Non-economic Losses Research Articles

Changes in the equilibrium of the urban transport system of a large city following an urban flood

Urban floods are among the most frequent and destructive natural disasters. They generate enormous economic and non-economic losses, including damage to buildings and transportation infrastructure, which are critical systems supporting community well-being. The purpose of this paper was to assess the impact an urban flood would have on the urban road transport system in Łódź and to determine changes in potential accessibility that would accompany a flood. This paper introduces a novel approach in terms of combining the modelling of direct impact ranges of urban flooding in the area of Łódź and a macroscopic multi-motivational traffic model for the city (using PTV Visum software). This made it possible to identify mechanisms of changes made in as many intra-system relationships as possible, as well as between the system and its surroundings. The results showed that changes in the spatial distribution of traffic volume in the city are closely dependent on the water level. The sections of the network most affected by the load changes are those that form the framework for the entire system of Łódź, indicating a lack of resilience of the car transport subsystem in the critical segment for the functioning quality of the entire subsystem. Additionally, the study was conducted for public transport, and it was indicated that changes in its utilization are minimal. It was also found that the greatest impact on transport accessibility from an urban flood is for ultra-short trips. This is primarily due to the base effect (the initial quality of the infrastructure and its potential) – the internal potential of the transport area deteriorates drastically during a flood, severely affecting accessibility.

Bridging evidence gaps in attributing loss and damage, and measures to minimize impacts

Losses and damages from climate change have been increasing as global temperatures continue to rise above pre-industrial levels. Low-income, climate vulnerable countries bear a disproportionate share of these losses and damages. After decades of international negotiations, the Loss and Damage Fund was established in late 2022, aiming at addressing both economic and non-economic losses arising from slow- and sudden-onset climate change events. Recognizing the complex nature of climate-related events, the establishment of the Loss and Damage Fund underscores an urgent need for precise attribution of these events to climate change, highlighting the fund’s reliance on scientific evidence to guide its efforts. Attribution science, which decouples specific causes of changes in climate hazards and impacts, can support loss and damage negotiations. Low-income countries, which have contributed the least to climate change, are experiencing more severe impacts. However, data quality and coverage required for scientific studies to attribute loss and damage to climate change remain limited in these developing countries. In this paper, we highlight the challenges to attribute losses and damages to climate change in developing countries and underscore strategies to overcome those challenges using examples from the agrifood sector. These strategies have implications for the operationalizing of the Loss and Damage Fund. We emphasize how improving data availability and quality can lead to rigorous scientific conclusions, supporting evidence-based, inclusive, and effective interventions. We also indicated measures that enable strengthening climate resilience to avoid and minimize losses and damages.

The human health burden of climate change: Non-economic losses and ethical considerations towards achieving planetary health

Climate change presents an urgent and growing threat to the health and well-being of people and the planet. More frequent and intense heatwaves, droughts and floods are breaching critical ecosystem boundaries, causing cascading impacts that are increasingly complex to govern. Unsustainable development pathways and economic choices that are fueling the climate crisis are also directly engendering global health issues. Furthermore, the global response to climate change has been uneven and the lack of a conceptual framework for loss and damage has allowed developed countries the latitude to adopt differing takes on its framing, undermining the urgency and progression of the loss and damage mechanism to the detriment of developing countries. Current research on the governance of climate ethics posits that while economic and legal considerations largely influence climate policies, decision-making processes in climate adjacent sectors such as health need to be further grounded on ethically sound principles. Framing the health impacts of climate change as a moral issue can therefore be viewed as an effort to reshape the current political discourse with a humanistic lens and move the international community and state-level actors to action. The framing of this issue is particularly important as it recenters the focus on human health as an imperative for effective climate policies rather than as a contributor to the cache of peripheral co-benefits. It also underscores climate change as an ethical issue, in which failure to respond to the climate impacts can worsen health inequities, especially for socially and economically marginalized communities and vulnerable groups.

Assessing “Invisible Loss” During Medium-Term Earthquake Recovery: The Case of Indonesia's 2016 Aceh Earthquakes

This study presents the results of a medium-term assessment of earthquake recovery, aiming to measure non-economic welfare losses resulting from the indirect impacts of earthquakes. While most earthquake assessments concentrate on the economic loss and damage caused by direct impacts of earthquakes, this study focuses on capturing these less visible non-economic losses. The 2016 Aceh earthquakes in Indonesia serve as the case study for this assessment. By applying the difference-in-differences method, we compared the changes in a range of non-economic welfare indicators in earthquake-affected and unaffected villages two years before (2014) and two years after (2018) the catastrophic earthquakes. In addition to administrative data, we tested the suitability of average monthly and annual night-time light data from the Visible Infrared Imaging Radiometer Suite (VIIRS) instrument as an alternative way to capture non-economic welfare losses. The findings from administrative data suggested a significant deterioration in, poverty, access to healthcare and access to socio-economic services in earthquake-affected villages relative to unaffected villages in 2018, compared to 2014. The analysis of nightlights data revealed contrasting results, suggesting that disaster recovery assessments using nightlights may not accurately capture non-economic welfare changes on the ground. Our research indicates that the detrimental effects of earthquakes on non-economic welfare persisted for years following the initial devastation. Utilizing administrative data can help pinpoint the nature and extent of non-economic losses and inform the development of policies to aid in the effective recovery of affected communities.

A Minimal Capabilities-Based Account of Loss and Damage

ABSTRACT The topic of loss and damage has generated contentious debates in international policymaking and climate negotiations. Up until now, political agreements have been possible because of the use of ambiguous language in defining loss and damage. However, with the agreement of creating a specific fund for loss and damage reached in the last COP27, the need to define loss and damage becomes more pressing. This definition will not only determine to whom the funds will flow, but also what kind of measures will be funded. This paper contributes to clarifying these two issues. First, it proposes what should count, minimally, as loss and damage by specifying a minimal account of loss and damage based on the capabilities approach. This minimal account develops and justifies an ex-post perspective on loss and damage that is coherent with the UNFCCC discourse. Moreover, it proposes to differentiate between economic damage, non-economic losses, and non-economic damage. Second, it proposes a variety of reparative measures (material and symbolic) that should be implemented in response to different forms of loss and damage.

Assessing climate change-induced losses and damages to coastal ecosystem services: Empirical evidence from Manpura Island, Bangladesh

Under the on-going climate change, slow-onset events, such as sea-level rise and salinity intrusion, have a more pronounced effect on biodiversity and ecosystem services, which have fewer options for adaptation compared to human systems, resulting in losses and damages. People who rely on ecosystems are also experiencing substantial damages and irreversible losses. Therefore, accurately assessing the losses and damages to ecosystem services becomes crucial. To address this issue, this paper employs an analytical framework adopted from Geest et al. (2019) and conducts a case study on the effects of extreme and slow-onset events on a coastal island of Bangladesh to evaluate the current losses and damages to ecosystem services. The study estimates the economic losses and damages to individual households, specifically in terms of some provisioning services, such as rice and fish, ranging from US$28 to US$419 per household. Furthermore, the case study elucidates the diverse values that individuals attributed to ecosystem services in their everyday lives, as well as non-economic losses, damages, and harms that are rooted in human emotions and experiences. It highlights non-economic losses and damages such as the gradual decline of social unity, an increase in mental illness, long-term physical health consequences, increased feelings of insecurity, and the depletion of fertile topsoil. The research concludes that building human capital for ecosystem-based adaptation is crucial to mitigating these impacts. It emphasises the need of documenting losses and damages locally using web-based recordkeeping in order to take evidence-based action to address losses and damages.

Reduction of the Quality of Life as an Independent Kind of Non-Economic Losses in Case of Damage to Health

The paper is devoted to examination of the decline in the overall quality of life of a person who has suffered health damage as an independent kind of non-economic losses. The author defines doctrinal and regulatory prerequisites for the development of scientifically grounded criteria for its assessment and compensation in tort obligations. It has been established that, despite the use of the term «physical suffering» in Article 151 of the Civil Code of the Russian Federation, this element does not have reliable accounting methods when determining compensation for moral damage, largely due to the concentration of the appropriate method of civil rights protection on the act of unlawful behavior itself and the combination of the functions of conditional restoration of individually perceived losses and private sanctions. Taking into account significant foreign experience (Australia, Spain, Italy, USA, France, etc.), the author substantiates that consideration of adverse changes in the general parameters of the physical condition of the victim separately from the moral harm construction is predetermined by their role as a non-economic basis for the life of each person, resulting from a resource-oriented approach to the category of quality of life. The author proposes the method of calculating compensation for non-material damagebased on the principles of isolation of the assessment of physical conditions for temporary and persistent injuries, the complexity of factors of the impact of health damage on the overall quality of life of the injured person, the objectivity of the characteristics of the severity of pain. The scope of application of the construction of moral harm in legal relations under consideration is clarified, extending it to physical and moral suffering, developing from the accompanying intangible losses of «special value» (loss of the ability to enjoy professional activities and ordinary daily activities, loss of prospects for personal growth in sports and hobbies, etc.).

What is lost from climate change? Phenomenology at the “limits to adaptation”

Abstract. Defining experiences of climate change loss and damage (L&D) is the topic of contentious debate across the social sciences and humanities. In this paper, we contribute to this debate by making loss(es) from climate change better legible. After detailing the complexity of the L&D debate from both a political and scientific perspective, we turn to phenomenological theory (Martin Heidegger, Tetsuro Watsuji, Bernhard Waldenfels) in order to make sense of climate's presence and the absences generated from changing climates. The phenomenology of loss we develop promises to help account for experiences of climate change that escape more traditional (social) scientific approaches to both economic and non-economic losses. More broadly, we present an alternative approach to applying phenomenology to research in social science (on climate change).

Anticipating environmental losses: Effects on place attachment and intentions to move

Environmental change is often accompanied by non-tangible, non-economic losses, including loss of valued attributes, connection to place, and social cohesion through migration in the face of such changes. Over two studies we sought to test whether imagining the loss of valued environmental characteristics influences intentions to migrate elsewhere and/or engage in place-protective actions, and whether this can be accounted for by changes to place attachment, using the city of Perth, Western Australia as a case study. In Study 1 (N = 148) we found imagined environmental loss significantly increased intentions to move away, and significantly decreased place attachment. There was no influence of imagining loss on place-protective action intentions. We replicated these findings in a representative community sample (Study 2: N = 333). In addition, we found that changes to moving intentions and place attachment related to the type of valued characteristic imagined loss, with characteristics that went beyond the explicitly environmental to encompass social relationships and lifestyle dimensions related to a tendency to stay, and lower reductions to place attachment. The implications of these findings include the inseparability of responses to environmental changes and perceptions of socio-cultural loss.

Evaluating progress on loss and damage: an assessment of the Executive Committee of the Warsaw International Mechanism under the UNFCCC

ABSTRACT The Warsaw International Mechanism for Loss and Damage Associated with Climate Change Impacts (WIM) was established in 2013, and its Executive Committee (ExCom) is developing a new five-year workplan. Seizing this opportune moment to assess institutional progress on the issue of loss and damage under the United Nations Framework Convention on Climate Change (UNFCCC) we address two research questions: (1) Has the ExCom delivered on its workplans to date, and (2) how has the ExCom’s progress varied across thematic areas? Drawing on public documentary sources, we assess the effectiveness and timeliness of the delivery of activities across five thematic areas: slow onset events; non-economic losses; comprehensive risk management approaches; human mobility; and finance, action and support. We find that there has been progress across the thematic areas, but that it has varied in pace. Delays are associated with activities from the two-year workplan being moved into the first five-year workplan or being devolved to the more recently established expert groups. Our results also show that decisions from the Conference of the Parties (COP) or the COP serving as the Meeting of the Parties to the Paris Agreement (CMA) have played a critical role in accelerating specific aspects of the ExCom’s work. Finally, we note that the ExCom is increasingly relying on its expert groups and their members to deliver many activities. This research advances our understanding of the nature and pace of progress on this issue, and raises new questions about the politics of global climate policy implementation. KEY POLICY INSIGHTS The WIM ExCom’s workplans are characterized by broad goals and are ambiguous about start dates and deadlines. To enhance accountability, future workplans would benefit from clearly defined objectives, outcomes, and timelines. The workplans do not seem to constitute strong commitments: Parties make use of COP/CMA decisions to strengthen the workplans by mandating specific activities or deadlines, adding new activities and prioritizing among existing ones. The politics of implementation merits greater attention: wider political dynamics around loss and damage shape the pace of the ExCom’s supposedly technical work. One example is the delayed establishment of the expert group on action and support.

Re-framing non-economic losses to non-economic impacts for effective policymaking: evidence from the Caribbean

ABSTRACT Weather-related natural disasters such as hurricanes are becoming more severe and more frequent due to human-induced climate change. Small Island Developing States are particularly vulnerable to such events. These extreme events have economic impacts on people’s lives but are also associated with non-economic losses (NELs) that are not easily quantifiable. The United Nations Convention Framework Convention on Climate Change (UNFCCC) has tasked the Warsaw International Mechanism for Loss and Damage to find ways to ‘address’ these losses. While the UNFCCC and literature identify NELs, these remain broad and high-level examples, potentially not applicable in local contexts. Therefore, international climate change policies that are developed to address NELs are at risk of being inadequate and might not address the needs of people affected. This paper addresses this research gap based on interviews with residents from the Caribbean islands Dominica and Barbuda who survived hurricanes Maria and Irma in 2017. Responses show that the categorization of NELs under the UNFCCC only partially aligns with those NELs identified by interviewees. Firstly, interviewees do not make a distinction between economic and non-economic losses and secondly the term ‘non-economic loss’ is best expressed as ‘non-economic impact’ in order to encapsulate the full breadth of NELs. Both terms should jointly be considered as fulfilling ‘life-functions’. HIGHLIGHTS The UNFCCC categories are not reflective enough of the broad range of non-economic losses (NEL) that exist. ‘Non-economic loss’ should be re-framed to ‘non-economic impact’ as a loss does not encapsulate the full breadth of losses identified by interviewees Another category for NELs is required as people do not always distinguish between economic and non-economic losses when economic items fulfil a life function The findings are detrimental for effective international and national policymaking

Empirical evidence from Bangladesh of assessing climate hazard-related loss and damage and state of adaptive capacity to address them

Under changing climate, more frequent and severe extreme climate events have been causing both economic and non-economic losses and damages to local communities living in disaster-prone areas. Based on 14 focused group discussions, 20 in-depth interviews, and eight key informant interviews, this study sought to understand the losses and damages experienced by rural communities in three locations of Bangladesh, which are vulnerable to riverine and flash floods or cyclones, associated surges & coastal flooding, and salinity intrusion. This paper first captured people’s perception about different extreme climate events and other climatic stressors affecting their lives and livelihoods. Considering the latest extreme climate events, the study estimated the economic loss and damage of individual households — in housing, agriculture, and health sectors — ranging from US$ 568 to US$ 1054 per household per event. These losses and damages were highest in the south-western coast than the two flood-prone areas in the north and north-east, since multiple hazards were causing relatively longer impacts on the coast. As non-economic losses and damages, change in productive land, stressed mental, emotional, and physical wellbeing, sacrificing celebrations, temporary migration, and permanent change in profession were common in all three locations. The study also found that increased adaptive capacity enabled households to address their extreme climate event-related impacts. Households of the study locations, who got exposed to information and communication technology, as participants of a grassroots development project, have improved their coping and adaptation strategies by using the accessed information, technologies, and training. They improved their income by changing agricultural practices and diversifying livelihood options. They also developed leadership, entrepreneurial skills, and connectivity with different social and institutional networks. Building on this evidence, this paper proposed a conceptual framework showcasing the relationships of adaptive capacity with anticipated higher loss and damage scenarios under changing climate. This research concluded that more investment on raising adaptive capacity of households living in climate vulnerable locations is highly required to minimize loss and damage in the projected climate change scenarios.

Migration as Adaptation?

AbstractThe discourse on climate change and migration has shifted from labelling migration merely as a consequence of climate impacts, to describing it as a form of human adaptation. This article explores the adaptation framing of the climate change and migration nexus and highlights its shortcomings and advantages. While for some groups, under certain circumstances migration can be an effective form of adaptation, for others it leads to increased vulnerabilities and a poverty spiral, reducing their adaptive capacities. Non-economic losses connected to a change of place further challenge the notion of successful adaptation. Even when migration improves the situation of a household, it may conceal the lack of action on climate change adaptation from national governments or the international community. Given the growing body of evidence on the diverse circumstances and outcomes of migration in the context of climate change, we distinguish between reactive and proactive migration and argue for a precise differentiation in the academic debate.

RELIABILITY ANALYSIS OF REINFORCED CONCRETE FLEXURAL ELEMENT ON CRACKING BASED ON FRACTURE MECHANICS

The article describes a probabilistic approach to the reliability analysis of a flexural reinforced concrete element by the cracking criterion using the provisions of fracture mechanics. Two mathematical models of limit state are proposed for reliability analysis: with the evaluation of the critical stress intensity coefficient directly and through the design concrete compressive strength. On the basis of regression analysis, the relationship between the critical stress intensity coefficient and the design concrete compressive strength is established which can be used in the inspection of reinforced concrete structural elements. The influence of the design concrete compressive strength on the failure (cracking) probability of the flexural reinforced concrete element is analyzed. The numerical example of reliability analysis is given for the reinforced concrete beam by the criterion of cracking. It is noted that the required level of reliability should be set for each structural object individually based on the acceptable risk value using economic and non-economic losses.

Justify State 'Piracy' after Allen: Introducing 'Apology' to the U.S. Copyright Regime

Copyright protection from state offenders is onerous because of the imbalanced bargaining power between states and authors, which is increased by the U.S. Supreme Court decision in Allen v. Cooper. This decision clarifies that state sovereign immunity is not abrogated by the Copyright Remedy Clarification Act of 1990 (“CRCA”). It secures states’ constitutional rights, the public interest, and the efficiency of copyright infringement litigations against states. However, a paradox of this decision is that it may harm innovation incentives or spirits of creativity due to the increased imbalanced bargaining power to prevent authors from being repaired for their economic or non-economic losses. This Article reviews the law and psychology literature and proposes to adopt compelled and voluntary state “apologies” in the copyright regime. It suggests that the “apologies” do not conflict with Allen’s benefits but can rebuild the reputation of authors and repair relationships between the authority and authors to promote or sustain their innovation incentives.

‘When we were children we had dreams, then we came to Dhaka to survive’: urban stories connecting loss of wellbeing, displacement and (im)mobility

ABSTRACT This article uses storytelling methodology to investigate the connections between urban climate-induced loss of wellbeing and (im)mobility in Bhola Slum, an informal settlement in Dhaka, Bangladesh. The settlement houses Internally Displaced People from the southern coast who built and named the slum after their home - Bhola Island. The storytelling sessions revealed that loss of belonging, identity, quality of life and social value produced in people a desire to return. Nostalgic storylines of home also shaped the narratives of the children born in the slum who often referred to the island as their home. Some women felt that the move had resulted in more liberty, but also claimed that it had increased the risk of social punishment and stigmatisation. Social stigma often extended from parents to children. More women than men reported feeling unsafe, depressed and anxious. Mental and physical ill health were both common consequences of the compromised living and working conditions of the slum. Loss of health (due to injuries or disease) damaged people's wellbeing and pushed already fragile families into a downward spiral with no escape. Few empirical studies investigate ‘trapped’ populations and non-economic losses and damages in urban environments. The insights gained from this work can therefore help safeguard vulnerable populations worldwide and build more robust climate policy frameworks.

Trapped in the prison of the mind: Notions of climate-induced (im)mobility decision-making and wellbeing from an urban informal settlement in Bangladesh

The concept of Trapped Populations has until date mainly referred to people ‘trapped’ in environmentally high-risk rural areas due to economic constraints. This article attempts to widen our understanding of the concept by investigating climate-induced socio-psychological immobility and its link to Internally Displaced People’s (IDPs) wellbeing in a slum of Dhaka. People migrated here due to environmental changes back on Bhola Island and named the settlement Bhola Slum after their home. In this way, many found themselves ‘immobile’ after having been mobile—unable to move back home, and unable to move to other parts of Dhaka, Bangladesh, or beyond. The analysis incorporates the emotional and psychosocial aspects of the diverse immobility states. Mind and emotion are vital to better understand people’s (im)mobility decision-making and wellbeing status. The study applies an innovative and interdisciplinary methodological approach combining Q-methodology and discourse analysis (DA). This mixed-method illustrates a replicable approach to capture the complex state of climate-induced (im)mobility and its interlinkages to people’s wellbeing. People reported facing non-economic losses due to the move, such as identity, honour, sense of belonging and mental health. These psychosocial processes helped explain why some people ended up ‘trapped’ or immobile. The psychosocial constraints paralysed them mentally, as well as geographically. More empirical evidence on how climate change influences people’s wellbeing and mental health will be important to provide us with insights in how to best support vulnerable people having faced climatic impacts, and build more sustainable climate policy frameworks.

Loss and damage in the IPCC Fifth Assessment Report (Working Group II): a text-mining analysis

ABSTRACT ‘Losses and damages’ refer to impacts of climate change that have not been, or cannot be, avoided through mitigation and adaptation efforts. After the establishment of the Warsaw International Mechanism for Loss and Damage (WIM), Loss and Damage is now considered the third pillar – besides mitigation and adaptation – of climate action under the United Nations Framework Convention on Climate Change (UNFCCC). This paper studies what the Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC WGII AR5) has to say about this emerging topic. We use qualitative data analysis software (text mining) to assess which climatic stressors, impact sectors and regions the report primarily associates with losses and damages, and compare this with the focus areas of the WIM. The study reveals that IPCC WGII AR5 primarily associates losses and damages with extreme weather events and economic impacts, and treats it primarily as a future risk. Present-day losses and damages from slow-onset processes and non-economic losses receive much less attention. Also, surprisingly, AR5 has more to say about losses and damages in high-income regions than in regions that are most at risk, such as small island states and least developed countries. The paper concludes with recommendations to the IPCC for its 6th Assessment Report (AR6) to include more evidence on losses and damages from slow-onset processes, non-economic losses and damages and losses and damages in vulnerable countries. Key policy insights IPCC WGII AR5 discusses evidence about losses and damages predominantly in relation to sudden-onset disasters and economic costs. More research is needed on losses and damages from slow-onset processes and non-economic loss and damage, particularly in vulnerable countries in the Global South. Funding agencies should support research in these areas and IPCC WGII AR6 should pay more attention to these topics. Losses and damages are not only a future risk, but already a present-day reality for vulnerable people in climate hotspots. People-centred research by social scientists is crucial for enhancing understanding of what losses and damages mean in the real world.

Insurance schemes for loss and damage: fools’ gold?

ABSTRACT Insurance schemes are a widely supported form of finance mechanism to address climate change-induced loss and damage, and are part of the Warsaw International Mechanism for Loss and Damage. This paper reviews active insurance schemes for loss and damage by exploring existing critiques. Novel insights into the fundamental challenges that insurance schemes face are then examined, in particular in the context of common but differentiated responsibilities and respective capabilities, intergenerational equity, economic and gender inequality, and human mobility. The analysis concludes that, despite their popularity among policy makers, insurance schemes seem ill-suited to address the full range of loss and damage. Therefore, pursuing these schemes, without backstopping from international finance, might undermine the objective of responding to loss and damage in a comprehensive manner. Consequently, it may be advisable for policy makers to consider how to overcome the apparent challenges in order to ‘insure the uninsurable’. Key policy insights Existing insurance schemes are ill-suited to fully respond to climate change loss and damage, given the increased frequency and severity of sudden onset events, slow onset events, and non-economic losses and damages. Insurance schemes fail to align with principles enshrined in the climate change regime, in particular the principle of common but differentiated responsibilities and respective capabilities (CBDR-RC) and intergenerational equity. Insurance products do not take economic inequality or gender considerations into account and loss and damage stemming from human mobility does not lend itself to insurance solutions as currently conceived, in certain circumstances. If insurance continues to be pursued as a response to loss and damage, it requires a major overhaul with innovative approaches. Policy makers must consider sourcing new and additional finance, reflecting the principle of CBDR-RC.

Feasibility of a Health‐Utility Approach to Quantifying Noneconomic Losses from Personal Injury

There is wide agreement that existing approaches to valuing noneconomic losses from personal injury lack coherence. “Health‐utility” measurement—an approach developed in health economics for valuing health outcomes in public health and medicine—holds considerable promise for bringing greater rationality and consistency to assessments of injury‐related noneconomic loss. However, the feasibility of creating utility measures that are suitable for use in personal injury compensation has not been demonstrated. This study takes that step. We surveyed more than 4,100 members of the general public in Australia to assess people's preferences for a variety of nonfatal “health states.” The health states were selected to reflect harms commonly seen in claims to compensation schemes for transport and workplace accidents. We then followed established methods for transforming the survey responses into a “severity weight” for each health state. We show how these severity weights can be used to define tiers in a schedule for guiding noneconomic damages determinations. We also discuss the strengths and limitations of the approach, and consider implementation challenges.