 The WHO is very explicit that numerous choices made in the construction of the DALY measure are value-based (Murray 1994; Prüss-Üstün et al. 2003). Clearly, there is no matter of fact whether paraplegia constitutes a more severe impairment of someone’s functional capacity than blindness, much less the precise extent to which it contributes to the burden of disease. The same is true of the duration of the time lost due to premature death, age weights and time preference. While any given choice will, due to its value-laden nature, be controversial, the WHO makes some efforts to represent societal preferences instead of, say, a priori philosophical arguments. For example, the disability weights used in the 2003 World Health Survey were based on health state valuations from large representative population samples in over 70 countries (Prüss-Üstün et al. 2003: Ch. 3). Similarly, age weights are based on empirical studies that have indicated there is a broad social preference to value a year lived by a young adult more highly than a year lived by a young child, or lived at older ages (Murray 1996).