Future states: the axioms underlying prospective, future-oriented, health planning instruments

Proscriptive planning exercises are critical to and generally accepted as i ntegral to health planning at varying scales. These require specific instru ments designed to predict future actions on the basis of present knowledge. At the macrolevel of health economics, for example, a number of future-ori ented Quality of Life Instruments (QL) are commonly employed. At the level of individual decision making, on the other hand, Advance Directives (AD's) are advanced as a means by which healthy individuals can assure their wish es will be carried out if at some future point they are incapacitated. As p roscriptive tools, both instrument classes;appear to share an axiomatic set whose individual parts have not been rigorously considered. This paper att empts to first identify and then consider a set of five axioms underlying f uture oriented health planning instruments. These axioms are then critiqued using data from a pre-test survey designed specifically to address their a ssumptions. Results appear to challenge the validity of the axioms underlyi ng the proscriptive planning instruments. (C) 2001 Elsevier Science Ltd. Al l rights reserved.