STANFORD UNIVERSITY MEDICAL CENTER

STANFORD, CALIFORNIA 94305 © (415) 321-1200

STANFORD UNIVERSITY SCHOOL OF MEDICINE

Depariment of Genetics

December 26, 1969

Year Yr. ~tarr:

Your letter of Dec. 4 (and your paper in Science which I nad already

noted with

great interest) raises, as you well know, too many questions

to be deslt with in the space of a letter. I will tieke a few comments,
will gladly enclose and continue to send other #ertinent writings, end
will also respond to the idea of a more intimate discussion -- especielly
if we can schedule it for just one day in LA or here. ('Here! might pos-
sibly be the Center for Beh. Sci., whwre there are surely several people
whom you would wish to recruit.)

I was intrigued by your effort st en economic analysis; but this has
even more than the usual defects of the oversimplification of the model
of a perfect market for value theory. Consider inverting the arcument,
whether you can establish an ecenomic value to a life by empirical analysis;
and you will pf course find sn enormous verisation with context -- from

Ba negetive

value in the context of populstion control, to some $10” for

e highly visible, specifically identified sstronaut, to infinite’ in some
tnhousht-less idealizations. I also have some coneern thet system sames
mey be mischievous if they incorrectly identify the velue functions. (For

example, I

have had great trouble letely over stndards of plenetary

querantinemmammmm becouse of Sagan's model that postulated (1) a static

estimation

of the stakes, rether than as a function of knowledge of Mars

sequentislly acquired at some risk, and(2) his having plated all the stakes
on the chance to do 9 clean trial for the occurrence of extraterrestrial
life, rather than currehtly unsyecifiable explotitations of ars and its
potential inhsebitants. )

Consider

how far we are from e rational expenditure of potential life-

Seving resources, in such fields as smoking end auto safety. Jhet our so-
ciety is willing to pey for dafety depends on a great many extra-economic

factors --

the precision of our understandins of hazerds (at e retional

level) and such cultural influences 3s mass advertising...

I believe it is not overwhelmingly difficult to ¢gV¢histé estinete explicit
risks mn most of the fields of concern. There may also be large uncertainties,
and we have to analyse the cost-effectiveness of not meking che investments
to reduce those uncertainties. (Consider the impact of the unresolved vos-
sibility that our current estimates of health hazards of radietion ere too

optimistic

by one or even two bels.)

whet I find more baffiting is how to assess the imvact of new (ZR imbalanced)

technology
technolocy
inguiry is
Or to take
for access

on our institutions; and one can asx the same question of the

of technology-sssessment. “het are the losses if the svirit of
stifled by our timidity from having been burned by past excesses?
another example, how many lives are saved by the use of eutomobiles

to medical care at urban centers? (I do not think our msrket mecha-

nism correctly factors this into our investment in trensporaaétion.).

LT. J. P. KENNEDY, JR. LABORATORIES FOR MOLECULAR MEDICINE, DEDICATED TO RESEARCH IN MENTAL RETARDATION

MOLECULAR BIOLOGY

HEREDITY NEUROBIOLOGY DEVELOPMENTAL MEDICINE
A more pertinent example: U.S. technology in nuclear energy end in

metellurgy end scircraft is the foundetion of our military end foreizn
thet over-~

policy. ‘The costs and benefits of that volicy sre issues
whelm every other question you raise.

vorgive Lhe vagreney of these thoushts. ‘This say well

the need for a conference such as you suggest. The Nobel-14 Sympo

illustre

was theoretically supposed to be directed at similer matters, and
never did -- but it lacked the quantitetive orientation that you seek

and I admire.

Lb

uL
oS
o

e

1umM