Are We Sending Mixed Messages? How Philosophical Naturalism Erodes Ethical Instruction

To develop critical thinking skills, higher order ethical reasoning, a better grasp of the implications of ethical decisions, and a basis for ethical knowledge, it is necessary to explore the philosophical premises foundational to one’s ethical persuasion. No philosophical premises are more important than those pertaining to the nature of human personhood and business’ responsibility to respect the inherent value of human beings. Philosophical naturalism assigns the essence of human personhood strictly to causal interactions of physical matter. Substance dualism, on the other hand, posits both a physical aspect and an immaterial substance to personhood, interacting within the totality of each being. This paper argues for the logical superiority of substance dualism in achieving the overriding objective of discerning ethical knowledge. Substance dualism offers a better explanation – and one that more closely follows the way most people commonly experience themselves and others–than naturalism for free agency and accountability, meaningful moral standards, confidence in knowing what ethical decisions to make, and the moral drive residing in conscience. Marjorie J. Cooper (aka Caballero), Ph. D. is a Professor of Marketing in the Hankamer School of Business at Baylor University in Texas. She received her B.A. from Wheaton College in 1970, her M.B.A. from Oklahoma City University in 1977, and her Ph. D. in Business Administration from Texas A&M University in 1981. Her articles have appeared in the Journal of Marketing, Journal of Advertising, Journal of the Academy of Marketing Science, Journal of Advertising Research, Journal of Business Research, Psychology & Marketing, Journal of Professional Selling & Sales Management, Journal of Business & Industrial Marketing, Business Horizons, Journal of Promotion Management, Journal of Small Business Management, Human Systems Management, and elsewhere.     

Cointegration analysis and the UK demand for nitrogen fertilizer

Nitrogen fertilizer taxes have been proposed as a means of controlling agricultural ‘over-production’ and nitrate pollution of water courses in the EC. This paper constructs time-series models of fertilizer demand which provide quantitative information relevant to this issue. Time-series data on the use of nitrogen fertilizer in UK agriculture is found to have a unit root with non-zero drift coupled with a one-time change in drift after testing against the alternative hypothesis that the process is trend-stationary with a break in trend. The stochastic component of the nitrogen use series is cointegrated with the ratio of the price of nitrogen fertilizer to the price of agricultural output. Appropriate error correction models are estimated. Both the short-run and long-run price elasticities of the response of nitrogen use are found to be rather low. Some brief policy conclusions are drawn.     

A review and validation of overall survival extrapolation in health technology assessments of cancer immunotherapy by the National Institute for Health and Care Excellence: how did the initial best estimate compare to trial data subsequently made available?

Background: Validation of overall survival (OS) extrapolations of immune-checkpoint inhibitors (ICIs) during the National Institute for Health and Care Excellence (NICE) Single Technology Assessment (STA) process is limited due to data still maturing at the time of submission. Inaccurate extrapolation may lead to inappropriate decision-making. The availability of more mature trial data facilitates a retrospective analysis of the plausibility and validity of initial extrapolations. This study compares these extrapolations to subsequently available longer-term data.

Methods: A systematic search of completed NICE appraisals of ICIs from March 2000 to December 2017 was performed. A targeted search was also undertaken to procure published OS data from the pivotal clinical trials for each identified STA made available post-submission to NICE. Initial Kaplan-Meier curves and associated extrapolations from NICE documentation were extracted to compare the accuracy of OS projections versus the most mature data.

Results: The review identified 11 STAs, of which 10 provided OS data upon submission to NICE. The extrapolations undertaken considered parametric or piecewise survival models. Additional data cut-offs provided a mean of 18 months of OS beyond the end of the original data. Initial extrapolations typically under-estimated OS from the most mature data cut-off by 0.4–2.7%, depending on the choice of assessment method and use of the manufacturer- or ERG-preferred extrapolation.

Conclusion: Long-term extrapolation of OS is required for NICE STAs based on initial immature OS data. The results of this study demonstrate that the initial OS extrapolations employed by manufacturers and ERGs generally predicted OS reasonably well when compared to more mature data (when available), although on average they appeared to underestimate OS. This review and validation shows that, while the choice of OS extrapolation is uncertain, the methods adopted are generally aligned with later-published follow-up data and appear appropriate for informing HTA decisions.