The aim of this paper is to consider what normative arguments might exist for advocating the use of any given measure of the average in the context of health state values. We begin by providing examples of the importance and implications of the choice of the measure of central tendency in stated preference studies (including both EQ-5D values and corresponding issues in the willingness to pay literature). Then, drawing on the theory of social choice, voting models and welfare economics, we consider the criteria that are available for judging the ‘goodness’ of alternative approaches to aggregation, and evaluate their relevance to the selection of the measure of average EQ-5D values.