Your Money, Your Life, or Your Freedom? A Discrete‐Choice Experiment on Trade‐Offs During a Public Health Crisis

• Published date: 01 January 2022
• Author: Nicola Belle,Paola Cantarelli
• Date: 01 January 2022
• DOI: http://doi.org/10.1111/puar.13429

Research Article

Your Money, Your Life, or Your Freedom? A Discrete-Choice Experiment on Trade-Offs During a Public Health Crisis 59

Abstract: We conducted a discrete-choice conjoint analysis on a sample of residents in Italy to explore trade-offs

between human lives, individual freedoms, and the economy that governments and their citizens face while coping

with a public health crisis. Our results indicate that people prefer to avoid income losses over reduction in the number

of victims by the same percentage. The relative preference for saving income over saving lives widens as the size of

losses at stake increases. The duration of restrictions to individual freedoms per se does not appear to have a sizable

impact on people’s preferences once income and human losses are accounted for. Our study contributes to scholarship

on the value of a statistical life and sheds light on morally problematic trade-offs. Further, we illustrate how conjoint

analysis through discrete choice modeling can address public administration and policy issues that are inherently

multidimensional.

Evidence for Practice

• Stark trade-offs between money, life, and freedom emerged during the COVID-19 pandemic in much the

same way as they did during previous crises of public health and public safety.

• Italian adults seem to have a preference for saving income versus saving lives, with this preference growing as

the losses at stake increase.

• Once economic and human losses are accounted for, the duration of restrictions on civil liberties does not

strongly affect Italian adults’ preferences between alternative lockdown measures.

• In coping with public health crises, discrete-choice experiments are cost-effective tools that can inform

government adoption of policies that involve trade-offs between citizens’ lives, their civil liberties, and the

economy.

A grim calculus. Covid-19 presents stark choices

between life, death and the economy.

The Economist (2020).

The COVID-19 pandemic has forced

governments to make uncomfortable

choices between citizens’ lives, their

freedoms, and the economy (e.g., Comfort et

al. 2020; Gostin and Wiley 2020; International

Monetary Fund 2020; McKee and Stuckler 2020;

The Economist 2020). These trade-offs (Fiske and

Tetlock 1997), which suddenly rose to the fore in

the public debate, had previously been relegated to

pure academic debate. As an example, scholarship

on the value of a statistical life (e.g., Organization

for Economic Cooperation and Development 2012;

Viscusi 2018) has typically explored the trade-off

between monetary and human losses as a thought

experiment conducted in isolation, without taking

into account other factors that come into play when

billions of individuals form this sort of judgment

in the real world. The lockdown measures that

governments across the globe have implemented

in response to the COVID-19 crisis (e.g., Chorus

et al. 2020; Gostin and Hodge 2020; Gostin

and Wiley 2020) have offered an unprecedented

setting for studying the relative importance that

citizens attach to human and economic losses while

factoring in the length of stay-at-home orders.

Our study seizes this window of opportunity to

disentangle the simultaneous and independent

effects of the three main types of losses that are

associated with government responses to health

emergencies—namely human lives, income, and

freedom of movement. In other words, adopting a

descriptive and exploratory rather than normative

and predefined approach, our work addresses the

following research question: “What is the relative

importance that citizens place on human life,

income, and freedom of movement when forming

their preferences regarding the lockdown measures

that governments take to address a public health

Nicola Belle

Paola Cantarelli

Scuola Superiore Sant’Anna

Your Money, Your Life, or Your Freedom? A Discrete-Choice

Experiment on Trade-Offs During a Public Health Crisis

Paola Cantarelli is an assistant

professor at Scuola Superiore Sant’Anna

(Management and Healthcare Laboratory,

Institute of Management and EMbeDS, Pisa,

Italy). Her research focuses on behavioral

human resource management and work

motivation in mission-driven organizations.

Email: paola.cantarelli@santannapisa.it

Nicola Belle is an assistant professor at

Scuola Superiore Sant’Anna (Management

and Healthcare Laboratory, Institute of

Management and EMbeDS, Pisa, Italy).

His research focuses on behavioral public

administration and management.

Email: nicola.belle@santannapisa.it

Public Administration Review,

Vol. 82, Iss. 1, pp. 59–68. © 2021 by

The American Society for Public Administration.

DOI: 10.1111/puar.13429.

Both the authors contributed equally to this work.