@cshentrup the objective data is she would die without the operation (i hope she is well!) while others might use the same million to buy a new house. but there is no science that can tell you that her (wonderfully) continued existence creates more "utils" than some particular person's new house. it's a choice about interpersonal values i agree with, but i can't fall back to some empirical science to make for us. we have to make it.