One of the key roles of the English National Institute for Health and Clinical Excellence (NICE) is technology appraisal. This essentially involves evaluating the cost effectiveness of pharmaceutical products and other technologies for use within the National Health Service. Based on a content analysis of key documents which shed light on the nature of appraisals, this paper draws attention to the multiple layers of uncertainty and complexity which are latent within the appraisal process, and the often socially constructed mechanisms for (...) tackling these. Epistemic assumptions, bounded rationality and more explicitly relational forms of managing knowledge are applied to this end. These findings are discussed in the context of the literature highlighting the inherently social process of regulation. A framework is developed which posits the various forms of uncertainty, and responses to these, as potential conduits of regulatory bias—in need of further research. That NICE’s authority is itself regulated by other actors within the regulatory regime, particularly the pharmaceutical industry, exposes it to the threat of regulatory capture. Following Lehoux, it is concluded that a more transparent and reflexive format for technological appraisals is necessary. This would enable a more robust, defensible form of decision-making and moreover enable NICE to preserve its legitimacy in the midst of pressures which threaten this. (shrink)
Despite much discussion over the existence of moral facts, metaethicists have largely ignored the related question of their possibility. This paper addresses the issue from the moral error theorist’s perspective, and shows how the arguments that error theorists have produced against the existence of moral facts at this world, if sound, also show that moral facts are impossible, at least at worlds non-morally identical to our own and, on some versions of the error theory, at any world. So error theorists’ (...) arguments warrant a stronger conclusion than has previously been noticed. This may appear to make them vulnerable to counterarguments that take the possibility of moral facts as a premise. However, I show that any such arguments would be question-begging. (shrink)
Several cognitive accounts of human communication argue for a language-independent, prelinguistic basis of human communication and language. The current study provides evidence for the universality of a prelinguistic gestural basis for human communication. We used a standardized, semi-natural elicitation procedure in seven very different cultures around the world to test for the existence of preverbal pointing in infants and their caregivers. Results were that by 10–14 months of age, infants and their caregivers pointed in all cultures in the same basic (...) situation with similar frequencies and the same proto-typical morphology of the extended index finger. Infants’ pointing was best predicted by age and caregiver pointing, but not by cultural group. Further analyses revealed a strong relation between the temporal unfolding of caregivers’ and infants’ pointing events, uncovering a structure of early prelinguistic gestural conversation. Findings support the existence of a gestural, language-independent universal of human communication that forms a culturally shared, prelinguistic basis for diversified linguistic communication. (shrink)
In everyday speech we seem to refer to such things as abstract objects, moral properties, or propositional attitudes that have been the target of metaphysical and/or epistemological objections. Many philosophers, while endorsing scepticism about some of these entities, have not wished to charge ordinary speakers with fundamental error, or recommend that the discourse be revised or eliminated. To this end a number of non-revisionary antirealist strategies have been employed, including expressivism, reductionism and hermeneutic fictionalism. But each of these theories faces (...) forceful objections. In particular, we argue, proponents of these strategies face a dilemma: either concedes that their theory is revisionary, or adopt an implausible account of speaker-meaning whereby the content of certain types of utterance is opaque to their speakers. In this paper we introduce a new type of antirealist strategy, which is thoroughly non-revisionary, and leaves speaker-meaning transparent to speakers. We draw on work on pragmatics in the philosophy of language to develop a theory we call ‘pragmatic antirealism’. The pragmatic antirealist holds that while the sentences of the discourses in question have metaphysically contentious truth conditions, ordinary utterances of them are pragmatically modified in context in such a way that speakers do not incur commitment to those truth conditions. After setting out the theory, we show how it might be developed for both mathematical and ethical discourse, before responding to some likely objections. (shrink)
This research applies the impression management theory of exemplification in an accounting study by identifying and measuring differences in both auditor and public perceptions of exemplary behaviors. The auditors were divided into two groups, one of which reported self-perceptions (A-S) while the other group reported their perceptions of a typical auditor (A-O). There were two separate public groups, which gave their perceptions of a typical auditor and were divided based on their levels of accounting sophistication. The more sophisticated public group (...) was comprised of bank loan officers (LO) while the less sophisticated public group consisted of investment club members (IC). Comparisons were made on 30 behaviors contained in the AICPA Code of Professional Conduct, which served as the basis for the research instrument. Profile analysis, a special form of MANOVA technique, was used to analyze the results. A-S perceptions were the highest of the four treatment levels and were significantly higher (i.e., more exemplary) than the perceptions of both the A-O and LO groups. The more sophisticated user group (LO) provided the lowest perceptions of the four treatment levels. For at least four of the six measures, the LO treatment group perceived the typical auditor to be less exemplary than both the IC and A-O treatments. There were no differences in perceptions between the A-O group and IC. Additional analysis revealed that auditors overrated the degree to which the public relied on financial statements. However, both public groups reported a reasonably high level of reliance on financial statements when making decisions. (shrink)
In three studies, factors influencing the incidence of fraudulent financial reporting were assessed. We examined (1) the effects of personal values and (2) codes of corporate conduct, on whether managers misrepresented financial reports. In these studies, executives and controllers were asked to respond to hypothetical situations involving fraudulent financial reporting procedures. The occurrence of fraudulent reporting was found to be high; however, neither personal values, codes of conduct, nor the interaction of the two factors played a significant role in fraudulent (...) financial reporting. (shrink)
