonomy or freedom that is a fit ethical principle upon which to set the ends of public policy. Fourth, that the use of cost-benefit methods rather than cost-effectiveness analysis implies that it can satisfy the requirements of both efficiency and autonomy. If the efficient policy choice also provided protection of individual autonomy then cost-benefit methods could be used for the analysis of public policy ends, but if it fails to have a deeper moral justification then the role of efficiency in the public sector must be limited only to its judgement of cost-effective means to policy ends arrived at by a non-efficiency standard. I will argue that the autonomy of individual choice in a market is a ‘thin' and morally impoverished ethical standard of judgement that adds no additional ‘moral weight' to market efficiency for the judgements of policy ends. This conclusion limits efficiency to the consideration of public means alone, eliminating cost-benefit methods as a fit approach to policy analysis while simultaneously promoting cost-effectiveness analysis and the search for an independent moral standard for the assessment of public ends.</subfield>
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