There is a long-standing philosophical discussion about the relationship between love and choice. The most simplistic versions see love as something one “falls” into, without any choice at all. A more sophisticated account of love would accommodate some degree of indirect choice: I feel an initial interest, and choose to seek her out more. I can also choose to create and sustain the conditions that support love, for example, by avoiding infidelity and long commutes. However, such indirect choices are (...) relatively discrete or time-limited. In contrast, I want to explore a more temporally extended kind of choice, which starts when I take responsibility for the other. This is an attitude involving a prospective commitment, an achievement of the imagination, and an active concern. I argue that one essential requirement of longer-term adult romantic and friendly love is precisely that the lover takes responsibility for meeting the beloved’s unpredictable and possibly onerous needs in the future. (shrink)

The aim of this article is to reveal how care workers in the home-help services handle the process when older people’s relocation to a residential home is under consideration. Since the care workers are engaged daily in defining care receivers’ needs and yet have no formal influence on care decisions in Sweden, the focus is on how they solve this dilemma. In this inductive study, the theoretical framework is based on occupational alliances, relationship-based practice, and discretion. Thirty-three care workers in (...) home-help services are included in open semi-structured interviews. Prominent features in the findings are that the care workers take their stand at the borderland of care management, when they know or try to find out what is right. The conclusions drawn are that care workers find ways to informally influence the decision-making process, quite contrary to the idea of approaches referred to as purchaser/provider models. The implications for social work policy and practice are that a distinction between assessment and intervention may not benefit the field of eldercare and should therefore be regarded as an area in need of thorough reconsideration. (shrink)

Discrete choice experiments (DCE) are often used to elicit preferences, for instance, in health preference research. However, DCEs only provide binary responses, whilst real-life choices are made with varying degrees of conviction. We aimed to verify whether eliciting self-reported convictions on a 0–100 scale adds meaningful information to the binary choice. Eighty three respondents stated their preferences for health states using DCE and the time trade-off method (TTO). In TTO, utility ranges were also elicited to account for preference (...) imprecision. We verified the properties of the conviction across three areas: (1) response to various choice task modifications (e.g. dominance, increase in complexity, distance from the status quo) and association with rationality violations (e.g. intransitivity); (2) association with test–retest results; (3) relation to the utility difference and imprecision estimated in TTO. Regarding (1), conviction increased in choice tasks with lower complexity, larger relative attractiveness, and lower distance to the status quo. Regarding (2), choices made with above-median conviction were sustained in 90% of the cases, compared to 68% for below-median conviction. Regarding (3), the conviction increases with utility difference and it decreases with utility imprecision; overconfidence seems to prevail: non-zero conviction is reported even for identical utilities. Self-reported conviction in DCE is associated in an intuitive way with the observed choices. It may, therefore, be useful in explaining or predicting behaviour or bridging the gap between the results of various elicitation tasks. (shrink)

In this article I argue that Part II of the Family LawAct 1996 gives expression to a new form ofresponsibility. I begin by suggesting thatresponsible behaviour has shifted from prohibiting orrequiring particular actions: we now exhibitresponsibility by our attitude towards our actions. I then examine where this new conception ofresponsibility has come from. Through an examinationof the work of post-liberal theorists, principallyMichael Sandel, I argue that a changing view ofpersonhood within post-liberal theory has led to aquestioning of the possibility of (...) choice, and that theabsence of choice necessitates a shift in thedefinition of responsible behaviour. If we are createdby our decisions then we cannot be held to account forour decisions, but only for the care we have takenover them. Responsibility is therefore measured notby our level of self-control but by our level ofself-awareness. Finally I examine the consequences ofthis shift in the meaning of responsibility. Withinthis framework autonomy is illusory thereforedecisions do not need to be respected. This explainswhy the implementation of Part II of the Family LawAct 1996 has been called into question. Within thisframework responsibility is relative therefore itextends indefinitely. This enables the Family Law Actto be uniquely intrusive and judgmental: everydivorcing couple, on being held up to scrutiny, isfound lacking. (shrink)

This essay presents an in-depth interpretation of the controversial dialogue in Analects 13.18 through careful and critical investigation of its historical background and philosophical significations. With a clarification of the multifaceted connotations of the word zhi (?, upright, forthright), my study brings out the play of irony in Confucius's words in Analects 13.18. According to my interpretation, not only is Confucius's reaction not inappropriate but it also demonstrates the art of early Confucian moral discretion that was informed by the teaching (...) of quan (? moral discretion). Accordingly, Confucius's judgment of the case embodied a high and bright middle way of moral choice originating in the openness and sincerity of heart. It epitomized a singular moment of deliberation and decision that was responsible for a sinuous opening of piety and individuality within the interplay of conflicting conditions and requisitions. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS I. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[i] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[ii] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. II. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[iii] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[iv] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[v] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[vi] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[vii] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[viii] In democratic societies, one must take into consideration community morals and values.[ix] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[x] III. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[xi] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[xii] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[xiii] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[xiv] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. IV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[xv] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[xvi] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[xvii] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[xviii] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[xix] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[xx] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[xxi] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. VI. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[xxii] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[xxiii] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[xxiv] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. VII. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [i] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [ii] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [iii] Moss, p. 1295-1298. [iv] Moss, p. 1296. [v] Moss, p. 1295-1298. [vi] Moss, p. 1295-1298. [vii] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [viii] Cohen, p. 1299-1301. [ix] Moss, p. 1297. [x] Cohen, p. 1300. [xi] Cappelen, p. 478-480. [xii] Cappalen, p. 478-480. [xiii] Cappelen, p.479. [xiv] Cappelen, p. 479. [xv] Cappelen, p. 479 [xvi] Cohen, p. 1301. [xvii] Cappelen, p. 478. [xviii] Cohen, p. 1299-1301. [xix] Cohen, p. 1301. [xx] Cappelen, p. 476-480. [xxi] Cappelen, p. 476-480. [xxii] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [xxiii] Kawachi, p. 18-33. [xxiv] Kawachi, p. 18-33. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS l. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[1] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[2] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. ll. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[3] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[4] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[5] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[6] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[7] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[8] In democratic societies, one must take into consideration community morals and values.[9] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[10] lll. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[11] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[12] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[13] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[14] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. lV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[15] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[16] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[17] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[18] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[19] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[20] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[21] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. Vl. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[22] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[23] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[24] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. Vll. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [1] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [2] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [3] Moss, p. 1295-1298. [4] Moss, p. 1296. [5] Moss, p. 1295-1298. [6] Moss, p. 1295-1298. [7] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [8] Cohen, p. 1299-1301. [9] Moss, p. 1297. [10] Cohen, p. 1300. [11] Cappelen, p. 478-480. [12] Cappalen, p. 478-480. [13] Cappelen, p.479. [14] Cappelen, p. 479. [15] Cappelen, p. 479 [16] Cohen, p. 1301. [17] Cappelen, p. 478. [18] Cohen, p. 1299-1301. [19] Cohen, p. 1301. [20] Cappelen, p. 476-480. [21] Cappelen, p. 476-480. [22] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [23] Kawachi, p. 18-33. [24] Kawachi, p. 18-33. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 12.2 (2004) 181-186 [Access article in PDF] Response to June Boyce-Tillman, "Towards an Ecology of Music Education" Claudia Gluschankof Levinsky College of Education, Israel I begin with two confessions. First, music was not my favorite class at school. I cannot even recall what we did there. It did not at all connect with the powerful, meaningful place that music had in my private (...) life, where I loved to sing with my family, and play and sing in ensembles in classes at a private music school. The private piano lessons were fine, but I found no joy in practicing on my own. Music was for me-and still is-a communal experience, associated with personal choice. School did not, and probably could not, provide that.Second, during a recent marketing meeting at the college where I teach and work, I finally said aloud, "I am not sure that I can market a product in which I don't believe." Being a teacher in overcrowded, resource-poor schools where parents are less involved yet more interfering and being expected to conform to standards and to act more as a producer of school ceremonies and festivals and less as a music educator is not a profession I would recommend entering. Boyce-Tillman's paper offers a model for music education in which the corrective emotional experience, in my own case, becomes a remedial object lesson in the setting of the music classroom and a reason to recommend music school teaching as a rewarding profession.Boyce-Tillman calls us to conceive of music "as intimately related to human society and the environment rather than as a discrete and separated category of knowing." Her position is in tune with Christopher Small's coined term "musicking": The act of musicking establishes in the place where it is happening a set of relationships, and it is in those relationships that the meaning of the act lies. They are to be found not only between those organized sounds which are [End Page 181] conventionally thought of as being the stuff of musical meaning but also between the people who are taking part, in whatever capacity, in the performance; and they model, or stand as metaphor for, ideal relationships as the participants in the performance imagine them to be: relationships between person and person, between individual and society, between humanity and the natural world and perhaps the supernatural world.1The five interlocking areas proposed in Boyce-Tillman's model are present in Small's musicking: the relationships among the sounds parallel the area called Materials; the relationships between people and sounds may parallel the area called Expression, which refers to the personal meaning given to the organized sounds. "In the area of Construction, effectiveness often depends on the right management of repetition and contrast within a particular idiom." Such a particular idiom is part of the style ideal of a particular culture. It is defined in terms of form and content, and expresses some inner quality of the society that produced it. The style ideal can be characterized by different factors (for example, historical period, geographic location, school, manner of performance, individual composer, and so on) and can be examined in terms of musical components (form, texture, harmony, melody).2According to Boyce-Tillman, the area of Values "is related to the context of the music-making experience. All musical experiences are culturally related." Because values are shared by groups, I found this present in the relationships be-tween a subculture and the larger society, in its broader meaning. The fifth area is Spirituality, defined by Boyce-Tillman as "the ability to transport the audience to a different time/space dimension." That different time/space dimension may be understood as the supernatural world, referred to by Small.Small sees the greatest challenge to music educators today to be that of providing "that kind of social context for informal as well as formal musical interaction that leads to real development and to the musicalizing of the society as a whole,"3... (shrink)

This research investigated whether perceived situational appropriateness (defined as the degree of fit between product and intended usage situations) is predictive of consumer choices for foods and beverages, on the theoretical premise that intended usage situation acts as a frame of reference in orienting choices. Extant research on the topic, though suggestive of a link, is very limited in scope and almost completely lacking with regards to choice behaviour (as opposed to other aspects such as food acceptability or (...) intake). To address the hypotheses, data collected in a series of 15 experiments ($N= 2731$ consumers in total) -- covering a wide range of product categories and usage situations -- are presented. In all studies, participants evaluated a set of stimuli varying with respect to perceived appropriateness (low to high), and evaluated each stimulus either monadically using a choice likelihood scale or by performing a discrete choice task. Regression analyses from all studies consistently indicated that perceived appropriateness significantly predicted choice response. The results were robust with respect to variation in product category and experimental protocol and, overall, strongly support the notion that appropriateness can provide a simple yet powerful (in some case accounting for over 50\% of variance) predictor of consumer choice. Effect sizes varied substantially: perceived appropriateness explained from a minimum of 3\% to over 65\% of variance in consumer choice, and this variation was linearly related to the degree of product heterogeneity in the product sets. This research also investigated possible moderators of the link between appropriateness and choice, by relating the results to consumers’ product familiarity and involvement. While both traits significantly (and positively) affected choice, they did not interact with appropriateness. Possible explanations for these results, as well as other possible candidate moderators to explore in future research, are highlighted. (shrink)

Research Articles Michael S. Moore, Social Philosophy and Policy, FirstView Article.

This collection of case studies in public management bridges the gap between mainstream CSR - confined to the for-profit corporations - and the vast bodies of workers and organizations that make up government and its public administration. The variety and discretion of managerial endeavours in public management calls for accountability and responsibility of government beyond current legal instruments: The book argues that CSR must be brought to bear with government. In government in fact, knowledge management is not a linear process, (...) but the result of working with passion of the parts, implying discretionary behaviour and creativity which in turn imply choice and responsibility. Cases ranging from the USA to Central America, New Zealand and Europe all confirm the complex nature of public management, entailing partnership synergy for disaster recovery, the intertwined link between management and new technology and mindfulness at individual level. The cases are set in a framework by theoretical essays on bureaucratic behaviour and unknown stakeholders. Public-sector management has long drawn upon principles, tools, and techniques developed in the private sector, aiming to infuse bureaucracies with touches of efficiency and productivity. But good governance is also central to good management. This fascinating, wide-ranging volume shows how ideas from the Corporate Social Responsibility movement apply to the governance and administration of public agencies. A series of detailed and informative case studies, written by researchers and practitioners with deep knowledge of their industries and agencies, explores the challenges of managing public and government agencies in a socially responsible manner. The book offers a nuanced and balanced portrait that calls for greater public involvement and oversight in keeping public organizations on track. Highly recommended! Peter G. Klein University of Missouri Norwegian School of Economics and Mises Institute Here are six compelling case studies that reveal the relevance, even the imperative, of Corporate Social Responsibility (CSR) in the public sector. In doing so, the authors simultaneously expand the role of CSR and provide us with a refreshed concept of government and public management. The authors then lay the theoretical groundwork for their observations in ways that enrich our understanding of both CSR and the evolving roles of government in our lives. This is "must reading" for corporate officers and for public managers. Thomas R. Sexton Stony Brook University, NY College of Business and School of Professional Development. (shrink)

We report on five experiments investigating response choices and response times to simple science questions that evoke student “misconceptions,” and we construct a simple model to explain the patterns of response choices. Physics students were asked to compare a physical quantity represented by the slope, such as speed, on simple physics graphs. We found that response times of incorrect answers, resulting from comparing heights, were faster than response times of correct answers comparing slopes. (...) This result alone might be explained by the fact that height was typically processed faster than slope for this kind of task, which we confirmed in a separate experiment. However, we hypothesize that the difference in response time is an indicator of the cause of the response choice. To support this, we found that imposing a 3-s delay in responding increased the number of students comparing slopes on the task. Additionally a significant proportion of students recognized the correct written rule , but on the graph task they incorrectly compared heights. Finally, training either with repetitive examples or providing a general rule both improved scores, but only repetitive examples had a large effect on response times, thus providing evidence of dual paths or processes to a solution. Considering models of heuristics, information accumulation models, and models relevant to the Stroop effect, we construct a simple relative processing time model that could be viewed as a kind of fluency heuristic. The results suggest that misconception-like patterns of answers to some science questions commonly found on tests may be explained in part by automatic processes that involve the relative processing time of considered dimensions and a priority to answer quickly. (shrink)

In a task requiring speeded bidirectional responses to arrow symbols , “free choice” responses to interspersed bidirectional stimuli are influenced by masked directional primes . By varying stimulus–response compatibility, we tested whether this priming effect is mediated by the conscious instructional set, or instead by pre-existing directional associations to the symbols. In two experiments, one group of participants was instructed to respond with the hand consistent with the implied direction of the arrow symbols, while another group was instructed to (...) make the spatially opposite responses. Both groups showed priming of “free choice” responses. However, such priming was always biased according to the instructional set rather than pre-existing associations. Subliminal priming of “free choice” responses therefore depends on conscious task goals. (shrink)

There is a concern that the widespread deployment of autonomous machines will open up a number of ‘responsibility gaps’ throughout society. Various articulations of such techno-responsibility gaps have been proposed over the years, along with several potential solutions. Most of these solutions focus on ‘plugging’ or ‘dissolving’ the gaps. This paper offers an alternative perspective. It argues that techno-responsibility gaps are, sometimes, to be welcomed and that one of the advantages of autonomous machines is that they enable us to embrace (...) certain kinds of responsibility gap. The argument is based on the idea that human morality is often tragic. We frequently confront situations in which competing moral considerations pull in different directions and it is impossible to perfectly balance these considerations. This heightens the burden of responsibility associated with our choices. We cope with the tragedy of moral choice in different ways. Sometimes we delude ourselves into thinking the choices we make were not tragic ; sometimes we delegate the tragic choice to others ; sometimes we make the choice ourselves and bear the psychological consequences. Each of these strategies has its benefits and costs. One potential advantage of autonomous machines is that they enable a reduced cost form of delegation. However, we only gain the advantage of this reduced cost if we accept that some techno-responsibility gaps are virtuous. (shrink)

Self-regulatory processes have predominantly been linked to the study of academic achievement in terms of learning behavior, cognitive engagement, and specific academic performance measures. If poorly regulated, academic behavior can have repercussions on social adaptation. Motivational processes constitute the other key element in ensuring successful regulation, as studies indicate that self-regulation can effectively influence achievement outcomes if learners have positive beliefs about their personal ability to negotiate difficulties and work towards the desired learning outcomes. This book takes a critical look (...) at the role of self-regulatory processes and personal agency beliefs in academic and social self-regulatory functioning, providing the reader with theoretical understanding of the issues and lending empirical support to the relevance of these processes in the East Asian educational context. In this way, the study explores the extent to which self-regulation and personal agency beliefs can offer an alternative explanation for the academic performance of students. (shrink)

ABSTRACT: This paper serves two purposes: (i) it can be used by students as an introduction to chapters 1-5 of book iii of the NE; (ii) it suggests an answer to the unresolved question what overall objective this section of the NE has. The paper focuses primarily on Aristotle’s theory of what makes us responsible for our actions and character. After some preliminary observations about praise, blame and responsibility (Section 2), it sets out in detail how all the key notions (...) of NE iii 1-5 are interrelated (Sections 3-9). The setting-out of these interconnections makes it then possible to provide a comprehensive interpretation of the purpose of the passage. Its primary purpose is to explain how agents are responsible for their actions not just insofar as they are actions of this kind or that, but also insofar as they are noble or base: agents are responsible for their actions qua noble or base, because, typically via choice, their character dispositions are a causal factor of those actions (Section 10). The paper illustrates the different ways in which agents can be causes of their actions by means of Aristotle’s four basic types of agents (Section 11). A secondary purpose of NE iii 1-5 is to explain how agents can be held responsible for consequences of their actions (Section 12), in particular for their character dispositions insofar as these are noble or base, i.e. virtues or vices (Section 13). These two goals are not the only ones Aristotle pursues in the passage. But they are the ones Aristotle himself indicates in its first sentence and summarizes in its last paragraph; and the ones that give the passage a systematic unity. The paper also briefly consider the issues of freedom-to-do-otherwise, free choice and free-will in the contexts in which they occur (i.e. in the final paragraphs of Sections 6, 7, 12, 13). (shrink)

In today's world, businesses are involved in several different initiatives to gain sustainable performance, which can discourse the expectations and demands of society. Emerging economics faces numerous challenges in terms of social, relational, governance, and financial, which made it necessary for firms to perform responsibly in order to make positive contributions toward sustainability. Therefore, this study based on upper-echelon theory constructs a comprehensive framework on responsible leadership, corporate social responsibility, and managerial discretion to provide the guideline for business sustainability. To (...) fulfill the study purpose, an empirical analysis was performed on 382 Pakistani respondents' data by using PLS-SEM through SmartPLS. Outcomes of the study indicated that responsible leadership entails enormous importance in corporations to influence their impact on society, environment, and economy, which leads to business sustainability. Moreover, the study provides insights into that more responsible and experienced leaders are better able to identify the concerns of their firm's stakeholders in the manners of relational, governing, and orientational perspectives, which help them in satisfying the stakeholders' and society's demands. Hence, responsible leadership enables the firm to better strive for sustainability by applying better CSR activities and directing the decisions by maintaining the compliance of the managers. Furthermore, the current study concluded that the managers and leaders of firms need to develop their business models in such a way that it supports the triple bottom line performance of the firm so that they can achieve sustainability. This study would help managers of firms to realize that they should reexamine their leadership practices and behaviors with the consideration of the triple bottom line framework and integrate the sustainable approach and CSR practice into their business strategy so that they can accomplish the goal of sustainability for business and fulfill the social demands and expectations. (shrink)

Patients are generally assumed to have the right to choices about treatment, including the right to refuse treatment, which is constrained by considerations of cost‐effectiveness. Independently, many people support the idea that patients who are responsible for their ill health should incur penalties that non‐responsible patients do not face. Surprisingly, these two areas have not received much joint attention. This paper considers whether restricting the scope of responsibility to pre‐treatment decisions can be justified, or whether a demand to hold (...) people responsible for 'usual suspect' choices such as smoking or failure to exercise commits us to also holding people responsible for their treatment choices. I argue that there is no good reason to support this restriction: those who advocate responsibility for (some) pre‐treatment choices should also advocate responsibility for (some) treatment choices. However, I also note that, as with pre‐treatment choices, patients may sometimes have reason to choose in ways that do not optimize their health. As such, I also consider a process, based on the idea of public reasons, for deciding which treatment choices patients cannot legitimately be held responsible for, along with a method for considering proposed changes to this category. (shrink)

We investigate the relationship of corporate social responsibility (CSR) (often assumed to reflect corporate voluntarism) and government (often assumed to reflect coercion). We distinguish two broad perspectives on the CSR and government relationship: thedichotomous(i.e., government and CSR are / should be independent of one another) and therelated(i.e., government and CSR are / should be interconnected). Using typologies of CSR public policy and of CSR and the law, we present an integrated framework for corporate discretion for engagement with public policy for (...) CSR. We make four related contributions. First, we explain the dichotomous and the related perspectives with reference to their various assumptions and analyses. Second, we demonstrate that public policy for CSR and corporate discretion coexist and interact. Specifically, we show, third, that public policy for CSR can inform and stimulate corporate discretion and, fourth, that corporations have discretion for CSR, particularly as to how corporations engage with such policy. (shrink)

Contemporary egalitarian theories of justice constrain the demands of equality by responsibility, and do not view as unjust inequalities that are traceable to individuals' choices. This paper argues that, in order to make non-arbitrary determinate judgements of responsibility, any theory of justice needs a principle of stakes , that is, an account of what consequences choices should have. The paper also argues that the principles of stakes seemingly presupposed by egalitarians are implausible, and that adopting alternative principles of (...) stakes amounts to fleshing out the demands of responsibility rather than imposing limits on them. (shrink)

Is choice necessary for moral responsibility? And does choice imply alternative possibilities of some significant sort? This paper will relate these questions to the argument initiated by Harry Frankfurt that alternative possibilities are not required for moral responsibility, and to John Martin Fischer and Mark Ravizza's extension of that argument in terms of guidance control in a causally determined world. I argue that attending to Frankfurt's core conceptual distinction between the circumstances that make an action unavoidable and those that bring (...) it about that the action is performed – a distinction emphasised in his recent restatement – provides a new route into an analysis of Frankfurt's argument by showing how it depends on a person's ‘decision to act’ involving the exercise of choice. The implicit reliance of Frankfurt's argument on this notion of choice, however, undermines his claim that the example of the counterfactual intervener strengthens the compatibilist case by providing a counter-example to the principle of alternative possibilities. I also argue that Frankfurt's reliance on the exercise of choice for moral responsibility is also evident in the Fischer/Ravizza argument, and that a close analysis of both arguments shows that such exercise of choice is not available if causal determinism is true. (shrink)

Mechanical Choices details the intimate connection that exists between morality and law: the morality we use to blame others for their misdeeds and the criminal law that punishes them for these misdeeds. This book shows how both law and morality presuppose the accuracy of common sense, a centuries-old psychology that defines people as rational agents who make honorable choices and act for just reasons. It then shows how neuroscience is commonly taken to challenge these fundamental psychological assumptions.

The Corporate Social Performance (CSP) model (Wood, Acad Manag Rev 164:691–718, 1991) assesses a firm’s social responsibility at three levels of analysis—institutional, organizational and individual—and measures the resulting social outcomes. In this paper, we focus on the individual level of CSP, manifested in the managerial discretion of a firm’s principles, processes, and policies regarding social responsibilities. Specifically, we address the human resources management of employees as a way of promoting CSR values and producing socially minded outcomes. We show that applying (...) the humanist philosophy to the managerial discretion of a business organization leads to the creation of an “autonomy supportive work environment”—as defined by the self-determination theory—which in turn, facilitates the internalization of social values, citizenship behaviors, and cooperation. The objective of promoting self-determination at work (i.e., the core of a humanist management) fits well with the ontology of social responsibility since autonomy and consideration of individuals as moral actors are central tenets. Furthermore, we show that applying humanistic management philosophy to the discretion of managers can lead to socially responsible outcomes. First, intra-organizational stakeholders (e.g., employees) are treated with respect and focus is put on their well-being, satisfaction, and self-actualization at work. Second, as employees’ need of self-determination is addressed by managers, it is likely that pro-social behaviors toward other stakeholders of the organization will be adopted, leading to socially responsible outcomes for extra-organizational stakeholders (Gagné, Motiv Emot 77:58–75, 2003). Thus, this paper ultimately posits that humanistic management applied to the HRM can be a solution for developing and maintaining socially responsible outcomes as determined at the individual level of the CSP model, through managerial discretion. (shrink)

How do social norms influence our choices? And does the presence of biased norms affect what we owe to each other? Looking at empirical research relating to PrEP rollout in HIV prevention policy, a...

Choice-based conceptions of substantive responsibility face a number of powerful counterexamples. In order to avoid some of these counterexamples, it is widely claimed that agents are substantively responsible for disadvantage arising from their choices only when the option set from which they chose satisfied a reasonability criterion. I examine three possible justifications for a reasonability criterion: an agent-responsibility-based motivation, a voluntariness-based motivation, and what I call a ‘denied-claim’-based motivation. In each case, I argue that the putative motivation cannot in (...) fact justify a reasonability condition. I end with some comments on what this result means for choice-based conceptions of substantive responsibility. (shrink)

How should the fact that a given policy offers people choice bear on policy selection? Should we favour choice-granting policies even if choices lead to harmful outcomes, and even if the causal thesis is true and people are not fully in control of how they choose? T.M. Scanlon and Alex Voorhoeve have tried to locate the significance of choice in the value or potential value that it has for choice-bearers. I show that this leaves them vulnerable to a general (...) dilemma: either they can explain the significance of choice by supposing the causal thesis is false, or they cannot explain it when faced with certain policy cases. I argue that we should locate the significance of choice in the fact that having a choice means being in a position to treat others as they are due or not. My view can be summed up in a slogan: ask not only what choice can do for you; ask what having the choice means you can do to others. (shrink)

This paper applies insights from behavioral economics and nudge theory to foster sustainable and responsible investment. SRI provides an opportunity to express and promote ethical values via choice of financial instruments. While policy-makers have tried to encourage greater participation in SRI, the majority of retail investors retain a conventional approach to investment. I develop a conceptual framework to improve the effectiveness of SRI policy-making. The first part of the framework comprises a transmission mechanism which emphasizes the role of SRI as (...) a driver for sustainable development. The second part is a model of the individual decision for or against SRI. The framework suggests that low SRI demand is a case of behavioral market failure, and that nudging is a suitable tool for dismantling behavioral barriers to SRI. A specific example of smart choice architecture is used to illustrate the framework’s potential in the design of an SRI nudge. Assuming the nudge stands up to the rigors of empirical testing, it may well provide a feasible alternative for policy-makers. (shrink)

ExtractImagine that you are struggling to finish a project, with the deadline fast approaching. Nearly done, you are about to print out what you have finished when a dialog box appears on your computer screen telling you that you must download and install an update for some piece of software. Frustrated, you try to make it go away, but it keeps reappearing. So you relent and click on ‘Install’, and your screen is filled with small print listing ‘Terms and Conditions’. (...) You do not have time to scroll through the whole thing. So you click ‘Agree’. The installation begins, and you are relieved that it takes only a few minutes. Soon you are back at work and have finished your project.Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.RESPONSIBILITY AND THE VALUE OF CHOICEVolume 12, Issue 33T. M. ScanlonDOI: https://doi.org/10.1017/S1477175612000280Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. RESPONSIBILITY AND THE VALUE OF CHOICEVolume 12, Issue 33T. M. ScanlonDOI: https://doi.org/10.1017/S1477175612000280Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. RESPONSIBILITY AND THE VALUE OF CHOICEVolume 12, Issue 33T. M. ScanlonDOI: https://doi.org/10.1017/S1477175612000280Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation. (shrink)

Michael S. Moore defends the ideas of free will and responsibility, especially in relation to criminal law, against several challenges from neuroscience. I agree with Moore that morality and the law presuppose a commonsense understanding of humans as rational agents, who make choices and act for reasons, and that to defend moral and legal responsibility, we must show that this commonsense understanding remains viable. Unlike Moore, however, I do not think that classical compatibilism, which is based on a conditional (...) understanding of the ability to do otherwise, provides a sufficiently robust account of free will, even when it is amended as Moore suggests. I argue that free will and responsibility can be defended more robustly by observing that, at the level of agency, there can be alternative possibilities and mental causation in a stronger sense than recognized by classical compatibilism, even if physical determinism is true. Moore’s arguments could thus be strengthened by embracing this compatibilist libertarian position. At the same time, I note that, although the idea of responsibility is robustly defensible, there are independent reasons for rejecting a retributivist approach to punishment. (shrink)

In this response article, we challenge a core assumption that lies at the centre of a round table discussion regarding the Pharmacogenetics to Avoid Loss of Hearing trial. The round table regards a genetic test for a variant that increases the risk of deafness if a carrier is given the antibiotic gentamicin. The idea is that rapid testing can identify neonates at risk, providing an opportunity to prevent giving an antibiotic that might cause deafness. We challenge the assumption that (...) a positive test unequivocally guides antibiotic choice because, aside from the risk of deafness, all antibiotics for neonatal sepsis are equivalent. We argue that this assumption is faulty and has particularly troubling moral consequences. We claim that giving an alternative to gentamicin is potentially providing inferior treatment and thereby may increase the risk of death. Parents and doctors are faced with a terrible choice as a result of positive point-of-care testing : give gold-standard treatment and risk deafness or give second line care and risk death. While we do not indicate an answer to this choice, what we do argue is that such a deep and difficult choice is one that may make parents wish genetic testing was never undertaken, and therefore, contra some authors in the round table, provides a reason to gain specific consent for POCT. (shrink)