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Huge variations in expenditure per life saved have been documented in the USA, Sweden, and Japan. Using an original-position argument, this paper examines normative rationales that might permit departures from equalization of marginal lifesaving investments. The conclusion is that adjustment for identifiability, as reflected in strict benefit-cost analysis, is not justified yet adjustments for consideration of longevity, quality of life and productivity are compelling. It is less clear as to whether factors such as ability to pay, voluntariness and catastrophic potential should influence lifesaving expenditures.

Large disparities in the cost per life saved for different lifesaving interventions have been reported in many studies. According to some researchers, these differences reflect the public's preoccupation with selected qualitative aspects of risk. However, it is not obvious that these disparities reflect public preferences. In studies of the variation in cost per life saved the public accepts, most respondents are willing to trade qualitative characteristics for lives saved, but there is a small but significant group of respondents who will not make the tradeoff, i.e. assign infinite value to one or more of the qualitative factors. It has been suggested that this group could be particularly vocal, which might account for the large variation in cost per life saved. In the first attempt to address this issue, a survey of people living under a power line in Stockholm was undertaken. This population was chosen because the local government had decided to remove the power line after being pressured by the citize...