So, C. I don’t know that T. Premises 1 and 2 are both plausible. However, C seems false—I do seem to know that there is a tree before me. AI presents a puzzle because its two plausible premises yield a conclusion whose negation is plausible. And no matter whether we accept or reject AI, we find that we must give up something plausible—either premise 1, premise 2, or the negation of C. But which of these should we give up? I (...) call this question the skeptical puzzle.1 Recently, Mark Heller2 has argued that we can solve the skeptical puzzle by giving up premise 2. I argue, however, that Heller does not adequately respond to an objection to his proposed solution. I go on to argue that we can solve the skeptical puzzle by giving up premise 1. (shrink)

Much of the extant discussion focuses on the question of whether contextualism resolves skeptical paradoxes. Understandably. Yet there has been less discussion as to the internal structure of contextualist theories. Regrettably. Here, for instance, are two questions that could stand further discussion: (i) what is the linguistic basis for contextualism and (ii) what is the parameter that shifts with context?

It is widely accepted that our initial intuitions regarding knowledge attributions in stakes-shifting cases (e.g., Cohen’s Airport) are best explained by standards variantism, the view that the standards for knowledge may vary with contexts in an epistemically interesting way. Against standards variantism, I argue that no prominent account of the standards for knowledge can explain our intuitions regarding stakes-shifting cases. I argue that the only way to preserve our initial intuitions regarding such cases is (...) to endorse position variantism, the view that one’s epistemic position may vary with contexts in an epistemically interesting way. Some had argued that epistemic position is incompatible with intellectualism. In reply, I point out that position variantism and intellectualism are compatible, if one’s truth-relevant factors with respect to p can vary with contexts in an epistemically interesting way. (shrink)

In The Appearance of Ignorance, Keith DeRose develops a version of epistemic contextualism that combines aspects of both safety and sensitivity theories of knowledge. This paper discusses some potential problems for DeRose’s account stemming from his Rule of Sensitivity, which is meant to model upwards shifts in epistemic standards.

Context is a pivotal concept for social scientists in their attempt to weave singularities or universals to moral codes and political orders. However, in this, social scientists might be neglecting the ways in which individuals or groups who are excluded from the collective production of knowledge want to politicize their concerns also by claiming their uniqueness and singularity. In this article, drawing on the public controversy about access to dementia drugs on the U.K. National Health Service and on the work (...) of pioneering sociologist Helen McGill Hughes on “human interest stories,” the author argues that the “politics of singularities” can be articulated in two related ways within technical controversies. First, it expresses the unraveling of sociotechnical ties caused by institutional failure to take concerns into account. Second, it expresses the concrete uniqueness of persons caught by standardized, “universal” and impersonal implements and/or policies. Both these effects are underpinned by resourcing to allegorical expression, a literary form that while fostering political imagination in technological democracies might weaken Science and Technology Studies' ambitions to influence decision making. (shrink)

In this paper I defend the “Standard View” of the semantics of ‘I’—according to which ‘I’ is a pure, automatic indexical—from a challenge posed by “deferred reference” cases, in which occurrences of ‘I’ are (allegedly) not speaker-referential, and thus non-automatic. In reply, I offer an alternative account of the cases in question, which I call the “Description Analysis” (DA). According to DA, seemingly deferred-referential occurrences of the first person pronoun are interpreted as constituents of a definite description, whose operator scopes (...) over an open sentence Rxy—where R is a contextually selected relation ranging over pairs of people and objects. The role of intentions is thus limited to the determination of R, which is posterior to the fixation of the reference of ‘I’. In support of the DA I present evidence that, in the cases in question, the (Determiner) phrase containing ‘I’ behaves in relevant ways like a description. I show that the DA can account for the problematic examples, while preserving the simplicity of the standard semantics of ‘I’. Finally, I examine a rival account of the data, offered by Nunberg (Linguist Philos 16:1–43, 1993), and argue for the superiority of the DA. (shrink)

Dating back to the 1930s, President Franklin D. Roosevelt argued that workers were entitled to a wage that allowed them to enjoy a decent standard of living—a conviction that led the president to propose the first federally-mandated minimum wage. Mr. Roosevelt’s proposal was met with highly partisan resistance in congress and the courts—reactions not different in kind from the highly partisan resistance former President Obama experienced in his proposal to increase the federal minimum wage from its current level of $7.25 (...) per hour. Reflecting President Roosevelt’s convictions, it is clear that many low wage workers today are not, and cannot, enjoying a decent standard of living at current minimum wage levels. Further, many of the economic arguments raised in opposition to increasing the minimum wage have been thoroughly discredited: empirical evidence suggests that increased minimum wages would not lead to dramatic spikes in unemployment, massive substitutions of capital for labor, business closings, and significantly increased consumer prices. However, as compelling as arguments for increasing the minimum wage may be, the reality is that this may not be sufficient to alleviate the plight of low income workers, particularly given the political nature of minimum wage adjustments. Indeed, it may be time to shift the national focus away from the minimum wage to an emphasis on viable living wage legislation, a proposition consistent with the social justice perspective of contemporary ethicists. (shrink)

Shifting Burdens explores the process and features of mental patient deinstitutionalization as it occurred in America in the 1950s and 1960s. This paper examines the disillusionments American society had with mental institutions, such as faltering standards of care, staff failures, and inadequate treatment options. These issues resulted in the movement towards deinstitutionalization, resulting in the burden of care for displaced mental patients being shifted onto community homes and patients families. Shifting Burdens challenges the notion that deinstitutionalization at (...) the time was a successful endeavour, as the question of care for mental patients continues to exist today. (shrink)

I have stressed here and elsewhere that perspective cannot and need not claim to represent the world "as we see it." The perceptual constancies which make us underrate the degree of objective diminutions with distance, it turns out, constitute only one of the factors refuting this claim. The selectivity of vision can now be seen to be another. There are many ways of "seeing the world," but obviously the claim would have to relate to the "snapshot vision" of the stationary (...) single eye. To ask, as it has so often been asked, whether this eye sees the world in the form of a hollow sphere or of a projection plane makes little sense, for it sees neither. The one point in focus can hardly be said to be either curved or flat, and the remainder of the field of vision is too indistinct to permit a decision. True, we can shift the point of focus at will, but in doing so we lose the previous perception, and all that remains is its memory. Can we, and do we, compare the exact extension of these changing percepts in scanning a row of columns extended at right angles from the central line of vision—to mention the most recalcitrant of the posers of perspectival theory?1 I very much doubt it. The question refers to the convenient choice of projection planes, not to the experience of vision.· 1. I now prefer this formulation to my somewhat laboured discussion in Art and Illusion, chap. 8, sec. 4.E.H. Gombrich was director of the Warburg Institute and Professor of the History of the Classical Tradition at the University of London from 1959 to 1976. His many influential works include The Story of Art, Art and Illusion, Meditations on a Hobby Horse, The Sense of Order, and Ideals and Idols. An early version of "Standards of Truth" was presented at Swarthmore College in October 1976 at a symposium to mark the retirement of Professor Hans Wallach. His contributions to Critical Inquiry include "The Museum: Past, Present, and Future" , "Notes and Exchanges" , and, with Quentin Bell, "Canons and Values in the Visual Arts: A Correspondence". (shrink)

This paper addresses an important but relatively unexplored question about the relationship between conceptual ethics and other philosophical inquiry: how does the epistemology of conceptual ethics relate to the epistemology of other, more “traditional” forms of philosophical inquiry? This paper takes as its foil the optimistic thought that the epistemology of conceptual ethics will be easier and less mysterious than relevant “traditional” philosophical inquiry. We argue against this foil by focusing on the fact that that conceptual ethics is a form (...) of normative inquiry. Because of the epistemic difficulties that face normative inquiry, we should not expect conceptual ethics to constitute an epistemic panacea. Instead, although the epistemological upshots can vary from case to case, there are systematic reasons why this shift may exacerbate, rather than mitigate, the epistemic difficulties we face in pursuing philosophical inquiry. (shrink)

Faring poorly by international standards, out-of-home childcare in Canada is often described as ‘in crisis’. This study addresses how national childcare movement actors, who are overwhelmingly women, have discursively constructed their collective identity during two contrasting political climates. Data comprise publically available media releases produced in 2005 and 2008 by the Child Care Advocacy Association of Canada, a national grassroots childcare social movement organization. Guided by Fairclough's overarching framework for critical discourse analysis and Koller's approach to analysing collective identity (...) through CDA, the discursive mechanisms of CCAAC movement actors have employed in relation to their collective identity construction are identified and explored. Finally, whether or not these mechanisms may have been strategic is explored. (shrink)

We analyze and study the tracking of nonrigid complex targets of sports video based on mean shift fusion color histogram algorithm. A simple and controllable 3D template generation method based on monocular video sequences is constructed, which is used as a preprocessing stage of dynamic target 3D reconstruction algorithm to achieve the construction of templates for a variety of complex objects, such as human faces and human hands, broadening the use of the reconstruction method. This stage requires video sequences of (...) rigid moving target objects or sets of target images taken from different angles as input. First, the standard rigid body method of Visuals is used to obtain the external camera parameters of the sequence frames as well as the sparse feature point reconstruction data, and the algorithm has high accuracy and robustness. Then, a dense depth map is computed for each input image frame by the Multi-View Stereo algorithm. The depth reconstruction with a too high resolution not only increases the processing time significantly but also generates more noise, so the resolution of the depth map is controlled by parameters. The multiple hypothesis target tracking algorithms are used to track multiple targets, while the chunking feature is used to solve the problem of mutual occlusion and adhesion between targets. After finishing the matching, the target and background models are updated online separately to ensure the validity of the target and background models. Our results of nonrigid complex target tracking by mean shift fusion color histogram algorithm for sports video improve the accuracy by about 8% compared to other studies. The proposed tracking method based on the mean shift algorithm and color histogram algorithm can not only estimate the position of the target effectively but also depict the shape of the target well, which solves the problem that the nonrigid targets in sports video have complicated shapes and are not easy to track. An example is given to demonstrate the effectiveness and adaptiveness of the applied method. (shrink)

Epistemological contextualism states that propositions about knowledge, expressed in sentences like “S knows that P,” are context-sensitive. Schaffer (2005) examines whether one of Lewis’ (1996), Cohen’s (1988) and DeRose’s (1995) influential contextualist accounts is preferable to the others. According to Schaffer, Lewis’ theory of relevant alternatives succeeds as a linguistic basis for contextualism and as an explanation of what the parameter that shifts with context is, while Cohen’s theory of thresholds and DeRose’s theory of standards fail. This paper argues (...) that Schaffer’s analysis is unsatisfactory since it fails to show that thresholds and standards cannot cope with skepticism, as it is ultimately the conversation participants who control how the conversation plays out. Moreover, Schaffer fails to show that gradability is of no importance in inquiries. (shrink)

In a globalizing world, cross-national differences in values and business culture and understanding these differences become increasingly central to a range of organizational issues and ethical questions. However, various concerns have been raised about extant empirical research on cross-national dissimilarities in the cultural values of managers (what we refer to as managerial values) and the development of a unified business culture. This paper seeks to address three such concerns with the literature on convergence versus divergence of cultural values. It develops (...) an empirical approach to the study of changing business cultures that revolves around birth cohorts and intergenerational values shifts and aims to advance empirical knowledge of the dynamics of cross-national differences in the cultural values of managers. We use time-series data covering 68,708 managers and are able to consider a sample of 32 countries that represent more than half of the cultural clusters recognized in the literature. Results reveal diverse shifts in managerial values across birth cohorts with cross-national dissimilarities waning for some basic cultural dimensions (“convergence”), remaining stable for other dimensions (“cultural stability”), and becoming more pronounced for other dimensions still (“divarication”). Moving beyond the standard convergence/divergence taxonomy, we conclude that a full-fledged convergence–stability–divarication perspective provides the best basis for thinking about the subtle ways in which business cultures are changing. (shrink)

The papers in this volume are largely about research ethics and cover questions of consent, reproduction, pediatric research, ethical codes, and clinical relationships. Half the papers have this common aspect: they are conservative—in the sense of supporting the standard, prevailing, or popular view—but they shift the focus—supporting the standard views in terms of moral factors generally neglected by the literature. The volume provides a diverse set of papers for the reader: variously addressing abstract and concrete problems from within different philosophical (...) traditions. (shrink)

In a globalizing world, cross-national differences in values and business culture and understanding these differences become increasingly central to a range of organizational issues and ethical questions. However, various concerns have been raised about extant empirical research on cross-national dissimilarities in the cultural values of managers and the development of a unified business culture. This paper seeks to address three such concerns with the literature on convergence versus divergence of cultural values. It develops an empirical approach to the study of (...) changing business cultures that revolves around birth cohorts and intergenerational values shifts and aims to advance empirical knowledge of the dynamics of cross-national differences in the cultural values of managers. We use time-series data covering 68,708 managers and are able to consider a sample of 32 countries that represent more than half of the cultural clusters recognized in the literature. Results reveal diverse shifts in managerial values across birth cohorts with cross-national dissimilarities waning for some basic cultural dimensions, remaining stable for other dimensions, and becoming more pronounced for other dimensions still. Moving beyond the standard convergence/divergence taxonomy, we conclude that a full-fledged convergence–stability–divarication perspective provides the best basis for thinking about the subtle ways in which business cultures are changing. (shrink)

During the last decade new developments in theoretical and speculative cosmology have reopened the old discussion of cosmology's scientific status and the more general question of the demarcation between science and non-science. The multiverse hypothesis, in particular, is central to this discussion and controversial because it seems to disagree with methodological and epistemic standards traditionally accepted in the physical sciences. But what are these standards and how sacrosanct are they? Does anthropic multiverse cosmology rest on evaluation criteria that (...) conflict with and go beyond those ordinarily accepted, so that it constitutes an “epistemic shift” in fundamental physics? The paper offers a brief characterization of the modern multiverse and also refers to a few earlier attempts to introduce epistemic shifts in the science of the universe. It further discusses the several meanings of testability, addresses the question of falsifiability as a sine qua non for a theory being scientific, and briefly compares the situation in cosmology with the one in systematic biology. Multiverse theory is not generally falsifiable, which has led to proposals from some physicists to overrule not only Popperian standards but also other evaluation criteria of a philosophical nature. However, this is hardly possible and nor is it possible to get rid of explicit philosophical considerations in some other aspects of cosmological research, however advanced it becomes. (shrink)

India is a major producer and exporter of hand-knotted carpets to the world since the beginning of the British rule over India. Majority of the hand-knotted carpets exported from India are produced in the Bhadohi-Mirzapur region, popularly called as the carpet belt of India. Given deplorable working conditions and very high prevalence of child labour in the cluster, in the mid-1990, four social labels were implemented to improve the labour standards, in addition to slew of labour laws implemented by (...) the state of India. The objective of this study is to explore the prevailing labour standards and effectiveness of social labels in improving labour standards in the hand-knotted carpet manufacturing cluster. This study found that even after the implementation of social labels and slew of labour laws, there had been barely any improvement in the working conditions of carpet workers. The workers continued to be adversely incorporated in the carpet commodity chain. However, realising that there is very little scope of social upgrading in this occupation, many carpet workers have shifted to other occupations. But this study found very few child workers in carpet manufactories in the cluster. (shrink)

Neoliberalism is invariably presented as a governing regime of market and competition-based systems rather than as a set of migratory practices that are re-setting the ethical standards of the academy. This article seeks to explore the way in which neoliberalism is shifting the prevailing values of the academy by drawing on two illustrations: the death of disinterestedness and the obfuscation of authorship. While there was never a golden age when norms such as disinterestedness were universally practiced they represented (...) widely accepted aesthetic ideals associated with academic life. By contrast, neoliberal academics embrace a new set of assumptions and norms that stand in sharp relief to many of the values that were previously espoused. Practices that might have been regarded as ethically dubious by earlier generations of academics, such as grantsmanship, self-justificatory expressions of interestedness and tangential claims to authorship, are now regarded as legitimate and positive virtues in a more aggressive age of hyper-performativity. (shrink)

During the last decade new developments in theoretical and speculative cosmology have reopened the old discussion of cosmology’s scientific status and the more general question of the demarcation between science and non-science. The multiverse hypothesis, in particular, is central to this discussion and controversial because it seems to disagree with methodological and epistemic standards traditionally accepted in the physical sciences. But what are these standards and how sacrosanct are they? Does anthropic multiverse cosmology rest on evaluation criteria that (...) conflict with and go beyond those ordinarily accepted, so that it constitutes an “epistemic shift” in fundamental physics? The paper offers a brief characterization of the modern multiverse and also refers to a few earlier attempts to introduce epistemic shifts in the science of the universe. It further discusses the several meanings of testability, addresses the question of falsifiability as a sine qua non for a theory being scientific, and briefly compares the situation in cosmology with the one in systematic biology. Multiverse theory is not generally falsifiable, which has led to proposals from some physicists to overrule not only Popperian standards but also other evaluation criteria of a philosophical nature. However, this is hardly possible and nor is it possible to get rid of explicit philosophical considerations in some other aspects of cosmological research, however advanced it becomes. (shrink)

Neoliberalism is invariably presented as a governing regime of market and competition-based systems rather than as a set of migratory practices that are re-setting the ethical standards of the academy. This article seeks to explore the way in which neoliberalism is shifting the prevailing values of the academy by drawing on two illustrations: the death of disinterestedness and the obfuscation of authorship. While there was never a golden age when norms such as disinterestedness were universally practiced they represented (...) widely accepted aesthetic ideals associated with academic life. By contrast, neoliberal academics embrace a new set of assumptions and norms that stand in sharp relief to many of the values that were previously espoused. Practices that might have been regarded as ethically dubious by earlier generations of academics, such as grantsmanship, self-justificatory expressions of interestedness and tangential claims to authorship, are now regarded as legitimate and positive virtues in a more aggressive age of hyper-performativity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Evaluation, Standards, Normalization: Historico-philosophical Formations and the Conditions of Possibility for Checklist Thought Bernadette Baker University of Wisconsin-Madison In education today a new vocabulary has emerged that is far more than just words. In the context of educational policy the setting of goals or objectives is now being subsumed under terms such as statewidestandards, child development is now being adjectivized by descriptors such as learning disability or emotionally (...) disturbed, and the evaluation ofclassroom-based performance is now being collated in aportfolio. These are more than just buzz words-at one level they are new ways of governing children and teachers, of organizing action, and of perceiving the world. What, for instance, does it tell us about ourselves when first-grade students Mikey, Enrique, Waldo, orDonal are introduced to visitors to the school by labels such as LD, ED, ADD, ADHD, and so forth, rather thanby their name? What does it tell us about ourselves when we say a curriculum or program of study is in line with the standards established somewhere else? And what story do we think is being narratedin the documentation of a child's performance in portfolio form across a semester or year? In consideringwhyterms suchasstandards, child development, or even evaluation have such contemporary currency I am necessarily drawn into a study of the timespaces in which they did not have such currency at all. This paper maps four moves into a moment that I think of as a rather long present-day-a present that is not simply this morning, yesterday, or the daybefore, but one that links the subjectivities ofthose now living in educational workto those made available about one hundred years ago. The four moves that I analyze here can be thought of as conditions of possibility for the operation of contemporary educational mies of reasoning, especially those that have formed around the resurgent popularity of"checklist thought" in reform efforts. The four moves collectively historicize how notions of standards, child development, and evaluation can pop up as commonsensical tropes through which to gather and degather action in the educational field. The first ofthese moves is that which flows from the operation ofan ideal to the operation of a norm. The second move is that which flows between the advent of statistics and the advent of eugenics. The third move is that which flows between the appearance ofnovels and fiction and the novel ficticityoffacts. And the fourth move is that which flows from the fictions of child development narratives to the stories that standards tell us. Collectively, these historico-philosophical moves will enable reconsideration of what we think evaluation, standards, and norms for child development actually narrate, lending food for thought to the specificityoftheir uptake in music education. From Ideal to Norm One way inwhichto examinethe shift from a seventeenth-century concept of the ideal to the nineteenth-century concept of the norm is by telling a story that was told in the early twentieth century. At this time when the educational field was formalizing, there was great care taken to record discussions held at conferences. When conferenceproceedings werepublished, theywere usually structured so that the presenter's paper©Philosophy ofMusic Education ReviewlO, no. 1 (Fall, 2002): 92-101. Bernadette Baker 93 was followed by a transcript of the conversation held after it. Like today, in the discussion time, audience members asked questions or made comments. Unlike today, the names of such participating audience members were typed into the proceedings and their specific questions or comments were written up as part ofreporting on the paper presented. In a discussion held at a conference in 1 905 on the topic of methods for training children labeledas feebleminded, apresenterhadspokenof the positive uses of a vegetable garden in the disciplining of feebleminded girls. The audience members relayed their own versions of experimenting with gardening and gathering, some complaining oftoo little space and others indicating the effects of having too many fields from which to gather. Dr. Dunlap was one such participant, indicatingimplicitlytheeffectsofhavingtoo many choices. In the spirit ofthe hunter/gatherer dichotomy, thegirlslabeledas feeblemindedatthe institutionwhereDr. Dunlap worked weresentout to pick com. The following story emerged. Dr. Dunlap: Our girls go out under an attendant and gather vegetables... (shrink)

Objectives: No systematic review or meta-analysis concerning the prevalence of shift work disorder has been conducted so far. The aim was thus to review prevalence studies of SWD, to calculate an overall prevalence by a random effects meta-analysis approach and investigate correlates of SWD prevalence using a random-effects meta-regression.Methods: Systematic searches were conducted in ISI Web of Science, PsycNET, PubMed, and Google Scholar using the search terms “shift work disorder” and “shift work sleep disorder.” No restrictions in terms of time (...) frame were used. Included studies had to present original data on the prevalence of SWD in an occupational sample published in English. A total of 349 unique hits were made. In all, 29 studies were finally included from which two authors independently extracted data using predefined data fields. The meta-regression included four predictors.Results: The overall prevalence of SWD was 26.5%. Cochran Q was 1,845.4, and the I2 was 98.5%, indicating very high heterogeneity across the observed prevalence estimates. Diagnostic criteria and sample size were inversely related to SWD prevalence.Conclusions: The prevalence of SWD was high across the included studies. The between-study disparity was large and was partly explained by diagnostic criteria and sample size. In order to facilitate comparative research on SWD, there is a need for validation and standardization of assessment methodology as well as agreement in terms of sample restrictions. (shrink)

As concerns over the negative social and environmental impacts of industrial agriculture become more widespread, efforts to define and regulate sustainable agriculture have proliferated in the US. Whereas the USDA spearheaded previous efforts, today such efforts have largely shifted to Tripartite Standards Regimes (TSRs). Using a case study of the Leonardo Academy’s initiative to develop a US sustainable agriculture standard, this paper examines the standards-development process and efforts by agribusiness to influence the process. Specifically, we analyze how politics (...) operate in seemingly “depoliticized” TSRs, and how agribusiness and the USDA use “framing practices” and procedural complaints to influence the standard-development process. We contend that although governance mechanisms are a potentially powerful tool for advocates of alternative agrifood, their efficacy may be constrained by science-based requirements, an agribusiness countermovement, and a captured state. (shrink)

Background: Positive effects of acute exercise on cognitive performances in general inspired research that investigated the effects of acute exercise on specific cognitive subdomains. Many existing studies examined beneficial effects of acute exercise on subsequent set shifting performance in healthy adults. Set shifting, a subdomain of executive function, is the ability to switch between different cognitive sets. The results of existing studies are inconsistent. Therefore, a meta-analysis was conducted that pooled available effect sizes. Additionally, moderator analyses were carried (...) out to identify covariates that determine the magnitude of exercise-induced set shifting benefits.Methods: Medline, PsycINFO, and SPORTDiscus were searched for eligible studies. Hedges' g corrected standardized mean difference values were used for analyses. Random-effects weights were applied to pool effects. Potential moderation of the effect of acute exercise on subsequent set shifting performance by exercise intensity, type of exercise, participants' age, and type of control group were examined.Results: Twenty-two studies were included into analysis. All aggregated effect sizes ranged from small to moderate. Overall, a small significant beneficial effect was revealed. Heterogeneity of included effect sizes was moderate and significant. Moderator analyses revealed a larger average effect in older adults than for studies examining younger adults. Light exercise led to larger effects than moderate or vigorous exercise. Studies testing acute exercise against active control groups showed a noticeably smaller average effect than studies that used passive or cognitive engaging control groups. Interestingly, application of resistance or aerobic exercise led to no different average effect sizes. However, none of the tested covariates reached statistical significance.Conclusion: Acute exercise improves subsequent set shifting performance. However, effect sizes are small, making the relevance for everyday life questionable. The results indicate that older adults benefit more from acute exercise than younger adults do. Light intensity exercise seems most effective while the type of exercise does not seem to influence the magnitude of effects. Research designs with active control groups show the smallest average effect, raising concerns about placebo effects.PROSPERO registration number: CRD42019138799. (shrink)

ABSTRACT:Existing research on certifiable management standards (CMS) and corporate social responsibility (CSR) tends to focus on large companies and is characterised by disagreement about the role of these standards as drivers of CSR. We contribute to the literature by shifting the analytical focus to the behaviour of small and medium-sized enterprises (SMEs) that subscribe to multiple CSR related standards. We argue that, in respect of motive and commitment, SMEs are not as different from large companies as (...) the literature suggests, as they are guided by similar institutional and economic motives. Results, based on ISO 9001, ISO 14001 and OHSAS 18001 certified SMEs in Greece, demonstrate that later adopters are more susceptible to coercive and mimetic motives and are less likely to commit fully to the CMS requirements, while earlier adopters react to normative motives and considerations of internal efficiency gains and tend to carry out CMS requirements with greater diligence. (shrink)

Given a subject so imbued with contention and conflicting theoretical stances, it is remarkable that automated instruments ever came to replace the human eye as sensitive arbiters of color specification. Yet, dramatic shifts in assumptions and practice did occur in the first half of the twentieth century. How and why was confidence transferred from careful observers to mechanized devices when the property being measured – color – had become so closely identified with human physiology and psychology? A fertile perspective on (...) the problem is via the history of science and technology, paying particular attention to social groups and disciplinary identity to determine how those factors affected their communities’ cognitive territory. There were both common and discordant threads motivating the various technical groups that took on the problems of measuring light and color from the late nineteenth century onwards, and leading them towards the development of appropriate instruments for themselves. The transition from visual to photoelectric methods could be portrayed as a natural evolution, replacing the eye by an alternative roviding more sensitivity and convenience – indeed, this is the conventional positivist view propounded by technical histories. However, the adoption of new measurement technologies seldom is simple, and frequently has a significant cultural component. Beneath this slide towards automation lay a raft of implicit assumptions about objectivity, the nature of the observer, the role of instruments, and the trade-offs between standardization and descriptive power. While espousing rational arguments for a physical detector of color, its proponents weighted their views with tacit considerations. The reassignment of trust from the eye to automated instruments was influenced as much by the historical context as by intellectual factors. I will argue that several distinct aspects were involved, which include the reductive view of color provided by the trichromatic theory; the impetus provided by its association with photometry; the expanding mood for a quantitative and objective approach to scientific observation; and, the pressures for commercial standardization. As suggested by these factors, there was another shift of authority at play: from one technical specialism to another. The regularization of color involved appropriation of the subject by a particular set of social interests: communities of physicists and engineers espousing a ‘physicalist’ interpretation, rather than psychologists and physiologists for whom color was conceived as a more complex phenomenon. Moreover, the sources for automated color measurement, and instrumentation for measuring color, were primarily from the industrial sphere rather than from academic science. To understand these shifts, then, this chapter explores differing views of the importance of observers, machines and automation. (shrink)

This paper develops a probabilistic model of belief change under interpretation shifts, in the context of a problem case from dynamic epistemic logic. Van Benthem [4] has shown that a particular kind of belief change, typical for dynamic epistemic logic, cannot be modelled by standard Bayesian conditioning. I argue that the problems described by van Benthem come about because the belief change alters the semantics in which the change is supposed to be modelled: the new information induces a shift in (...) the interpretation of the sentences. In this paper I show that interpretation shifts can be modeled in terms of updating by conditioning. The model derives from the knowledge structures developed by Fagin et al [8], and hinges on a distinction between the propositional and informational content of sentences. Finally, I show that Dempster-Shafer theory provides the appropriate probability kinematics for the model. (shrink)

That i) there is a somehow determined chronology of Plato’s dialogues among all the chronologies of the last century and ii) this theory is subject to many objections, are points this article intends to discuss. Almost all the main suggested chronologies of the last century agree that Parmenides and Theaetetus should be located after dialogues like Meno, Phaedo and Republic and before Sophist, Politicus, Timaeus, Laws and Philebus. The eight objections we brought against this arrangement claim that to place the (...) dialogues like Meno, Phaedo and Republic both immediately after the early ones and before Parmenides and Theaetetus is epistemologically and ontologically problematic. -/- Key Words: Plato; chronology; knowledge; being; Parmenides -/- Introduction While the ancient philosophers, doxographers and commentators from Aristotle onward considered, more or less, the question of the date and arrangement of the dialogues (cf. Irwin 2008, 77 n. 69), they would not observe a firm necessity to consider the progress of Plato’s theories in dialogues, maybe because they did not think of any essential shift in there. We might be able to say, nevertheless, that the most prominent feature of the ancient attitude to Plato was its peculiar attention to the Republic and the Timaeus as the most mature works in his philosophy and also the consideration of Laws as a later work. This tendency can be discovered from the general viewpoint of the first chronologies of the early 19th century after starting to deal with the issue. That Schleiermacher observed Republic as the culmination of Plato’s philosophy and as one of the latest dialogues besides Laws and Timaeus could reflex the implicit chronology of the tradition in the first mirrors it found. Another tendency in Schleiermacher is taking the triology of Theaetetus, Sophist and Politicus as relatively early. From the last quarter of 19th century onward, stylometry helped scholars to establish a new framework to constructa new arrangement between the dialogues. Based on stylistic as well as literary findings, Campbell (1867, xxxff.) argued for the closeness of the style of Sophist and Politicus with Timaeus, Critias, Philebus and Lawsthat, especially because of the certain evidence about this last dialogue’s lateness, led to the consideration of all as late dialogues. Almost every other stylistic effort after Campbell approved the similarities between Sophist and Politicus with Timaeus, Critias, Philebus and Laws. The result of all such investigations led to a new chronology that, despite some differences, has a fixed structure in all its appearances. 1. The Standard Chronology of the Dialogues The chronologies that are now commonly accepted are mostly based on the arrangement of dialogues to three groups corresponding to three periods of Plato’s life, which became predominant after applying stylistic features in assessing the similarities between dialogues. The fact that all the stylometric considerations reached to the similar results about the date of dialogues while they were assessing different stylistic aspects helped the new chronology become prevailing not only among stylistic chronologies but also between those like Fine, Kahn and Vlastos who were inclined more to the content-based arrangements. Even this latter group could not neglect the apparently certain results of using the method of stylometry. This was the main reason, I think, that made what they called content-based chronology be under the domination of stylometry much more than they could expect. The division of the dialogues into three separate groups became something that most of the scholars took for granted so far as Kahn thinks this division 'can be regarded as a fixed point of departure in any speculation about the chronology of the dialogues' (1996, 44). Thereafter, all the chronologists are accustomed to divide the dialogues to three groups of early, middle and late corresponding to the three stages of Plato’s life. Nevertheless, some of them tried to make subdivisions among each group and introduce some of the dialogues as transitional between different periods and thus reached to a fourfold classification of the dialogues. Although theycould never achieve to a consensus about the place of some dialogues, about which we will discuss soon, the whole spirit of theirchronological arrangements is the same and thus compelling enough for us to unify all of them with the label of 'Standard Chronology of Dialogues' (SCD). We brought together some of the most famous chronologies in the table below to make a comparison easier and to show how all are approximately of the same opinion about the place of some dialogues. The following points must be noted about this table: 1. I divided the dialogues to eight groups of early, late early, transitional, early middle, late middle, post-middle, early late, and late. Although none of the chronologists applies this classification, it can be helpful to compare them. In this table, for example, if one of the chronologist’s beholds one of the dialogues as later than all the dialogues of middle group, it is considered here as late middle. Otherwise, if it is emphasized that it is after all of them, it is considered as post-middle. The same is true about the dialogues of the late group in which I regarded the first dialogues of that period as early late only in those who explicitly considered some dialogues as earlier than other ones in the late group. Though, therefore, some of the dialogues might have not been considered as forming a distinct class, they are distinguished here. A. SCD’s Early and Transitional Dialogues When we move from stylometric to content-based chronologies, the homogeneity between the dialogues of each group is more understandable. Guthrie (1975, v. 4, 50) distinguishes three groups, the first of them includes Apology, Crito, Laches, Lysis, Charmides, Euthyphro, Hippias Minor, Hippias Major, Protagoras, Gorgiasand Ion. In addition to Meno, Phaedo and Euthydems, his first group does not include Cratylus and Menexenus. Unlike Guthrie, almost all the other content-based chronologiesof our study desire to distinguish two categories inside the first group of which the latter must be considered as the transitional group leading to the dialogues of the middle period. Kahn distinguishes four groups of dialogues and arranges two of them before middle period dialogues. The first group including Apology, Crito, Ion, Hippias Minor, Gorgiasand Menexenus he calls 'early' or 'presystematic' dialogues (1998, 124). The second group he calls the 'threshold', 'pre-middle' or 'Socratic' dialogues including seven: Laches, Charmides, Lysis, Euthyphro, Protagoras, Euthydemus and Meno. Based on Vlastos’ arrangement we must distinguish Euthydemus, Hippias Major, Lysis, Menexenus and Meno as 'transitional' dialogues from the 'elenctic' dialogues that are the other dialogues of Kahn’smentioned first two groups plus the first book of theRepublic. Fine also distinguishes 'transitional' dialogues from early or 'Socratic' dialogues,but her transitional dialogues are Gorgias, Meno, Hippias Major, Euthydemus and Cratylus of which she thinks the last two dialogues are 'controversial' (2003, 1). Her Socratic dialogues are all the remaining dialogues of Kahn’s first two groups. In spite of all the differences between the mentioned chronologies, it can be seen that all of them are inclined to arrange the early dialogues in a way that: i) Besides the dialogues that are considered as late, it never includes Republic II-X, Theaetetus, Phaedrus and Parmenides. ii) It intends to consider the dialogues like Euthydemus and Hippias Majorthat look more critical as later among the earlier dialogues or as transitional group. iii) Those who do not consider Meno as a middle period dialogue place it in their second or transitional group. iv) None of the content-based chronologies considers Phaedo and Symposium as early. Stylometric chronologies also intend to put them either as last dialogues among their early ones or as middle. B. SCD’s Middle Period Dialogues Campbell listed Republic, Phaedrus, Parmenides and Theaetetus as his second group of dialogues, an idea thatwas accepted by Brandwood. Ledger’smiddle period dialogueshad Euthydemus, Symposium and Cratylus in addition to the dialogues that Campbell and Brandwood had mentioned as middle. Among content-based chronologies, Guthrie’s list of middle period dialogues did not include Parmenides but some dialogues which had been considered as early in stylometric ones: Meno, Phaedo, Republic, Symposium, Phaedrus, Euthydemus, Menexenus and Cratylus. In sofar as I know, Euthydemus and Menexenus have not been considered as middle by other content-based chronologists and Guthrie is an exception among them. That Phaedo, Phaedrus, Symposium and Republic were middle period dialogues almost all the philosophical chronologists like Kahn, Fine, Vlastos (except Rep.I), Irwin andKraut came along. The dialogues they do not string along about are Meno, Cratylus, Parmenides and Theaetetus. Those like Guthrie, Kraut and Irwin who did not consider Meno as early presumably posit it among middles. The same can be said about Cratylus in the suggested chronologies of Guthrie, Kahn, Vlastos and Kraut. Nonetheless, it is different in case of Parmenides and Theaetetus. Whereas all the mentioned stylometric chronologists like Campbell, Brandwood and Ledger set them among middle period dialogues,the philosophical chronologists, it might seem at first, did not arrive at a consensus about them. While Guthrie and Fine put them as the first dialogues of the late group, Vlastos and Kraut set them as the latest of the middle group, as well as Kahn who puts them as post-middle and amongst the late period dialogues. Regardless the way they classify their groups, their disagreement does not affect the arrangement of the dialogues: they all posit Parmenides and Theaetetus after the series of Meno, Phaedo, Phaedrus, Symposium and Republic and before Sophist, Politicus, Timaeus, Philebus and Laws. To sum up SCD’s arrangement of the middle period dialogues we can add: v) Republic and Phaedrus have been considered by all the mentioned chronologists as dialogues of the middle period. vi) All the philosophical chronologies have reached a consensus about setting Phaedo and Symposium alongside with Republic and Phaedrus as middle. vii) While Stylometric alongside some philosophic chronologists arrange Parmenides and Theaetetus among their middle period dialogues and mostly as the latest among them, other philosophical chronologists put them as the early among the late dialogues. We can conclude then that SCD intends to locate these two dialogues at the boundary between the middle and late period dialogues. -/- . (shrink)

The “best interests of the patient” standard—a complex balance between the principles of beneficence and autonomy—is the driving force of ethical clinical care. Clinicians’ fear of litigation is a challenge to that ethical paradigm. But is it ever ethically appropriate for clinicians to undertake a procedure with the primary goal of protecting themselves from potential legal action? Complicating that question is the fact that tort liability is adjudicated based on what most clinicians are doing, not the scientific basis of whether (...) they should be doing it in the first place. In a court of law, clinicians are generally judged based on the “reasonably prudent” standard: what a reasonably prudent practitioner in a similar situation would do. But this legal standard can have the effect of shifting the medical standard of care—enabling a standard‐of‐care sprawl where actions undertaken for the primary purpose of avoiding liability reset the standard of care against which clinicians will be adjudicated. While this problem has been recognized in the legal literature, neither current ethical models of care nor legal theory offer workable solutions.One of the best examples of the conflict between evidence‐based medicine and common clinical practice is the use of electronic fetal monitoring. Despite strong evidence and professional guidelines that argue against the use of EFM for healthy pregnancies, the practice persists. One of the main reasons for this is often assumed to be physicians’ concerns about liability. (shrink)

The “best interests of the patient” standard—a complex balance between the principles of beneficence and autonomy—is the driving force of ethical clinical care. Clinicians’ fear of litigation is a challenge to that ethical paradigm. But is it ever ethically appropriate for clinicians to undertake a procedure with the primary goal of protecting themselves from potential legal action? Complicating that question is the fact that tort liability is adjudicated based on what most clinicians are doing, not the scientific basis of whether (...) they should be doing it in the first place. In a court of law, clinicians are generally judged based on the “reasonably prudent” standard: what a reasonably prudent practitioner in a similar situation would do. But this legal standard can have the effect of shifting the medical standard of care—enabling a standard-of-care sprawl where actions undertaken for the primary purpose of avoiding liability reset the standard of care against which clinicians will be adjudicated. While this problem has been recognized in the legal literature, neither current ethical models of care nor legal theory offer workable solutions. One of the best examples of the conflict between evidence-based medicine and common clinical practice is the use of electronic fetal monitoring. Despite strong evidence and professional guidelines that argue against the use of EFM for healthy pregnancies, the practice persists. One of the main reasons for this is often assumed to be physicians’ concerns about liability. (shrink)

Psychopathy fascinates. Modernist writers construct out of it an image of alienated individualism pursuing the moment, killing they know not why, exploiting in passing, troubled, if troubled at all, not by guilt, but by perplexity (Camus 1989; Gide 1995; Mailer 1957; Musil 1996). Psychiatrists and psychologists—even those who should know better—are drawn by it to take off into philosophical speculation about morality, evil, and the beast in man (Mullen 1992; Simon 1996). Philosophers succumb to the temptation of attempting to ground (...) speculation in the supposed facticity of psychopathy. -/- Psychopathy is a cultural construct with roots going back to the eighteenth century, but which only came to full flower over the last fifty years (Hare 1998; Lewis 1974). The currently fashionable constructions of psychopathy find wide acceptance among clinicians and academics. The problem is, however, whether the concept has connections that have been established to the behavior, psychopathology, or the structure and function of brain worthy of according even a modest level of scientific status. There is little point in basing an argument on some supposed scientific gold standard if what glitters is iron pyrites (fools' gold). -/- Neil Levy's opening paragraph contains the statement "Yet in other respects they seem quite irrational; so much so that the term moral insanity has sometimes been applied to them" (p. 129). This both asserts that there is a category "them," namely the psychopaths, and connects them to "moral insanity." Moral insanity entered the language of psychiatry when Pritchard chose to use the term to translate Pinel's category of mania sans deliré (Pritchard 1836). Pinel was attempting to conceptualize a range of disorders that bordered on insanity in the sense of severe disturbances of affect, judgment, and behavior, but that were not accompanied by hallucinations or delusions (Pinel 1798/1964). In today's terminology, the cases he described would probably fall into diagnostic groups, including major depression, bipolar disorder, epilepsy, and a range of personality disorders. A number of his more striking case histories involved antisocial and even murderous behavior, which probably reflected Pinel's role in assessing offenders for the criminal courts of Paris. Pritchard's use of the English word "moral" reflected an appeal first to its use at the time to designate something which was like or similar, but not identical (a usage the OED labels "vulgar"), and second moral in the sense of ethical, conforming to virtuous behavior. Anglophones seized on the latter meaning, although Pinel emphasized the former. Forty years later, Henry Maudsley, the most widely read psychiatrist of his generation, could assert that moral insanity was as real as Colour blindness, some people being Colour blind and some moral blind (Maudsley 1879). Moral insanity became connected variously to phrenology with its own bump over the underlying moral cortex, with the twisted genetics of degeneration, with atavistic theories of criminality, and with a range of disorders of brain from epilepsy to frontal lobe damage (Combed 1853; Ellis 1890; Pick 1989). Although it is anachronistic to use the terms "psychopathy" and "moral insanity" together, it is clear they occupied a similar social and psychiatric space, albeit in different era. This should caution against too ready acceptance of psychopathy which may turn out to be as empty and dangerous a conceptualization as moral insanity. Why dangerous? Dangerous to those labeled, because the morally insane and the moral imbeciles were placed in preventive detention in asylums and prisons, and even sterilized in some jurisdictions. Dangerous to society, because it gave a spurious scientific justification for viewing crime not as reflecting the social evils of deprivation, ignorance, and inequality but as the ravages of the born criminals. -/- Psychopaths are not, as Levy asserts, "(causally) responsible for … more than fifty percent of violent crime" (p. 129). A proportion of violent offenders, which varies widely between observers, are labeled psychopaths. This is often on the basis of Hare's psychopathy checklist, which is a subjective, albeit through training aspiring to be reproducible, and to some extent self-sustaining, evaluation system (Hare 1980, 2003). Part of the checklist gathers data on prior antisocial behavior; part constrains the examiner to subjectively estimate such matters as glibness and callousness, part requires judgments about whether the... (shrink)

In contrast with other subfields within religion-and-violence studies, the study of violence and new religious movements has tended to focus on a small set of incidents involving the mass deaths of members of controversial NRMs. Beginning with the suicide-murders of hundreds of members of the People’sTemple in Jonestown, Guyana in 1978, various explanations of such incidents have been offered – some focusing on the psychological make-up of the leaders; others on the near approach of the new millennium. Scholars of violent (...) new religions eventually settled on what might be called the ‘Standard Model’ of NRM violence, a model that takes into account internal factors, external factors and the dynamic polarization between these two sets of influences. Unfortunately, this model is not predictive. However, if the various factors within the standard model are reshuffled, several new factors added and the focus shifted to violent incidents involving group suicide, a modified model emergences that appears to be able to predict mass suicide in NRMs. (shrink)

Drawing on Membership Categorization Analysis, we aim to tease out how narrators talk into being the social group constellations in their storyworlds and how these – potentially shifting – constellations can be related to the narrator’s identity constructions. We investigate two World War II-testimonies narrated by Belgian concentration camp survivors and scrutinize whether the expected Standardized Relational Pair of victim-perpetrator – viz. the camp prisoners versus the Nazis – is in operation, how these two categories are talked into being, (...) whether other social groups are mentioned and how all these processes affect the narrators’ identity work. It proved to be the case that, even though the victim-perpetrator Standardized Relational Pair is indeed present in both testimonies, it functions very differently in both stories, resulting in almost opposing identity work by the two narrators. (shrink)

Epistemic contextualism is the view that the truth-conditions for knowledge attributions can vary across contexts as a result of shifting epistemic standards. According to Keith DeRose, the “chief bugaboo of contextualism has been the concern that the contextualist is mistaking variability in the conditions of..

From a cultural-historical perspective, the impairments of a child with a condition like cerebral palsy have biological origins, but the disability evolves from the mismatch between the child and his/her social conditions for development. One example of this dialectical production of disability can be seen in the challenge of the 21st-century welfare state: How to provide economically feasible health and educational services anchored in evidence-based methods and practices. Standardized social service pathways for children with CP illustrates an attempt to address (...) this challenge and moderate the mismatch by acting in the intersection between impairment and society. The aim of the article is to analyze challenges in the practice of connecting research and practice-based knowledge with societal practices in order to diminish the disability of the child. A multidisciplinary group assembled by the Danish National Board of Social Services engaged in a practice of developing a guideline for a social service pathway. Agendas and minutes from their series of meetings provide insight in how the work evolved through conflictual discussions. Rather than a neutral transformation of knowledge into practice, the practice revealed itself as a value-laden process in which the needs of the child and family were at times decentred and the focus shifted to how social services could be realised in complex, structured social practices. While the group managed to overcome several conflicts and agree of a social service pathway, a socio-economic analysis was unable to argue for the comprehensive social service pathway as an economic sound choice for municipal decision-makers. The conflict between the welfare ideology and economic feasibility remains unresolved and can be expected to limit the extent that impairments can be remedied and the mismatch decreased. Overcoming or diminishing the mismatch might never become economic worthwhile. As the political pendulum oscillates between welfare and economic concerns, the experience of disability will likewise diminish or expand. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment (...) to both distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

Public health emergencies invariably entail difficult decisions among medical and emergency first responders about how to allocate essential, scarce resources. To the extent that these critical choices can profoundly impact community and individual health outcomes, achieving consistency in how these decisions are executed is valuable. Since the terrorist attacks on September 11, 2001, however, public and private sector allocation plans and decisions have followed uncertain paths. Lacking empirical evidence and national input, various entities and actors have proffered multifarious approaches on (...) how best to allocate scarce resources to protect the public's health. Though beneficial in some jurisdictions, these approaches fail to clarify how the type and amount of care delivered in major emergencies might be curtailed. This is due, in part, to a lack of meaningful guidance on shifting standards of care in major emergencies. (shrink)

Double standards are widespread throughout biomedicine, especially in research on reproductive health. One of the clearest cases of double standards involves the feminine gendering of reproductive responsibility for contraception and the continued lack of highly effective, reversible methods for cisgender men. While the biomedical establishment accepts diversity and inclusion as important social values for clinical trials, their continued use of inequitable standards undermines their ability to challenge unfair social hierarchies by developing male contraception. Thus, the gender/sex bias (...) present in contraceptive research raises the “New Demarcation Problem”: If we accept that values can and will play important roles in science, how can we nevertheless distinguish positive influences of values from more corrosive bias? I argue that biomedical researchers ought to aim their clinical trials at equity and utilize methodologies that actually achieve that aim. More specifically, I contend that we can avoid the problem of double standards by gender/sex in contraceptive research by utilizing more equitable standards. My demarcation strategy captures dynamic interplay between values and their effects, with direct policy implications for institutions conducting, funding, and evaluating clinical trials. For male contraceptive trials, this involves shifting risk assessment from an individual model to a shared model for sexual partners. (shrink)

In recent years consumer law has come more and more into the focus of legislation within the EU. One of the EU’s key objectives, completing the final stage of the internal market, is to place consumer rights in the centre of it. Following the adaption of various consumer law measures for some decades, the EU has undertaken a thorough review of its consumer acquis. After years of consultations, the Consumer Rights Directive 2011/83/ EU, which was supposed to set new (...) class='Hi'>standards of consumer protection, came into force and will have to be implemented by the Member States by 13 December, 2013. Renouncing its principal practice of minimum harmonisation in the area of consumer law, i.e. allowing Member States on the basis of Directives to adopt more protective rules, the EU legislator now turned to a targeted full harmonisation approach by means of the Consumer Rights Directive, aiming at increasing the consumer protection across the EU by bringing together the currently distinct laws for distance selling and off-premises contracts as well as other types of consumer contracts in a single instrument. The article briefly introduces the background of the Directive and discusses the shift in means of harmonisation concepts. Then, it analyses the scope, concepts and content of the Directive, which mainly brings considerable reforms in the areas of information requirements and the right of withdrawal. Taking into account the Directive’s improvements and shortcomings, conclusions are drawn that further harmonisation and a uniform and universally applicable set of European consumer rights are needed. (shrink)

Recently, there have been a number of government proposals and reforms seeking to ensure that standard setting in risk regulation is carried out in a more accountable and transparent manner. These proposals were a direct and indirect response to distrust in government both in relation to risk regulation and across government more widely. The problem, however, is that few of these proposals and reforms have been grounded in an understanding of the nature of standard setting in risk regulation. Such standard (...) setting has three significant features. It is directly concerned with normative issues about risk acceptability, is carried out in circumstances of scientific uncertainty, and requires some form of expert judgment. Rather, these proposals were based on a presumption that standard setting is primarily an analytical process which is verifiable and objective. There are a number of likely consequences of the disjunction between the nature of standard setting and these developments which include problems of ossification, the submersion of normative debate, and a fundamental shift in the nature of public administration. These problems provide an excellent example of the dangers of implementing accountability mechanisms without regard to the complexities of the decision-making context. (shrink)

The increased competition for a share of the market of insured patients, which arose in the wake of failed comprehensive health care reform, has provoked questions about what, if any, standards will govern new “competitive” health care organizations. Managed care arrangements, which typically shift to providers and patients some or all of the financial risk for patient care, are of special concern because they can create incentives to withhold beneficial care from patients. Of course, fee-for-service medical practice creates incentives (...) to provide unnecessary services, and managed care can avoid that type of harm. Still, as Edmund Pellegrino has noted, “managed care, by its nature, places the good of the patient into conflict with … the good of all the other patients served by the plan; the good of the plan and the organization, themselves…; and the self-interest of the physician. (shrink)

The increased competition for a share of the market of insured patients, which arose in the wake of failed comprehensive health care reform, has provoked questions about what, if any, standards will govern new “competitive” health care organizations. Managed care arrangements, which typically shift to providers and patients some or all of the financial risk for patient care, are of special concern because they can create incentives to withhold beneficial care from patients. Of course, fee-for-service medical practice creates incentives (...) to provide unnecessary services, and managed care can avoid that type of harm. Still, as Edmund Pellegrino has noted, “managed care, by its nature, places the good of the patient into conflict with … the good of all the other patients served by the plan; the good of the plan and the organization, themselves…; and the self-interest of the physician. (shrink)