Animal and human studies suggest that parenting style is transmitted from one generation to the next. The hypotheses of this study were that a mother’s rearing experiences would predict her own parenting resources and current maternal mood, motivation to care for her offspring, and relationship with her parents would underlie this association. In a subsample of 201 first-time mothers participating in the longitudinal Maternal Adversity, Vulnerability and Neurodevelopment project, we assessed a mother’s own childhood maltreatment and rearing experiences using the (...) Childhood Trauma Questionnaire and the Parental Bonding Instrument. At 6 months postpartum, mothers completed questionnaires on parenting stress, symptoms of depression, maternal motivation, and current relationship with their own parents. The sample consisted of mostly high socioeconomic status mothers recruited from Montréal or Hamilton, Canada, with an age range from 18 to 43 years. More severe maltreatment and less supportive rearing by the mother’s parents predicted increased parenting stress at 6 months. These associations were mediated through distinct psychosocial pathways: maltreatment on parenting stress through symptoms of depression ; maternal rearing on parenting stress through maternal motivation and symptoms of depression ; and paternal rearing on parenting stress through current relationship with the father. Maternal rearing experiences predict a mother’s own parenting resources though distinct psychosocial pathways, including depressed mood, maternal motivation, and social support. (shrink)

Climate change economists have called it “the most important number you’ve never heard of” and the “holy grail of climate economic analysis.” It is the social cost of carbon (SCC), and its purpose is to reflect—in one dollar figure—the harm caused by emitting a single ton of carbon dioxide into the atmosphere. The SCC is an essential concept for environmental cost-benefit analysis, and for the idea of an “optimal tax” on carbon emissions. It is also the subject of fierce debate (...) in the academic literature and in American politics. This book offers the most systematic analysis yet of the social cost of carbon, its theoretical basis, and its proper role in climate economics and climate policy design. It explains that the SCC is not one concept but four, each of which is addressed to a distinct task in climate economics. Moreover, these four concepts can be sorted into two families that correspond to the two main branches of welfare economics, social choice theory and general equilibrium theory. The book explains these radically different theoretical frameworks and how a mathematically identical pair of SCC concepts can emerge from each. It then argues that the analytical power of each SCC concept is limited by its inability to capture the full array of ethical considerations that bear on responsible climate policy. Despite these limitations, the book explains how at least some SCC concepts can and should be put to work in real-world climate change policy analysis. (shrink)

Background: Omalizumab, an anti-immunoglobulin E antibody, reduces exacerbations and symptoms in uncontrolled allergic asthma. The study objective was to estimate the costs and consequences of omalizumab compared to usual care from a US payer perspective. Methods: We estimated payer costs, quality-adjusted survival (QALYs), and the incremental cost-effectiveness ratio (ICER) of omalizumab compared to usual care using a state-transition simulation model that included sensitivity analyses. Every 2 weeks, patients could transition between chronic asthma and exacerbation health states. The best available evidence (...) informed the clinical and cost input estimates. Five years of omalizumab treatment followed by usual care was assumed to estimate a lifetime horizon. Omalizumab responders (60.5% of treated) were modeled as a separate scenario where nonresponders reverted back to usual care after 16 weeks of active treatment. Results: The mean lifetime discounted costs and QALYs were $83 400 and 13.87 for usual care and $174 500 and 14.19 for omalizumab plus usual care resulting in $287 200/QALY (95% interval: $219 300, $557 900). The ICER was $172 300/QALY when comparing omalizumab to usual care in the responder scenario. One-way sensitivity analyses indicated that the results were sensitive to the difference in treatment-specific utilities for the chronic state, exacerbation-associated mortality, omalizumab price, exacerbation rates, and response definition. Conclusions: The results suggest that adding omalizumab to usual care improves QALYs at an increase in direct medical costs. The cost-effectiveness of omalizumab is similar to other chronic disease biologics. The value increases when omalizumab response is used to guide long-term treatment. (shrink)

Comment une école publique d’art en Grande Bretagne a-t-elle été créée, comment a-t-elle évolué au XIXe siècle et quelle fut sa place vis-à-vis de la Royal Academy of Arts? Quelles furent l’incidence et l’importance de l’économie politique utilitariste et plus particulièrement des écrits de J. Bentham sur le goût, l’éthique et l’utilité, dans le développement d’une institution subventionnée par l’État et destinée à l’éducation artistique de la nation? Quels furent les débats et les apories..

Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is (...) based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care. (shrink)

The Social Value Judgments consultation document reveals NICE’s failure to understand its role in healthcare prioritisationThe National Institute for Health and Clinical Excellence has published a draft guideline, Social Value Judgments: Guidelines for the Institute and its Advisory Bodies , which outlines the ethical framework that will guide its decision making in the future.1 NICE guidance has a profound effect upon the delivery of health care within the National Health Service so it is crucial that an overarching guideline such as (...) this is suited to the task that it needs to perform. In this paper we argue that NICE has misunderstood the way in which its advice fits into prioritisation decisions. This misunderstanding is amplified by its views about the ethical principles that should apply to prioritisation and, in particular, its failure to appreciate the role of fair processes in prioritisation.The national and international standing of NICE means that the definitive version of Social Value Judgments: Guidelines for the Institute and its Advisory Bodies is likely to have influence beyond the institute itself. There is much to welcome about the document, not least the acknowledgement that there are important ethical dimensions to NICE’s decision making. Indeed, the significance of the document lies in the fact that NICE is attempting to create an explicit ethical framework for funding decisions.There is, however, much that is of concern. Although John Harris has made some important points about the NICE position on age and sex,2 there are other important problems that need to be discussed. First, there appears to be confusion over the nature of the funding decisions taken by NICE and, as a result, the role of its guideline. It is of vital importance that professionals and public alike understand the precise nature of …. (shrink)

In this study, we present a cost-sharing rule for cost-sharing problems. This rule prescribes the same allocations in a problem and in its dual one. Moreover, in some specific problems it gives the same allocations as the serial cost-sharing rule (Moulin and Shenker, Econometrica, 60, 1009–1037, 1992) does in a related problem. That is why we call it as the self-dual serial cost-sharing rule. We give two axiomatizations of this new rule and another one for the serial cost-sharing rule.

In this article, we investigate how state-to-state differences in U.S. childcare costs and gender norms are associated with maternal employment. Although an abundance of research has examined factors that influence mothers’ employment, few studies explore the interrelationship between maternal employment and culture, policy, and individual resources across U.S. states. Using a representative sample of women in the 2017 American Community Survey along with state-level measures of childcare costs and gender norms, we examine the relationship between these state conditions and mothers’ (...) probability of employment. We pay careful attention to differences in mothers’ level of education. Our results suggest that expensive childcare is associated with lower maternal employment, particularly for those with less education. For the college educated, expensive childcare is negatively associated with maternal employment in states with traditional gender norms that uphold mothers as primary caregivers. Among mothers with lower levels of education, gender norms have a limited association with employment. These findings suggest that highly educated mothers mobilize resources to remain in the labor force when paid work is supported by local gender norms. For less-educated mothers, expensive childcare predicts lower employment regardless of gender norms, indicating that structural constraints outweigh normative expectations among those with fewer resources. (shrink)

This paper argues for a non-moral interpretation of the libertarian conception of interpersonal liberty as ‘the absence of imposed cost.’ In the event of a clash of imposed costs, observing such liberty entails ‘minimising imposed costs’. Three fundamental criticisms are examined: strictly interpreted, this would logically imply genocide in practice; it is impractically unclear and moralised; it could entail mob rule of some kind. Self-ownership and private property are then non-morally derived merely from applying this formula in a state of (...) nature. Various subsidiary issues arise throughout. (shrink)

The private sector has implemented many cost containment measures in efforts to control rising health care costs. However, these measures have not controlled costs in the long run, and can be expected not to succeed as long as business cannot control factors within the health care system which affect costs. Controlling private sector health care costs requires constraints on cost shifting which necessitates a unified financing system with expenditure limits. A unified financing system will involve a partnership between the public (...) and private sectors. (shrink)

This essay addresses a stream of thought manifested in some forms of social justice activism – namely, that members of marginalized groups have privileged insight into the nature of social reality which others cannot understand, much less critique. This position, which I call “epistemic isolationism,” seems to rest on the claim that the knowledge that is embedded in lived experience is incommunicable. The essay proceeds in three parts: first, there is a brief overview of standpoint epistemology, including a recent version (...) which seems to support epistemic isolationism. Second, there is an explication of the concept of “lived experience” as developed by Wilhelm Dilthey. Third, there is an argument against the claim that lived experience is incommunicable, drawing from the work of Dilthey, Hans-Georg Gadamer, and Paul Ricoeur. The payoff of the argument is that sharing lived experience through expressions like literature and narrative inspires mutual recognition and respect which can, in turn, support a robust form of solidarity and serve as a foundation for more effective social justice advocacy. (shrink)

The purpose of this paper is to review the rising influence of commercialism in American medicine and to examine some of the consequences of this trend. Increased competition subverts physician collegiality, draws hospitals into for-profit ownership and behavior, and leads clinical investigators into secrecy and possibly into bias and abuse. Medicine faces a deprofessionalization evidenced in loss of control over the clinical setting and over self-regulation. Health care becomes a commodity relying on cultivation of desires instead of satisfaction of needs, (...) even as many basic needs go unmet. Patients become consumers empowered with lawsuits and the connection of medicine to the relief of suffering is attenuated. Medical encounters are increasingly impersonal, dominated by specialization, technology, and bureaucracy. Patients are losing their physician-advocates to new conflicts of interests, physicians are losing their impulse to charity, and trust in the doctor-patient relationship and in medicine generally is eroding. (shrink)

The social cost of carbon (SCC) is a central concept in climate change economics. This chapter explains the SCC and investigates it philosophically. As is widely acknowledged, any SCC calculation requires the analyst to make choices about the infamous topic of discount rates. But to understand the nature and role of discounting, one must understand how that concept—and indeed the SCC concept itself—is yoked to the concept of a value function, whose job is to take ways the world could be (...) across indefinite timespans and to rank them from better to worse. A great deal, therefore, turns on the details of the value function and on just what is meant by “better” and “worse.” This chapter seeks to explicate these and related issues, and then to situate them within the evolving landscape of federal climate policy in the United States. (shrink)

Costly signalling theory has become a common explanation for honest communication when interests conflict. In this paper, we provide an alternative explanation for partially honest communication that does not require significant signal costs. We show that this alternative is at least as plausible as traditional costly signalling, and we suggest a number of experiments that might be used to distinguish the two theories.

Julian Huxley’s contribution to twentieth-century biology and science popularisation is well documented. What has not been appreciated so far is that despite Huxley’s eminence as a public scientific figure and the part that he played in the rise of experimental zoology in Britain in the 1920s, his own research was often heavily criticised in this period by his colleagues. This resulted in numerous difficulties in getting his scientific research published in the early 1920s. At this time, Huxley started his popular (...) science career. Huxley’s friends criticised him for engaging in this actively and attributed the publication difficulties to the time that he allocated to popular science. The cause might also have its roots in his self-professed inability to delve deeply into the particularities of research. This affected Huxley’s standing in the scientific community and seems to have contributed to the fact that Huxley failed twice in the late 1920s to be elected to the Royal Society. This picture undermines to some extent Peter J. Bowler’s recent portrayal of Huxley as a science populariser. (shrink)

Correspondence to: John Harris The Centre for Social Ethics and Policy, Institute of Medicine Law and Bioethics, School of Law, University of Manchester, Williamson Building, Oxford Road, Manchester M13 0JH, UK; [email protected] and Culyer1 have written an interesting and considered response, as people intimately connected to the National Institute for Health and Clinical Excellence , to the two editorials that I wrote on recent NICE decisions. Before commenting on their response, I would like to consider a point they made, which (...) echoes a point already made by Rawlins and Dillon,2 about the tone of my editorials. Claxton and Culyer accuse me of making “personally abusive charges”. In my original editorial, I criticised an institution, NICE, in robust terms, but in doing so I was continuing a long and respected tradition in English philosophy. Consider the following extract from Jeremy Bentham:" In English law, fiction is a syphilis, which runs in every vein, and carries into every part of the system the principle of rottenness...Fiction of use to justice? Exactly as swindling is to trade...It affords presumptive and conclusive evidence of moral turpitude in those by whom it was invented and first employed.3"My remarks were not an ad hominem criticism of anyone but directed at the published, but anonymous statements of an institution—a body corporate. In robustly criticising NICE, I no more attacked any individual associated with NICE than I attacked Tony Blair or the various ministers of state who are ultimately responsible for NICE. And, contra Claxton and Culyer’s claims, I have not denigrated the views of people who beg to differ from me.i If the apologists for NICE, whether they are Tony Culyer or Tony Blair, choose to identify themselves with criticism of NICE, that is entirely a matter for them. The only ad hominem remarks in this entire exchange have been made by Rawlins and Dillon, and Claxton and Culyer. The idea that criticism of the anonymously authored publications of …. (shrink)

Strategic Reliabilism addresses resource allocation considerations within a cost-benefit framework. However, there are serious reasons to worry about the feasibility of a cost-benefit approach to epistemology. First, there are serious general objections to cost-benefit analyses; and second, it is not clear how we can identify the costs and benefits of reasoning. This chapter addresses these two concerns. It is argued that although many of the deep general concerns about cost-benefit analysis are legitimate, flawed cost-benefit analyses can be very useful, especially (...) if we are clear about the ways in which such analyses are flawed. It is further argued that there are measurable proxies for the costs and benefits of reasoning we can employ in a cost-benefit approach to epistemology. (shrink)

The puzzle of how altruism can evolve has been at the center of recent debates over Hamilton’s Rule, inclusive fitness, and kin-selection. In this paper, I use recent debates over altruism and Hamilton’s legacy as an example to illustrate a more general problem in evolutionary theory that has philosophical significance; I attempt to explain this significance and to draw a variety of conclusions about it. The problem is that specific behaviours and general concepts of organism agency and intentionality are defined (...) in terms of concepts of evolutionary “costs” and “benefits,” and these terms have determined the role that agency should play in evolutionary explanation. However, costs, benefits, and agency are not only or even best conceived through evolutionary effects in a biological context. The paper proceeds as follows: first, I explain how the issue of agency relates to the evolutionary puzzle of altruism. Next, I discuss how questions about agency have figured in recent debates over Hamilton’s legacy. In the final section, I argue that Denis Walsh’s “situated Darwinism,” which attempts to return the organism to central status in biological explanation, offers a more productive route for thinking about different forms of costs, benefits, and agency. Finally, I argue that the upshot of all this is that there may be many different, and equally valid, ways to express what organisms are doing and how they are behaving based on different currencies of cost and benefit—even if these may stand in some tension. I illustrate this through returning to the case of altruism and using examples to show that even in non-humans there can be many forms of altruism, even if they are not all biological altruism as defined in the conventional evolutionary terms. (shrink)

This paper deals with the question of how to price drugs for tropical diseases. The thesis defended in the paper is: (i) there should be no legal constraints on the profits pharmaceutical companies can make on their products for tropical diseases. In essence, (i) expresses the idea that drugs for tropical diseases should be treated as any other product on the free market and that the producers of these drugs should be allowed to sell their products at whatever price the (...) market can bear. The main argument in favour of (i) is first outlined. Five common arguments against (i) are thereafter discussed, and it is argued that all of these fail in their intended purpose. (shrink)

The Clinton administration's revised rules regulating but not prohibiting the common practice in managed care of linking physician compensation with cost cutting and control of services demonstrates the complexity of ethical issues in managed care. As originally proposed, the federal guidelines on payment for Medicare and Medicaid services would have precluded any interrelationship between payment to physicians and delivery of services. Such a restriction would have gutted the primary mechanism in managed care plans to curb the unacceptably high cost of (...) healthcare delivery: making physicians directly responsible for cost control by placing them at direct financial risk. At first blush such a linkage seems to involve an obvious and irreconcilable conflict of interest. How can a physician be responsible for the well-being of a patient while at the same time aware that a proportion of his or her income is linked to the provision of cost-conscious care? (shrink)

A commentary on “Financial Side Effects: Why Patients Should Be Informed of Costs,” by Alicia Hall, in the May‐June 2014 issue.

As the transaction cost theory of the firm was taking shape in the 1970s, another important movement in economics was emerging: a revival of the ‘Austrian’ tradition in economic theory associated with such economists as Ludwig von Mises and F. A. Hayek . As Oliver Williamson has pointed out, Austrian economics is among the diverse sources for transaction cost economics. In particular, Williamson frequently cites Hayek , particularly Hayek’s emphasis on adaptation as a key problem of economic organisation . Following (...) Williamson’s lead, a reference to Hayek’s ‘The Use of Knowledge in Society’ has become almost mandatory in discussions of economic organisation . However, there are many other potential links between Austrian and transaction cost economics that have not been explored closely and exploited.This article argues that characteristically Austrian ideas about property, entrepreneurship, economic calculation, tacit knowledge, and the temporal structure of capital have important implications for theories of economic organisation, transaction cost economics in particular. Austrian economists have not, however, devoted substantial attention to the theory of the firm, preferring to focus on business-cycle theory, welfare economics, political economy, comparative economic systems, and other areas. Until recently the theory of the firm was an almost completely neglected area in Austrian economics, but over the last decade, a small Austrian literature on the firm has emerged. While these works cover a wide variety of theoretical and applied topics, their authors share the view that Austrian insights have something to offer students of firm organisation. (shrink)

This book examines transaction cost economics, the influential theoretical perspective on organizations and industry that was the subject of Oliver Williamson's seminal book,Markets and Hierarchies. Written by leading economists, sociologists, and political scientists, the essays collected here reflect the fruitful intellectual exchange that is occurring across the major social science disciplines. They examine transaction cost economics' general conceptual orientation, its specific theoretical propositions, its applications to policy, and its use in systematic empirical research. The chapters include classic texts, broad review (...) essays, reflective commentaries, and several new contributions to a wide range of topics, including organizations, regulations and law, institutions, strategic management, game theory, entrepreneurship, innovation, finance, and technical information. The book begins with an overview of theory and research on transaction cost economics, highlighting the specific accomplishments of scholars working within the perspective and emphasizing the enormous influence that transaction cost reasoning exerts on the social sciences. The following section covers conceptual uses for the transaction cost framework and major theoretical or methodological elements within it, such as bounded rationality. While advancing some interesting theoretical propositions, these chapters are in fact more ambitious: each examines a specific field, area, or research program and attempts to fashion a new way of thinking about research questions. In the section on industrial applications, contributors study the application of transaction cost theory to a range of problems in utilities, telecommunications, laser printing, and early international trade. The book closes with four microanalytical chapters that delve into the structures and behaviors of specific aspects of firms and organizations: boards of directors, equity structures, employment models, human resource policies and practices, technology strategies, and innovation events. Firms, Markets, and Hierarchies collects excellent social science work on transaction cost economics, taking stock of its status, charting its future development, and fostering its renewal and evolution. (shrink)

Over the last decade, the news media have reported on corporate scandals involving high-profile organizations such as Arthur Anderson, AOL Time Warner,Enron, Halliburton, Kmart, and Xerox. In 2001, the Conference Board of Canada noted that supplier relationships represent some of the most common ethical problems in the private sector, and estimated that 95% of corporations in the United States and 86% of corporations in Canada have implemented ethical codes of conduct and are espousing their commitment to building relationship with ethical (...) suppliers. While a significant amount of research on corporate ethics has been published (for examples see Akaah and Riordan 1989; Cullen et al. 2003; Román and Ruiz 2005; Schminke et al. 2005; and Weaver et al. 1999a, 1999b), what still remains unknown is how and when a supplier’s ethical code of conduct matters to the buyer making decisions regarding their choice of suppliers. (shrink)

Groups need contributions that are personally costly to their members. Such cooperation is only adaptive when others cooperate as well, as unconditional cooperation may incur high costs to the individual. We argue that individuals can useWe-if-then plans (collective implementation intentions, cIIs) to regulate their group-directed behavior strategically, helping them to cooperate selectively with group members in the situation planned for. In line with this prediction, a cII to consider group earnings increased cooperative decisions in a prisoners’ dilemma game when playing (...) against another group member but not when playing against a stranger (i.e., non-group member). Moreover, cIIs to cooperate in the prisoners’ dilemma game did not increase cooperation in a structurally similar investment game that participants had not planned for. We discuss the role of collective planning in solving social dilemmas. (shrink)

Childhood scholars have found that age inequality can be as profound an axis of meaningful difference as race, gender, or class, and yet the impact of this understanding has not permeated the discipline of sociology as a whole. This is one particularly stark example of the central argument of this article: despite decades of empirical and theoretical work by scholars in “the social studies of childhood,” sociologists in general have not incorporated the central contributions of this subfield: that children are (...) active social agents (not passive), knowing actors strategizing within their constraints (not innocent), with their capacities and challenges shaped by their contexts (not universally the same). I contend that mainstream sociology’s relative imperviousness has led to theoretical costs for both childhood scholars—who must re-assert and re-prove the core insights of the field—and sociologists in general. Using three core theoretical debates in the larger discipline—about independence, insecurity, and inequality—I argue that children’s perspectives can help scholars ask new questions, render the invisible visible, and break through theoretical logjams. Thus would further research utilizing children’s perspectives and the dynamics of age extend the explanatory power of social theory. (shrink)

Cost‐effectiveness analysis (CEA) raises questions that are too important to be left to policy analysts and economists. Those who utilize CEA should acknowledge its inherent value system and adapt it to a more ethical usage.

The Indiana Court of Appeals, in JKB, Sr. v. Armour Pharmaceutical Co. ), held that the state's Blood Shield Act does not protect pharmaceutical companies that produce blood-derived products from product liability suits based on injuries attributable to tainted blood supplies. Blood shield statutes help to guarantee adequate blood supplies by limiting the liability of blood banks. This holding limits the defenses available to pharmaceutical companies sued under product liability theory.The defendant, Armour Pharmaceutical, produces and sells clotting factor agents, which (...) are derived through plasmapheresis. Plasmapheresis is a costly and complex donation process through which the plasma and red blood cells of a donor's blood are separated. After separation, the process returns the red blood cells to the donor but retains the plasma. (shrink)