AbstractIn this extended case study, we examine how business leaders translate a responsible leadership mindset into practice. By studying the leadership team and stakeholders of a large US college dining provider, we found that organization executives leverage the lenient market category of local food to successfully connect with and satisfy the interests of different stakeholder groups. We show that lenient categories, those with ambiguity and unclear boundaries, could be used by organizations as strategic devices to integrate the diverse needs of (...) their stakeholders and foster positive stakeholder relationships. Based on our findings, we develop a theoretical model to illustrate how responsible leaders take advantage of meaning structures of the market category they have adopted to achieve both financial and social benefits for a broad range of stakeholders. (shrink)

The Asian financial crisis, which devastated many of the newly industrializing countries, is said to have demonstrated the inherent fragility of economies built upon laissez‐faire principles. However, it appears that the major sources of disruption have come from policies that deviate from laissez faire, such as government‐guaranteed bailouts and international monetary policy. That capitalist economies were afflicted by the crisis does not constitute an indictment of free markets.

Healthcare priority-setting institutions have good reason to want to demonstrate that their decisions are morally justified—and those who contribute to and use the health service have good reason to hope for the same. However, finding a moral basis on which to evaluate healthcare priority-setting is difficult. Substantive approaches are vulnerable to reasonable disagreement about the appropriate grounds for allocating resources, while procedural approaches may be indeterminate and insufficient to ensure a just distribution. In this paper, we set out a complementary, (...) coherence-based approach to the evaluation of healthcare priority-setting. Drawing on Rawls, we argue that an institutional priority-setter’s claim to moral justification can be assessed, in part, based on the extent to which its many normative commitments are mutually supportive and free from dissonance; that is, on the ability to establish narrow reflective equilibrium across the normative content of a priority-setter’s policy and practice. While we do not suggest that the establishment of such equilibrium is sufficient for moral justification, we argue that failure to do so might—like the proverbial canary in the coalmine—act as a generalised warning that something is awry. We offer a theoretical argument in support of this view and briefly outline a practical method for systematically examining coherence across priority-setting policy and practice. (shrink)

Background As the UK’s main healthcare priority-setter, the National Institute for Health and Care Excellence (NICE) has good reason to want to demonstrate that its decisions are morally justified. In doing so, it has tended to rely on the moral plausibility of its principle of cost-effectiveness and the assertion that it has adopted a fair procedure. But neither approach provides wholly satisfactory grounds for morally defending NICE’s decisions. In this study we adopt a complementary approach, based on the proposition that (...) a priority-setter's claim to moral justification can be assessed, in part, based on the coherence of its approach and that the reliability of any such claim is undermined by the presence of dissonance within its moral system. This study is the first to empirically assess the coherence of NICE’s formal approach and in doing so to generate evidence-based conclusions about the extent to which this approach is morally justified. Methods The study is grounded in the theory, methods and standards of empirical bioethics. Twenty NICE policy documents were coded to identify and classify the normative commitments contained within NICE technology appraisal policy as of 31 December 2021. Coherence was systematically assessed by attempting to bring these commitments into narrow reflective equilibrium (NRE) and by identifying sources of dissonance. Findings Much of NICE policy rests on coherent values that provide a strong foundation for morally justified decision-making. However, NICE’s formal approach also contains several instances of dissonance which undermine coherence and prevent NRE from being fully established. Dissonance arises primarily from four sources: i) NICE’s specification of the principle of cost-effectiveness; ii) its approach to prioritising the needs of particular groups; iii) its conception of reasonableness in the context of uncertainty, and iv) its concern for innovation as an independent value. Conclusion At the time of analysis, the level of coherence across NICE policy provides reason to question the extent to which its formal approach to technology appraisal is morally justified. Some thoughts are offered on why, given these findings, NICE has been able to maintain its legitimacy as a healthcare priority-setter and on what could be done to enhance coherence. (shrink)

The World Health Assembly has encouraged WHO member-states to establish capacity in health technology assessment (HTA) as a support for achieving universal health coverage (UHC). Simultaneously, the WHO has stated that UHC is “a practical expression of the concern for health equity and the right to health.” This has prompted questions about potential tensions between priority-setting efforts and the right to health on the road to UHC. South Africa (SA) is an ideal setting in which to explore how the priority-setting (...) work of an HTA body may be integrated with an existing rights framework. (shrink)

Following the death on April 19, 2015 of Freddie Gray from injuries sustained while unarmed and in police custody, many citizens of Baltimore took to the streets and the National Guard was called into the city. A 2017 article published in the American Journal of Public Health measured the effect of this civil unrest on maternal and child health. I argue that this research does not acknowledge the full range of motivations, behaviors, aims and values that may have been inherent (...) in this unrest. I first describe the article’s characterization of Baltimore’s unrest as community violence. I then provide a negative argument against employing this characterization alone, before providing positive arguments for two alternative characterizations—as protest and apt anger. Finally, I discuss upshots of considering these alternatives. Broadly, while viewing civil unrest as community violence focuses exclusive attention on victims of unrest, these alternatives direct attention to unrest participants, with implications for public health research and practice. While I focus on Baltimore’s 2015 unrest, the proposals raised here apply wherever civil unrest occurs. (shrink)

The opening sections of some exegetical Midrashim deal with the same type of material that is found in introductions to medieval rabbinic Bible commentaries. The application of Goldberg's form analysis to these sections reveals the new form "Inner-Midrashic Introduction" as a thematic discourse on introductory issues to biblical books. By its very nature the IMI is embedded within the comments on the first biblical verse. Further analysis of medieval rabbinic Bible commentary introductions in terms of their formal, thematic, and material (...) characteristics, reveals that a high degree of continuity exists between them and the IMIs, including another newly discovered form, the "Inner-Commentary Introduction". These new discoveries challenge the current view that traces the origin of Bible introduction in Judaism exclusively to non-Jewish models. They also point to another important link between the Midrashim and the commentaries, i.e., the decomposition of the functional form midrash in the new discoursive context of the commentaries. Finally, the form analysis demonstrates how larger discourses are formed in the exegetical Midrashim. (shrink)

Volume 19, Issue 6, June 2019, Page 71-73.

There is a special need for solidarity at the global level to address global health disparities. Ter Meulen argues that solidarity must complement justice, and is, in fact, more fundamental than justice to the arrangement of health care practices. We argue that PG/SHG, though a theory of justice, is fundamentally synergistic with solidarity. We relate PG/SHG to Jodi Dean’s conceptual work on reflective solidarity, contrasted with conventional solidarity, as an approach to transnational solidarity that dovetails with PG/SHG. We argue that (...) PG/SHG meets both the need for solidarity at the global level and the need for solidarity within theories of the arrangement of health care practices. (shrink)

Over the course of the 1990s, donor enthusiasm for participation came to be institutionalized in a variety of ways. One particular methodology—Participatory Rural Appraisal (PRA)—came to enjoy phenomenal popularity. New aid modalities may have shifted donor and lender concern away from the grassroots towards “policy dialogue.” But “civil society participation,” “social accountability,” and “empowerment”—some of the issues PRA grapples with—retain a place in the new aid discourse. PRA and its variants also continue to be used by government agencies, non-governmental, and (...) community-based organizations in local-level assessment, planning, monitoring, and evaluation, as well as in national-level poverty assessments. It has sometimes been conflated, by donors and critics alike, with doing participatory development, and has elicited critiques that often go far beyond the bounds of the methodological. Yet these critics have tended to be academics with little experience as practitioners or facilitators. In this article, we draw on an action research project with PRA practitioners. We explore, through their critical reflections, some of the conundrums and contradictions faced by those who were active as PRA practitioners in the early 1990s. We suggest that the story of PRA’s success and of subsequent concerns about abuse and misuse by mainstream development institutions offers broader lessons with continued salience for development. (shrink)

Schools may be one important context where adolescents learn and shape the behaviors necessary for promoting global inclusivity in adulthood. Given the importance of bystanders in halting bullying and peer aggression, the focus of this study is on both moral judgments regarding one type of bullying, social exclusion, and factors that are associated with bystander intervention. The study includes 896 adolescents, who were 6th, and 9th graders, approximately evenly divided by gender. Participants were primarily European–American. Results revealed that girls and (...) participants who perceived better relationships between students and teachers were more likely to judge exclusion to be wrong. Further, ethnic minority participants, those who were more anxious about being rejected by their teachers and reported more teacher discrimination were less likely to judge exclusion as wrong. Participants who reported more positive student–teacher relationships, perceptions of a more positive school social environment and more prior experiences of teacher discrimination were more likely to report that they would seek help for the victim. On the other hand, participants who reported being more angry about teacher rejection, experiencing either peer or teacher discrimination, and perceiving they are excluded from opportunities at school were less likely to intervene to come to the aid of a peer who is being excluded. The results document the complex interplay of school and teacher factors in shaping adolescents’ bystander responses to social exclusion. Our findings suggest that positive school climate can promote intentions to intervene. However, findings indicate that adolescents who are marginalized in their school environments, and who report experiences of rejection, exclusion or discrimination are not willing or likely to intervene to prevent others from experiencing exclusion. (shrink)

Although previous work has linked parent autonomy support to the development of children’s executive function skills, the role of specific autonomy-supportive behaviors has not been thoroughly investigated. We compiled data from four preschool-age samples in the Midwestern United States to examine three relevant autonomy-supportive behaviors and their associations with child EF. We coded parent autonomy-supportive behaviors from a 10-min interaction between parent and child dyads working on challenging jigsaw puzzles together. Children completed a battery of EF. Overall, child EF was (...) most consistently correlated with the offering choice subscale. Additionally, only the offering choice subscale predicted child EF while controlling for the other autonomy support subscales and child age. These results suggest that parent provision of choice is an especially relevant aspect of autonomy-supportive parenting and may be important to the development of EF in early childhood. Future research should directly measure children’s experience with choice and how it relates to emerging EF. (shrink)

Vaccination programmes against infectious diseases aim to protect individuals from serious illness but also offer collective protection once a sufficient number of people have been immunized. This so-called ‘herd immunity’ is important for individuals who, for health reasons, cannot be immunized or who respond less well to vaccines. For these individuals, it is pivotal that others establish group protection. However, herd immunity can be compromised when people deliberately decide not to be immunized and benefit from the herd’s protection. These agents (...) are often referred to as free riders: their omissions are deemed to be unfair to those who do contribute to the collective’s health. This article addresses the unfairness of such ‘free riding’. An argument by Garett Cullity is examined, which asserts that the unfairness of moral free riding lies neither in one’s intentions, nor in one’s reluctance to embrace a public good. This argument offers a strong basis for justifiably arguing that free riding is unfair. However, it is then argued that other considerations also need to be taken into account before simply holding free riding against non-compliers. (shrink)

Following the success of Hong Kong Corner Houses, German photographer Michael Wolf continues his collaboration with Hong Kong University Press to produce Small God, Big City. Wolf again uses his creative eye to draw attention to overlooked objects in the visually rich urban environment of Hong Kong. This time the object is the Earth God shrine, found commonly by the doorways of shops and homes throughout Hong Kong. Through his visually stimulating and thought-provoking photographs, Wolf challenges our sensitivity to seemingly (...) familiar everyday things. An interpretative text for the photographs is authored by two familiar names: Lee Ho Yin and Lynne DiStefano, who are well-known academics and practitioners of heritage conservation in Hong Kong. The text is a highly readable curatorial essay that leads readers to a better understanding of the topic and the meaning behind Wolf 's photographs of Earth God shrines in urban Hong Kong. The topic of this book is timely, given the vulnerability of traditional beliefs and practices in an increasingly urbanized Hong Kong. It is hoped that Small God, Big City will provoke deeper thoughts on who we are and what we believe in this modern world. (shrink)

If emotion is not an arbitrary compilation of fixed types of (descriptive, conceptual, conative, prescriptive) content, nor a state that can be reduced to other types of pre-existing (perceptual, cognitive, behavioral) states, then what sort of thing is it really? Tom Cochrane has proposed that emotions are valent representations of situated concerns. Valent representation is a type of mental content whose function is to detect the presence or absence of certain conditions; what makes that type of content valent is that (...) without needing the mediation of any other state, a response is triggered that is disposed to increase or decrease the presence of the condition represented. I raise doubts about the plausibility of that account in light of recent work in philosophy of biology and philosophy of mind. (shrink)