We propose simple nonlinear mathematical models for the legal concept of balancing of interests. Our aim is to bridge the gap between an abstract formalisation of a balancing decision while assuring consistency and ultimately legal certainty across cases. We focus on the conflict between the rights to privacy and to the protection of personal data in Art. 7 and Art. 8 of the EU Charter of Fundamental Rights (EUCh) against the right of access to information derived from Art. 11 (...) EUCh. These competing rights are denoted by ( \(i_1\) ) _right to privacy _ and ( \(i_2\) ) _access to information_; mathematically, their indices are respectively assigned by \(u_1\in [0,1]\) and \(u_2\in [0,1]\) subject to the constraint \(u_1+u_2=1\). This constraint allows us to use one single index _u_ to resolve the conflict through balancing. The outcome will be concluded by comparing the index _u_ with a prior given threshold \(u_0\). For simplicity, we assume that the balancing depends on only selected legal criteria such as the social status of affected person, and the sphere from which the information originated, which are represented as inputs of the models, called legal parameters. Additionally, we take “time” into consideration as a legal criterion, building on the European Court of Justice’s ruling on the right to be forgotten: by considering time as a legal parameter, we model how the outcome of the balancing changes over the passage of time. To catch the dependence of the outcome _u_ by these criteria as legal parameters, data were created by a fully-qualified lawyer. By comparison to other approaches based on machine learning, especially neural networks, this approach requires significantly less data. This might come at the price of higher abstraction and simplification, but also provides for higher transparency and explainability. Two mathematical models for _u_, a time-independent model and a time-dependent model, are proposed, that are fitted by using the data. (shrink)

Stakeholder theory is widely recognized as a management theory, yet very little research has considered its implications for individual managerial decision-making. In the two studies reported here, we used stakeholder theory to examine managerial decisions about balancing stakeholder interests. Results of Study 1 suggest that indivisible resources and unequal levels of stakeholder saliency constrain managers’ efforts to balance stakeholder interests. Resource divisibility also influenced whether managers used a within-decision or an across-decision approach to balance stakeholder (...) class='Hi'>interests. In Study 2 we examined instrumental and normative implications of these two approaches. We conclude by considering the contributions of this research. (shrink)

Volume 20, Issue 4, May 2020, Page 116-118.

Stakeholder theory is widely recognized as a management theory, yet very little research has considered its implications for individual managerial decision-making. In the two studies reported here, we used stakeholder theory to examine managerial decisions about balancing stakeholder interests. Results of Study 1 suggest that indivisible resources and unequal levels of stakeholder saliency constrain managers’ efforts to balance stakeholder interests. Resource divisibility also influenced whether managers used a within-decision or an across-decision approach to balance stakeholder (...) class='Hi'>interests. In Study 2 we examined instrumental and normative implications of these two approaches. We conclude by considering the contributions of this research. (shrink)

It is often challenging for mental health‐care providers and health organizations to perform their various roles and to meet their varied obligations. In complex mental health‐care circumstances the concurrent application of relevant ethical principles and values often leads to the emergence of completing obligations that need to be carefully weighed and balanced in the making of care‐related decisions. Although some clinical circumstances, such as those potentially triggering the duty to warn, are adequately guided by existing rules based on legal precedents, (...) there is a gap in decision‐making support in other mental health‐care domains. This article proposes that a set of targeted, decision‐making approaches be developed to assist in the handling of specific, challenging circumstances. By way of illustration, two novel approaches are introduced; that is, choosing to work within a moral relational space of optimal therapeutic engagement (at the micro level of clinical practice), and the use of a health policy development approach that instantiates deliberative engagement (at the meso and macro levels of health organization). (shrink)

Purpose This paper aims to use the writings of Mikhail Bakhtin to reveal new insights into the role and impact of social media in health-care settings. Design/methodology/approach With the help of Bakhtin’s constructs of dialogism, polyphony, heteroglossia and carnival, the power and influences of the social media phenomenon in health-care settings, are explored. Findings It is apparent from the in-depth analysis conducted that there is a delicate balance between the need to increase dialogue and the need to safeguard public (...) health, in the use of social media for health-related communication. Bakhtin‘s constructs elucidate this delicate balance and highlight the need for health-care providers that use social media to find the right balance between these competing communicational priorities. Originality/value This paper advances a nascent theoretical approach to social media research. By applying Bakhtinian ideas to consumer health informatics, this paper has the potential to open a new approach to theorizing the role of social software in health-care settings. Stakeholders in digital health will find this paper useful, as it opens up dialogue to further discuss the role of social media in health care. (shrink)

Pragmatic clinical trials (PCTs) seek to show the effectiveness of treatments in routine, clinical practice (MacPherson 2004). However, a number of ethical challenges come to the fore when collater...

The author defends the ancient claim that justice is at bottom a body of social conventions. Recent analytical and empirical concepts and results from the social sciences together with insights and arguments of past masters of moral and political philosophy are integrated into a new game-theoretic conventionalist analysis of justice.

Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights—the right (not) to be a gestational, genetic, and social parent—are negative rights that do not entail a right to assistance. Since terminating (...) or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, “prior assistance” does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent. (shrink)

The welfare and protection of human subjects is critical to the integrity of clinical investigation and research. Institutional review boards were thus set up to be impartial reviewers of research protocols in clinical research. Their main role is to stand between the investigator and her human subjects in order to ensure that the welfare of human subjects are protected. While there is much literature on the conflicts of interest faced by investigators and researchers in clinical investigations, an area that is (...) less explored is CIs that may affect members of IRBs during the institutional ethics review of clinical investigations. This article examines the notion of CIs in clinical research and attempts to develop a framework for a clearer and more balanced approach to identifying CIs that may influence members of IRBs and impede their independence. It will also apply the proposed framework to demonstrate how IRBs possess, or at least may appear to possess, forms of financial CIs and non-financial CIs. The proper identification and management of these CIs is critical to preserving the integrity of clinical investigations and achieving the primary aim of human subjects protection. (shrink)

The U.S. Supreme Court’s Dobbs ruling triggered a global debate about access to abortion and the legislative models governing it. In the United States, there was a sudden reversal of federal guidance about pregnancy termination that is unprecedented in Western and high-income countries. The strong polarization on the issue of abortion and the difficulty of finding a point of compromise lead one to consider the experiences of countries that have had different paths. Italy stands as a candidate for being a (...) partially alternative model because it allows abortion up to 12 weeks, but without considering it a subjective right. The legislation in place since 1978 aims to balance the interests of the fetus and those of the woman. An issue often raised concerning Italian law is that of conscientious objection granted to doctors. Many gynecologists declare themselves objectors, and this makes access to abortion more difficult in some regions of Italy. After discussing this issue and envisaging different ways to deal with it, the article concludes by highlighting new dilemmas about a possible divorce between the law and medical ethics in different directions and offers some avenues to begin setting up a response. (shrink)

Recent law and ethics literature has been inundated with recommendations of the "best interests" criterion as the appropriate guide for neonatal and maternal-fetal decision-making. Increasingly, however, its adequacy is being questioned. In Chapter 1, I survey the arguments of "best interests" defenders and critics and suggest one problem is that the "best interests" criterion has yet to be subjected to a systematic conceptual and ethical analysis. In Chapter 2, therefore, I conduct such an analysis to evaluate more (...) systematically its appropriateness as a decision-making guide in neonatal and maternal-fetal medicine, concluding that the "best interests" criterion cannot assist us in seeing and addressing all that is at stake in neonatal and maternal-fetal decision-making because it excludes any consideration of the "interdependent" and other interests of family members. Therefore, I suggest that an ethical criterion or set of criteria which can explicitly consider and adequately balance the interests of infants or fetuses and family members would be a more helpful guide for neonatal and maternal-fetal decision-making. ;In Chapters 3-7, I attempt to move beyond the "best interests" criterion, drawing on fieldwork I conducted in the United States, Sweden, and India to point out some conceptual and normative gaps to be addressed in the development of a more adequate guide for neonatal and maternal-fetal decision-making. In Chapter 3, I describe this fieldwork and explain its purpose as illustrating the clinical ethical strategies employed in these countries to balance the interests of various parties in actual decision-making. In Chapters 4-6, I describe these strategies. Finally, in Chapter 7, I point out some conceptual and normative gaps in these decision-making strategies, noting that these gaps have also been unaddressed by the "best interests" critics reviewed in Chapters 1 and 2. I suggest that we must address these gaps to develop theoretical structures that will enable us to explicitly consider and adequately balance the "interdependent" and other interests of infants or fetuses, their family members, and even society in neonatal and maternal-fetal decision-making. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 15.2 (2005) 199-210 [Access article in PDF] Conflict-of-Interest Policy at the National Institutes of Health: The Pendulum Swings Wildly* Evan G. DeRenzo **This article addresses the National Institutes of Health (NIH) employee conflict-of-interest (COI) policy that went into effect February 2005. It is not, however, merely an account of another poorly crafted government policy that cries out for revision. Instead, it is also a (...) story about one of our nation's most important and prestigious institutions and its struggles to navigate the crosscurrents of scientific aspirations, power politics, public ambivalence toward capitalist economics in the biosciences, and the media's inclination to exaggerate problems and under report complicated facts. It is also a tale of greed, politics, purgatory, and redemption. The dramatic and abrupt change in the NIH COI policy demonstrates the difficulty of balancing the production of cutting-edge science with the demands for transparency resulting from work performed in the public interest on the public tab. It is an unhappy chapter in the life of a government agency that is also a national treasure. And, one hopes, it will be an example of how harmful and ill-conceived law can be revised and amended to advance national health and well-being. What is the New NIH COI Policy? The new NIH COI employee policy, more accurately referred to as the Interim Final Rule (Federal Register 2005), is a sweeping set of prohibitions on activities and holdings to reduce the possibility that NIH employees will have any actual [End Page 199] or apparent conflicts of interest. For the most part, the prohibitions are applied across-the-board—i.e., without distinction to employee category or function. The new policy includes prohibitions on outside activities, stock holdings, and awards. It prohibits all NIH employees from engaging in any compensated or uncompensated employment, including consulting, serving on advisory or other such boards, and compensated teaching, speaking, writing, or editing with certain kinds of entities. The first class of such entities is referred to as substantially affected organizations, defined as biotechnology, pharmaceutical, medical device companies, and others with similar interests. But these are not the only entities included in the prohibitions. Other organizations from which NIH employees now are cut off are hospitals, clinics, and other health care institutions; health, science, or health research-related professional associations and consumer and advocacy groups. Included also are educational institutions and not-for-profit independent research institutes that are, or were, recent NIH funding applicants, grantees, contractors, or cooperative research and development agreement (CRADA) partners. The only exemptions appear to be for health care institutions at which NIH employees provide clinical care and some forms of writing—e.g., an NIH physician who moonlights at her/his local hospital's emergency room or submits a manuscript to a peer-reviewed journal that receives only unrestricted funding from a prohibited entity. Prohibited and/or restricted holdings include stock in biotechnology, pharmaceutical, and medical device companies and others in research, development, or manufacture of medical devices, equipment, preparations, treatments, or products. The prohibitions apply to senior NIH employees; restrictions in the amount of such holdings apply to all remaining employees. Both apply to the spouses and minor children of NIH employees. If an NIH employee wins an award, the monetary allowance in most cases is limited to $200. In sum, the scope of this policy is vast, too vast to be reasonable. Too many employees are restricted in too many ways. Where appropriate restrictions have been placed on senior NIH employees, even these constructive aspects of the policy are overshadowed by the unfairness and destructiveness of other aspects. This policy far exceeds anything that could be considered sound. Fortunately, the policy has a built-in assessment process to begin at the end of the policy's first year of implementation. One can only hope that a fair and open evaluation will be conducted, the results of which surely must result in major revisions to what is now bad regulation. Why the Policy... (shrink)

The present paper aims at addressing a crucial legal conflict in the information society: i.e., the conflict between security and civil rights, which calls for a “fine and ethical balance”. Our purpose is to understand, from the legal theory viewpoint, how a fine ethical balance can be conceived and what the conditions for this balance to be possible are. This requires us to enter in a four-stage examination, by asking: (1) What types of conflict may be dealt (...) with by means of balancing? (2) What is meant by balancing? Is it a metaphor that hides and dissimulates discretionary powers and subjective decisions or a rational instrument that helps us cope with conflicts between fundamental values and interests? (3) What models of balancing are available to us? Are these models irreducible to each other? What can provide us with a common understanding of different models of balancing? (4) How can the crucial issues of rational controllability, predictability, and homogeneity of legal decisions be dealt with? Our paper will try to answer those questions by trying to reconstruct the act of balancing in terms of a rational legal reasoning, which relies upon information. In fact, every judicial decision contains some information that is delivered to the legal system: that information may serve as the basis for future evaluations, decisions, and actions, and thus influence the way we recognize and hence we protect our values, interests, and rights. In this perspective, our examination will attempt to understand those questions in informational terms. This informational treatment can provide us with a more universalistic understanding of those issues and offer us a novel way to conceptually deal with them. To this aim, we will avail yourself of Luciano Floridi’s philosophy of information: notably, we believe his constructionist conception of epistemology is crucial, based on the Maker’s Knowledge approach and his solution of the upgrading problem (i.e., from information to knowledge) in terms of a network theory of account. The informational approach will help us having a better understanding of the balance between competing interests. (shrink)

Eva Schmidt argues that facts about incoherent beliefs can be non-evidential epistemic reasons to suspend judgment. In this commentary, I argue that incoherence-based reasons to suspend are epistemically superfluous: if the subjects in Schmidt’s cases ought to suspend judgment, then they should do so merely on the basis of their evidential reasons. This suggests a more general strategy to reduce the apparent normativity of coherence to the normativity of evidence. I conclude with some remarks on the independent interest that reasons-first (...) epistemology might have within an evidentialist framework. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume XXI, Number 2, November 1995, pp. 315-332 Robertson, Hume, and the Balance of Power FREDERICK G. WHELAN William Robertson, like his Scottish Enlightenment colleague David Hume, practiced a kind of philosophic history which, although it appears to consist mainly of narratives of political and military events, is also designed to teach moral and political lessons of general significance and utility. The principal theme of Hume's (...) History of England, for example, is the growth of legal and constitutional government in connection with the emergence of modern society; Hume's narrative implicitly justifies both such a government and the moderate politics on which it depends. A theme of comparable importance in Robertson's History of Charles V (1769) is the emergence of a balance of power and thence a relatively stable international system among European states in the early sixteenth century, when the policy of balance first clearly appeared. As he declares in his Preface: The political principles and maxims then established still continue to operate. The ideas concerning the balance of power, then introduced or rendered general, still influence the councils of nations. (R 307)1 Robertson both describes the relevant policy decisions (especially the alliance between the traditional enemies, England and France, to counter the threat posed by Charles Vs unprecedentedly large empire) and justifies such policies as reasonable and beneficial.2 Frederick G. Whelan is at the Political Science Department, University of Pittsburgh, Pittsburgh PA 15260 USA. 316 Frederick G. Whelan In treating this theme, Robertson was taking up a topic that was of interest to Hume as well. Hume refers on a number of occasions to the sixteenth century balance of power in his History chapters on the reign of Henry VIII (1759),3 especially in the portion extending through the 1520s, and he treats the topic more systematically in his earlier essay "Of the Balance of Power" (1752).4 Hume like Robertson defends balance of power policies in general, and Hume certainly (Robertson probably) had a more particular reason for doing so: to justify contemporary British (Whig) foreign policy (and several wars), which since the reign of Louis XIV had aimed at maintaining a European counterbalance to France.5 Hume's and Robertson's favorable descriptions of the sixteenth century anti-Habsburg policy provide a useful background for defending the eighteenth century anti-Bourbon policy.6 Indeed, both Hume and Robertson probably exaggerated the prevalence of the balance of power, at least as a conscious policy, in the early sixteenth century; although they were no doubt correct in noting that something like the modern state system first began to take shape at that time, they seem to have projected the eighteenth century emphasis on balance backwards in time as a way of legitimizing it.7 Robertson sums up the fifty year period he covers by observing that the similar stage of development of the states of Europe at that time, together with the policy of balance, permitted the preservation of a fairly stable system of independent states that has lasted until the present: But the advantages possessed by one state were counterbalanced by circumstances favourable to others; and thus prevented any from attaining such superiority as might have been fatal to all. The nations of Europe in that age, as in the present, were like one great family.... There was not among them that wide diversity of character and of genius which, in almost every period of history, hath exalted the Europeans above the inhabitants of the other quarters of the globe, and seems to have destined the one to rule and the others to obey. (R 704) Hume's concern with contemporary policy, and with France, is more conspicuous: Europe has now, for above a century, remained on the defensive against the greatest force that ever, perhaps, was formed by the civil or political combination of mankind. And such is the influence of the maxim here treated of, that tho' that ambitious nation, in the five last general wars, have been victorious in four, and unsuccessful only in one, they have not much enlarged their dominions, nor acquired a total ascendant over EUROPE.... In the last three of these general Hume... (shrink)

The purpose of this article is to introduce a model of value-based leadership. The model is based on tensions among values, interests, and power ; and tensions that take place within and among citizens, workers, and leaders. The VIP-CWL model describes the forces at play in the promotion of value-based practice and formulates recommendations for value-based leadership. The ability to enact certain values is conditioned by power and personal interests of communities, workers, and leaders of organizations. People experience (...) internal conflicts related to VIP as well as external conflicts related to disagreements with the CWL. Value-based practice is predicated on the ability to alleviate these tensions. Leaders have 4 main roles in promoting value-based practice: clarify values, promote personal harmony among VIP, enhance congruence of VIP among CWL, and confront people and groups subverting values or abusing power to promote personal interests. (shrink)

The selfish goal metaphor is interesting and intriguing. It accounts for the idiosyncrasies and inconsistencies in peoples' goal pursuits without invoking free will, self-regulatory, or self-control failures. However, people pursue multiple goals, sometimes simultaneously. We argue that the model proposed in the target article may gain significant theoretical and practical value if the principles underlying goal selection and/or balancing on a moment-to-moment basis are clearly specified and integrated with the notion of the selfish goal.

Grounding on Holland’s RIASEC model of vocational interests and the respective assumptions on person-environment fit, this paper focuses on how congruence is related to study outcomes, especially students’ persistence, performance, and satisfaction. The paper distinguishes the measure of congruence with respect to social congruence and aspirational congruence and also distinguishes the effects of congruence for gender and six different study areas including Science, Technology, Engineering, Mathematics, medicine, economics, education, and languages. The paper analyses 10,226 university freshmen of the German (...) National Educational Panel Study and follows them longitudinally with respect to their study outcomes. The results show that students’ persistence was more related to SOC than to ASP, especially for male students. Furthermore, SOC was particularly important for students in STEM areas. Regarding performance, however, ASP was more important. Here, we notably found correlations for STEM subjects with a balanced proportion of female students. Regarding satisfaction, mainly marginal correlations could be found. The results indicate conceptual differences between social and aspirational congruence as well as specific effects for gender and study area. While research might take this into account by specifically developing their models for different study areas, career counseling may reflect on the different significance of the interest-based person-environment fit for different study areas. Initiatives for raising young people’s participation in STEM should therefore specifically focus on students that have high chances to develop interest profiles that are congruent to STEM rather than students who show profiles which already indicate a low congruence. (shrink)

Although the generation of reactive oxygen species is an activity normally associated with phagocytic leucocytes, mammalian spermatozoa were, in fact, the first cell type in which this activity was described. In recent years it has become apparent that spermatozoa are not the only nonphagocytic cells to exhibit a capacity for reactive oxygen species production, because this activity has been detected in a wide variety of different cells including fibroblasts, mesangial cells, oocytes, Leyding cells endothelial cells, thryroid cells, adipocytes, tumour cell (...) and platelets. Since the capacity to generate reactive oxygen species is apparently so widespread, the risk‐benefit equation for these potentially pernicious molecules becomes a matter of intese interest. In the case of human spermatozoa, the risk of manufacturing reactive oxygen metabolites is considerable because these cells are particularly vulnerable to lipid peroxidation. Indeed, there is now good evidence to indicate that oxygen radicals are involved in the initiation of peroxidative damage to the sperm plasma membrane, seen in many cases of male infertility. This risk is off‐set by recent data suggesting that superoxide anions and hydrogen peroxide also participate in the induction of key biological events such as hyperactiavated motility and the acrosome reaction. Thus, human spermatozoa appear to use reactive oxygen species for a physiological purpose and have the difficult task of ensuring the balanced generation of these potentially harmful, but biologically important, modulators of cellular function. (shrink)

This article argues that David Hume's essay 'Of the Liberty of the Press' points to significant elements of his conception of the public realm and, in particular, his thoughts on the nature and importance of political discourse. Hume saw the opposition of interests as both a key constitutional support and a potential source of faction and fanaticism. His account of politeness suggests an important means through which a free press might improve the quality of public discourse such that the (...) educative facet of discourse and, what I have termed, its messy facet, could be united towards maintaining the constitutional balance, the latter by providing a forum for the opposition of interests and the former by deflating factional bigotry. (shrink)

It is often claimed that managed care organizations involve physicians in conflicts of interest by creating financial incentives for physicians to refrain from ordering treatments or making referrals. Such incentives, the argument goes, force the physician to balance the patient's health interests against the MCO's interests and the physician's own financial interest. I assume, for the sake of argument, that such arrangements at least provide reason to believe that physicians in MCOs are involved in conflicts of interest. (...) Two approaches have evolved for dealing with these conflicts. On one approach, MCOs disclose the financial arrangements under which their physicians work so that patients can consent to the managed care plan and thereby to the plan's limitations. The chief proponent of this approach is Mark Hall, whose recent book Making Medical Spending Decisions applies prior consent to a variety of decisions regarding medical financing and allocation. The other approach is simply to forbid conflicts of interest through regulations. (shrink)

It is often claimed that managed care organizations involve physicians in conflicts of interest by creating financial incentives for physicians to refrain from ordering treatments or making referrals. Such incentives, the argument goes, force the physician to balance the patient's health interests against the MCO's interests and the physician's own financial interest. I assume, for the sake of argument, that such arrangements at least provide reason to believe that physicians in MCOs are involved in conflicts of interest. (...) Two approaches have evolved for dealing with these conflicts. On one approach, MCOs disclose the financial arrangements under which their physicians work so that patients can consent to the managed care plan and thereby to the plan's limitations. The chief proponent of this approach is Mark Hall, whose recent book Making Medical Spending Decisions applies prior consent to a variety of decisions regarding medical financing and allocation. The other approach is simply to forbid conflicts of interest through regulations. (shrink)

While all states in the United States require certain vaccinations for school attendance, all but three allow for religious exemptions to receiving such vaccinations, and 18 allow for exemptions on the basis of other deeply held personal beliefs. The rights of parents to raise children as they see fit may conflict with the duty of the government and society to protect the welfare of children. In the U.S., these conflicts have not been settled in a uniform and consistent manner. We (...) apply a test that provides a concrete and formal rubric to evaluate such conflicts. For some vaccinations, based on the individual medical characteristics of the disease and the risks of being unvaccinated, the test would suggest that permitting conscientious exemptions is ethical. However, for vaccinations protecting against other diseases that are more severe or easily transmitted, the test would suggest that the federal government may ethically impose laws that deny such exemptions. (shrink)

Although the mathematics of interest is very precise, the practice of charging computing and disclosing interest or cost of credit is full of variations and therefore often questionable on ethical grounds. The purpose of this paper is to examine some of the prevalent practices which are incorrect, illogical, unfair or deceptive. Both utilitarian and formalist schools of ethical theory would find these practices to be inappropriate. The paper will specifically look at unfair practices in the areas of estimation of intrayear (...) rates, use of 360 days in a year, the "rule of 78th", interest rate ('APR') advertising, and computation of unpaid balance by credit card issuers to figure interest costs.The current practices are not in the best interest of the average consumer. There is, therefore, an urgent need for new legislation, change in regulatory code and disclosure requirement for eliminating these unethical practices. The author recommends that the Truth in Lending Code of the Federal Reserve should require the disclosure of the effective APR if the periodic rate is determined by dividing the 'APR' by the number of payment period in a year; the use of 360 days in a year methods and the "Rule of 78ths" should be immediately discontinued; Deceptive advertising, which tend to understate the true cost of credit or hides hidden costs and fees should be outlawed; interest should be payable with the same frequency as the frequency of compounding and credit card holders should be provided with a comparative example of various methods of balance computation. (shrink)

Critical-care decision making is highly complex, given the need for health care providers and organizations to consider, and constructively respond to, the diverse interests and perspectives of a variety of legitimate stakeholders. Insights derived from an identified set of ethics-related considerations have the potential to meaningfully inform inclusive and deliberative policy development that aims to optimally balance the competing obligations that arise in this challenging, clinical decision-making domain. A potential, constructive outcome of such policy engagement is the collaborative (...) development of an as-fair-as-possible dispute resolution process that incorporates an appropriated-justified, defensible critical-care obligation threshold. (shrink)

This article aims to shed some light on the concepts embedded in the expressions ‘services of general interest’ (‘SGI’), ‘services of general economic interest’ (‘SGEI’), ‘non-economic services of general interest’ (‘NSGI’) and ‘social services of general interest’ (‘SSGI’). It is submitted that the expression ‘SGI’ conveys a general concept which comprises both SGEI and NSGI. SGEI may be distinguished from NSGI in that only the former involve an economic activity. In contrast to SGI, SGEI and NSGI, the expression ‘SSGI’ is (...) nowhere to be found in primary EU law. This means that it is for the EU legislator and, as the case may be, for the Member States to define such expression. Furthermore, this article supports the contention that a definition of the principles and conditions underpinning the operation of SGI must be capable of adapting to changing times and social perceptions, whilst being respectful of the vertical and horizontal allocation of powers set out in the Treaties. Vertically, a definition of SGI must not impinge upon the powers retained by the Member States. In the absence of harmonisation, it is for the Member States to define the services they consider to be of general interest, unless they commit a manifest error of assessment. In the presence of EU harmonising measures, the margin of discretion enjoyed by the Member States is, if still existent, narrowed down, given that national authorities are required to comply with the objectives pursued by the EU legislator. Horizontally, a definition of SGI must not encroach upon the prerogatives of the Commission in the realm of competition law. Moreover, in light of Article 9 TFEU and secondary EU legislation, the specific features of SSGI must be taken into consideration when determining the compatibility with EU State aid rules of public service compensation awarded to the providers of those services. An EU conceptual framework for the SGI must thus be the result of a constructive dialogue between the different levels of governance, as well as of a balanced solution among different policy areas in relation to which the EU enjoys competences. (shrink)

I vindicate Hume’s argument against belief in miracle reports against a prevalent objection. Hume has us balance the probability of a miracle’s occurrence against the probability of its being falsely attested to, and argues that the latter must inevitably be the greater; thus, reason requires us to reject any miracle report. The "flaw" in this reasoning, according to Butler and many others, is that it proves too much--it counsels us to never believe historians, newspaper reports of lottery results, and (...) so on; and this is clearly absurd. I show that this objection is misguided: far from providing counterexamples to Hume’s "balancing principle", as I call it, these cases actually confirm it, as some simple calculations of probabilities show. (shrink)

BackgroundThis paper investigates the content of Australian policies that address withholding or withdrawing life-sustaining treatment to analyse the guidance they provide to doctors about the allocation of resources.MethodsAll publicly available non-institutional policies on withholding and withdrawing life-sustaining treatment were identified, including codes of conduct and government and professional organization guidelines. The policies that referred to resource allocation were isolated and analysed using qualitative thematic analysis. Eight Australian policies addressed both withholding and withdrawing life-sustaining treatment and resource allocation.ResultsFour resource-related themes were (...) identified: doctors’ ethical duties to consider resource allocation; balancing ethical obligations to patient and society; fair process and transparent resource allocation; and legal guidance on distributive justice as a rationale to limit life-sustaining treatment.ConclusionOf the policies that addressed resource allocation, this review found broad agreement about the existence of doctors’ duties to consider the stewardship of scarce resources in decision-making. However, there was disparity in the guidance about how to reconcile competing duties to patient and society. There is a need to better address the difficult and confronting issue of the role of scarce resources in decisions about life-sustaining treatment. (shrink)

At first glance, this case might give the impression that a resolution would have been straightforward. A 17-year-old young man with moderate to severe learning disabilities and other conditions discussed below required a kidney transplant–the Court of Protection was tasked with determining whether this was in his best interests. However, the case of WV was in fact far more technical and required nuanced discussion and expert medical evidence from a range of specialists to objectively balance the needs of (...) WV and the risks to WV, and to ultimately determine his fate of life or death based on receiving a kidney transplant.Manchester University NHS Foundation Trust applied for a declaration in relation to the capacity of William Verdon and for the court to consider whether an order should be made that it was not in his best interests to have a kidney transplant with sedation and ventilation post-operatively. (shrink)

Aristotle listed moderation as one of the moral virtues. He also defined virtue as the mean between extremes, implying that moderation plays a vital role in all forms of moral excellence. But moderation's protean character—its vague and ill-defined omnipresence in judgment and action—makes it exceedingly difficult to grasp theoretically. At the same time, moderation seems to be the foundation of many contemporary democratic political regimes, because the competition between parties cannot properly function without compromise and bargaining. The success of representative (...) government and its institutions depends to a great extent on the virtue of moderation, yet the latter persists in being absent from both the conceptual discourse of many political philosophers and the campaign speeches of politicians fearful of losing elections if they are perceived as moderates. Aurelian Craiutu aims to resolve this paradox. Examining the writings of prominent twentieth-century thinkers such as Raymond Aron, Isaiah Berlin, Norberto Bobbio, Michael Oakeshott, and Adam Michnik, he addresses the following questions: What does it mean to be a moderate voice in political and public life? What are the virtues and limits of moderation? Can moderation be the foundation for a successful platform or party? Though critics maintain that moderation is merely a matter of background and personal temperament, Craiutu finds several basic norms that have consistently appeared in different national and political contexts. The authors studied in this book defended pluralism, of ideas, interests, and social forces, and sought to achieve a sound balance between them through political trimming. They shared a preoccupation with political evil and human dignity, but refused to see the world in Manichaean terms that divide it neatly into the forces of light and those of darkness. Faces of Moderation argues that moderation remains crucial for today's encounters with new forms of extremism and fundamentalism across the world. (shrink)

The job of being a sports team physician is difficult, regardless of the level, from high school to the National Football League. When a sports league receives the intensity of attention leveled at the NFL, though, a difficult occupation becomes even more challenging. Even for the NFL players themselves, players’ best interests regarding health issues are often unclear. Football players are, as a lot, highly competitive individuals. They want to win, and they want to help the team win. It's (...) a warrior culture, and respect is earned by playing hurt. Should the team physician respect a player's autonomy when this means allowing him to make choices that might lead to further personal harm, especially if the player's choices align with the preference of the coach and management? Or should the doctor set limits and balance the player's choices with a paternalistic set of constraints, perhaps in opposition to both the player's and the team's desires? Simplification of this web of conflicts of interest is the goal of the model proposed by Glenn Cohen, Holly Lynch, and Christopher Deubert. In my view, their proposal is very clever. As an idea, it meets the expectations its authors set, namely, to minimize the problem of conflict of interest in the delivery of health care services to NFL football players. The ethics of the proposal align well with certain moral goals, like treating the player's interests more fairly and treating the player's health as an end instead of as the means to an end. But will such a proposal ever make headway in the pressurized environment of the NFL? (shrink)

In this book, Koo discusses political change in the view of Confucian thought. This study focuses on the Book of Change, which is one of the nine basic books of Confucius School; it has dominated oriental thought in this field for more than three thousand years. The aim of this study is to analyze and arrange its theory of change, and to apply it to political reality. Therefore, this book analyzes and summarizes the theories of change and applies those theories (...) to political change. From that process, the theories of political changes are developed. Their usefulness is tested in the real world and compared to the existing theories of political change. The result is to develop and present a new theory of political change. (shrink)

This book discusses political change in the view of Confucian thought. This study focuses on the Book of Change, which is one of the nine basic books of Confucius School, and has dominated oriental thought in this field for more than three thousand years.

In Propelled, Elpidorou persuasively argues that the three prima facie undesirable conditions of boredom, frustration and anticipation are, in fact, importantly valuable to human life. His method is an interesting combination of existentialist explorations and reporting of cognitive science research, all written in a style more friendly to the analytic-philosophical tradition. However, I argue, the book’s precision and depth of philosophical analysis have some limitations. This is so in two main respects: first, in the relative lack of discussion of important (...) philosophical antecedents, and secondly, in the relative lack of critical engagement with some of the empirical literature the book discusses. (shrink)

Physicians expressing opinions on medical matters that run contrary to the consensus of experts pose a challenge to licensing bodies and regulatory authorities. While the right to express contrarian views feeds a robust marketplace of ideas that is essential for scientific progress, physicians advocating ineffective or dangerous cures, or actively opposing public health measures, pose a grave threat to societal welfare. Increasingly, a distinction has been made between professional speech that occurs during the physician-patient encounter and public speech that transpires (...) beyond the clinical setting, with physicians being afforded wide latitude to voice empirically false claims outside the context of patient care. This paper argues that such a bifurcated model does not sufficiently address the challenges of an age when mass communications and social media allow dissenting physicians to offer misleading medical advice to the general public on a mass scale. Instead, a three-tiered model that distinguishes between citizen speech, physician speech and clinical speech would best serve authorities when regulating physician expression. (shrink)