Editorial: Hard Choices

Hard Choices in Scienti c Inquiry

Are Hard Choices Cases of Incomparability

This paper presents an argument against the widespread view that ‘hard choices’ are hard because of the incomparability of the alternatives. The argument has two parts. First, I argue that any plausible theory of practical reason must be ‘comparativist’ in form, that is, it must hold that a comparative relation between the alternatives with respect to what matters in the choice determines a jus...

Reforming health insurance: realistic options and hard choices.

The persistently high number of people reporting that they have no health insurance has precipitated a number of new comprehensive proposals to extend coverage to most Americans. Such proposals must find solutions to fundamental problems that have thus far eluded policymakers, including the role of government regulation, how much to spend, and who should pay. The experience of the 1990s suggest...

Investing in health: progress but hard choices remain.

e34 www.thelancet.com Vol 382 December 7, 2013 The world has changed radically since the World Development Report (WDR) Investing in Health was published 20 years ago, so it is valuable and timely to look ahead once again. The Lancet Commission’s optimistic report on investing in health confi rms my view that the best times for public health are still ahead of us. As we debate the place of heal...

Hard Choices: The Role of Evidence in Clinical Decision- Making

The pressure to improve the quality of patient care while controlling costs affects both wealthy countries, such as the United States and Western European nations, and countries going through economic restructuring such as those in the NIS and CEE. Clinicians are being driven to search for and identify sources of cost that do not produce commensurate benefit to patients. Newly-developed treatme...