The Relevance of Value Commitments in the Supply of Public Goods

Hinsichtlich des Problems der Bereitstellung öffentlicher Güter produziert die Logik des Handlungsmodells eigennütziger Akteure ein Dilemma: einerseits tritt hinsichtlich ihrer Bereitstellung im Rahmen dieses Modells ein Marktversagen auf, andererseits lassen die theoretischen Modellannahmen die einzige Lösung - dass der Staat für solche Güter zu sorgen hat - als ineffektiv erscheinen (Staatsversagen). Auch im Rahmen einer "Konstitutionellen Politischen Ökonomie", nach der bei der Bereitstellung öffentlicher Güter der gleiche soziale Mechanismus wirksam werden muss wie beim Zustandekommen eines imaginären Gesellschaftsvertrages, entsteht letztlich aufgrund einer mangelnden Wertverpflichtung der Akteure ein "Gefangenen-Dilemma". Diese Konsequenz lässt sich im Bezugsrahmen der Klassischen Politischen Ökonomie vermeiden, da sich hier individuelle Nutzenorientierung und normative Wertverpflichtung gerade nicht ausschließen, so dass die Akteure in der Lage sind, die Dilemma-Situationen zu überwinden.Wertverpflichtungen müssen deshalb neben Markt, Staat und Gemeinschaft als zentrale Mechanismen der Koordination sozialen Handelns berücksichtigt werden, wobei sich allerdings solche reinen Mechanismen der Handlungskoordination empirisch zu komplexen Koordinationsweisen verdichten.Concerning the problem of the supply of public goods the logic of the utilitarian action model produces a dilemma: on the one hand, a market failure appears in regard to their supply within the scope of this model; on the other hand, the theoretical model assumptions make the only solution - that the state has to provide for such goods - seem ineffective (state failure). The solution offered in the framework of a "constitutional political economy," according to which the same social mechanism must become effective as in the conclusion of an imaginary social contract, will ultimately results in a "prisoner's dilemma" due to the actors' lacking value commitment. This consequence can be avoided in the frame of reference of classical political economy, because here individual utility orientation and normative value commitments do not exclude each other, so that the actors are able to overcome the dilemma. As a result, value commitments must be taken into account alongside market, state, and community as central mechanisms in the coordination of social action. However, such pure mechanisms of action coordination condense empirically into a complicated manner of coordination

No Difference in Penetrance between Truncating and Missense/Aberrant Splicing Pathogenic Variants in MLH1 and MSH2: A Prospective Lynch Syndrome Database Study

Background. Lynch syndrome is the most common genetic predisposition for hereditary cancer. Carriers of pathogenic changes in mismatch repair (MMR) genes have an increased risk of developing colorectal (CRC), endometrial, ovarian, urinary tract, prostate, and other cancers, depending on which gene is malfunctioning. In Lynch syndrome, differences in cancer incidence (penetrance) according to the gene involved have led to the stratification of cancer surveillance. By contrast, any differences in penetrance determined by the type of pathogenic variant remain unknown. Objective. To determine cumulative incidences of cancer in carriers of truncating and missense or aberrant splicing pathogenic variants of the MLH1 and MSH2 genes. Methods. Carriers of pathogenic variants of MLH1 (path_MLH1) and MSH2 (path_MSH2) genes filed in the Prospective Lynch Syndrome Database (PLSD) were categorized as truncating or missense/aberrant splicing according to the InSiGHT criteria for pathogenicity. Results. Among 5199 carriers, 1045 had missense or aberrant splicing variants, and 3930 had truncating variants. Prospective observation years for the two groups were 8205 and 34,141 years, respectively, after which there were no significant differences in incidences for cancer overall or for colorectal cancer or endometrial cancers separately. Conclusion. Truncating and missense or aberrant splicing pathogenic variants were associated with similar average cumulative incidences of cancer in carriers of path MLH1 and path_MSH2

Analysis in the Prospective Lynch Syndrome Database identifies sarcoma as part of the Lynch syndrome tumor spectrum

Non peer reviewe