Harris’ reply to our defence of the National Institute for Clinical Excellence’s (NICE) current cost-effectiveness procedures contains two further errors. First, he wrongly draws a conclusion from the fact that NICE does not and cannot evaluate all possible uses of healthcare resources at any one time and generally cannot know which National Health Service (NHS) activities would be displaced or which groups of patients would have to forgo health benefits: the inference is that no estimate is or can be made (...) by NICE of the benefits to be forgone. This is a non-sequitur. Second, he asserts that it is a flaw at the heart of the use of quality-adjusted life years (QALYs) as an outcome measure that comparisons between people need to be made. Such comparisons do indeed have to be made, but this is not a consequence of the choice of any particular outcome measure, be it the QALY or anything else. (shrink)

This essay seeks to characterise the essential features of an equitable health care system in terms of the classical Aristotelian concepts of horizontal and vertical equity, the common language of “need” and the economic notion of cost-effectiveness as a prelude to identifying some of the more important issues of value that policy-makers will have to decide for themselves; the characteristics of health that can cause policy to be ineffective ; the information base that is required to support a policy directed (...) at securing greater equity, and the kinds of research that are needed to underpin such a policy. (shrink)

This editorial provides a review of the current ways in which health economics is impacting on policy and reviews some of the key ethical and value-judgmental issues that commonly arise in and as a result of the work of economists. It also briefly highlights the contributions of the authors of this special issue of the journal, all of which illustrate how economists have approached ethical issues in health service policy , and some of which explore the major methodological matters that (...) arise and go on to discuss their potential as sources of conflict or harmony with other approaches to the same questions. (shrink)

Annihilationism provides a fruitful point of contact between philosophers and theologians for further reflection on nonexistence. In this paper I articulate a key commitment of annihilationism; namely, that some persons cease to exist. Such a commitment, I argue, amounts to the claim that some persons exist at time t and then do not exist at t+1, become ‘annihilated objects.’ Claims about annihilated objects induct the annihilationist into a wider realism/anti-realism debate about nonexistent objects. I survey some major viewpoints in this (...) debate. I then draw out some implications for each view for the annihilationist’s commitment to annihilated objects. I show that annihilationism is consistent with some forms of realism and anti-realism and inconsistent with others. (shrink)

This essay shows how Conrad Hal Waddington is at the very center of divergent genealogies of theoretical biology: he is at once remembered for his contribution to epigenetics and complex systems biology (in its current formation) and largely forgotten for the debt that he owes to Alfred North Whitehead’s philosophy of organism. The essay traces Waddington's debt to Whitehead and demonstrates the way in which this conceptual lineage challenges the transcendental conditions of biological knowledge presupposed by the reigning paradigm of (...) complex systems biology. (shrink)

DNA replication is both highly conserved and controlled. Problematic DNA replication can lead to genomic instability and therefore carcinogenesis. Numerous mechanisms work together to achieve this tight control and increasing evidence suggests that post‐translational modifications (phosphorylation, ubiquitination, SUMOylation) of DNA replication proteins play a pivotal role in this process. Here we discuss such modifications in the light of a recent article that describes a novel role for the deubiquitinase (DUB) USP7/HAUSP in the control of DNA replication. USP7 achieves this function (...) by an unusual and novel mechanism, namely deubiquitination of SUMOylated proteins at the replication fork, making USP7 also a SUMO DUB (SDUB). This work extends previous observations of increased levels of SUMO and low levels of ubiquitin at the on‐going replication fork. Here, we discuss this novel study, its contribution to the DNA replication and genomic stability field and what questions arise from this work. (shrink)

This article argues for the relevance of mythical signification in our geological epoch. More than this, it contends that we need to revise our assumptions about media and communication systems in order to grasp the importance of myth in an era where the future of human and nonhuman life on the Earth is entirely uncertain. To make this case, I focus on the growing consensus in the sciences and theoretical humanities that mythical stories about geological and planetary processes cannot simply (...) be disqualified or disregarded because they do not conform to the norms of modern scientific epistemology. Whether these stories come to us from pre-modern civilizations and attempt to give... (shrink)

Duhem's great contribution to the study of the history of medieval science is indisputable. His book remains an excellent source of information concerning the ideas of the epoch's thinkers about the foundations of the universe. Ariew's painstaking translation of a considerable portion of Duhem's ten-volume work deserves the deep gratitude of all those interested in medieval science. Le Systéme du monde regains its actuality. Nevertheless, to write now about a book produced by this great scholar at the beginning of the (...) century is not an easy undertaking, and involves some risk. Too many changes have taken place in the principles of studying the history of science during the seventy-odd years since the book was written, and some notions that seemed then to be perfectly clear are not so simple and indisputable now. With profound respect for this feat of scholarship, I should like to make some observations in connection with the recent English publication of Duhem's book. (shrink)