Your interpretation also seems reasonable to me. I would say that "utilitarian calculus" in the second level represents possible disagreements over what the be

Your interpretation also seems reasonable to me. I would say that "utilitarian calculus" in the second level represents possible disagreements over what the best calculus is, like "is measuring QALYs a good idea or should we measure something else?". I think "we should put a lot of thought into figuring out which methods are more/most effective" is in the first level, but the specific conclusion you reach through that thought is in the second level.