When assessing the cost effectiveness of health care programmes, health economists typically presume that distant events should be given less weight than present events. This article examines the moral reasonableness of arguments advanced for positive discounting in cost-effectiveness analysis both from an intergenerational and an intrapersonal perspective and assesses if arguments are equally applicable to health and monetary outcomes. The article concludes that behavioral effects related to time preferences give little or no reason for why society at large should favour (...) the present over the future when making intergenerational choices regarding health. The strongest argument for discounting stems from the combined argument of diminishing marginal utility in the presence of growth. However, this hinges on the assumption of actual growth in the relevant good. Moreover, current modern democracy may be insufficiently sensitive to the concerns of future generations. The second part of the article categorises preference failures (which justify paternalistic responses) into two distinct groups, myopic and acratic. The existence of these types of preference failures makes elicited time preferences of little normative relevance when making decisions regarding the social discount rate, even in an intrapersonal context. As with intergenerational discounting, the combined arguments of growth and diminishing marginal utility offer the strongest arguments for discounting in the intrapersonal context. However, there is no prima facie reason to assume that this argument should apply equally to health and monetary values. To be sure, selecting an approach towards discounting health is a complex matter. However, the life-or-death implications of any approach require that the discussion not be downplayed to merely a technical matter for economists to settle. (shrink)

We obtain rich measures of the risk preferences of a sample of Vietnamese farmers, and revisit the link between risk preferences and economic well-being. Far from being particularly risk averse, our farmers are on average risk neutral and, thus, more risk tolerant than typical Western subject populations. This generalises recent findings indicating that students in poorer countries are more risk tolerant than students in richer countries to a general population sample. Risk aversion is, furthermore, negatively correlated with income within our (...) sample, but does not correlate with wealth. This also casts doubt on high levels of risk aversion causing failure to adopt new technologies, which we discuss. (shrink)

Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of (...) medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals. (shrink)

Daniel M. Hausman holds that preferences in economics are total subjective comparative evaluations—subjective judgments to the effect that something is better than something else all things told—and that economists are right to employ this conception of preference. Here, I argue against both parts of Hausman’s thesis. The failure of Hausman’s account, I continue, reflects a deeper problem, that is, that preferences in economics do not need an explicit definition of the kind that he seeks. Nonetheless, Hausman’s labors were not (...) in vain: his accomplishment is that he has articulated a useful model of the theory. (shrink)

This book provides an evaluation of 18 voting procedures in terms of the most important monotonicity-related criteria in fixed and variable electorates. All voting procedures studied aim at electing one out of several candidates given the voters' preferences over the candidates. In addition to (strict) monotonicity failures, the vulnerability of the procedures to variation of the no-show paradoxes is discussed. All vulnerabilities are exemplified and explained. The occurrence of the no-show paradoxes is related to the presence or absence of (...) a Condorcet winner. The primary readership of this book are scholars and students in the area of social choice. (shrink)

The topic of this paper is the semantic structure of belief reports of the form 'a believes that p'. it is argued that no existing theory of these sentences satisfactorily accounts for anaphoric relations linking expressions within the embedded complement sentence to expressions outside. a new account of belief reports is proposed which assigns to embedded expressions their normal semantic values but which also exploits frege's idea of using senses to explain the apparent failures of extensionality in the reports.

Satisficing is a central concept in both individual and social multiagent decision making. In this paper we first extend the notion of satisficing by formally modeling the tradeoff between costs and decision failure. Second, we extend this notion of “neo”-satisficing into the context of social or multiagent decision making and interaction, and model the social conditioning of preferences in a satisficing framework.

The multiverse hypothesis is growing in popularity among theistic philosophers because some view it as the preferable way to solve certain difficulties presented by theistic belief. In this paper, I am concerned specifically with its application to Rowe’s problem of no best world, which suggests that God’s existence is impossible given the fact that the world God actualizes must be unsurpassable, yet for any given possible world, there is one greater. I will argue that, as a solution to the problem (...) of no best world, the multiverse hypothesis fails. To defend my thesis, I will first define the multiverse hypothesis and articulate the problem of no best world and how the multiverse hypothesis is thought to solve it. I will then show that the solution fails by articulating two problems that have been mentioned, but not developed, in the literature—what I call the problem of no highest standard and the problem of multiverse cardinality. In each case, after articulating the problem, I will offer possible responses to the problem and show why those responses are inadequate. (shrink)

This article offers a realist interpretation of Tacitus’s analysis of political failure. Tacitus described the early Roman Empire as a balance between the conflicting and irreconcilable values and interests of the emperor, the army, and the senate. For him Stoic-republican morality in itself—without the intervention of a political standard demanding political agency in every circumstance—cannot provide an all-purpose guide to action. He provides a fine-grained analysis of types of political failure, such as failing to act, or to realize one’s limited (...) scope for maneuver, or the inevitability of failure given particular political circumstances. Tacitus also describes Thrasea, a moderate member of the senatorial opposition to Nero, as an exceptionally laudable figure. His preference for moderate politics places Tacitus on the side of contemporary status-quo oriented, liberal, realists (e.g., Bernard Williams), rather than on the side of radical realists (e.g., Raymond Geuss, Enzo Rossi), but the central lesson of his understanding of Roman politics is not so much that political order is fragile as that the cost of political failure can indeed be unbearably high. (shrink)

Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, a surrogate decision maker ought to make the decision that the incompetent patient would have made, had he or she been competent. Empirical research has been conducted in order to find out whether surrogate decision makers are sufficiently good at doing their job, as this is defined by the substituted judgment standard. This research investigates to what extent surrogates (...) are able to predict what the patient would have preferred in the relevant circumstances. In this paper we address a methodological shortcoming evident in a significant number of studies. The mistake consists in categorizing responses that only express uncertainty as predictions that the patient would be positive to treatment, on the grounds that the clinical default is to provide treatment unless it is refused. We argue that this practice is based on confusion and that it risks damaging the research on surrogate accuracy. (shrink)

Determining the precise nature of the connection between preference, choice, and welfare has arguably been the central project in the field of welfare economics, which aims to offer a proper guide for economists in the making of policy decisions that affect people’s welfare. The two leading approaches here historically – the revealed preference and latent preference approaches – seem equally incapable of so guiding economists. I argue that the deadlock here is due to welfare economists’ failure to (...) recognize a crucial distinction between two senses of “preference.” I analyze and defend these senses of “preference,” and argue that each shares a close connection with just one of choice and welfare. This analysis reveals how economists should conceive of both the connections between “preference,” choice, and welfare, and the proper roles of these concepts in welfare economics. I conclude by showing this analysis to best explain the plausibility of two leading alternative approaches from Hausman and Sugden. (shrink)

This paper merges the non-expected utility approach (Tversky and Kahneman, J Risk Uncertain 5:297–323, 1992 and Quiggin, J Econ Behav Organ 3:323–343, 1982) into Akerlof’s (Quart J Econ 84:488–500, 1970) model of Market for Lemons. We derive the results for different probability weighting functions and analyze the phenomenon of market failure in light of non-expected utility maximization. Our main finding suggests that when the proportion of traded lemons is high (low), the problem of market failure is mitigated (enhanced). In addition, (...) for the case of Cumulative Prospect Theory, we show that (a) the higher the loss aversion is, the more pronounced is the market failure; (b) gain-domain elevation is negatively related to the extent of market failure; and (c) the value function is (i) negatively monotonic in the gain-domain diminishing sensitivity parameter when the market is characterized by a high proportion of “peaches,” and (ii) positively monotonic in the loss-domain diminishing sensitivity parameter when the market is characterized by a high proportion of “lemons.”. (shrink)

In this paper, I will argue that the most systematic arguments for the impossibility of reducing of social facts are not, in fact, good arguments. The best of these, the multiple realizability argument, has been very successful in convincing people to be non-reductionists in the philosophy of mind, and can plausibly be adapted to argue for anti-reductionism in the social sciences. But it, like the other arguments for the impossibility of social reduction, cannot deliver. Any preference we have for (...) social scientific explanations that don't refer to properties of individuals should not be based on a belief in the impossibility of reduction. (shrink)

This article sets out the moral failure of single-tier basic healthcare. Single-tier basic healthcare has been advocated on the grounds that the provision of healthcare should be divorced from ability to pay and unequal access to basic healthcare is morally intolerable. However, single-tier basic healthcare encounters a host of catastrophic moral failings. Given the fact of human pluralism it is impossible to objectively define “basic” healthcare. Attempts to provide single-tier healthcare therefore become political processes in which interest groups compete for (...) control of scarce resources with the most privileged possessing an inherent advantage. The focus on outputs in arguments for single-tier provision neglects the question of justice between individuals when some people provide resources for others without reciprocal benefits. The principle that only healthcare that can be provided to everyone should be provided at all leads to a leveling-down problem in which advocates of single-tier provision must prefer a situation where some individuals are made worse-off without any individual being made better-off compared to plausible multi-tier alternatives. Contemporary single-tier systems require the exclusion of noncitizens, meaning that their universalism is a myth. In the light of these pathologies, it is judged that multi-tier healthcare is morally required. (shrink)

Public choice theory presents itself as a new institutional economics that rectifies the failure of the neo-classical tradition to treat the institutional dimension of economics. It offers criticism of both neo-classical defenders of cost-benefit analysis and their environmental critics. Both assume the existence of benign political actors. While sharing some of its scepticism about this assumption, this paper argues that the public choice perspective is flawed. The old institutionalism of classical economics provides a better perspective to examine both explanatory and (...) nonnative problems occasioned by environmental problems than does the new institutionalism, raising significant questions about the relationship between environmental goods, virtues and institutions which have been lost to recent discussion. (shrink)

Redish et al. suggest that their failures-in-decision-making framework for understanding addiction can also contribute to improving our understanding of a variety of psychiatric disorders. In the spirit of reflecting on the significance and scope of their research, I briefly develop the idea that their framework can also contribute to improving our understanding of the pervasive problem of procrastination.

This paper wishes to problematize the foundations of production governance and offer an analytical perspective on the interrelation between agents’ preferences, strategic choice, and the public sphere . The value is in the idea of preferences being social in nature and in the application both to the internal stakeholders of the organisation and its impacts on people outside. Using the concept of ‘strategic failure’ we suggest that social preferences reflected in deliberative social praxis can reduce false beliefs and increase individual (...) wellbeing. From this approach, the paper offers a taxonomy of production organisations, based on social preferences about two variables: the governance form other strategic decisions that characterize the management of a company at a more operational level, once its fundamental legal form has been chosen. Each dimension is then categorised alongside two basic preferences: towards inclusion or exclusion of ‘publics’ that have no substantial access to decision power about these variables. Our framework explains governance heterogeneity by contrasting exclusive and inclusive social preferences in cooperatives, social enterprises, as well as traditional corporations. A discussion of the evolution of social preferences and organizational forms is addressed through examples and regional experiences. (shrink)

. Consistent valuation and societal prioritization of risks presupposes comparability among risks, that is, in order to rank risks in order of severity, and allocate risk preventative resources accordingly, we must be able to determine whether one risk is better or worse than another, and by how much. It is often claimed, however, that some risks are not amenable to this kind of comparison because they are incommensurable, which roughly means that they are not comparable with respect to a common (...) cardinal measure. The aim of this thesis is to i) consider what it means to say that two risks are incommensurable, ii) explore if incomparability - comparison failure with respect to a common ordinal scale - ever occurs, and how to model it if it does. Essay I is a critical examination of the most prominent argument for incomparability, the so-called small improvement argument. It is argued that the argument fails because it conflates incomparability and a kind of evaluative indeterminacy. Essay II outlines so-called margin of error principles for comparative value judgements. They are based on the idea that if a proposition concerning the value relation between two value-bearing options is true, but there are sufficiently similar cases in which it is false, it is not available to be known. The usefulness of these principles is demonstrated by utilizing them in an epistemological case against SIA. Essay III presents a novel account of incomplete preference orderings which acknowledges that incomparability can vary in degrees. This is achieved by means of a probabilistic analysis of preferences. (shrink)

The purpose of advance care planning is to allow an individual to maintain autonomy in end-of-life medical decision-making even when incapacitated by disease or terminal illness. The intersection of EOL medical technology, ethics of EOL care, and state and federal law has driven the development of the legal framework for advance directives. However, from an ethical perspective the current legal framework is inadequate to make ADs an effective EOL planning tool. One response to this flawed AD process has been the (...) development of Physician Orders for Life Sustaining Treatment. POLST has been described as a paradigm shift to address the inadequacies of ADs. However, POLST has failed to bridge the gap between patients and their autonomous, preferred EOL care decisions. Analysis of ADs and POLST reveals that future policy should focus on a communications-based approach to ACP that emphasizes ongoing interactions between healthcare providers and patients to optimize EOL medical care to the individual patient. (shrink)

Much of the discussion on cosmopolitanism and nationalism has focused on their different normative views. The purpose of this article is to shift the attention away from the normative debate to the metatheoretical argument about how we determine moral and political principles independently of each other. I argue that the discussion among proponents of cosmopolitanism and contextualist models boils down to latent methodological and metatheoretical assumptions about what selection of facts are considered politically relevant. In the article, I explore what (...) I call ‘the indeterminacy failure’ of moral cosmopolitanism, that is, the view according to which moral principles fail to determine what political-institutional level might be preferable; and the ‘indeterminacy failure’ of liberal nationalism, that is, the view according to which national identity fails to determine moral principles. In opposition to dichotomist cosmopolitan models and alternative contextualist approaches, I promote a ‘split-level’ model that is set to avoid the difficulties in the other approaches. The split-level corrects the indeterminacy failures of cosmopolitanism and contextualism by distinguishing clearly between the level of moral theorising and the level of political theorising. (shrink)

Lorenzo Sacconi’s recent re-statement of his social contract account of business ethics is a major contribution to our understanding of the normative nature of CSR as the expression of a fair multi-party agreement supported by the economic rationality of each participant. However, at one crucial point in his theory, Sacconi introduces the concept of stakeholders’ conformist preferences – their disposition to punish the firm if it defects from the agreement, refusing to abide by its own explicit CSR policies and norms. (...) We take issue with him over this concept: we show that the assumption of conformist preferences is a moral premise, and it arguably weakens the normativity of the theory as a whole. As an alternative, we propose an evolutionary game theoretic approach. We draw upon recent applications of evolutionary game theory to moral philosophy (Skyrms, Danielson), and we use a computer simulation of the trust game. According to this approach, the failure of the logic of reputation, which is the problem conformist preferences were introduced to solve, is overcome through the dynamics of interaction. (shrink)

Davidson and Burge have claimed that the conditions under which self-knowledge is possessed are such that externalism poses no obstacle to their being met by ordinary speakers and thinkers. On their accounts. no such person could fail to possess self-knowledge. But we do from time to time attribute to each other such failures; so we should prefer to their accounts an account that preserves first person authority while allowing us to make sense of what appear to be true attributions (...) of such failures.While the core idea behind Davidson’s and Burge’s accounts appears inadequate to this task, I argue that it can be deployed in such a way as to deliver the desired result. What makes this possible is that two attitude-types can differ as follows: the self-knowledge required for an utterance to be a Φing that p is different from the self-knowledge required for it to be a Ψing that p. (shrink)

Davidson and Burge have claimed that the conditions under which self‐knowledge is possessed are such that externalism poses no obstacle to their being met by ordinary speakers and thinkers. On their accounts, no such person could fail to possess self‐knowledge. But we do from time to time attribute to each other such failures; so we should prefer to their accounts an account that preserves first person authority while allowing us to make sense of what appear to be true attributions (...) of such failures.While the core idea behind Davidson's and Burge's accounts appears ioadequate to this task, I argue that it can be deployed in such a way as to deliver the desired result. What makes this possible is that two attitude‐types can differ as follows: the self‐knowledge required for an utterance to be a Oing that p is different from the self‐knowledge required for it to be a Ψfing that p. (shrink)

Two critical thinking skills—the tendency to avoid myside bias and to avoid one-sided thinking—were examined in three different experiments involving over 1200 participants and across two different paradigms. Robust indications of myside bias were observed in all three experiments. Participants gave higher evaluations to arguments that supported their opinions than those that refuted their prior positions. Likewise, substantial one-side bias was observed—participants were more likely to prefer a one-sided to a balanced argument. There was substantial variation in both types of (...) bias, but we failed to find that participants of higher cognitive ability displayed less myside bias or less one-side bias. Although cognitive ability failed to associate with the magnitude of the myside bias, the strength and content of the prior opinion did predict the degree of myside bias shown. Our results indicate that cognitive ability—as defined by traditional psychometric indicators—turns out to be surprisingly independent of two of the most important critical thinking tendencies discussed in the literature. (shrink)

In voting theory, monotonicity is the axiom that an improvement in the ranking of a candidate by voters cannot cause a candidate who would otherwise win to lose. The participation axiom states that the sincere report of a voter’s preferences cannot cause an outcome that the voter regards as less attractive than the one that would result from the voter’s non-participation. This article identifies three binary distinctions in the types of circumstances in which failures of monotonicity or participation can (...) occur. Two of the three distinctions apply to monotonicity, while one of those and the third apply to participation. The distinction that is unique to monotonicity is whether the voters whose changed rankings demonstrate non-monotonicity are better off or worse off. The distinction that is unique to participation is whether the marginally participating voter causes his first choice to lose or his last choice to win. The overlapping distinction is whether the profile of voters’ rankings has a Condorcet winner or a cycle at the top. This article traces the occurrence of all of the resulting combination of characteristics in the voting methods that can exhibit failures of monotonicity. (shrink)

The starting point regarding consent has to be that it is both extremely important, and that it is often suspicious. In this article, the author tries to make sense of both of these claims, from a largely liberal perspective, tying consent, predictably, to the value of autonomy and distinguishing between autonomy as sovereignty and autonomy as nonalienation. The author then discusses adaptive preferences, claiming that they suffer from a rationality flaw but that it's not clear that this flaw matters morally (...) or politically. What matters is whether they suffer from an autonomy flaw. To answer this question, the author develops an account of autonomy failure, according to which a preference is nonautonomous if an injustice played an appropriate role in its causal history. The author then discusses the moral implications—and in an initial way, the political ones as well—of proclaiming a preference, or consent based on it, nonautonomous in this way. (shrink)

The primary challenge for generating a useful scientific definition of life comes from competing concepts of biological activity and our failure to make them explicit in our models. I set forth a three-part scheme for characterizing definitions of life, identifying a binary , a range , and a preference . The three components together form a proper activity in biology . To be clear, I am not proposing that proper activity be adopted as the best definition of life or (...) even as a desirable definition for life. Instead, I am arguing that some notion of proper activity already exists within common scientific definitions. By making the implicit elements explicit, the notion can be analyzed to see whether it is useful and appropriate in the context of the biological sciences. (shrink)

When we communicate with others, we usually know when we are expected to contribute to an evolving dialogue, such as during a debate, or when it is suitable to generate predictable responses, for example, at a marriage ceremony. However, in cross-cultural communication situations, communicating partners may have different assumptions in this respect. In particular, when a western communicator expects a dialogical development, a Russian participant may expect the same communication situation to progress as a sequence of predictable communication acts. This (...) clash of implicit expectations often results in communication failure, without either party realizing that implementing incompatible approaches to information sharing is the reason for this failure. In this article, I introduce the terms ‘dialogical engagement’ and ‘monological sequencing’ whilst exploring cross-cultural communication problems between Russia and the West. I use these terms to describe mechanisms that characterize both cultures’ preferred communication patterns and which, when inadvertently deployed, cause collisions between Russian and western communicating partners. By uncovering these differences, I intend to progress beyond merely acknowledging cross-cultural communication problems between the two worlds. Besides, as in the Russian cultural setting, more communication situations are implicitly expected to develop as monological sequences than similar situations in the West, understanding this particular distinction may prevent practitioners in numerous fields from making the mistake of expecting cross-cultural communication situations to develop in line with their implicit assumptions. (shrink)

Lorenzo Sacconi's recent re-statement of his social contract account of business ethics is a major contribution to our understanding of the normative nature of CSR as the expression of a fair multi-party agreement supported by the economic rationality of each participant. However, at one crucial point in his theory, Sacconi introduces the concept of stakeholders' conformist preferences - their disposition to punish the firm if it defects from the agreement, refusing to abide by its own explicit CSR policies and norms. (...) We take issue with him over this concept: we show that the assumption of conformist preferences is a moral premise, and it arguably weakens the normativity of the theory as a whole. As an alternative, we propose an evolutionary game theoretic approach. We draw upon recent applications of evolutionary game theory to moral philosophy , and we use a computer simulation of the trust game. According to this approach, the failure of the logic of reputation, which is the problem conformist preferences were introduced to solve, is overcome through the dynamics of interaction. (shrink)

This chapter focuses on the psychological mechanisms behind the construction of preference, especially the actual processes used by humans when they make decisions in their everyday lives or in business situations. The chapter uses cognitive psychological techniques to break down these processes and set them in their social context. When attributes are compatible with the response scale, they are assigned greater weight because they are most easily mapped onto the response. For instance, when subjects are asked to set a (...) price for a gamble this task is compatible with the information about the gamble payoff, which is also expressed in monetary values (e.g., dollars). Conversely, when the task requires a choice the payoff information is not easily mapped onto the response anymore and loses some of its salience. In fact, Slovic, Griffin, and Tversky (1990) could show that using non-monetary outcomes attenuates preference reversals when no compatibility between the pricing task and the outcome attribute was possible. An assumption of the compatibility effect is that response modes compatible with specific characteristics of the options (e.g., payoffs) draw attention to them. One of the main themes that has emerged from behavioral decision research during the past decades is the view that people's preferences are often constructed—not merely revealed—in the process of elicitation (see e.g. Slovic). This conception is derived in part from studies demonstrating that normatively equivalent methods of elicitation often give rise to systematically different responses. These "preference reversals" violate the principle of procedure invariance fundamental to theories of rational choice and raise difficult questions about the nature of human values. If different elicitation procedures produce different orderings of options, how can preferences be defined and in what sense do they exist? Describing and explaining such failures of invariance will require choice models of far greater complexity than the traditional models -/- . (shrink)

Joseph Heath defends competitive markets and conceptualizes business ethics with reference to Pareto efficiency, which he takes to be the “implicit morality of the market.” His justification for markets is that they generate Pareto efficient outcomes, meaning that markets optimally satisfy consumer preferences. And, for Heath, business ethics is the set of normative constraints—regulation and beyond-compliance norms—needed to preserve that outcome. The present paper accepts Heath’s claim that the economic justification for markets is ethical, in that satisfying consumer preferences is (...) a good. But, contra Heath, the ethical consideration at work is a consequentialist one; and acknowledging this consequentialism exposes limitations of Heath’s “market failures” approach to business ethics. We suggest two limitations, and we expect many will accept our argument that Heath’s conception of business ethics is too narrow. The present paper outlines two broader implications. First, acknowledging that the justification for markets is ethical eliminates the apparent—and false—conflict between purportedly amoral economic activity on one hand and ethical considerations on the other; instead, business ethics is a matter of weighing the consequentialist ethical benefit of economic activity and markets against other moral arguments/other ethical considerations. Second, Heath restricts business ethics to the constraints needed to protect the market’s ability to efficiently satisfy consumer preferences, constraints he calls “efficiency imperatives”; this restriction supports the widespread tendency to think that all social problems are economic; and, a business ethics so-conceived diminishes the perceived importance of noneconomic values—this attitude is dangerous. (shrink)

I consider models of political failure based on self-deception. Individuals discard free information when that information damages their self-image and thus lowers their utility. More specifically, individuals prefer to feel good about their previously chosen affiliations and shape their worldviews accordingly. This model helps explain the relative robustness of political failure in light of extensive free information, and it helps to explain the rarity of truth-seeking behavior in political debate. The comparative statics predictions differ from models of either Downsian or (...) expressive voting. For instance, an increased probability of voter decisiveness does not necessarily yield a better result. I also consider political parties as institutions and whether political errors cancel in the aggregate. I find that political failure based on self-deception is very difficult to eliminate. (shrink)

This article examines the consequences of the politicization of health care in the United Kingdom following the creation of the National Health Service (NHS) in 1948. The NHS is founded on the principle of universal access to health care free at the point of use but in reality charges exist for some services and other services are rationed. Not to charge and/or ration would create a common-pool resource with no means of conserving scarce resources. Taking rationing decisions in the political (...) realm means that the values and priorities of individual patients are marginalized and the preferences of powerful organized groups able to capture the political process dominate. The key lesson for international health care reform is that the politicization of health care via the NHS has not led to the realization of egalitarian ends but rather has empowered vested and organized interests at the expense of individual patients. (shrink)

Criminal violence is one of the most pressing problems in Latin America and the Caribbean, with profound political consequences. Its effects on social policy preferences, however, remain largely unexplored. This article argues that to understand such effects it is crucial to analyze victimization experiences and perceptions of insecurity as separate phenomena with distinct attitudinal consequences. Heightened perceptions of insecurity are associated with a reduced demand for public welfare provision, as such perceptions reflect a sense of the state’s failure to provide (...) public security. At the same time, acknowledging the mounting costs and needs that direct experience with crime entails, victimization is expected to increase support for social policies, particularly for health services. Survey data from twenty-four Latin American and Caribbean countries for the period 2008–12 show that perceptions of insecurity indeed reduce support for the state’s role in welfare provision, whereas crime victimization strongly increases such preferences. (shrink)

Critical types of infrastructure are provided by the state to maintain the people’s livelihood, ensure economic development, and systematic government operations. Given the development of ever more complicated critical infrastructure systems, increasing importance is being attached to the protection of the components of this infrastructure to reduce the risk of failure. Power facilities are one of the most important kinds of critical infrastructure. Developing an effective risk detection system to identify potential failure modes of power supply equipment is crucial. This (...) study seeks to improve upon prior approaches for risk assessment by proposing a hybrid risk-assessment model using the concepts of failure mode and effect analysis and multiple-criteria decision-making. The proposed model includes a cost-based factor for decision-makers. The subjectivity and uncertainty in FM assessment are adjusted through the rough number method. The original risk priority number can be expanded by including the entropy weights in the risk index. Furthermore, to rank the risk priorities in a rational manner, a modified technique for order preference by similarity to ideal solution is adopted. The applicability and effectiveness of the proposed method were demonstrated by considering an example of a turbine steam engine in a nuclear power plant. (shrink)

We argue that analyzing everyday memory failures in terms of the “unity of consciousness” can elucidate the bases of such failures. A perfect unity amongst one’s mental states is rare. In extreme cases the unity of consciousness can breakdown in dramatic fashion , but such breakdowns also occur in less dramatic ways that affect us in everyday life. For example, disruptions in the unity of consciousness can result in everyday memory failures, such as forgetting to put on (...) a tie for an important formal meeting. After providing some philosophical background into the notions of “unity of consciousness” and “functionalism,” we offer preliminary analyses of three examples of everyday memory failure. We then introduce and develop what we call the “unity model” of memory failure and show how it explains the examples. We also describe different ways that unity can break down which, in turn, can lead to memory failure and inappropriate behavior. We then show how slips of action and other kinds of cognitive failures differ from everyday memory failures. Finally, we examine alternative models arguing that the unity model is preferable, and then show how our model is consistent with some experimental results. (shrink)

PurposeThe acute-on-chronic exacerbations of end-stage respiratory diseases often result in prolonged hospital stays, relating these events to ethical conflicts in the fields of medical futility and distributive justice. This study aimed to understand patients’ preferences for life-sustaining treatments when clinically stable and during regular follow-up visits, and to determine the factors that can influence these preferences.ProcedureThis was a prospective, observational, exploratory study using convenience sampling. Over a three-year period, the study enrolled 106 adult outpatients with end-stage pulmonary disease on long-term (...) oxygen treatment with/without noninvasive mechanical ventilation with dyspnoea scores of 6 or more in the modified Borg dyspnoea scale and one of the following: Gold stage IV, diffusing capacity <40%, heart failure ) stage III/IV, or systolic pulmonary artery... (shrink)

Many are unwilling to donate their vital organs in death. To affirm this choice is to prefer the integrity of one's corpse over possibly saving and improving the lives of others. This position enjoys no sound defence. Refusing to donate amounts to a gratuitous moral failure.Export citation.

When censorship was reformed during the era of Joseph II publishing and the book trade underwent a liberalisation. Enlightenment conceptions helped create the image of the ideal reader—someone who reads to acquire knowledge or to improve his spiritual life. During the reign of Joseph II reading spread to all social strata, but readers’ preferences did not follow a reading ideal. This is demonstrated by significant urban-rural disparities. The publishing projects of the Protestant elite met with failure in the distribution phase (...) and with the indifference country people displayed towards spiritual literature. This relates to several other social phenomena such as literacy and living conditions. Archival sources, which are relevant to lending library research, indicate the reading preferences of the urban classes. An uncontrollable reading mania targeted literature and short political and anticlerical writing, which triggered public discussions on the dangers of uncontrolled reading. The print medium helped shape a “reading public“, whose reading activities occupied an area between mainstream cultural consumption and the dissemination of political news. (shrink)

This Article explores several meanings of a regulatory preference for government inaction. It explains the rise to dominance of this inaction preference in the United States and its distorting influence on the perception and understanding of regulation. Specifically, the Article demonstrates how basic terms in regulation, such as “government failure,” “regulatory capture,” and “deregulation,” acquired misleading connotations suggesting that government inaction is always superior to government action. The Article further explains how, through government inaction, the U.S. legal system (...) accommodates rent extraction - the profitable exploitation of market imperfections and favorable laws. Several developments in recent decades have considerably improved the capacity of very small groups in society to collect rents, namely, use talent and positional advantages to gain increasing levels of earnings. The Article argues that the parallel rise of the inaction preference has contributed to this trend, primarily because the availability of rent extraction opportunities draws talent that utilizes them with growing effectiveness. The purpose of the Article is to clarify several aspects of the relationships between regulation and rent extraction or, more precisely, to emphasize that government inaction may entail undesirable income effects. (shrink)

Collectively, lawyers probably seek in vain to be sufficiently trusted, even when most individual lawyers appear to do their utmost to behave responsibly. Efforts to address lawyers' behavioural failures remain an important social policy objective and a professional obligation. In this article we argue that it is politically sensible and socially responsible for the legal profession to continue to address its misbehaving members in a more fundamental manner than just the post-facto disciplinary process. We suggest that pre-emptive (pre-offence), ethics (...) self-assessments may limit the later incidence of misbehaviour and assist in rehabilitation programs for disciplined lawyers. We report on an experimental approach to lawyers' discovering more about their innate ethics. We have trialled lawyers' responses to a series of concrete statements about their ethical priorities and developed a statistically valid 'scale' (or set of statements) to allow lawyers in an Australian context to observe and reflect upon, their differing ethical approaches. To date, no such a scale has been developed for lawyers' ethics. The results of this scale development process are sufficiently encouraging to justify further work on similar scales for different cultures and legal traditions, in the interest of producing a tailored, reliable and valid instrument for general pre-emptive use within each local profession. The proposition that awareness improves conscious decision-making is not revolutionary or particularly contentious. While raising lawyers' awareness of how they make choices may only make a modest contribution to enhancing the ethical quality of their professional behaviour, it nevertheless seems plausible that it will raise their awareness and is therefore a worthwhile exercise. (shrink)

The market failures approach to business ethics argues that economic theory regarding the efficient workings of a market can generate normative prescriptions for managerial behaviour. It argues that actions that inhibit Pareto optimal solutions are immoral. However, the approach fails to identify goods that should be regulated or prohibited from the market, something common to the moral limits to markets approach to business ethics. There are, however, numerous assumptions underlying Paretian efficiency, including some about the preferences of market participants. (...) Trade in some goods violates some of these assumptions, and so these goods are morally suspect and can be understood to indicate that the market for these goods is not moral. This creates grounds sufficient for regulating, and possibly prohibiting, these goods. To help determine whether it is then necessary to regulate the goods, I propose a supplementary economic analysis to ascertain why an assumption regarding a particular preference is being violated. (shrink)

This paper is about the shaping of student workload preferences by educational institution design, and how this creates distrust by staff in those preferences when staff are asked to use those preferences in re-designing the courses they teach. It is a case study of the construction of student workload preferences by the context of a particular higher education institution. In more detail: Failures to standardize the work required to receive equal credit points from different courses make credit points unfit (...) for their official purposes. Moreover, increasingly, institutions are found where students are required to take a high number of courses simultaneously. This study aimed to identify plausible hypotheses about how high course-loads and standardization failure interact by examining credit point standardization failure at an Estonian university where students are required to take twice as many courses as their peers at better performing universities. The hypotheses supported by the study are: the high course-load both made standardization failure useful to students seeking to manage the high course-load and contributed toward standardization failure because it rendered students’ assessments of workload untrustworthy to lecturers who regulate that workload. Existing advice on standardization of workloads within the European Credit Transfer and Accumulation System is criticized for its insensitivity to the constructive effects of course-load on student workload preferences. (shrink)

Agency is an amazing thing: it transduces cognitivity into causality, it makes thought real. How it does so has been a matter of considerable dispute, the resolution of which has been hampered by moral complications. The supposition of a rational basis for morality can play an essential role in clarifying agency by providing a ground for legitimizing the objects of desire and the motivation they provide. The four-stage model of agency presented here – deliberation, calculation, intention, and enactment – emerges (...) when the moral concerns regarding desire have been detoxified. A crucial distinction is between the cognitive and causal aspects of desire, between the estimation of desirability (preference) and the actual motivation it may initiate (desire). Failure to recognize desire’s cognitive aspect preemptively disables its participation in practical reasoning. (shrink)