The authors refute Harris’s criticism of the work of NICE and in turn criticise his description of the institute’s positionHarris’s recent editorial,1It’s not NICE to discriminate, is long on both polemic and invective but short on scholarship. He offers nothing to illuminate the debate about allocating health care in circumstances of finite resources; he has no understanding of the quality adjusted life year and its use in health economic evaluation; and he makes ill researched, unsubstantiated charges against the institute and (...) its advisory bodies.ALLOCATING HEALTHCARE RESOURCESThe British National Health Service , like every other healthcare system in the world, has finite resources. How the NHS’s budget should be most appropriately allocated is a very specific example of the more general problem of distributive justice.2The NHS, with its requirement3 to provide all care that is “necessary and appropriate”, was founded with an egalitarian purpose. Yet despite its laudable emphasis on fairness, the implementation of the NHS’s egalitarian approach remains uncertain. What is necessary? What is appropriate? How should the tensions between the service’s egalitarian aspirations, and the need to provide health care from finite resources, be resolved? On what principles should these allocative decisions be made?Utilitarianism, with its goal to maximise overall good, is another approach. Yet experience with the original Oregon plan demonstrated that, when rigidly applied, it can yield solutions that most find unacceptable—for example, tooth capping taking precedence over emergency appendectomy.4 Moreover, some versions of utilitarianism can allow the interests of minorities to be overridden by the majority; and it has next to nothing to offer in eradicating health inequalities.There is no single, broadly accepted, theory of distributive justice …. (shrink)

This book is a qualitative, interpretive, phenomenological, and interdisciplinary, examination of food and food practices and their meanings in the modern world. Each chapter thematically focuses upon a particular food practice and on some key details of the examined practice, or on the practice’s social and cultural impact.

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; john.m.harris@man.ac.ukClaxton 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)

In a little over two hundred years, American legal thought moved from premodernism through modernism and into postmodernism. This book charts that intellectual voyage, stressing both the historical contexts in which ideas unfolded and the inherent force of the ideas themselves.Author Stephen M. Feldman first defines "premodernism," "modernism," and "postmodernism," then explains the development of American legal thought through these three intellectual periods. His narrative revolves around two broad, interrelated themes: jurisprudential foundations and the notion of progress. He points out (...) that much of American legal thought has grappled with the problem of identifying the foundations of the American judicial system and judicial decision making. The various ideas of jurisprudential foundations, moreover, are closely tied to shifting notions of progress-the definition of the term, assumptions about the possibility of progress, and hopes about how law might contribute to it.This book's broad historical sweep and its clear explanations of the competing theoretical positions of current legal scholarship make it indispensable to students and scholars of jurisprudence and American legal history. (shrink)

The Eton Latin Grammar, For Use in the Higher Forms. By Francis Hay Rawlins, M.A., and William Ralph Inge. London: Murray, 1888. 6s.The Revised Latin Primer. By Benjamin Hall Kennedy, D.D. Longmans, 1888. 2s. 6d.The New Latin Primer. Edited by J. P. Postgate, M.A., and C. H. Vince, M.A. Cassell, 1888. 2s. 6d.The Shorter Latin Primer, by Dr. Kennedy. Longmans, 1888. 1s.

The title of my paper may look odd. If one is questioned “What is a dog?”, everyone could give a more or less valid answer. But to the question “What is not a dog?”, there can be innumerable answers which may be correct, but mostly quite unhelpful. Provisionally, what I intend to do under this title is to consider what we should not hold time to be. Through the history of ideas we meet various opinions and theories concerning what time (...) is. But it seems to me that most of them are not adequate enough, though each has its reason and often profound import as well. So I would like here to make a proposal for reconsidering how time appears in our life and thinking. (shrink)

A Select Bibliography Michael McMahon Sheehan Jacqueline Murray. 16 Ritual and Iconography 134 12-14c Studies in Medieval Domestic Architecture ed M.J. Swanton (London 1975). [English aristocratic housing] 135 11-12c WEDZKI,...

This paper explores the psychoanalytic conception of the unconscious and critiques it from a phenomenlogical perspective, especially Sartre and Heidegger, with a view to conceptualizing the unconscious from an ontological rather than psychological mindset.

Upshot: Michael Tomasello is Director of the Department of Developmental and Comparative Psychology and Co-Director of the Max Planck Institute for Evolutionary Anthropology in Leipzig. He completed his PhD with Ernst as his supervisor in 1980. In his reminiscence essay he describes the “total enculturation” he experienced on encountering Ernst von Glasersfeld.