Who lives, who dies, who cares? Valuing life through the disability-adjusted life year measurement

Laurie, E. W. (2015) Who lives, who dies, who cares? Valuing life through the disability-adjusted life year measurement. Transactions of the Institute of British Geographers, 40(1), pp. 75-87. (doi: 10.1111/tran.12055)

Abstract

Agamben's work on bare life, sovereignty and spaces of exception is widely drawn upon by those seeking to understand the topologies of abandonment within contemporary society. While the majority of work has focused on the spectacular forms of violence and extraordinary spaces of exception, neoliberal ideology has been germinating a new version of biopolitics and as such creating new sacred populations, new camps and new sovereign powers. This paper brings Agamben out from the battlefield, to employ his thinking as a means to understand the systemic violence conducted through a biopolitical regime increasingly governed by the logic of profit accumulation. Focusing on vector-borne diseases, the paper demonstrates a perpetual devaluation of lives within a prevailing economic system that searches out, and targets, ‘profitable’ populations, as exemplified by the current pharmaceutical industry and supporting apparatus that pursues the protection of profits over the preservation of lives. This abandonment within economic markets has spilled over into the arena of global health where equity is increasingly superseded by a goal of efficiency. Through a critique of the disability-adjusted life year (DALY) measurement (a calculation drawn upon to justify interventions, and frequently invoked under the rubric of ‘cost-effectiveness’), this paper argues that DALYs are symptomatic of a wider shift within global health governance and constitutive of a new biopolitical regime – where the body is incorporated within political and economic systems – by judging an individual's ‘worth’ through their economic productivity.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Laurie, Dr Emma
• Authors: Laurie, E. W.
• College/School: College of Science and Engineering > School of Geographical and Earth Sciences
• Journal Name: Transactions of the Institute of British Geographers
• Publisher: Royal Geographical Society
• ISSN: 0020-2754
• ISSN (Online): 1475-5661
• Published Online: 13 April 2014
• Copyright Holders: Copyright © 2014 Royal Geographic Society (with the Institute of British Geographers)
• First Published: First published in Transactions of the Institute of British Geographers 40(1): 75-87
• Publisher Policy: Reproduced in accordance with the publisher copyright policy