As the only nation in the western world without a national health insurance program, the United States faces ongoing issues of access and fairness in health care coverage. The Clinton administration tried and failed to address the problem of universal coverage. Since then we have focused on the narrower, but nonetheless real, issues of fairness and equity in the benefits package provided in insurance plans. The LORAN Commission spent two years trying to devise agreed-upon principles to govern such issues. The (...) lesson learned was the same as that of the Ethics Force study: there was no possibility of getting agreement, let alone consensus, among the participants on how to decide what should be a covered benefit. There were, however, two generally agreed upon principles that emerged regarding health care: “Every individual should be treated alike,” and “When it comes to health, cost cannot be a consideration.” That formula translated into providing everyone with everything. The only certain outcome from such a policy would be fiscal insolvency and ultimately bankruptcy. (shrink)

The 2008 crisis has revived debates on the relevance of laissez-faire, and thus on the role of the State in a modern economy. This volume offers a new exploration of the writings of Keynes and Friedman on this topic, highlighting not only the clear points of opposition between them, but also the places in which their concerns where shared. This volume argues that the parallel currently made with the 1929 financial crisis and the way the latter turned into the Great (...) Depression sheds new light on the proper economic policy to be conducted in both the short- and the long-run in a monetary economy. In light of the recent revival in appreciation for Keynes’ ideas, Rivot investigates what both Keynes and Friedman had to say on key issues, including their respective interpretations of both the 1929 crisis and the Great Depression, their advocacy of the proper employment policy, and the theoretical underpinnings of the latter. The book asks which lessons should be learnt from the Thirties? And what is the relevance of Keynes’ and Friedman’s respective pleas for today? (shrink)

A critical element in building stronger health systems involves strengthening good governance to build capacity for transparent and fair health planning and priority setting. Over the past 20 years, the ethical framework Accountability for Reasonableness has been a prominent conceptual guide in strengthening fair and legitimate processes of health decision-making. While many of the principles embedded within the framework are congruent with Western conceptualizations of what constitutes procedural fairness, there is a paucity in the literature that captures the (...) degree of resonance between these principles and the views of decision makers from non-Western settings; particularly in Africa, where many countries have only recently, within the last 20-30 years, become more democratic. This paper contributes to the ethics literature by examining how Ethiopian decision makers conceptualize fair and legitimate health decision-making, and reflects on the degree of conceptual resonance between these views and the principles embedded in A4R. A qualitative case study approach from three districts in Ethiopia was undertaken. Fifty-eight decision makers from district, regional, zonal, and national levels were interviewed to describe their conceptualization of fairness and legitimacy in the district health planning process. Findings revealed that Ethiopians have a broad conception of fairness and legitimacy that while congruent with procedural justice, also aligned with principles of distributive and organizational justice. Researchers and practitioners seeking to strengthen procedural fairness in health priority setting must therefore recognize the significance of other philosophical dimensions influencing how fairness and legitimacy of health decision-making are constructed within the Ethiopian setting. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used (...) by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

Artificial Intelligence (AI) is increasingly being used in disaster risk management applications to predict the effect of upcoming disasters, plan for mitigation strategies, and determine who needs how much aid after a disaster strikes. The media is filled with unintended ethical concerns of AI algorithms, such as image recognition algorithms not recognizing persons of color or racist algorithmic predictions of whether offenders will recidivate. We know such unintended ethical consequences must play a role in DRM as well, yet there (...) is surprisingly little research on exactly what the unintended consequences are and what we can do to mitigate them. The aim of this perspective is to call researchers working on fairness, accountability, and transparency to work with DRM and local experts—so we can ensure that disaster mitigation and relief is accountable, considers local values, and is not unintentionally biased. (shrink)

This article examines the fairness of business competition in the field of information and communication technologies. In the era of "postcontemporary society" economy, the dominant factor of development is the use of information. The share of business in the field of information and communication technologies in the economy is constantly growing. For businesses, its integration into the Internet, which has become an important market for the sale and promotion of goods and services, is becoming increasingly important. Various digital innovations, social (...) networks, mobile applications, information and communication technologies have become commonplace in today's society, which affects the need to study their impact on business. Technology transfer is the basis of innovative activities of small businesses and a means of their sustainable development, a guarantee of profit and social impact. It is noted that in order to win in the competition, personal brand and trademarks, strategic management and balanced business plans are of special importance. A characteristic feature of leading high-tech companies is the use of digital platforms through which they provide their services. Digital platforms are used for interaction in social networks, use of search and payment systems, exchange of information materials. The need for high start-up costs leads to the difficulty of entering this market and the concentration of large amounts of data in the hands of a small number of players, which carries the threat of monopolization in the market of digital platforms. (shrink)

Queen Mary, University of London, School of Law, Mile End Road, London E1 4NS, UK. Tel: +442078825126, Fax: +442089818733, Email: r.ashcroft{at}qmul.ac.uk ' + u + '@' + d + ' '//--> Abstract Recent doctrine in both national and international organisations concerned with public health planning and resource allocation has it that direct ethical justification of substantive decisions is so difficult as to be impossible. Instead, we should agree on criteria of procedural justice and reach decisions whose justification lies in how (...) they are arrived at, rather than any direct ethical justification on the ground of substantive moral principles. In this polemical article, I argue that this amounts to a serious dereliction of intellectual duty on the part of the bioethics community. Our role in these settings is to produce and defend the best substantive arguments we can. Failing to do this makes bioethicists at best redundant and at worst leads us to seriously defective conclusions. The argument is illustrated by analysis of the ethical frameworks for resource allocation under the UNAIDS ‘3 by 5’ programme and for pandemic influenza planning. CiteULike Connotea Del.icio.us What's this? (shrink)

Fabriquer des visions du futur est une activité qui, alimentée par la crise écologique, occupe de plus en plus d’acteurs et d’experts. Chaque expertise produit un type de récit caractéristique qui modèle les futurs et sculpte les imaginaires. La collapsologie a ainsi imposé massivement le motif de l’effondrement. Mais que se passerait-il si au motif de l’effondrement était substitué celui du tremblement? Le motif du tremblement trace un plan de continuité entre des corps très hétérogènes (corps terrestre, humain, vivant, (...) social, politique…). À la logique verticale de l’effondrement, il propose une oscillation horizontale à l’intérieur des limites, scénarios, programmes préétablis. Tous et toutes des corps tremblants! (shrink)

An overview and assessment of the current state of research on individual consumption of Fair Trade (FT) products is given on the basis of 51 journal publications. Arranging this field of ethical consumption research according to key research objectives, theoretical approaches, methods, and study population, the review suggests that most studies apply social psychological approaches focusing mainly on consumer attitudes. Fewer studies draw on economic approaches focusing on consumers’ willingness to pay ethical premia for FT products or sociological approaches (...) relying on the concept of consumer identity. Experimental, qualitative and conventional survey methods are used approximately equally often. Almost all studies draw on convenience or purposive samples and most studies are conducted in the USA or the United Kingdom. Several problems in current research are identified: amongst others, studies’ rather narrow theoretical focus, potential hypothetical and social desirability bias of conventional survey data, and a lack of generalizability of empirical findings. In turn, we suggest that research would benefit from both a multiple-motives and a multiple-methods perspective. Considering competing theories can help to single out key behavioral determinants of individual FT consumption. The combination of different methods such as conventional surveys and field experiments contributes to uncovering respondents’ truthful answers and improves generalizability of results. Scholars in the field of ethical consumption research should use experiments to detect causal relations proposed by theories and conduct cross-country surveys to gather insights as to how differences in market structures, cultural traits, and other path dependencies affect patterns of individual FT consumption. (shrink)

In Alienation and the Soviet Economy, 2nd ed., Paul Craig Roberts attributes the excesses of war communism, the resistance to market?type reforms, and the retention until very recently of administered material allocation in the Soviet Union, to Marxist ideology, and in particular to Marx's views on the link between markets and ?alienation.? However, war communism was due in some part also to war emergency, and it was not only ideology but also the interests of the ruling stratum that delayed the (...) much?needed move towards a market economy. There are indeed problems in reconciling socialist ideas with efficiency and entrepreneurship, and Lange's attempt to define a sort of neoclassical socialism was unsatisfactory. However, it does not follow that the only alternative to Soviet?type planning is untrammelled laissez faire. Our own system can also give rise to alienation, and to the need for action by public authorities to take care of environmental and other externalities and provide essential social services. (shrink)

In 2017, Ukraine’s Parliament passed legislation establishing a single health benefit package for the entire population called the Programme of Medical Guarantees,‎ financed through general taxes and administered by a single national purchasing agency. This legislation was in line with key principles for financing universal health coverage. However, health professionals and some policymakers have been critical of elements of the reform, including its reliance on general taxes as the source of funding. Using qualitative methods and drawing on deliberative democratic theory (...) and criteria for procedural fairness, this study argues that the acceptance and sustainability of these reforms could have been strengthened by making the decision-making process fairer. It suggests that three factors limited the extent of stakeholders’ participation in this process: first, a perception among reformers that fast-paced decision-making was required because there was only a short political window for much needed reforms; second, a lack of trust among reformers in the motives, representativeness, and knowledge of some stakeholders; and third, an under-appreciation of the importance of dialogic engagement with the public. These findings highlight a profound challenge for policymakers. In retrospect, some of those involved in the reform’s design and implementation believe that a more meaningful engagement with the public and stakeholders who opposed the reform might have strengthened its legitimacy and durability. At the same time, the study shows how difficult it is to have an inclusive process in settings where some actors may be driven by unconstrained self-interest or lack the capacity to be representative or knowledgeable interlocutors. It suggests that investments in deliberative capital (the attitudes and behaviours that facilitate good deliberation) and in civil society capacity may help overcome this difficulty. (shrink)

It is good for people to understand their insurance coverage and the reasoning that has shaped it, to be able to contribute their two cents if they want to, and to know that their plan has at least attempted to make decisons that are consistent, fair and compassionate. It is also good for them to be told that attention to cost is ethically required. Nevertheless, while following the recommendations of Wynia et al (2004) might make benefits design and (...) administration appear more fair, it will not do as much as they suggest for them to be more fair. (shrink)

Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which (...) is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework’s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors. (shrink)

We are morally obligated to plan for disaster because it affects human life and well-being. Because contemporary disasters affect the public, such planning should be public in democracies and it should not violate the basic ethical principles of normal times. Current Avian Flu pandemic planning is restricted to a response model based on scarce resources, or inadequate preparation, which gives priority to some lives over others. Rather than this model of ‘Save the Greatest Number,’ the public would be more (...) ethically served by a model of ‘Save All Who Can Be Saved,’ which is based on adequate preparation. And where events exceed adequate preparation, scarce resources should be allocated fairly. (shrink)

Étienne Kola | : L’Afrique est riche de son patrimoine culturel. Cependant peut-elle se réjouir de l’apport de ses filles et de ses fils sur le double plan de la démocratie et de la rationalité moderne? Le relatif retard de ce continent dans certains domaines semble s’enraciner dans des écueils d’ordre éducatif. La plupart des systèmes éducatifs africains sont en effet perçus comme des structures inadaptées aux réalités socioculturelles des peuples. Le paradigme de la philosophie pour enfants consacre la (...) culture du débat sensé, de l’esprit critique, des valeurs éthiques et démocratiques à travers l’institution des communautés de recherche philosophique. Un usage judicieux du substrat culturel africain comme support heuristique dans les communautés de recherche peut s’avérer bénéfique pour l’éveil de la jeunesse. Cette expérience de la philosophie pour enfants vaut la peine d’être menée en Afrique. | : Africa enjoys a rich cultural heritage. Can it, however, rejoice over the contribution of its daughters and sons to both democracy and modern rationality? The relative delay of that continent in some domains seems to be rooted in failures in education. Most African systems of education are indeed perceived as unadapted to the sociocultural realities of the people. The paradigm of philosophy for children gives precedence to the culture of sensible debate, critical thinking, ethical and democratic values through the institution of philosophical research communities. Judicious recourse to the African cultural substrate as a heuristic support in the research communities may prove beneficial for the awakening of youth. This experience of philosophy for children is worth carrying out in Africa. (shrink)

Cet article analyse les ressorts du comique des caractères vicieux de Théophraste à partir d’un double arrière-plan : d’une part l’analyse aristotélicienne du comique et ce qu’on peut reconstituer des intérêts de Théophraste pour le rire et la plaisanterie, d’autre part la manière dont Théophraste prolonge la doctrine éthique d’Aristote en développant principalement les travers ayant un impact sur la vie en société. Le style si particulier de ces portraits, procédant par accumulation d’actions ou de paroles en l’absence de (...) toute analyse psychologique, suscite le rire en faisant prendre conscience des normes morales et sociales transgressées par ces comportements déviants, et en pointant les troubles de l’interaction avec autrui qui en résultent. (shrink)

Cet article analyse les ressorts du comique des caractères vicieux de Théophraste à partir d’un double arrière-plan : d’une part l’analyse aristotélicienne du comique et ce qu’on peut reconstituer des intérêts de Théophraste pour le rire et la plaisanterie, d’autre part la manière dont Théophraste prolonge la doctrine éthique d’Aristote en développant principalement les travers ayant un impact sur la vie en société. Le style si particulier de ces portraits, procédant par accumulation d’actions ou de paroles en l’absence de (...) toute analyse psychologique, suscite le rire en faisant prendre conscience des normes morales et sociales transgressées par ces comportements déviants, et en pointant les troubles de l’interaction avec autrui qui en résultent. (shrink)

My paper reconstructs Fichte's property theory and political economy in Foundations of Natural Right and The Closed Commercial State. Fichte's theory of property requires the rejection of the classical liberal theory of property rights. Fichte's alternative theory of property, in conjunction with his republican account of the state's role in guaranteeing individual rights, further requires the rejection of a market economy in favor of a planned economy. For Fichte's view entails the normative necessity of a political economy in which the (...) production and transfer of goods and services, across large sectors of the economy, are mandated by the state in advance in accordance with an economic plan. As a result, Fichte reconceives his contractualism as necessarily including the negotiation of a state‐enforced plan for eco- nomic activity. Thus, Fichte's new theory of property in Foundations of Natural Right has extremely wide‐ranging implications for the rest of his political and economic thought. The negotiation of fair terms of political associa- tion characteristic of classical contractualist thought becomes in Fichte's hands the negotiation of an economic plan that defines each individual's socioeconomic rights. I conclude with some brief remarks on the sense in which Fichte's theory serves as a cautionary tale for later socialists. (shrink)

The article explores the problem of preferable technological changes in the context of work. To this end, it addresses the ‘why’ (motives and values) and the ‘how’ (organizational forms) of automation from a normative perspective. Concerning the ‘why,’ automation processes are currently mostly driven by values of economic efficiency. Yet, since automation processes are part of the basic structure of society, as is the division of labor, considerations of justice apply to them. As for the ‘how,’ the article suggests ‘ (...) class='Hi'>fair hybrid cooperation’ as an alternative ideal to guide automation priorities. It is achieved when the division of labor between humans and machines does not hinder, and preferably enables, workers’ experience of certain primary qualities in their work activity. By analogy with Rawls’ primary goods, these are qualities that it is necessary for every worker to experience in order to pursue their life plans: security, self-direction, self-development, dignity, and recognition. According to this criterion, the tasks to automate first are those hindering these contributive primary qualities. This provides us with a normative vocabulary and a standard to orient automation decisions but also to assess existing organizational forms and envisage alternative cooperative imaginaries. To illustrate how the ideal may play out in the real world, the article concludes with a ‘fair hybrid cooperation test’ and a nurse bots case for meaningful work. (shrink)

The replicability of findings in experimental psychology can be improved by distinguishing sharply between hypothesis-generating research and hypothesis-testing research. This distinction can be achieved by preregistration, a method that has recently attracted widespread attention. Although preregistration is fair in the sense that it inoculates researchers against hindsight bias and confirmation bias, preregistration does not allow researchers to analyze the data flexibly without the analysis being demoted to exploratory. To alleviate this concern we discuss how researchers may conduct blinded analyses. (...) As with preregistration, blinded analyses break the feedback loop between the analysis plan and analysis outcome, thereby preventing cherry-picking and significance seeking. However, blinded analyses retain the flexibility to account for unexpected peculiarities in the data. We discuss different methods of blinding, offer recommendations for blinding of popular experimental designs, and introduce the design for an online blinding protocol. (shrink)

How can health plans make fair determinations about when “experimental” (and costly) treatments such as high dose chemotherapy with autologous bone marrow transplantation should be covered despite lack of clear clinical consensus about their benefits? Different models for managing “last chance” therapies evolving in some health plans offer promising examples of how issues of fairness and legitimacy in decisionmaking can be addressed.

The financial crisis of 2007–2008 and the COVID-19 pandemic have caused many enterprises to suffer great losses. Thus, companies have to take measures such as pays cut, furloughs, or layoffs, which caused dissatisfaction among employees and triggered labor disputes. Therefore, this study explores the service-oriented organizational citizenship behavior based on the decomposed theory of planned behavior in order to understand the behavioral intentions of employees through their mental states, job attitudes, subjective norms, and perceived behavioral control. This study conducted questionnaire (...) surveys for employees in different industries, collected 281 valid questionnaires, and applied Structural Equation Model for the analysis. The results show: employees believe organizational justice in the organization is important, and when they feel treated fairly, their job attitudes and beliefs are enhanced. Employees’ job attitudes and beliefs support service-oriented organizational citizenship behavior, in other words, they have positive job attitudes and beliefs and will actively provide better service to customers. When employees are treated reasonably and fairly by the organization and have positive job attitudes and perceived behavior control, their spontaneous service-oriented organizational citizenship behavior is stimulated, thus increasing organizational development. (shrink)

In 2007, Massachusetts instituted a universal coverage health plan that requires all citizens to purchase insurance. I argue that there is nothing wrong in principle with the use of an individual mandate to force citizens to secure health insurance. I argue that state neutrality is not tenable on this issue. Then I proceed to show that even if state neutrality were viable, it is not a violation of state neutrality (thought of as neutrality of intent) to force citizens to (...) insure themselves with the primary purpose of securing the normative good of health. I adapt recent work on universal medical coverage to demonstrate that such a mandate is in keeping with several principles of fairness shared in liberal democratic societies. This argument not only applies to the Massachusetts plan but likely to any other health care coverage schemes using individual mandates in the US political context, including recently passed federal health care reform measures. However, even though the Massachusetts plan may provide increased access to health care for many, there are still legitimate worries that it currently places disproportionate financial burdens on the working poor and thus will need refinement. (shrink)

This paper examines the reasons for the high level of unmet needfor contraception in rural Egypt, using data from the individual survey andservice availability module of the 1988Ð89 Egypt Demographic and HealthSurvey. Two broad sets of potential factors are considered: characteristics ofa woman which influence her desire for children and thus her propensity touse contraception, and factors relating to the family planning serviceenvironment in which she lives. The results from a multivariate analysis showthat certain individual characteristics, such as family composition (...) andeducation, have a strong impact on the level of contraceptive use and on theproportion of total demand for spacing or limiting childbearing that is metby use of family planning. Unmet need, however, remains fairly constantacross demographic and socioeconomic subgroups of the population. Thelargest variations in unmet need are regional, but elements of the familyplanning services, namely the provision of a community-based nurse whodistributes family planning and female doctors at clinics, also play animportant role. (shrink)

Legal systems must proceed in the face of two conceptions of procedural fairness. The first, embodied in the rule of law ideal, calls for clear rules, laid down in advance and susceptible to mechanical application in individual cases. The second calls for a high degree of individuation, on the theory that fairness requires particularized consideration of the whole person. Both conceptions can be found in judicial interpretation of the due process clause of the American Constitution, which sometimes requires rule-bound decisions, (...) and sometimes requires individuation. Both conceptions have a great deal of appeal in particular settings. The choice between the two depends largely on an investigation of the costs of decision and the costs of error. In addition, "planning costs" play a large role; where people need to be able to plan in advance, rule-bound judgments look fairer and much more attractive even if they produce significant unfairness and arbitrariness. (shrink)

Much of what makes Hayek so controversial can be found in The Road to Serfdom, the theoretical basis of which is provided by The Counter-Revolution of Science. The first book, a polemic against the “planning mentality,” did not defend complete laissez faire, but argued that planning disrupts the coordination between prices and supply and demand; that effective planning is thus impossible in a modern industrial society; that it is coercive; and, of course, that it leads to totalitarianism. In The Counter-Revolution (...) of Science, Hayek argued that the “planning mentality” is the result of the hubristic attempt to reconstruct society along scientific lines. But the likes of Edward Bellamy envisioned a planned but free society, while John Dewey contrasted planning, where people collectively choose their goals, against a planned economy that is coercively imposed. Hayek's welcome strictures against a scientistic society and an overly ambitious social science aside, his binary approach to intellectual history distorted through oversimplification. (shrink)

Legal systems must proceed in the face of two conceptions of procedural fairness. The first, embodied in the rule of law ideal, calls for clear rules, laid down in advance and susceptible to mechanical application in individual cases. The second calls for a high degree of individuation, on the theory that fairness requires particularized consideration of the whole person. Both conceptions can be found in judicial interpretation of the due process clause of the American Constitution, which sometimes requires rule-bound decisions, (...) and sometimes requires individuation. Both conceptions have a great deal of appeal in particular settings. The choice between the two depends largely on an investigation of the costs of decision and the costs of error. In addition, "planning costs" play a large role; where people need to be able to plan in advance, rule-bound judgments look fairer and much more attractive even if they produce significant unfairness and arbitrariness. (shrink)

Despite projected devastating impacts on human communities, the US still lacks comprehensive national policies aimed at reducing greenhouse gas emissions. This vacuum has provided the space for a surge of promising sustainability and climate action planning efforts at the state and local level. Meanwhile, according to the National Low Income Housing Coalition’s (2015) Out of Reach Report, ‘there is no state in the US where a minimum wage worker working full time can afford a one-bedroom apartment at the fair (...) market rent’. We are calling for a reimagining of local climate action planning that encourages policies and programs designed to reduce GHG emissions from the built environment while explicitly and comprehensively addressing the affordability component. With equitable local climate action planning, we can address both environmental and social justice issues. (shrink)

It is still remarkably difficult for public health officials charged with developing and implementing pandemic influenza preparedness plans at the community levelto obtain clear, concrete, and consistent guidance on how to construct plans that are both ethical and actionable. As of mid-2007, most of the federal and state pandemic plans filed with the Centers for Disease Control and Prevention, describing how public health officials will coordinate public agencies and private entities in the event of an outbreak, failed to include ethical (...) guidance for first responders responsible for providing essential services and making fair decisions during a public health emergency. (shrink)

This chapter reiterates the proposition that practical cognition should not aim at finding optimal solutions to practical problems. A rational cognizer should instead look for good solutions, and replace them with better solutions if any are found. Solutions come in the form of plans. In general, a change to the master plan may consist of deleting several local plans and adding several others. This theory is still fairly schematic. It leaves most details to the imagination of the reader, and (...) in philosophy, that is often a recipe for disaster. When philosophical theories fail, it is not because they did not look good in the abstract—it is because it is impossible to make the details work. This chapter simply gives a preliminary sketch of how a resource bounded agent can actually perform locally global planning. (shrink)

The manner in which limited vaccines are distributed during a pandemic is an ethical issue. The utility principle has been used to argue priority be given to certain individuals based on factors such as the epidemiology of the spread of disease and maintaining the functioning of society. The equity principle has been used to encourage fair practices that account for the economic and social costs of all decisions made. We argue that both principles are met through priority vaccination of (...) homeless individuals, as this strategy protects a medically vulnerable population while reducing the chances of transmission to others as they move through populated urban spaces. We begin by reviewing debates around ethical vaccine distribution. We then argue the homeless are a medically high-risk population who may contribute to the spread of disease through their mobility. As immunization rates are generally lower among the homeless and many do not access mainstream health care, we argue that community vaccine clinics must be used to reach these individuals. We provide support by analyzing Toronto Public Health’s operation of vaccine clinics in shelters and drop-in centres during pH1N1 and conclude that this strategy is effective for immunizing homeless individuals, bringing together the equity and utility principles. (shrink)

Background:A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population.Research aim:To identify challenges in implementing the ‘Let Me Decide’ advance care planning programme in long-term-care.Research design:This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families.Participants and research context:long-term-care residents in two nursing homes and one community hospital.Ethical considerations:The local research ethics committee granted ethical approval.Findings:Following implementation, over (...) 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training.Discussion:The challenges encountered were largely concerned with preserving resident’s autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources.Conclusions:Although it may be too late for many long-term-care residents to complete their own advance care directive, the ‘ Let Me Decide’ programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice. (shrink)

RÉSUMÉ : John Searle, Hubert Dreyfus et Charles Taylor défendent la thèse voulant qu’il y ait des formes de «compréhension» ou de «savoir» qui, contrairement aux formes courantes, ne sont pas de nature représentationnelle ou conceptuelle mais sont plutôt du type des «savoir-faire». Cet article examine l’argument avancé en faveur de cette thèse ainsi que l’affirmation de ces auteurs suivant laquelle les Recherches philosophiques de Wittgenstein démontrent que celui-ci, au moins implicitement, l’acceptait. Les conclusions qui découlent de cet examen sont, (...) d’une part, que l’argument n’est pas concluant et, de l’autre, qu’il aurait été récusé par l’auteur des Recherches. ABSTRACT : A thesis held by John Searle, Hubert Dreyfus and Charles Taylor is that there is a kind of “understanding” or “knowledge” that differs from ordinary knowledge in being by nature non-representational or non-conceptual and rather a kind of “know-how.” The aim of this article is to examine the argument in support of their common thesis and their claim that it was endorsed, at least implicitly, by Wittgenstein in the Philosophical Investigations. This examination shows that the argument is not convincing and that Wittgenstein would have rejected it. (shrink)

This paper offers a new concept of the firm that aims at balancing the corporate economic, social, and environmental responsibilities and goes beyond the stakeholder approach. It intends to provide a conceptual and operationalizable basis to fairly assess corporate conduct from both inside and outside the companies. To a large extent these different responsibilities may overlap and reinforce each other. However, if they conflict, they should be clearly evaluated for their own sake and in terms of wealth creation. Only then (...) can a balanced approach be realized. Section 1 briefly discusses some general aspects of the relationship between concepts and measurement. In Section 2, a concept of the firm is developed that is based on the notion of responsibility and balances economic, social and environmental responsibilities. According to these concepts, different ways of measuring corporate planning and performance are examined in Section 3, followed up by a summary and conclusions. (shrink)

Despite the reasonable explanatory power of existing models of consumers’ ethical decision making, a large part of the process remains unexplained. This article draws on previous research and proposes an integrated model that includes measures of the theory of planned behavior, personal norms, self-identity, neutralization, past experience, and attitudinal ambivalence. We postulate and test a variety of direct and moderating effects in the context of a large scale survey study in London, UK. Overall, the resulting model represents an empirically robust (...) and holistic attempt to identify the most important determinants of consumers’ support for the fair-trade movement. Implications and avenues for further research are discussed. (shrink)

Risk and crisis communication (RCC) is a current ethical issue subject to controversy, mainly due to the tension between individual liberty (a core component of fairness) and effectiveness. In this paper we propose a consistent definition of the RCC process in public health emergencies (PHERCC), which comprises six key elements: evidence, initiator, channel, publics, message, and feedback. Based on these elements and on a detailed analysis of their role in PHERCC, we present an ethical framework to help design, govern and (...) evaluate PHERCC strategies. The framework aims to facilitate RCC, incorporating effectiveness, autonomy, and fairness. It comprises five operational ethical principles: openness, transparency, inclusivity, understandability, and privacy. The resulting matrix helps understanding the interplay between the PHERCC process and the principles of the framework. The paper includes suggestions and recommendations for the implementation of the PHERCC matrix. (shrink)

In Shared Agency: A Planning Theory of Acting Together, Michael Bratman refines, systematizes, and defends his “planning theory” of shared agency, various elements of which were sketched in a series of earlier essays on the topic. The book is analytically rigorous and fairly technical at points, but organized and written with extraordinary clarity. It represents a valuable contribution to the literature on shared intention and joint activity, and is essential reading for philosophers working in that area.Bratman takes as his central (...) foils Margaret Gilbert and John Searle, both of whom argue that there is a fundamental discontinuity between individual agency and shared agency in that the resources needed to explain the latter extend beyond those that enable us to explain the former. According to those theorists, an adequate account of shared agency requires appeal to “some new and fundamentally different kind of practical element” : an irreducible “joint commitment” on Gilbert’s .. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used (...) by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

Advance directives are useful ways to express one's wishes about end of life care, but even now most people have not completed one of the documents. David Doukas and William Reichel strongly encourage planning for end of life care. Although Planning for Uncertainty is at times fairly abstract for the general reader, it does provide useful background and practical steps.

Le concept de plan utilisé en planification socialiste est rapproché du concept de plan invoqué par diverses philosophies de l'histoire. Pour ce faire, la notion de « plan divin » est analysée à l'aide d'une structure à sept termes qui, s'appliquant également au concept socialiste de plan, permet de fonder ce rapprochement. Les avatars du concept de plan en philosophie de l'histoire sont ensuite examinés de manière à faire ressortir un parallèle entre les dilemmes de (...) cette philosophie et ceux de la planification soviétique, yougoslave ou chinoise.The concept of planning used in socialist experiences is approached by the "plan" concept put forward by diverse philosophies of history. In order to do this, the notion of "divine plan" is analysed with the help of a structure of seven terms which, being equally applied to the socialist concept of planning, allows the foundation of this "rapprochement" . The transformations of the concept of plan in the philosophy of history are next examined in such a manner to manifest a parallel between the dilemmas of this philosophy and those of Soviet, Yugoslav or Chinese planning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Shame is Not an Effective Diet PlanJudith BrukThe stigma of being obese is so strong that it is assumed that anyone with the condition is (or should be) deeply ashamed. After all, it’s really easy to lose weight, right? Just cut out dessert and walk around the block three times a week. If you can’t even do that, then you are definitely a moral failure, have succumbed to Gluttony (...) and Sloth, and deserve to be shunned by society.The problem is that shame is not a very effective diet plan; quite the opposite. It’s no surprise that recent research shows that shame leads to depression that leads to isolation, which, in the morbidly obese, leads to a suicide rate twelve times that of healthy–weight people.Unfortunately, it is indeed true that many obese people feel a great deal of shame, even if we occasionally put on a façade of bravado or seeming shamelessness, e.g., the “large and in charge” sitcom staple trope. The bottom line is that our shame about our weight does keep us from engaging with other people, limits our willingness to participate in physical activities, and generally makes us reluctant to simply exist out in public. None of these are behaviors conducive to positive lifestyle changes.For years I engineered my life so I would only go out of my house when absolutely necessary: grocery shopping and the occasional meeting at work were pretty much it (I usually work from home). I went for years without going to a movie, shopping for clothes in a store, eating in a restaurant, gardening, or any of the other activities I once enjoyed. I was ashamed to be seen. And since I had tried and tried and tried and tried to lose weight for three decades and only ended up more overweight as the years went by, I finally, truly gave up. I convinced myself my psychological makeup was so flawed (or was missing whatever ingredient it was that made someone succeed at sustained weight loss) that I just hoped my inevitable heart attack would be instantaneously fatal. This thinking is irrational, or at least unhealthy. (I am an otherwise fairly smart person with an advanced degree and am professionally employed.) Yet, it is basically the path that both societal attitudes and medical treatment lead us down at this point in time.Here are a few examples that illustrate how the path to irrationality evolved for me.About twelve years ago, I decided to see a psychotherapist to get to the bottom of my subconscious psychological issue that was keeping me overweight. This therapist suggested I see a nutritionist who gave me a list of detailed thyroid tests to take to my doctor so she could order the labs and we could get a full profile of how my thyroid was functioning. Upon presenting the list to my doctor’s PA (my doctor was not available that day), she rolled her eyes, gave a very deep sigh and said to me, “Every fat woman wants to believe it’s because of her thyroid and it never, ever is.” I was so embarrassed for having even brought the subject up that in an effort to save face, I reacted to my shame by replying, “Yeah, I just assume my extreme lack of energy and excess weight is simply because I eat too much.” She said, “Right, so let’s not even bother running these tests.” It was at least ten years later that I finally had the thyroid panel run and found out it was very low functioning.After about a year of seeing that shrink, she declared me “cured” and sent me on my way, though I had not lost any weight. It was about this time I first began thinking that throwing in the towel [End Page 91] was a good option. That didn’t mean that I went out and ate pizza and ice cream every day. Not at all. In fact, given the fact that I had been vegetarian and general health–food freak beginning in my mid–twenties, I rarely had anything in the house that contained sugar... (shrink)

Financing innovative and costly treatments in various therapeutic fields entails a number of problems in countries where costs are covered by public services. Providing these drugs is forcing actors to define the maximum sums of money society is willing to spend for given health improvements. This raises the question of whether maximum financing should vary according individuals’ circumstances, such as the rareness of a disease, lifestyles, social inequalities experienced over a life time, etc. This article examines a particular priority, namely (...) that given to the youngest patients, such prioritising usually refers to the “fair innings argument”. We question what could justify such a prioritization criterion. Three arguments are considered. At first we consider that FIA could be justified by the objective of equalizing the opportunities of well-being. Next, we proposed justifying the fair innings argument with the aim of equalizing the time provided to individuals to achieve their plan of life, in accordance with Rawls’s theory of justice as fairness. Finally, we proposed considering the FIA as being justified because of the goal of equalizing the time provided to individuals to accept death. These three arguments, of course, have many limitations, some of which we have highlighted. This article doesn’t aim to convince about the superiority of one argument over the other ones. We seek to contribute to the discussions which could happen on prioritization criteria regarding health care, by making explicit what could justify one specific criterion: the age criterion. (shrink)

: In spite of recent political setbacks for the movement toward universal health insurance, considerable support remains for the idea. Among those supporting such plans, most assume that a universal insurance system, especially if it is a single-payer system, would offer a single list of basic covered services. This paper challenges that assumption and argues for the availability of multiple lists of services in a universal insurance system. The claim is made that multiple lists will be both more efficient and (...) more fair. Any single list will fund some services that are quite attractive to some people, but only marginally attractive to others. Thus any single-list plan will fund some services that produce only marginal benefit for the resources used. Moreover, since some people will hold values quite compatible with the single list and others will hold values leading to preferences for unfunded services, some people will get much more benefit from any single list than other people will. Fairness and efficiency require providing an entitlement to universal access to health insurance that could be purchased by typical consumers for a fixed price of perhaps $3500. By permitting everyone to pick their preferred list of services available at that price, each person will efficiently use his or her entitlement while getting more equal opportunity for benefits. (shrink)

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.

One of the stated aims of the “2008 Policy Plan on Asylum” by the European Commission is increased ‘responsibility sharing’ between Member States with respect to asylum seekers. Luc Bovens and Günperi Sisman assess the extent to which UNHCR outcome data reflect these aims between 2006 and 2011 – from the end of the first phase of the Common European Asylum System until the latest available data. They find that Greece, Portugal and Spain take on very low responsibility for (...) asylum seekers per capita and per unit of GDP. Eastern European states do poorly per capita, but do much better per unit of GDP. There is also an overall trend towards greater responsibility sharing for acceptances and stocks per unit of GDP. (shrink)

Supply chain management is critical for addressing uncertainties caused by random demand and production yield. In this study, a random yield supply chain, in which the production process of fresh agricultural products is easily affected by factors, such as weather, soil, or plant diseases and insect pests, was considered. Therefore, the actual output is typically less than the planned output. A model in which the producer faces yield uncertainty was considered, and the influence of the producer’s fairness concerns on the (...) planned output of the contract-farming supply chain was considered. Methods to motivate the producer to increase planned output through reasonable contracts were investigated. The results revealed that the producer’s fairness concern considerably influences the optimal expected profit. In the case of the random output, the planned output and maximum expected profits reduce when the farmer exhibits fairness concerns. As the degree of the producer’s fairness concern increases, the planned output and expected profit gradually decrease The cost-sharing contract can effectively encourage the producer to increase his planned output and expected utility. Finally, the results were verified numerically. (shrink)

Pour cet article de réflexion critique, il s’agit de montrer en quoi les sites de rencontre, en proposant un dispositif spécifique de mise en relation de possibles partenaires, contribuent à modifier à différents niveaux la façon de concevoir le couple et de réfléchir à ce qu’il représente. L’intellectualisation que représente la nécessité de présentation de soi avant même l’éventuelle rencontre, tout autant que la définition des attentes envers le possible partenaire, positionnent différemment l’individu par rapport à une rencontre « classique (...) ». Les dimensions plus concrètes, physiques, et aussi inconscientes en jeu dans une rencontre « spontanée » semblent passer au second plan, au moins dans un premier temps. Mais ce processus de rationalisation porte en lui un certain nombre de contradictions, qui peuvent entrer en phase avec les paradoxes de l’hypermodernité : réalisation de soi dans l’autre et exacerbation des attentes envers autrui en parallèle avec l’affirmation individualiste de soi…. (shrink)