The restructured globalized economy has provided women with employment opportunities. Globalisation has also meant a shift towards self-regulation of multinationals as part of the restructuring of the world economy that increases among others things, flexible employment practices, worsening of labour conditions and lower wages for many women workers around the world. In this context, as part of the global trend emphasising Corporate Social Responsibility (CSR) in the 1980s, one important development has been the growth of voluntary Corporate Codes (...) of Conduct to improve labour conditions. This article reviews from a feminist interdisciplinary perspective the broad academic literature on women workers, covering the more classical debate on women workers in the industrialization process and entering into women workers in the global supply chains and women workers and corporate codes of conduct. The main argument is that this research on women workers is crucial to frame the issues of business ethics and in particular CSR and Codes of Conduct in the context of women in the global political economy. When this crucial knowledge is ignored, then the ethical policies of the companies also ignore the real situation of the women workers at the bottom of their supply chains. (shrink)

One of the essential ethical issues in the employment relationship is the loss of employee voice. Many of the ways employees have previously exercised voice in the employment relationship have been rendered less effective by (1) the changing nature of work, (2) employer preferences for flexibility that often work to the disadvantage of employees, and (3) changes in public policy and institutional systems that have failed to protect workers. We will begin with a discussion of how work has changed (...) in the last 20 years in countries like Australia and the United States, and then take up the issue of employees as organizational stakeholders and the ethical duties that are owed them, with special attention given to issues of power. We will then consider whether voluntary action by employers such as social auditing is sufficient to ensure equity for employees, and conclude with a discussion of how changes in public policy might ensure greater fairness in the employment relationship by bringing employers and employees together in partnership. (shrink)

This article endeavors to establish the moral force behind the worker’s claim to a compensatory wage in return for the labor burdens she endures. The apparent incompatibility between compensation and voluntary losses suggests that the only reason for providing a compensatory wage is the need to entice a valued service. In response, the article considers and rejects attempts to ground the compensatory wage on duress, mutual trade, and desert. Instead, it argues that the worker is not responsible for her (...) loss of well-being because she would not have incurred it in the absence of the employer’s promise to compensate. Key Words: compensatory wage • contributory wage • detrimental reliance • desert • labor burdens • promises • responsibility. (shrink)

One of the essential ethical issues in the employment relationship is the loss of employee voice. Many of the ways employees have previously exercised voice in the employment relationship have been rendered less effective by (1) the changing nature of work, (2) employer preferences for flexibility that often work to the disadvantage of employees, and (3) changes in public policy and institutional systems that have failed to protect workers. We will begin with a discussion of how work has changed (...) in the last 20 years in countries like Australia and the United States, and then take up the issue of employees as organizational stakeholders and the ethical duties that are owed them, with special attention given to issues of power. We will then consider whether voluntary action by employers such as social auditing is sufficient to ensure equity for employees, and conclude with a discussion of how changes in public policy might ensure greater fairness in the employment relationship by bringing employers and employees together in partnership. (shrink)

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a (...) qualitative approach to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

This article proposes a rigorous method to “map” the law on to the facts in the legal analysis of “sexual consent” using a series of mandatory questions of law designed to eliminate the legal errors often made by decision-makers who routinely rely on personal beliefs about and attitudes towards “normal sexual behavior” in screening and deciding cases. In Canada, sexual consent is affirmative consent, the communication by words or conduct of “voluntary agreement” to a specific sexual activity, with a (...) specific person. As in many jurisdictions, however, the sexual assault laws are often not enforced. Reporting is lowest and non-enforcement highest in cases involving the most common type of assailants, those who are not strangers but instead persons the complainant knows, often quite well -- acquaintances, supervisors or co-workers, and family members. Reliance on popular narratives about “seduction” and “stranger-danger” leads complainants, police, prosecutors, lawyers, and trial judges, to truncate legal analysis of the facts and leap to erroneous conclusions about “consent.” Wrongful convictions and perverse acquittals, questionable plea bargains and ill-considered decisions not to charge, result. This proposal is designed to curtail the impact of pre-judgments, assumptions, and biases in legal reasoning about voluntariness and affirmative agreement and produce decisions that are legally sound, based on the application of the rule of law to the material facts. Law has long had better tools than the age-old and popular tales of “ravishment” and “seduction.” Those tools can and should be used. (shrink)

This study was conducted from May to June 2005 to describe the demographic characteristics and factors that affect the VCT acceptance as well as the HIV prevalence among youth VCT acceptors in Addis Ababa. Both quantitative and qualitative methods of data collection were employed. The quantitative data was generated from a two years (October 2002 to December 2004) VCT service utilization data obtained from four youth centers located in Addis Ababa. The data was analysed using univariate and multivariate analysis and (...) results were presented in the form of text, table and figures. The significance and level of associations between independent and dependant variables was computed using X2 tests and odds ratios with 95% confidence interval. The qualitative data was presented in a form of narrations using excerpts. During the period a total of 3220, youth age 15 - 24 years have sought VCT service from the four youth centres VCT service outlets. Higher proportions of females (60.2%) and youth in the age category of 20 – 24 years (58.0%) have accessed the service. The major reasons given for seeking VCT were found to be similar for male and female acceptors. About 71.2% said that they sought for VCT service because they wanted to know their HIV status, 9.5% reported because they were suspicious of being infected with HIV and 5.0% tested because they wanted to go aboard. The HIV prevalence rate is found to be significantly higher, (p = 0.00), among females 9.2 % than in males 1.7 %. Gender segregated multivariate analysis of risk factors indicated significant association of HIV infection with lack of formal education for both males and female: for males P= 0.045, OR = 18.3, 95% CI: 1.1 – 317.7 and for females P=0.00, OR=19.4, 95 % CI: 5.1 – 73.8. Additionally for females HIV infection is markedly associated with being widowed and commercial sex worker. The most common barrier for youth in Addis from accessing VCT were found to be: fear of being emotionally affected if found out HIV positive, stigma and discrimination, lack of money to pay for VCT service, absence of care and support services for people who are already infected. The challenges encountered by youth VCT counsellors were stress, absence of medical care for PLWHA, inadequacy of budget, lack of counsellors and supportive supervision. This study showed high burden of HIV infection among female youth and the risk factors associated with it. Formal education for both females and males is strongly recommended. Female focused HIV prevention interventions are indicated. Additional recommendations are also made in relation to barriers to access youth VCT and for the challenges encountered by youth VCT service providers. (shrink)

This paper considers the normative assessment of bonded labor from the perspectives of libertarianism and Paretian welfare economics. I argue that neither theory can account for our objections to bonded labor arrangements; moreover, they fail in interesting ways. Reflecting on their normative failures focuses us on other considerations besides individual choice and efficiency. Such considerations include: the effects of labor markets on workers' preferences and capacities; the exploitation of the vulnerabilities of the poor; and the permanent binding of one (...) person to another. (shrink)

One of the essential ethical issues in the employment relationship is the loss of employee voice. Many of the ways employees have previously exercised voice in the employment relationship have been rendered less effective by (1) the changing nature of work, (2) employer preferences for flexibility that often work to the disadvantage of employees, and (3) changes in public policy and institutional systems that have failed to protect workers. We will begin with a discussion of how work has changed (...) in the last 20 years in countries like Australia and the United States, and then take up the issue of employees as organizational stakeholders and the ethical duties that are owed them, with special attention given to issues of power. We will then consider whether voluntary action by employers such as social auditing is sufficient to ensure equity for employees, and conclude with a discussion of how changes in public policy might ensure greater fairness in the employment relationship by bringing employers and employees together in partnership. (shrink)

Seven COVID-19 vaccines are now being distributed and administered around the world (figure correct at the time of submission), with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce (...) patient morbidity if properly implemented. Using the principle of least restrictive alternative, we have developed an intervention ladder for COVID-19 vaccination policies among healthcare workers. We argue that healthcare workers refusing vaccination without a medical reason should be temporarily redeployed and, if their refusal persists after the redeployment period, eventually suspended, in order to reduce the risk to their colleagues and patients. This ‘conditional’ policy is a compromise between entirely voluntary or entirely mandatory policies for healthcare workers, and is consistent with healthcare workers’ established professional, legal and ethical obligations to their patients and to society at large. (shrink)

In response to the COVID‐19 pandemic, some authors have advocated a program of controlled voluntary infection (CVI) with SARS‐CoV‐2. Under CVI, during periods where the medical system is under capacity, volunteers from low‐risk groups would be intentionally infected after giving informed consent, and then quarantined until they have developed immunity. Proponents claim that this could have benefits for society, such as building herd immunity and ensuring that critical workers won’t be incapacitated during the peak of the infection. They (...) also claim that this could have benefits for individuals, such as being safely exempted from lockdown measures and (for individuals who are likely to be infected anyway) ensuring that the infection happens under relatively less dangerous conditions. Some respond that CVI would unethical. Here, I argue that, while CVI may or may not be ill‐advised for empirical reasons, there are no in‐principle ethical objections to it (i.e., if CVI would work as well as its proponents think, it would be ethical to implement it). I present three arguments for this conclusion. The first is an argument from informed consent: informed consent to relevantly similar medical procedures renders performing these procedures permissible, so informed consent to CVI would render it permissible. The second is an argument from reasonable beneficence: it draws on recent work by Caspar Hare on relevantly similar choices to argue that CVI is permissible. The third is an argument from precedent: smallpox variolation was permissible, and CVI is relevantly similar to that, so CVI is permissible. (shrink)

Solnica et al argue that “Jewish law and modern secular approaches based on professional responsibilities obligate physicians to care for all patients even those with communicable diseases”. The authors base their viewpoint on the opinion of Rabbi Eliezer Waldenberg and apply it to suggest that physicians are obligated to endanger themselves during epidemics, such as COVID-19. It is argued that Solnica et al’s analysis of Rabbi Waldenberg’s text and their conclusion that healthcare workers are obligated to endanger themselves while (...) treating patient who suffer from contagious illness during epidemics according to Jewish law suffer from various shortcomings. Indeed, Jewish law looks favourably on healthcare workers who take a reasonable risk in treating their patients in the context of epidemics. However, it is considered a voluntary supererogatory act—not obligatory. Solnica et al may express a legitimate ethical viewpoint. However, it does not seem to represent the mainstream approach of what Jewish law would demand as obligatory from its practitioners. (shrink)

IntroductionAfter three decades of the absolute prohibition of abortion, Chile enacted Law 21,030, which decriminalizes voluntary pregnancy termination when the person is at vital risk, when the embryo or fetus suffers from a congenital or genetic lethal pathology, and in pregnancy due to rape. The law incorporates conscientious objection as a broad right at the individual and institutional levels.ObjectivesThe aim of the study was to explore the exercise of conscientious objection in public health institutions, describing and analyzing its consequences (...) and proposals to prevent it from operating as structural violence.Materials and methodsThis study uses a qualitative, post-positivist design. At the national level, according to the chain technique, people who were identified as key actors due to their direct participation in implementing the law were included. Grounded theory was used to analyze the information obtained through a semi-structured interview. The methodological rigor criteria of transferability or applicability, dependability, credibility, auditability, and theoretical-methodological adequacy were met.ResultsData from 17 physicians, 5 midwives, 6 psychologists, 8 social workers, 2 nursing technicians, and 1 lawyer are included. From an inductive process through open coding, conscientious objection as structural violence and strategies to minimize the impact of objection emerge as meta-categories. The first meta-category emerges from the barriers linked to the implementation of the law, the infringement of the rights of the pregnant person, and pseudo conscientious objection, affecting timely and effective access to pregnancy termination. The second meta-category emerges as a response from the participants, proposing strategies to prevent conscientious objection from operating as structural violence.ConclusionConscientious objection acts as structural violence by infringing the exercise of sexual and reproductive rights. The State must fulfill its role as guarantor in implementing public policies, preventing conscientious objection from becoming hegemonic and institutionalized violence. (shrink)

Drawing on face-to-face and online ethnographic, survey and interview data with participants in distributed computing projects around the world, this book sheds light on the organizational and social structures of voluntary distributed computing projects, communities and teams, with close attention to questions of motivation in projects that offer little or no traditional forms of reward, either financially or in terms of participants' careers. With its focus on non-market, non-hierarchical cooperation, this book is a case study of networked individuals around (...) the world who are part of a new social production of information. (shrink)

The claim that workers are subject to structural domination in the labor market is a central contention of the recent radical turn in republican political theory, but it remains undertheorized. Two core components—the claim that workers have “no reasonable alternative” to selling their labor to capitalists and the relevance of exposure to potential interference in such cases—remain unclear. Without a more precise specification of the conditions of structural domination, it is difficult to assess how well republican prescriptions minimize (...) it. I develop a revised defense of the central claim through an analysis of these components. I clarify what it is to have reasonable alternatives in the labor market but show that holding such options is insufficient to avoid structural domination. I argue that the dependence at the heart of structural domination can be constituted multifariously and develop an additional criterion directed at capturing such dependence in production. (shrink)

Environmental degradation and extractive industry are inextricably linked, and the industry’s adverse impact on air, water, and ground resources has been exacerbated with increased demand for raw materials and their location in some of the more environmentally fragile areas of the world. Historically, companies have managed to control calls for regulation and improved, i.e., more expensive, mining technologies by (a) their importance in economic growth and job creation or (b) through adroit use of their economic power and bargaining leverage against (...) weak national governments, regional and international regulatory bodies. More recently, the industry has had to contend with another set of challenges that involved treatment of indigenous people and their traditional land rights, fair treatment of workers, human rights abuses, and bribery and corruption involving local officials and political leaders. These challenges currently fall outside the traditional areas of regulation and control. Nevertheless, they pose serious threat to the industry’s business practices because of their global scope, threat to company’s reputation, and long-term risks of political instability leading to increasing cost of capital. Industry has responded to these challenges by creating voluntary codes of conduct that would signify their intent to comply with higher standards of conduct, and assuage public opinion that no further action is called for. These codes, however, lack any monitoring mechanism and reporting integrity to assure the public that the industry members are indeed meeting their commitments. Consequently, pressure on the industry continues unabated and with ever increasing calls for mandatory regulation and oversight. This article examines the activities of one mining company, Freeport-McMoRan Copper & Gold, Inc., which has taken a radically different approach in responding to these challenges at its mining operations in West Papua, Indonesia. While cooperating with industry-based efforts of voluntary codes of conduct, Freeport also initiated a radically different response through its own voluntary code that would directly focus on issues of human rights, treatment of indigenous people on whose traditional land its mine was located; economic development and job creation and, improvements in health, education, and housing facilities, to name a few. Additionally, the company earmarked large sums of money and involved representatives of the indigenous people in their management and disbursement. The company took an even more radical action when it committed itself to independent external audits of the company’s compliance with the code, and that these findings and company’s responses would be made public without prior censorship by the company. We analyze the nature of corporate culture, vision and risk-taking propensities of its management that would impel the company to embark on a high risk strategy whose outcomes could not be predicted with any degree of certainty before the fact. The parent company also had to confront discontent among the management ranks at the mine site because of cultural differences and management styles of expatriates and local (Indonesian) managers. Finally, we discuss in some detail the extensive and intensive character of a two phase audit conducted by the outside monitors, their findings, and the process by which they were implemented and reported to general public. We also evaluate the strengths and challenges posed by such audits, their importance to the company’s future, and how such projects might be undertaken by other companies. (shrink)

Over recent decades, developments in network governance have seen governments around the world cede considerable authority and responsibility to commercial migration intermediaries for recruiting and managing temporary migrant labour. Correspondingly, a by-product of network governance has been the emergence of soft employment regulation in which voluntary codes of conduct supplement hard legal employment standards. This paper explores these developments in the context of temporary migrant workers employed in Australian horticulture. First the paper analyses the growing use of temporary (...) migrant labour in this industry. It then describes how different types of intermediaries interact with this workforce. The paper then outlines both hard and soft employment regulations, and contrasts them with actual employment conditions, questioning how a network governance approach has affected this vulnerable workforce. The paper concludes that changes in network governance of migration and employment relations have emasculated formal legal regulation, leaving market forces to operate without effective or ethical constraints at the expense of the public good. (shrink)

Over recent decades, developments in network governance have seen governments around the world cede considerable authority and responsibility to commercial migration intermediaries for recruiting and managing temporary migrant labour. Correspondingly, a by-product of network governance has been the emergence of soft employment regulation in which voluntary codes of conduct supplement hard legal employment standards. This paper explores these developments in the context of temporary migrant workers employed in Australian horticulture. First the paper analyses the growing use of temporary (...) migrant labour in this industry. It then describes how different types of intermediaries interact with this workforce. The paper then outlines both hard and soft employment regulations, and contrasts them with actual employment conditions, questioning how a network governance approach has affected this vulnerable workforce. The paper concludes that changes in network governance of migration and employment relations have emasculated formal legal regulation, leaving market forces to operate without effective or ethical constraints at the expense of the public good. (shrink)

Introduction: The COVID-19 pandemic is asking health care workers to meet extraordinary challenges. In turn, HCWs were experiencing tremendous psycho-social crisis as they have had to deal with unexpected emotional requirements arising from caring for suffering and dying patients on a daily basis. In that context, recent studies have highlighted how HCWs working during the COVID-19 outbreak manifested extreme emotional and behavioral reactions that may have impacted their mental health, increasing the risk for developing post-traumatic stress symptoms.Purpose: The aim (...) of the study was to investigate post-traumatic stress symptoms, such as intrusion symptoms, as a potential mediator of the link between ERs and crying at work, and whether rumination moderates the relationship between ERs and intrusion-based PTS symptoms among HCWs who have had to deal with patients dying from COVID-19.Methods: An online cross-sectional study design was performed. A total of 543 Italian HCWs participated in the study. Participation was voluntary and anonymous. We used the SPSS version of bootstrap-based PROCESS macro for testing the moderated mediation model.Results: ERs had an indirect effect on crying at work through the mediating role of intrusion symptoms. Results from the moderated mediation model showed that rumination moderated the indirect effect of ERs on crying at work via intrusion symptoms, and this effect was significant only for high rumination. Furthermore, when we tested for an alternative model where rumination moderates the direct effect of ERs on crying at work, this moderation was not significant.Conclusions: As the second wave of the COVID-19 pandemic is ongoing, there is an urgent need for decision-makers to rapidly implement interventions aimed at offering timely psychological support to HCWs, especially in those contexts where the risk of emotional labor associated to patients dying from COVID-19 is higher. (shrink)

While analysis of what takes people into prostitution has been widely documented, this article explores the way adult ‘30 something’ prostitutes consider their futures and the ideas they have about leaving or staying in prostitution. Drawing on contested notions of prostitution as ‘work’ and the broader context of life-history research with sex workers, it explores the experiences that frame prostitutes’ own narratives about their working lives and futures. An illustrative range of five life-history accounts from British sex workers (...) are analysed as ‘imagined’ curriculum vitae, listing emergent categories of: aliases, education, interests, thoughts on retirement, financial planning, getting older, hopes and ambitions and fantasy futures. These ‘stories’ are analysed looking at ways they inform on-going feminist debates about the realities of (voluntary adult) sex workers’ concerns. They point again to the relevance for sex workers and feminists of understanding sex work as ‘a job’. (shrink)

The present study examines how collectivism, an important cultural value, plays a moderating role in the association between job attitudes and actual turnover in a sample of 781 Chinese female workers. Results show that collectivism moderates the relationships between job attitude variables and turnover intention. Job satisfaction and organizational commitment are more powerful in predicting turnover intention when levels of collectivism are high rather than low. However, collectivism only moderates the mediation of turnover intention in the relationship between job (...) satisfaction and actual turnover. The study deepens the understanding of the moderating effect of cultural values in organizational behavioral outcomes as Taras et al. suggest. Also discussed are the practical implications on how to control the voluntary termination of female laborers who constitute an important part in Chinese manufacturing. (shrink)

In the present context of aging populations, the question of how to support older workers who want to stay in employment longer is of particular importance, especially from a social justice perspective with regards to income. The challenges faced by organizations and governments are unprecedented. Interesting conclusions can be drawn from our research with regard to these challenges. First of all, the perception of retirement appears more or less unchanged over the years and remains very positive. Consequently, one of (...) the barriers to the employment of older workers may be the image of retirement itself, since it is still perceived as a gift or a right. Secondly, our results confirm that forcing people to stay longer in the labour market is a largely unpopular measure. Consequently, if public retirement plans offer limited income, governments and organizations should adopt a more voluntary approach to encourage older workers to stay in employment longer for a better income. Our results highlight the importance of the sector and type of job in the measures or incentives that could encourage older workers to stay in employment longer. Consequently, governments and organizations will probably have to adopt a contingent approach; i.e., all incentives do not necessarily fit all jobs or all sectors and social justice would require this be taken into account. We identified three sets of measures that could encourage older workers to stay in employment longer, and thus have access to better economic security: the reduction of working time, the flexibility of working time, and the individualization of retirement options and working time. The progressive reduction of their working time appears most interesting to our respondents. These measures appear to favour social justice in terms of income and right to employment at the end of active careers. (shrink)

The requirement of randomization in experimental design was first stated by R. A. Fisher, statistician and geneticist, in 1925 in his book Statistical Methods for Research Workers. Earlier designs were systematic and involved the judgment of the experimenter; this led to possible bias and inaccurate interpretation of the data. Fisher's dictum was that randomization eliminates bias and permits a valid test of significance. Randomization in experimenting had been used by Charles Sanders Peirce in 1885 but the practice was not (...) continued. Fisher developed his concepts of randomizing as he considered the mathematics of small samples, in discussions with "Student," William Sealy Gosset. Fisher published extensively. His principles of experimental design were spread worldwide by the many "voluntary workers" who came from other institutions to Rothamsted Agricultural Station in England to learn Fisher's methods. (shrink)

Hospices consider themselves places that practise a holistic form of terminal care, encompassing physical and psychological symptoms, and also the social and spiritual support for a dying patient. So far, the underlying ethical principles have been treated predominantly in terms of a normative theoretical discussion. The interview study discussed in this paper is a qualitative investigation into general and hospice-related conceptions of morality among full-time and voluntary workers in German inpatient hospices. It examines moral conflicts and efforts leading (...) to their solution. The main ideas identified include moral neutrality towards the patients and their requests, the capability of acceptance, the idea of self-restraint with respect to the dying patient and the principle of respect for the natural course of dying. Essential triggers for moral conflicts were the inadequate education of patients, problems of acceptance in view of incurable disease, and disagreements between members of patients' families. The interviewees expressed their scepticism towards formal institutions of ethical counselling. The study has shown a type of virtue ethics that forms an integral part of the overall concept of hospice care, which cannot be treated separately from a holistic idea of care at the end of life. (shrink)

Union security has long been an industrial relations controversy. While compulsory unionism supporters say it benefits the working class, right-to-work advocates denounce it as an unethical infringement of individual rights and freedom. Unfortunately, neither side has adequately addressed the shortcomings of their viewpoint, nor the broader worker concerns about effective representation beyond just "unionism". In this paper, we examine the ethical and practical problems of compulsory and voluntary unionism and propose a new resolution, compulsory proportional representation, that has the (...) advantages of: ensuring workers' freedom to associate or not associate, promoting freedom to contract, allowing free competition in representation in line with anti-trust principles, improving industrial peace and efficiency, enhancing fairness and social justice, and addressing the employer-employee power imbalance. It is superior to either voluntary unionism, which often lead to management unilateralism, or compulsory unionism, where workers are compelled to join unions against their will. (shrink)

Introduction Scholars have debated how to define coercion and undue influence, but how institutional review boards (IRBs) view and make decisions about these issues in actual cases has not been explored. Methods I contacted the leadership of 60 US IRBs (every fourth one in the list of the top 240 institutions by National Institutes of Health funding), and interviewed 39 IRB leaders or administrators from 34 of these institutions (response rate=55%), and 7 members. Results IRBs wrestled with defining of ‘coercion’ (...) and ‘undue inducement’, most notably in deciding about participant compensation. IRBs often use these terms synonymously and define undue inducement in varying ways, often wrestling with these issues, relying on ‘gut feelings’, and seeking compromises. Ambiguities arose, partly reflecting underlying tensions: whether subjects should ‘get paid’ versus ‘volunteer’ (ie, whether subjects should be motivated by compensation vs altruism), and whether subjects should be paid differently based on income, given possible resultant selection bias. Lack of consistent standards emerged between and even on single IRBs. Questions arose concerning certain aspects and types of studies; for example, how to view and weigh providing free care in research, whether and how recruitment flyers should mention compensation, and how to avoid coercion in paediatric, developing world, or students research. Conclusions These data, the first to probe qualitatively how IRBs view and approach questions about coercion, undue influence and participant compensation, and to examine how IRBs have reviewed actual cases, reveal several critical ambiguities and dilemmas, and have vital implications for future practice, education, policy and research. (shrink)

Reality medical television, an increasingly popular genre, depicts private medical moments between patients and healthcare providers. Journalists aim to educate and inform the public, while the participants in their documentaries—providers and patients—seek to heal and be healed. When journalists and healthcare providers work together at the bedside, moral problems precipitate. During the summer of 2010, ABC aired a documentary, Boston Med, featuring several Boston hospitals. We examine the ethical issues that arise when journalism and medicine intersect. We provide a framework (...) for evaluating the potential benefits and harms of reality medical television, highlighting critical issues such as informed consent, confidentiality, and privacy. (shrink)

Over the last 20+ years, multinational corporations (MNCs) have been confronted with accusations of abuse of market power and unfair and unethical business conduct especially as it relates to their overseas operations and supply chain management. These accusations include, among others, worker exploitation in terms of unfairly low wages, excessive work hours, and unsafe work environment; pollution and contamination of air, ground water and land resources; and, undermining the ability of natural government to protect the well-being of their citizens. MNCs (...) have responded to these accusations by creating voluntary codes of conduct which commit them to specific standards for addressing these issues. These codes are created at both the industry-wide and the individual company level. Unfortunately, these codes have generated little credibility and public trust because their compliance claims cannot be independently verified, and they lack transparency and full public disclosure. In this article, we present a case study of the voluntary code of conduct by Mattel, Inc., the world's largest toy company. The code, called the Global Manufacturing Principles (GMP), confronts the general criticism leveled against voluntary codes of conduct by (a) creating detailed standards of compliance, (b) independent external monitoring of the company's compliance with its code of conduct, and (c) making full, and uncensored public disclosure of the audit findings and company's response in terms of remedial action. We present a detailed account of how Mattel's voluntary code of conduct was created, implemented, and ultimately abandoned over 9 years. We provide an evaluative analysis of the company's GMP compliance throughout its life span, which suggests a bellshaped curve, where early top management commitments were met with pockets of resistance from operational groups, who were concerned about balancing GMP compliance efforts with traditional performance criteria. The early stage response from Mattel's top management was quick and supported with the requisite resources. As a result, the compliance process accelerated, becoming increasingly more robust and effective. The success of code compliance and increased transparency in public disclosure energized field managers with a sense of professional satisfaction and publicly recognized accomplishments.The decline in GMP compliance was equally steep. When all the easily attainable targets had been reached at the company-operated plants, addressing vendor plants' compliance presented a new set of challenges, which taxed corporate resources and management commitment. It would seem that value-based and ethicsoriented considerations, i. e., doing the right thing for the right reason, were no longer the driving force for Mattel's management. Mattel did not see any economic benefit from its proactive stance, when competitors did not seem to suffer adverse consequences for not following suit. The final contributing factor to the code's abandonment was a widely publicized series of product recalls which absorbed top management's attention. (shrink)

Compulsory (health) service contracts have recently received considerable attention in the normative literature. The service contracts are considered and offered as a permissible and liberal alternative to emigration restrictions if individuals relinquish their right to exit via contract in exchange for the state‐funded tertiary education. To that end, the recent normative literature on the service programmes has particularly focused on discussing the circumstances or conditions in which the contracts should be signed, so that they are morally binding on the part (...) of the skilled workers. However, little attention is devoted to the relevance of the right to exit for the debate on compulsory service programmes. In this paper, I argue that even if the service contracts are voluntary, and thus the would‐be medical students voluntarily relinquish their right to exit, the reasons behind the right should be taken into account for the contracts to be morally valid. A clear understanding of the right to exit is a must in order not to breach its basic components and for the service contracts to be morally binding. To that end, I provide two accounts of the reasons to value the right to exit by presenting Patti Lenard's discussion of the right to exit and by reconstructing James Griffin's account of human rights. I conclude by offering brief ethical considerations for compulsory health service programmes grounded in the reasons to value the right to exit. (shrink)

Considerable research evidence has accumulated indicating that there is an increased likelihood for illness and injury among employees working in long-hour schedules and schedules involving unconventional shift work. In addition, studies show that fatigue-related errors made by employees working in these kind of demanding schedules can have serious and adverse repercussions for public safety. As the result of these concerns, new protective legislation is being advocated in the United States, for instance, to restrict the hours of work among nurses and (...) other healthcare professionals. This article reviews the history of concerns about long working hours and the current scientific evidence regarding their effects on workers' health. The ethical implications of unconventional shift work and long work-hour schedules are considered. Relevant ethical considerations involve mandatory or unpaid overtime and the possibility of employer coercion, the political basis for government regulation of working hours, potential limits on voluntary assumption of risk, societal benefits accruing from the equitable distribution of available working hours, gender-based inequities related to working hours, and employer responsibilities for protecting individuals who are not employees from the spillover effects of demanding work schedules. (shrink)

Background Healthcare workers frequently face ethically demanding situations in their work, potentially leading to stress of conscience. Long-term work intensification (more and more effort demanded year after year), organizational change and COVID-19 may be risk factors concerning stress of conscience. Aims The main aim was to investigate the relationship between long-term work intensification and stress of conscience among the personnel in a healthcare organization. Organizational change management was considered a mediator and COVID-19-related work stress a moderator in the association (...) between work intensification and stress of conscience. Research design, participants and context A total of 211 healthcare district employees participated in a longitudinal survey using questionnaires collected in 2019 (major organizational change in the planning stage) and 2021 (organizational change completed). Ethical considerations The study was implemented according to the guidelines of the Finnish National Board on Research Integrity. The Finnish instructions were that no review by an ethics committee was necessary because participation was voluntary, informed consent was requested, participants were assured that they were free to withdraw from the longitudinal study at any time and no health data were collected. Findings Long-term work intensification was associated with more severe stress of conscience. Long-term work intensification was partially mediated through change management to stress of conscience. High COVID-19 stress strengthened the association between long-term work intensification and stress of conscience. Conclusions Long-term work intensification must be addressed to reduce stress of conscience in healthcare, otherwise the healthcare system will be vulnerable to changes and crisis. Extra resources for personnel and management should be allocated because of work intensification during organizational change and health crises like the COVID-19 pandemic to alleviate stress of conscience. (shrink)

Background: Nurses, social workers, and medical residents are ethically mandated to engage in policy advocacy to promote the health and well-being of patients and increase access to care. Yet, no instrument exists to measure their level of engagement in policy advocacy. Research objective: To describe the development and validation of the Policy Advocacy Engagement Scale, designed to measure frontline healthcare professionals’ engagement in policy advocacy with respect to a broad range of issues, including patients’ ethical rights, quality of care, (...) culturally competent care, preventive care, affordability/accessibility of care, mental healthcare, and community-based care. Research design: Cross-sectional data were gathered to estimate the content and construct validity, internal consistency, and test–retest reliability of the Policy Advocacy Engagement Scale. Participants and context: In all, 97 nurses, 94 social workers, and 104 medical residents were recruited from eight acute-care hospitals in Los Angeles County. Ethical considerations: Informed consent was obtained via Qualtrics and covered purposes, risks and benefits; voluntary participation; confidentiality; and compensation. Institutional Review Board approval was obtained from the University of Southern California and all hospitals. Findings: Results supported the validity of the concept and the instrument. In confirmatory factor analysis, seven items loaded onto one component with indices indicating adequate model fit. A Pearson correlation coefficient of.36 supported the scale’s test–retest stability. Cronbach’s α of.93 indicated strong internal consistency. Discussion: The Policy Advocacy Engagement Scale demonstrated satisfactory psychometric properties in this initial test. Findings should be considered within the context of the study’s limitations, which include a low response rate and limited geographic scope. Conclusion: The Policy Advocacy Engagement Scale appears to be the first validated scale to measure frontline healthcare professionals’ engagement in policy advocacy. With it, researchers can analyze variations in professionals’ levels of policy advocacy engagement, understand what factors are associated with it, and remedy barriers that might exist to their provision of it. (shrink)

This study examines the social impacts of labor-related corporate social responsibility policies or corporate codes of conduct on upholding labor standards through a case study of CSR discourses and codes implementation of Reebok - a leading branded company enjoying a high-profiled image for its human rights achievement - in a large Taiwanese-invested athletic footwear factory located in South China. I find although implementation of Reebok labor-related codes has resulted in a "race to ethical and legal minimum" labor standards when notoriously (...) inhumane and seriously illegal labor rights abuses were curbed, Chinese workers were forced to work harder and faster but, earned less payment and the employee-elected trade union installed through codes implementation operated more like a "company union" rather than an autonomous workers' organization representing worker' interests. In order to explain the paradoxical effects of Reebok labor-related codes on labor standards, I argue the result is determined by both structural forces and agency-related factors embedded in industrial, national and local contexts. To put it shortly, I find the effectiveness of Reebok labor-related codes is constrained not only by unsolved tension between Reebok's impetus for profit maximization and commitment to workers' human rights, but also by hard-nosed competition realities at marketplace, and Chinese government's insufficient protection of labor rights. Despite drawing merely from a single case study, these findings illuminate key determinants inhibiting the effectiveness of labor-related CSR policies or codes in upholding labor standards, and hence two possible way-outs of the deadlock: sharing cost for improving labor standards among key players in global supply chain; and combining regulatory power of voluntary codes and compulsory state legislations. (shrink)

This paper argues that a sweatshop worker's choice to accept the conditions of his or her employment is morally significant, both as an exercise of autonomy and as an expression of preference. This fact establishes a moral claim against interference in the conditions of sweatshop labor by third parties such as governments or consumer boycott groups. It should also lead us to doubt those who call for MNEs to voluntarily improve working conditions, at least when their arguments are based on (...) the claim that workers have a moral right to such improvement. These conclusions are defended against three objections: 1) that sweatshop workers' consent to the conditions of their labor is not fully voluntary, 2) that sweatshops' offer of additional labor options is part of an overall package that actually harms workers, 3) that even if sweatshop labor benefits workers, it is nevertheless wrongfully exploitative. (shrink)

In this review, I survey theoretical accounts of exploitation in business, chiefly through the example of low wage or sweatshop labor. This labor is associated with wages that fall below a living wage standard and include long working hours. Labor of this kind is often described as self-evidently exploitative and immoral (Van Natta 1995). But for those who defend sweatshop labor as the first rung on a ladder toward greater economic development, the charge that sweatshop labor is self-evidently exploitative fails (...) adequately to explain the nature of the alleged wrongdoing. While all sides might agree that poor working conditions are unfortunate and undesirable, defenders of sweatshop labor argue that they provide the best available employment alternative for some workers and the best chance at economic development for many low and middle income countries (LMICs). Some defenders of sweatshop labor even embrace the label of exploitation. <br><br>Unless there is a clear, widely understood account by which exploitation is a moral wrong, then charging a practice as exploitative will do little to advance debates over whether and why a practice is morally problematic. A considerable body of work has been developed applying a growing literature on exploitation to sweatshop labor. While many forms of moral wrong are associated with sweatshop labor, I will focus specifically on the worry that low wages allow relatively wealthy employers wrongfully to take advantage of or gain from relatively poor workers, especially in LMICs. In particular, I will focus on instances of alleged exploitation in employment relationships that are voluntary and mutually beneficial. I have two reasons for doing so. First, by restricting this review to voluntary and mutually beneficial instances of exploitation, I can isolate the moral wrong of exploitation from other moral wrongs, especially the wrongs of coercion and outright harms to workers. Second, the focus on mutually beneficial and voluntary relationships will allow for arguments that sweatshop labor is not only not exploitative, but is a morally praiseworthy means of helping to encourage economic growth in poor areas of the world and to provide jobs that pay better and are more stable than any existing alternatives.<br><br>In this review, I aim to accomplish three goals. First, I will provide an overview of the many different uses of the charge of exploitation in business practice through an examination of the uses of the term in the literature on sweatshop labor. While it is often not clear what kind of moral wrong is assumed to take place when the charge of exploitation is used, I will demonstrate that many distinct types of exploitation, connected to distinct moral wrongs, are used in the literature on sweatshop labor and elsewhere in business ethics. Specifically, I will identify two broad categories of exploitation—exploitation as unfairness and exploitation as the mere use of others—with subgroups under each main category of exploitation. Second, I will discuss which of these senses of exploitation are defensible as identifying clear moral wrongs that take place in the context of business and, specifically, sweatshop labor. As I will argue, not all uses of the charge of exploitation are capable of persuasively identifying clear moral wrongs. Moreover, there is not a single, clear type of exploitation that takes place in business but, rather, several distinct forms. Third, I will apply the lessons learned from my exploration of exploitation in sweatshop labor to other specific areas of business. As I will argue, there are multiple viable models of exploitation in the sweatshop literature that can illuminate exploitative practices of relatively well compensated employees, customers, suppliers, and entire communities. <br><br>While discussions of theories of exploitation tend to argue for a single, correct account of this moral wrong, my review of the literature on exploitation in sweatshop labor supports the conclusion that there are multiple defensible accounts of the moral wrong of exploitation. For this reason, those who would charge that a relationship is exploitative should specify the form of exploitation that they believe is taking place. (shrink)

Corporations have increasingly turned to voluntary, multi-stakeholder governance programs to monitor workers’ rights and standards in global supply chains. This article argues that the emphasis of these programs varies significantly depending on stakeholder involvement and issue areas under examination. Corporate-influenced programs are more likely to emphasize detection of violations of minimal standards in the areas of wages, hours, and occupational safety and health because focusing on these issues provides corporations with legitimacy and reduces the risks of uncertainty created (...) by activist campaigns. In contrast, these programs are less likely to emphasize workers’ rights to form democratic and independent unions, bargain, and strike because these rights are perceived as lessening managerial control without providing firms with significant reputational value. This argument is explored by coding 805 factory audits of the Fair Labor Association between 2002 and 2010, followed by case studies of Russell Athletic in Honduras, Apple in China, and worker rights monitoring in Vietnam. (shrink)

The large, professionally managed corporation is the distinctive economic institution of the twentieth century. It has proved uniquely effective in mobilizing resources and knowledge; increasing productivity; and creating new technologies, products, and services. Corporations have proliferated and grown because they meet the needs of various members of society: customers, workers and communities, as well as investors. The worldwide spread of corporate activity has produced an increasingly integrated and interdependent global economy.The success of the corporation, however, inevitably gives rise to (...) questions and criticisms. Corporations are spontaneous and voluntary associations in which diverse individuals and interests collaborate for the creation and distribution of wealth. Some critics question whether organizations with the vast scale and scope of contemporary multinationals can be effectively controlled and directed toward these purposes. Others are concerned about the limited range of interests directly represented in corporate governance, and the lack of openness in corporate decision-making. And, as multinational corporations expand their activities and linkages, both corporate managers and their critics search for principles for action that transcend national borders and cultural values, and modes of operation that will achieve the broad purposes of the corporation on a long-term and sustainable basis, without undue conflict with diverse human and social norms. (shrink)

Abstract In this paper, I pursue the question whether extending democratic rights to work is good in the broadest possible sense of that term: good for workers, firms, market economies, and democratic states. The argument makes two assumptions in a broadly consequentialist framework. First, the configuration of any relationship among persons in which there is less rather than more coercion makes individuals better off. Second, extending democratic rights to work will entail costs and benefits to both the power and (...) authority of employers and meaningful work for employees. These costs and benefits cannot be determined in advance because they are largely empirical, but there are still good reasons for expanding worker participation all-things-considered. First, I examine the parallel case for extending democratic rights to the workplace based on several similarities between politics and work organization. In addition, I consider the objections from voluntariness and efficiency. Although both objections raise interesting problems I believe that a properly formulated conception of democratic workplaces can answer them. In the final section, I sketch a minimal conception of these rights at the level of the firm that does not require a large-scale transformation of the market economy. (shrink)

Sweatshop labour is sometimes defended from critics by arguments that stress the voluntariness of the worker’s choice, and the fact that sweatshops provide a source of income where no other similar source exists. The idea is if it is exploitation—as their opponents charge—it is mutually beneficial and consensual exploitation. This defence appeals to the non-worseness claim (NWC), which says that if exploitation is better for the exploited party than neglect, it cannot be seriously wrong. The NWC renders otherwise exploitative—and therefore (...) morally wrong—transactions permissible, making the exploitation of the global poor a justifiable path to development. In this paper, I argue that the use of NWC for the case of sweatshops is misleading. After reviewing and strengthening the exploitation claims made concerning sweatshops, most importantly by refuting certain allegations that a micro-unfairness account of exploitation cannot evaluate sweatshop labour as exploitative, I then argue that even if this practice may seem permissible due to benefits otherwise unavailable to the global poor, there remains a duty to address the background conditions that make this form of wrong-doing possible, which the NWC cannot accommodate. I argue that the NWC denies this by unreasonably limiting its scope and is therefore incomplete, and ultimately unconvincing. (shrink)

It is widely thought that firms that employ workers in “sweatshop” conditions wrongfully exploit those workers. This claim has been challenged by those who argue that because companies are not obligated to hire their workers in the first place, employing them cannot be wrong so long as they voluntarily accept their jobs and genuinely benefit from them. In this article, I argue that we can maintain that at least many sweatshop employees are wrongfully exploited, while accepting the (...) plausible claim at the core of many defenses of sweatshops, namely that engaging in a voluntary and mutually beneficial transaction with a person in need cannot constitute morally worse treatment of that person than doing nothing at all to benefit her. We can do this, I claim, by accepting that wealthy multinational corporations have positive duties to employ or otherwise benefit the global poor. I argue that these duties can be plausibly grounded in the fact that potential sweatshop workers are victims of global structural injustice, from which multinational corporations typically benefit. (shrink)

Insofar as John Stuart Mill can be accurately described as a socialist, his is a socialism that a classical liberal ought to be able to live with, if not to love. Mill's view is that capitalist economies should at some point undergo a `spontaneous' and incremental process of socialization, involving the formation of worker-controlled `socialistic' enterprises through either the transformation of `capitalistic' enterprises or creation de novo. This process would entail few violations of core libertarian principles. It would proceed by (...) way of a series of voluntary transactions. Capitalists' property rights would be respected throughout. The process would take place within a national system of laws that permits private ownership of productive property and competition, and would not result in that system's overthrow. And, if we accept some basic tenets of Mill's social philosophy, the outcome at which we should expect the process to arrive is a `patchwork' economy in which capitalistic and socialistic enterprises exist side by side. Key Words: Ludwig von Mises • John Stuart Mill • socialism • capitalism • worker control. (shrink)

Over the last 20+ years, multinational corporations have been confronted with accusations of abuse of market power and unfair and unethical business conduct especially as it relates to their overseas operations and supply chain management. These accusations include, among others, worker exploitation in terms of unfairly low wages, excessive work hours, and unsafe work environment; pollution and contamination of air, ground water and land resources; and, undermining the ability of natural government to protect the well-being of their citizens. MNCs have (...) responded to these accusations by creating voluntary codes of conduct which commit them to specific standards for addressing these issues. These codes are created at both the industry-wide and the individual company level. Unfortunately, these codes have generated little credibility and public trust because their compliance claims cannot be independently verified, and they lack transparency and full public disclosure. In this article, we present a case study of the voluntary code of conduct by Mattel, Inc., the world’s largest toy company. The code, called the Global Manufacturing Principles, confronts the general criticism leveled against voluntary codes of conduct by creating detailed standards of compliance, independent external monitoring of the company’s compliance with its code of conduct, and making full, and uncensored public disclosure of the audit findings and company’s response in terms of remedial action. We present a detailed account of how Mattel’s voluntary code of conduct was created, implemented, and ultimately abandoned over 9 years. We provide an evaluative analysis of the company’s GMP compliance throughout its life span, which suggests a bell-shaped curve, where early top management commitments were met with pockets of resistance from operational groups, who were concerned about balancing GMP compliance efforts with traditional performance criteria. The early stage response from Mattel’s top management was quick and supported with the requisite resources. As a result, the compliance process accelerated, becoming increasingly more robust and effective. The success of code compliance and increased transparency in public disclosure energized field managers with a sense of professional satisfaction and publicly recognized accomplishments. The decline in GMP compliance was equally steep. When all the easily attainable targets had been reached at the company-operated plants, addressing vendor plants’ compliance presented a new set of challenges, which taxed corporate resources and management commitment. It would seem that value-based and ethics-oriented considerations, i.e., doing the right thing for the right reason, were no longer the driving force for Mattel’s management. Mattel did not see any economic benefit from its proactive stance, when competitors did not seem to suffer adverse consequences for not following suit. The final contributing factor to the code’s abandonment was a widely publicized series of product recalls which absorbed top management’s attention. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary (...) and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

Much of the recent discussion in progressive circles [e.g., Stiglitz; Galbraith; Piketty] has focused the obscene mal-distribution of wealth and income as if that was "the" problem in our economic system. And the proposed redistributive reforms have all stuck to that framing of the question. To put the question in historical perspective, one might note that there was a similar, if not more extreme, mal-distribution of wealth, income, and political power in the Antebellum system of slavery. Yet, it should be (...) obvious to modern eyes that redistributions in favor of the slaves, while leaving the institution of owning workers intact, would not address the root of the problem. The system of slavery was eventually abolished in favor of the system we have today which differs in two important respects: the workers are only rented, hired, or employed ; and the rental relationship between employer and employee is voluntary. Today, the root of the problem is the whole institution for the voluntary renting of human beings, the employment system itself, not the terms of the contract or the accumulated consequences in the form of the mal-distribution of income and wealth. (shrink)

Production in sweatshops entails an elevated risk of occupational injury and sickness due to accidents and exposure to dangerous working conditions. As most sweatshop locations lack basic social security systems, health problems have severe consequences for affected workers. Against this background, this article considers what obligations employers of sweatshop labor have to their workers, and how they should meet them. Based on core libertarian concepts, it shows that they are morally responsible for health problems caused by their management (...) decisions, that they should compensate affected workers, and that they must prevent potentially irreversible health problems. In line with Nozick’s contractarian method, the article further argues that these obligations should be implemented through a compulsory employment injury insurance system. Such a system would impose industry-wide health and safety standards, in contrast to the view that libertarianism excludes any labor regulation for the protection of workers, as an illegitimate interference in voluntary labor contracts. (shrink)

Widespread concerns about the long-term fiscal gap in Social Security have prompted various proposals for structural reform, with individual accounts as the centerpiece. Carving out individual accounts from the existing system would shift significant risks and responsibilities to individual workers. A parallel development has already occurred in the area of private pensions. Experience with 401 plans indicates that many workers will have difficulty making prudent decisions concerning investment and withdrawal of funds. Moreover, in implementing any system of (...) class='Hi'>voluntary individual accounts, it will be important to design default settings that provide appropriate guidance for workers with heterogeneous levels of financial sophistication and risk tolerance. The central goal of Social Security reform should be to close the fiscal gap in a way that preserves rather than undermines the existing system of mandatory defined benefits for all workers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.4 (2004) 411-425 [Access article in PDF] Vulnerability, Vulnerable Populations, and Policy Mary C. Ruof "Special justification is required for inviting vulnerable individuals to serve as research subjects and, if they are selected, the means of protecting their rights and welfare must be strictly applied."Guideline 13: Research Involving Vulnerable Persons International Ethical Guidelines for Biomedical Research Involving Human Subjects Council for International Organizations of (...) Medical Sciences (CIOMS) and World Health Organization (WHO) Geneva, Switzerland, 2002 Within medical research and healthcare certain groups are afforded special protections and services because of their designation as vulnerable. The vulnerable require special justification to participate in human subject research in order to eliminate potential human rights abuses. The Nuremberg Code of 1947 was written in response to the extreme human subject abuses that occurred under the Nazi regime, and, although the intent of the 1947 Code was to protect human rights, rigid voluntary consent requirements deprived some individuals of the right to participate in clinical trials. Recent human research guidelines, such as the CIOMS/WHO guidelines referenced above and the guidelines referenced in Section V of this Scope Note, attempt to balance both protection from abuse in research and access to new, experimental treatments for the vulnerable.Although various protective guidelines stipulate special protections for vulnerable populations, the concept of vulnerability and consequently the criteria designating vulnerable populations remain vague. Precisely who are the vulnerable? The word "vulnerability" stems from the Latin vulnerare, "to wound." (Oxford Encyclopedic English Dictionary 1995). In clinical research, the term [End Page 411] vulnerable generally is applied to individuals who are unable to give informed consent or who are susceptible to coercion. The Common Rule (45 CFR 46, Subpart A) includes as vulnerable research subjects: children, prisoners, pregnant women, and persons who are handicapped, mentally disabled, economically disadvantaged, or educationally disadvantaged. Although the Common Rule specifies certain vulnerable categories, the guidelines were not intended to be exclusive, leaving open the interpretation of vulnerability.In medical research and health policy, vulnerability is an abstract concept that has concrete effects both for those labeled vulnerable and for those not. Clinical researchers, healthcare workers, ethical reviewers, and policymakers must be able to identify vulnerable subjects to establish how healthcare resources will be allocated and who will qualify for special protections and socialized benefits. Attempts to quantify vulnerability in clear, measurable ways have met little if any consensus. As Alexander Morawa (II, 2003, p. 150) states, "There is no single approach to definition of vulnerability. In fact, there is no purposeful categorisation at all."Difficulties in defining vulnerability have prompted discourse surrounding its utility as a qualifying factor in the allocation of health resources and its appropriateness as a guiding principle in bioethics. Some of the authors cited in this Scope Note argue against the labeling and categorization of vulnerable individuals and populations. "Labeling individuals as 'vulnerable' risks viewing vulnerable individuals as 'others' worthy of pity, a view rarely appreciated" (III, Danis and Patrick 2002, p. 320). The categories of vulnerable groups listed under the Common Rule have been the source of controversy, "for example, many find the suggestion that pregnant women are vulnerable to be quite sexist" (IV, DeBruin 2001, p. 7). Instead of creating categories of vulnerable populations, would it not be better to derive an account of just treatment from a just social policy at large that encompasses human vulnerabilities (II, Brock 2002, p. 283).For some of the authors listed here, the concept of vulnerability is essential to bioethics. Robert Goodin (I, 1985, p. 107) writes that the vulnerability of other human beings is the source of our special responsibilities to them. In contrast to the four American principles of biomedical ethics—autonomy, nonmaleficence, beneficence, and justice—the four principles of European bioethics and biolaw include vulnerability along with autonomy, dignity, and integrity. According to, Jacob Dahl Rendtorff and Peter Kemp (I, 2000, p. 274) "the principle of vulnerability is ontologically prior to the other [European] principles, it expresses better than all of the other ethical principles... the finitude of the human condition."Some of the... (shrink)

With advances in medical technology, the potential uses for human blood have proliferated, and in turn, so has the demand for blood. Blood and blood products circulate in a medical marketplace as a `good' that can be bought and sold to meet various health and commercial demands. Nevertheless, its point of origin — or `production' — remains the individual human body, and reliance on voluntary blood donation remains a cornerstone for meeting this growing market demand. This article examines the (...) contradictions surrounding blood donation in the ethnographic context of contemporary urban China. Specifically, it focuses on both how the circulation of blood outside the individual body interfaces with its circulation in the Chinese social body, and how individual Chinese conceptualize their acts of donation in this process. In ethnographic interviews for this project, many urbanites describe donation as both voluntary and as meeting a social obligation. Yet their donation practices remain structured by meeting work unit quotas and are compensated with monetary and food donations and paid time off. Their descriptions of the mechanisms for motivating and compensating donors echo the socialist calls for contributing to society's greater good typical of the Maoist era propaganda. These descriptions highlight the complexities of sociocultural change in what has come to be described in much of the literature as a `postsocialist' Chinese society characterized by a burgeoning consumer culture and increasing emergence of individual autonomy. Our interviews suggest that the socialist workplace remains a critical social and economic structure in China through which workers' production is transformed into a social `good'. This transformation originates within the individual bodies of workers (not on the factory floor) and is extracted through exhortations to contribute to better society via the work unit and one's obligations to the work unit. Rather than a shift to individual autonomy and self-improvement, or a re-emergence of traditional values — both of which have been described as hallmarks of the postsocialist era — this process highlights the role that the socialist work unit plays in defining Chinese citizenship, consumer culture and embodied desires. (shrink)

BackgroundA requisite for ethical human subjects research is that participation should be informed and voluntary. Participation during the informed consent process by way of asking questions is an indicator of the extent to which consent is informed.AimsThe aims of this study were to assess the extent to which parents providing consent for children's participation in an observational tuberculosis (TB) research study in India actively participated during the informed consent discussion, and to identify correlates of that participation.MethodsIn an observational cohort (...) study of tuberculosis in infants in South India, field supervisors who were responsible for obtaining informed consent noted down questions asked during the informed consent discussions for 4,382 infants who were enrolled in the study. These questions were post-coded by topic. Bivariate and multivariate analysis was conducted to examine factors associated with asking at least one question during the informed consent process.ResultsIn total, 590 out of 4,382 (13.4%) parents/guardians asked any question during the informed consent process. We found that the likelihood of parents asking questions during the informed consent process was significantly associated with education level of either parent both parents being present, and location.ConclusionsThe findings have implications for planning the informed consent process in a largely rural setting with low levels of literacy. Greater effort needs to be directed towards developing simple participatory communication materials for the informed consent process. Furthermore, including both parents in a discussion about a child's participation in a research study may increase the extent to which consent is truly informed. Finally, continuing efforts need to be made to improve the communication skills of research workers with regard to explaining research processes and putting potential research participants at ease. (shrink)