What should be the ‘informational base’ of welfare economics if one takes the insights from behavioral economics seriously? Sugden proposes individuals’ sets of opportunities. This paper discusses...

Background Providing understandable information to patients is necessary to achieve the aims of the Informed Consent process: respecting and promoting patients’ autonomy and protecting patients from harm. In recent decades, new, primarily digital technologies have been used to apply and test innovative formats of Informed Consent. We conducted a systematic review to explore the impact of using digital tools for Informed Consent in both clinical research and in clinical practice. Understanding, satisfaction and participation were compared for digital tools versus the (...) non-digital Informed Consent process. Methods We searched for studies on available electronic databases, including Pubmed, EMBASE, and Cochrane. Studies were identified using specific Mesh-terms/keywords. We included studies, published from January 2012 to October 2020, that focused on the use of digital Informed Consent tools for clinical research, or clinical procedures. Digital interventions were defined as interventions that used multimedia or audio–video to provide information to patients. We classified the interventions into 3 different categories: video only, non-interactive multimedia, and interactive multimedia. Results Our search yielded 19,579 publications. After title and abstract screening 100 studies were retained for full-text analysis, of which 73 publications were included. Studies examined interactive multimedia, non-interactive multimedia, and videos, and most studies were conducted on adults. Innovations in consent were tested for clinical/surgical procedures and clinical research. For research IC, 21 outcomes were explored, with a positive effect on at least one of the studied outcomes being observed in 8/12 studies. For clinical/surgical procedures 49 outcomes were explored, and 21/26 studies reported a positive effect on at least one of the studied outcomes. Conclusions Digital technologies for informed consent were not found to negatively affect any of the outcomes, and overall, multimedia tools seem desirable. Multimedia tools indicated a higher impact than videos only. Presence of a researcher may potentially enhance efficacy of different outcomes in research IC processes. Studies were heterogeneous in design, making evaluation of impact challenging. Robust study design including standardization is needed to conclusively assess impact. (shrink)

Behavioral paternalism raises deep concerns that do not arise in traditional welfare economics. These concerns stem from behavioral paternalism’s acceptance of the defining axioms of neoclassical rationality for normative purposes, despite having rejected them as positive descriptions of reality. We argue that behavioral paternalists have indeed accepted neoclassical rationality axioms as a welfare standard; that economists historically adopted these axioms not for their normative plausibility, but for their usefulness in formal and theoretical modeling; that broadly rational individuals might fail to (...) satisfy the axioms for various reasons, making them unpersuasive as normative criteria; and that even if their violation did constitute irrationality, that would not justify paternalists’ choosing among inconsistent preferences to define an individual’s “true” preferences. (shrink)

A powerful critique of nudge theory and the paternalist policies of behavioral economics, and an argument for a more inclusive form of rationality.

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate, however, VR content also plays a significant role. The primary objective of this systematic review and meta-analysis was to examine the literature on HMDs that report Simulator Sickness Questionnaire (SSQ) scores to determine the impact (...) of content. User factors associated with VR sickness were also examined. A systematic search was conducted according to PRISMA guidelines. Fifty-five articles met inclusion criteria, representing 3,016 participants (mean age range 19.5-80; 41% female). Findings show gaming content recorded the highest total SSQ mean 34.26 (95%CI 29.57-38.95). VR sickness profiles were also influenced by visual stimulation, locomotion and exposure times. Older samples (mean age ≥35 years) scored significantly lower total SSQ means than younger samples, however, these findings are based on a small evidence base as a limited number of studies included older users. No sex differences were found. Across all types of content, the pooled total SSQ mean was relatively high 28.00 (95%CI 24.66-31.35) compared with recommended SSQ cut-off scores. These findings are of relevance for informing future research and the application of VR in different contexts. (shrink)

Institutional review board delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in (...) the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improv... (shrink)

The variety and complexity of the eight papers in this Symposium issue are evidence that immigration is a tough nut to crack both as a matter of policy and application. There is no way that any short summary can do justice to these papers, which take a variety of moral, economic, historical, and empirical approaches to some of the recurrent issues in the field, so it is best in this short issue to try to situate the problem in a general (...) classical liberal context, to show where the pressure points are most likely to appear.The initial way to approach this problem is to start with the simple proposition that the world today is divided into national territories where the practical norm is well-nigh universal: That each sovereign state has exclusive control over its own territory, which, among other things, allows it to decide which individuals are members of that state. These citizens have privileges that may be exercised, no questions asked, on such key matters as entering labor markets, owning property, voting, and otherwise participating in political affairs. All these activities may be denied or granted, at will, to any and all outsiders by the territorial sovereign.No one doubts the need for having some form of territorial control. The need to have some monopoly of force could not be achieved if the entire world, with its infinite diversity of locations and populations, were under a single sovereign. Indeed, in many cases, the divisions within a given country may be so pronounced that separation rather than aggregation is the norm. Thus, at the end of the British Raj, India split into India and Pakistan, and later Pakistan split into Pakistan and Bangladesh. Less dramatically, Czechoslovakia split into two countries, the Czech Republic and Slovakia, while the former Yugoslavia split into five nations, starting from the northwest: Slovenia, Croatia, Bosnia and Herzegovina, Serbia, and Macedonia. Clearly, these ethic differences, be they large or small, are a major obstacle to the expansion of the size of the state. And today, the territorial instinct reasserts itself as the member states of the European Union impose more restrictions on immigration.Yet at the same time, the normative foundations of this system seem elusive. There is the following deep skepticism about the importance of these borders, expressed in these essays by Jeremy Waldron and Ilya Somin, that these national boundary lines should have such a pronounced role in political economy. Michael Blake pursues this theme further by asking the extent to which classical liberals can justify exclusion through the use of violence—or is it force? The inquiry into the dominant role of territoriality can then be expanded, as by Peter Margulies, to examine all sorts of negative externalities that could be created both by easy and strict rules of admission.Taken as a whole, there is no doubt that these national barriers are a serious obstacle to the free trade in goods and services between two individuals, one inside the boundary and one outside. The general view is that these barriers block the gains from trade, which is what drives economic progress, so that ideally all tariffs and quantitative restrictions should give way to a system of free trade in which petty objections by domestic competitors of foreign firms should not dictate local policies.It should, of course, be evident that powerful conflicting forces on free trade and protectionism ebb and flow over time. It should therefore come as no surprise that the stakes are even higher where what is at stake is the movement of people across national boundaries. The loss to any given country from keeping out potential citizens can be enormous, and we see powerful political forces clamp down on open immigration, so many of these gains from trade are lost. The situation can be even more heartbreaking when the ability to leave a country exposes innocent people to imprisonment or death.So what is the explanation for so many nations closing their borders? Much of the explanation comes from old-fashioned protectionism. Your computer programmers will take the jobs of our specialists. There is all sorts of occupational licensing and other barriers to entry within a domestic economy, so there is no reason to expect that these forces will not exert even greater influence against outsiders who do not, after all, have a voice in the local economy and who, therefore, as Alex Nowrasteh, Michael Howard, and Andrew Forrester observe, have little ability to influence domestic policy even after they enter a country. In addition, as Gabriel Chin discusses, strong racial prejudices also lead to exclusions from the domestic economy. Not only are there objections in, say, the United States and much of Western Europe, of exclusion on straight racial grounds, as exemplified by Chinese exclusion acts. The force of these exclusions are also subject to political change. Thus, the Immigration Act of 1924 (the Johnson-Reed Act) was part of a white supremacist program, which gave way two decades later to a very different legal regime with the Immigration Act of 1965, which put an end to the venerable system of national-origin quotas.Yet two other reasons for exclusion are constantly at issue. Immigrants not only bring in their labor but also their families, cultures, and traditions that, in public spaces, may clash with local norms and cultures on such elementary and critical matters as to whether women should dress modestly and wear head coverings. Will freewheeling Danes and Swedes feel comfortable if large numbers of Muslims continue their traditional practices with strong barriers between men and women? There are no obvious market mechanisms that will mitigate these issues, and the situation becomes even more fraught if there are large welfare or educational costs that fall, at least in the short run, on local citizens. These are compounded by the fact that immigrants will typically gain political rights that could easily skew the balance of political power between established and newly arrived ethnic groups by altering the outcome of national and local elections. And letting people in is not just done on a simple open-borders policy. Thus, in many countries, as Lance Pritchett discusses, there is the controversial option of letting foreigners in on short-term labor visas that require them to leave after a certain period. And there are further questions about whether people should be deported if they lied on their entry applications or committed some crime while in the new country, as has occurred in the United States. The numbers of cases can be high and their complexity great, so it is fair to ask, along with Jill Family, whether some self-conscious exceptions to the Administrative Procedure Act of 1946, analogous statutes elsewhere, should be regarded as part of the new normal.It is therefore necessary to deal with the thrust and counterthrust on all these issues. It is also fair to ask whether classical liberalism has a distinctive view on these issues, or whether the combination of private gains and multidirectional externalities gives rise to empirical questions that, as always, require further reflection, even when certain situations—the major influx of illegal immigrants on the US southern border—will generate such powerful emotions that detached intellectual inquiry is ever more difficult. We cannot answer these questions, and thus offer to you a set of essays that take a stab at these difficult topics. (shrink)

Accountable Care Organizations are a key mechanism of the Patient Protection and Affordable Care Act. ACOs will influence incentives for providers, who must understand these changes to make well-considered treatment decisions. Our paper defines an ethical framework for physician decisions and action within ACOs. Emerging ethical pressures providers will face as members of an ACO were classified under major headings representing three of the four principles of bioethics: autonomy, beneficence, and justice. Conflicts include a bias against transient populations, a motive (...) to undertreat conditions lacking performance measures, and the mandate to improve population health incentivizing life intrusions. After introducing and explaining each conflict, recommendations are offered for how providers ought to precede in the face of novel ethical choices. Our description of novel ethical choices will help providers know what to expect and our recommendations can guide providers in choosing well. (shrink)

Taxation is more than one thing. Taxes can be levied in various ways on various things, with varying effects on a culture and an economy, and raising different challenges of justification.

The cinematic apparatus and the transcendental subject -- Re-thinking representation : new lines of thought in feminist philosophy -- Cinematic assemblages : an ethological approach to film-viewing -- The slasher film : a Deleuzian feminist analysis -- The alien series : alien-becomings, human-becomings -- The molecular poetics of the assemblage : before night falls -- Conclusion : a feminist cinematic assemblage.

This study, drawing upon contemporary theories in the field of migration, postcolonialism, and translation, offers an analysis of literary works by Monica Ali and Jhumpa Lahiri. Ali and Lahiri epitomize second-generation immigrant literature, play with the linguistic concept of translating and interpreting as forms of hybrid connections, and are significant examples of how a text may become a space where multi-faceted identities co-habit in a process of deconstructing and reconstructing their own sense of emplacement in non-native places. Each immigrant text (...) becomes a hybrid site, where second- and third generations of immigrant subjects move as mobile, fluctuating and impermanent identities, caught up in the act of transmitting their bicultural and bilingual experience through the use of the English language as their instrument of communication in a universe which tends to marginalize them. This investigation seeks to demonstrate how Ali and Lahiri represent two different migrant experiences, Muslim and Indian, each of which functioning within a multicultural Anglo-American context. Each text is transformed into the lieu where identities become both identities-intranslation and translated identities and each text itself may be looked at as the site of preservation of native identities but also of the assimilation of identity. Second-generation immigrant women writers become the interpreters of the old and new cultures, the translators of their own local cultures in a space of transition. (shrink)

Vaesen argues that functional knowledge differentiates humans from non-human primates. However, the rationale he provides for this position is open to question – with respect to both the underlying theoretical assumptions and inferences drawn from certain empirical studies. Indeed, there is some recent empirical work that suggests that functional fixedness is not necessarily uniquely human. I also question the central role of stable function representations in Vaesen's account of tool production and use.

Older and newer forms of vulnerability are manifesting themselves today, denouncing a suffering which is both material and existential, individual and societal. It is particularly evident within urban contexts and amplified by the crumbling of collective belonging and the increasing scarcity of places of participation where responsibility and the commitment to building one’s own personal biography are increasingly delegated to each individual, both materially and symbolically. Two separate pedagogical studies will explore some processes of signification of the experiences connected to (...) new poverty, emphasizing the risks of simplification and normativity identified in some of the current interpretations in the common sense, such as the problematic proximity which these are in danger of sharing with the interpretative premises that shape the same local educational services dedicated to new poverty itself. (shrink)

Though accountable care organizations are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid (...) enrolling high-cost patients. (shrink)

ExcerptIt can be argued that we are currently living in a time characterized by a widespread perception of “discontinuity,” of a rupture in historical continuity. This rupture appears to have been brought about by the alleged demise of the secular paradigm, underpinning the Enlightenment project of modernity, caused by the outbreak of religious fervor and spirituality at the dawn of the new millennium. The perceived rupture in the natural progression of secular modernity has led to the questioning of the assumed (...) link of modernity and secularity1 and to the critique of Enlightenment theories and postulates regarding the disenchantment of the…. (shrink)

ExcerptThere are a number of ways of considering the current crisis in Western universities and, in particular, their problems with ideas and practices about truth and truthfulness. One is to see it as a problem created by what is often termed “modernity,” which is to say the issues raised and the processes set in motion by the Enlightenment and the various reactions to it in the West. Going down this road invariably means invoking modern thinkers, ranging from Nietzsche to Weber (...) to Foucault, all of whom provide considerable insight into the way in which certain ideas in the West have…. (shrink)

Investigating perceptual and cognitive abilities of zoo animals might help to improve their husbandry and enrich their daily life with new stimuli. Developing new environmental enrichment programs and devices is hence necessary to promote species-specific behaviours that need to be maintained in controlled environments. As far as we are aware, no study has ever tested the potential benefits of motion illusions as visual enrichment for zoo animals. Starting from a recent study showing that domestic cats are spontaneously attracted by a (...) well-known motion illusion, the Rotating Snake (RS) illusion, we studied whether this illusion could be used as a visual enrichment for big cats. We observed the spontaneous behaviour of three lionesses when three different visual stimuli were placed in their environment: the RS illusion and two control stimuli. The study involved two different periods: the baseline and the RS period, in which the visual stimuli were provided to the lionesses. To assess whether the lionesses were specifically attracted by the RS illusion, we collected data on the number of interactions with the stimuli, as well as on the total time spent interacting with them. To investigate the effect of the illusion on the animals’ welfare, individual and social behaviours were studied and compared between the two periods. The results showed that two lionesses out of three interacted more with the RS stimulus than with the two control stimuli. The fact that the lionesses seemed to be more inclined to interact with the RS stimulus indirectly suggests the intriguing possibility that they were attracted by the illusory motion. Moreover, behavioural changes between the two periods were reported for one of the lionesses, highlighting a reduction in self-directed behaviours and an increase in attentive behaviours, suggesting positive welfare implications. Thus, behavioural observations made before and during the presentation of the stimuli showed that our visual enrichment actually provided positive effects in lionesses. These results call for the development of future studies on the use of visual illusions in the enrichment programs of zoo animals. (shrink)

Despite the belief that autism is an empathy disorder, autistics declare their ability to empathize. To explore this experiential vision, we present the alternative explanation for social impairments in autism offered by the Intense World Theory (IWT) and substantiate it through the phenomenological analysis of empathy as an experienced phenomenon. According to IWT, autistics are characterized by hyper-emotionality and therefore their detachment is not the sign of a disrupted empathy, but a strategy to face a world of overwhelming stimuli. Taking (...) the phenomenological account of empathy as a tendency to minimize the emotional and conceptual space dividing embodied and conscious subjects, our purpose is to explain that although autistics seem to expand this space, they may still be considered empathetic. (shrink)