Value focused rationality in AIDS policy.

Abstract

A health policy analysis to contain the effects of the HIV epidemic in Norway has been carried out. It was performed as a Multi Criteria Decision Analysis where participants in a decision panel used personal values to weight benefits and costs of alternative policies. The analysis is of particular interest since Norway afterwards adopted a controversial HIV policy: the authorities warned the general population against sexual relations with immigrants from countries south of Sahara. The policy might reap benefits, but a certain cost was to stigmatise that group. This paper describes the analysis and defends the underlying consequentialistic ethics against other approaches involving rule-based ethics and benefit-cost analysis. The main argument is based on Hume's insight that reason alone does not prompt action; values will always be involved and should therefore be more explicitly focused on. The paper concludes that we need an extended notion of rationality that includes well-foundedness of values. Decision-makers should try to reach an emotional equilibrium where their values concerning the issue at hand become stable. The paradigm of decision analysis provides useful methods to approach this situation, although it must be considered only an input to policy rather than something producing a final answer.