Procrastination describes a ubiquitous scenario in which individuals voluntarily postpone scheduled activities at the expense of adverse consequences. Steel pioneered a meta-analysis to explicitly reveal the nature of procrastination and sparked intensive research on its demographic characteristics. However, conflicting and heterogeneous findings reported in the existing literature make it difficult to draw reliable conclusions. In addition, there is still room to further investigate on more sociodemographic features that include socioeconomic status, cultural differences and procrastination education. To this end, we (...) performed quantitative sociodemographic meta-analyses to fill this gap. It was found that the general tendency and academic procrastination tendency of males were stronger than females. No significant effects of differences in socioeconomic status, multiculturalism, nationality, family size, and educational background were found to affect procrastination tendencies. Furthermore, it was noteworthy that the gender differences in procrastination tendencies were prominently moderated by measurements, which has a greater effect on the Aitken Procrastination Inventory than on the General Procrastination Scale. In conclusion, this study provides robust evidence that males tended to procrastinate more than females in general and academic profiles, and further indicates that procrastination tendencies do not vary based on sociodemographic situations, including socioeconomic status, multiculturalism, nationality, family size, and educational background. (shrink)

Climate change assessments rely upon scenarios of socioeconomic developments to conceptualize alternative outcomes for global greenhouse gas emissions. These are used in conjunction with climate models to make projections of future climate. Specifically, the estimations of greenhouse gas emissions based on socioeconomic scenarios constrain climate models in their outcomes of temperatures, precipitation, etc. Traditionally, the fundamental logic of the socioeconomic scenarios—that is, the logic that makes them plausible—is developed and prioritized using methods that are (...) very subjective. This introduces a fundamental challenge for climate change assessment: The veracity of projections of future climate currently rests on subjective ground. We elaborate on these subjective aspects of scenarios in climate change research. We then consider an alternative method for developing scenarios, a systems dynamics approach called ‘Cross-Impact Balance’ (CIB) analysis. We discuss notions of ‘objective’ and ‘objectivity’ as criteria for distinguishing appropriate scenario methods for climate change research. We distinguish seven distinct meanings of ‘objective,’ and demonstrate that CIB analysis is more objective than traditional subjective approaches. However, we also consider criticisms concerning which of the seven meanings of ‘objective’ are appropriate for scenario work. Finally, we arrive at conclusions regarding which meanings of ‘objective’ and ‘objectivity’ are relevant for climate change research. Because scientific assessments uncover knowledge relevant to the responses of a real, independently existing climate system, this requires scenario methodologies employed in such studies to also uphold the seven meanings of ‘objective’ and ‘objectivity.’. (shrink)

This article analyzes some important aspects of socioeconomic and political development of the world in the near future. The future always stems from the present. The first part of the article is devoted to the study of some crucial events of the present, which could be regarded as precursors of forthcoming fundamental changes. In particular, it is shown that the turbulent events of late 2010 and 2011 in the Arab World may well be regarded as a start of the (...) global reconfiguration. The article also offers an analysis of some aspects of the global financial system that, according to the authors, notwithstanding all its negative points, performs certain important positive functions including the ?insurance? of social guaranties at the global scale. The second part of the article considers some global scenarios of the World System's new future and describes a few characteristics of the forthcoming ?Epoch of New Coalitions.? The article attempts to answer such questions as the following: What are the implications of the economic weakening of the United States as the World System center? Will the future World System have a leader? Will it experience a global governance deficit? Will the world fragmentation increase? (shrink)

Despite globalization a progressively increasing economic and financial concentration in the ‘cores’ of the world economy (e.g. EU) as well as the rise of new socioeconomic marginalization of peripheries (e.g. Maghreb and Mashraq) has been observed since the early 1980s. Marginalization has produced its own models of specialization in production which reflect in various countries and regions the needs of the ‘cores’ economy forces. A regional strategy for regional co-operation, so called co-development, is advanced to overcome the current economic (...) and social problems faced by marginalized regions in relation to world economic trends. (shrink)

Although germline editing has been the subject of debate ever since the 1980s, it tended to be based rather on speculative assumptions until April 2015, when CRISPR/Cas9 technology was used to modify human embryos for the first time. This article combines knowledge about the technical and scientific state of the art, economic considerations, the legal framework and aspects of clinical reality. A scenario will be elaborated as a means of identifying key ethical implications of CRISPR/Cas9 genome editing in humans and (...) possible ways of dealing with them. Unlike most other discussions of CRISPR/Cas9 germline editing, which are generally based on deontological arguments, the focus in this case will be on a consequentialistic argument against certain applications of germline and somatic editing that takes not only the potential benefits and risks but also socioeconomic issues into consideration. The practical need for an indication catalogue, guidelines for clinical trials, and for funding of basic research will be pointed out. It will be argued that this need for regulatory action and discussion does not stem primarily from the fact that CRISPR/Cas9 germline editing is revolutionary in terms of its ethical implications and potential for human therapy, although this is the prevailing view in the current discussion. Understanding the value and interest dependency of arguments put forward by different stakeholders and learning from past debates related to similar technologies might prove a fruitful method of reaching judgments and decisions that come closer to a consensus upon which society as a whole can agree - which after all should be the true goal of an ethical debate and of bioethics. (shrink)

According to Chen's Linguistic Savings Hypothesis, our native language affects our economic behavior. We present three studies investigating how cross-linguistic differences in the grammaticalization of future-time reference affect intertemporal choices. In a series of decision scenarios about finance and health issues, we let speakers of altogether five languages that represent FTR with increasing strength, that is, Chinese, German, Danish, Spanish, and English, choose between hypothetical sooner-smaller and later-larger reward options. While the LSH predicts a present-bias that increases with FTR-strength, (...) our decision makers preferred later-larger options and this future-bias increased with FTR-strength. In multiple regressions, the FTR-strength effect persisted when controlled for socioeconomic and cultural differences. We discuss why our findings deviate from the LSH and ask in how far the FTR-strength effect represents a habitual constitution of linguistic relativity or an instance of online decision framing. (shrink)

As physicians encounter an increasingly diverse patient population, socioeconomic circumstances, religious values and cultural practices may present barriers to the delivery of quality care. Increasing cultural competence is often cited as a way to reduce healthcare disparities arising from value and cultural differences between patients and providers. Cultural competence entails not only a knowledge base of cultural practices of disparate patient populations, but also an attitude of adapting one's practice style to meet patient needs and values. Gender roles, relationship (...) dynamics and boundaries are culture specific, and are frequently shaped by religious teachings. Consequently, religion may be conceptualised as a cultural repertoire, or dynamic tool-kit, by which members of a faith adapt and negotiate their identity in multicultural societies. The manner in which Islamic beliefs and values inform Muslim healthcare behaviours is relatively under-investigated. In an effort to explore the impact of Islam on the relationship between patients and providers, we present an Islamic bioethical perspective on cross-gender relations in the patient-doctor relationship. We will begin with a clinical scenario highlighting three areas of gender interaction that bear clinical relevance: dress code, seclusion of members of the opposite sex and physical contact. Next, we provide a brief overview of the foundations of Islamic law and ethical deliberation and then proceed to develop ethicolegal guidelines pertaining to gender relations within the medical context. At the end of this reflection, we offer some practice recommendations that are attuned to the cultural sensitivities of Muslim patient populations. (shrink)

As physicians encounter an increasingly diverse patient population, socioeconomic circumstances, religious values and cultural practices may present barriers to the delivery of quality care. Increasing cultural competence is often cited as a way to reduce healthcare disparities arising from value and cultural differences between patients and providers. Cultural competence entails not only a knowledge base of cultural practices of disparate patient populations, but also an attitude of adapting one's practice style to meet patient needs and values. Gender roles, relationship (...) dynamics and boundaries are culture specific, and are frequently shaped by religious teachings. Consequently, religion may be conceptualised as a cultural repertoire, or dynamic tool-kit, by which members of a faith adapt and negotiate their identity in multicultural societies. The manner in which Islamic beliefs and values inform Muslim healthcare behaviours is relatively under-investigated. In an effort to explore the impact of Islam on the relationship between patients and providers, we present an Islamic bioethical perspective on cross-gender relations in the patient-doctor relationship. We will begin with a clinical scenario highlighting three areas of gender interaction that bear clinical relevance: dress code, seclusion of members of the opposite sex and physical contact. Next, we provide a brief overview of the foundations of Islamic law and ethical deliberation and then proceed to develop ethicolegal guidelines pertaining to gender relations within the medical context. At the end of this reflection, we offer some practice recommendations that are attuned to the cultural sensitivities of Muslim patient populations. (shrink)

Scarcity acts as a mental burden that disrupts how people process information and make decisions (Mullainathan and Shafir in Scarcity: Why having too little means so much. Macmillan, Basingstoke, 2013; Mani et al. Science 342:976–980, 2013). In this study, we replicated Mani et al.’s (Science 342:976–980, 2013) experimental design to explore whether scarcity also taxes Colombian high school students’ mental bandwidth. In a lab-in-the-field experiment, we tested how 417 high school students from high and low socioeconomic status (SES) in (...) Bogotá, Colombia, responded to different scarcity situations. Students were first presented with hypothetical scenarios of harsh or soft scarcity. Next, participants had to solve a series of tasks that measured higher cognitive functions (i.e. Raven’s Progressive Matrices, Cognitive Reflection Task and questions to assess their Delay Discounting value) and had to explain how they would solve the scarcity situation. As opposed to Mani et al. (Science 342:976–980, 2013), we did not find that scarcity taxed individuals’ mental bandwidth, neither their cognitive nor executive functions. We found that low-SES individuals, under the harsh scarcity condition, displayed more empathic attributes than high-SES individuals. Taken together, the results of this study show the importance of replication in different cultures and environments. (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)

Individuals are often restricted to indirect cues when assessing the mate value of a potential partner. Females of some species have been shown to copy each other’s choice; in other words, the probability of a female choosing a particular male increases if he has already been chosen by other females. Recently it has been suggested that mate-choice copying could be an important aspect of human mate choice as well. We tested one of the hypotheses, the so-called wedding ring effect—that women (...) would prefer men who are already engaged or married—in a series of live interactions between men and women. The results show that women do not find men signaling engagement, or being perceived as having a partner, more attractive or higher in socioeconomic status. Furthermore, signs of engagement did not influence the women’s reported willingness to engage in short-term or long-term relationships with the men. Thus, this study casts doubt on some simplified theories of human mate-choice copying, and alternative, more complex scenarios are outlined and discussed. (shrink)

Pediatric dentists rely on access to hospital operating rooms for safe, effective, and humane delivery of dental care. The children who benefit most from dental treatment in a hospital operating room are those who are very young, have dental anxieties or phobias, are precommunicative or noncommunicative, need extensive or invasive dental treatments, or have special healthcare needs. Diminishing access to hospital operating rooms for pediatric dental treatment has become an escalating problem in contemporary times. Financial barriers, hospital costs, reimbursement rates, (...) health insurance policies and deductibles, out-of-network hospitals, socioeconomic factors, and the COVID-19 pandemic are prominent contributing factors. This problem in access to care has resulted in long waiting times for hospital operating rooms, deferral of medically necessary dental care, and pain and infection among this vulnerable patient population. Pediatric dentists have responded to the problem by utilizing alternative methods of care delivery, such as in-office deep sedation or in-office general anesthesia, and by implementing aggressive medical management of dental caries. However, the youngest of pediatric patients and children with special healthcare needs still remain at a disadvantage in receiving definitive dental treatment. This article aims to highlight the ethical challenges faced by pediatric dentists in contemporary practice in the face of limitations in hospital operating room access through four case scenarios. (shrink)

Purpose Existing algorithms for predicting suicide risk rely solely on data from electronic health records, but such models could be improved through the incorporation of publicly available socioeconomic data – such as financial, legal, life event and sociodemographic data. The purpose of this study is to understand the complex ethical and privacy implications of incorporating sociodemographic data within the health context. This paper presents results from a survey exploring what the general public’s knowledge and concerns are about such publicly (...) available data and the appropriateness of using it in suicide risk prediction algorithms. Design/methodology/approach A survey was developed to measure public opinion about privacy concerns with using socioeconomic data across different contexts. This paper presented respondents with multiple vignettes that described scenarios situated in medical, private business and social media contexts, and asked participants to rate their level of concern over the context and what factor contributed most to their level of concern. Specific to suicide prediction, this paper presented respondents with various data attributes that could potentially be used in the context of a suicide risk algorithm and asked participants to rate how concerned they would be if each attribute was used for this purpose. Findings The authors found considerable concern across the various contexts represented in their vignettes, with greatest concern in vignettes that focused on the use of personal information within the medical context. Specific to the question of incorporating socioeconomic data within suicide risk prediction models, the results of this study show a clear concern from all participants in data attributes related to income, crime and court records, and assets. Data about one’s household were also particularly concerns for the respondents, suggesting that even if one might be comfortable with their own being used for risk modeling, data about other household members is more problematic. Originality/value Previous studies on the privacy concerns that arise when integrating data pertaining to various contexts of people’s lives into algorithmic and related computational models have approached these questions from individual contexts. This study differs in that it captured the variation in privacy concerns across multiple contexts. Also, this study specifically assessed the ethical concerns related to a suicide prediction model and determining people’s awareness of the publicness of select data attributes, as well as which of these data attributes generated the most concern in such a context. To the best of the authors’ knowledge, this is the first study to pursue this question. (shrink)

his chapter discusses some of the basic tenets of a critical realist social ontology. It defines capitalism, which Roy Jacques conspicuously fails to do. Jacques argues that the very point of explanatory critique is to facilitate useful action. For Geoffrey Hodgson, the epsilon scenario could be described as beyond capitalism. A form of employment contract remains, but it is a mere shell of its former capitalist self. In the work process, the degree of control by the employer over the employee (...) is minimal. Hodgson argues that 'impurity' necessarily characterizes all socioeconomic systems. However, any assessment of feasibility depends crucially upon an adequate theoretical analysis of concrete socio-economic systems. The chapter explains the nature of disaggregative analysis, which is predicated upon a realist ontology. Transcendentally the social world is composed of internal and external social relations; disaggregative analysis enables thought experiments about alternative social arrangements. The chapter addresses the nature of division of labour, knowledge and Hayek. (shrink)

Are women's movement and feminist theories still connected to radical politics and the interest in changing social inequalities, when feminism has been `institutionalized', for instance in the academia, and has become a mainstreaming issue in social policies? This main question was put to eminent feminist scholars, with the aim of investigating the renewed critical role of international feminism and women's/gender studies in society, science, information, education and research. A reconstruction of the main changes which have occurred to women's movements and (...) feminist theories in the last decades were the core of the interview, stressing differences and disagreement, also in relation to the new sociopolitical claims, supported by younger generations. The conclusion was that feminism has not lost its historical political mission, even though the world scenario and ideologies have dramatically changed. Indeed, feminism has become transcultural and `glocal', facing new socioeconomic inequities induced by globalization both in western societies and countries in development, confronting with the transformation of collective/gender identities and questioning the increasing importance of technologies. (shrink)

In this paper, we challenge one of the criticisms against the idea of a universal basic income, namely, that people will waste the support on high-end consumption. We rely on the literature from various disciplines from which we developed high- and low-UBI scenarios for respondents to decide what they would do if the state were to provide an unconditional stipend. We analyzed the multiple-choice responses, using an ordered probit, and the written explanations of the respondents’ choices, using content analysis. (...) The results suggest that while a higher UBI would increase consumption, it would likely be done responsibly. People with low incomes showed restraint in all categories. The qualitative analysis captures some of the complexities of people’s socioeconomic circumstances that support the notion of responsible consumption. The policy implication is that a UBI could be introduced at a low level and gradually increased to a level that maximizes societal benefits. (shrink)

With the rapid development of the economy, the land use/cover change in the Greater Bay Area has undergone tremendous changes, which have had directly negative effects on ecosystem functions and services. The development of sustainable land use strategies to quantitatively evaluate ecosystem services is required. Based on multitemporal land use data, the equivalent coefficients table method was used to assess the ecosystem service values, and the impact of LUCC on ecosystem services was analyzed. A future land use simulation model and (...) multiscenario simulations were employed to predict land use change in 2030. Our results indicated that the loss of ESVs decreased by 14.29 billion yuan from 2005 to 2020. The spatial distribution of the high-value ecosystem services was concentrated around the peripheral area of the northern regions in the GBA, and those areas had less land use development and human activity. Compared with those in 2020, the total ESVs of the business-as-usual scenario, socioeconomic development scenario, and cultivated protection priority scenario in 2030 decreased, while they increased in the ecological protection priority scenario. In the CPP scenario, regulating, supporting, provisioning, and cultural services increased slightly, but they decreased in the other scenarios. The patterns of LUCC were the main reasons for the decrease in ESVs, such as the loss of land with high ecological value. Additionally, a four-quadrant analysis is introduced to determine which land use simulation will be expected to be adopted by the government. The findings of this study provide valuable information for decision-making and policy development in the coastal zones and for the sustainable management of ecosystems. (shrink)

Socioeconomic Darwinism is one of the great dilemmas of our industrialized culture, playing itself out in economic events as it does periodically, in an appalling way. The authors expect marketplace competition to result in the better quality, availability, and affordability of a wider range of goods. In each episode of South Park, the authors talk about the boys reflecting on daily life, spiced up with bizarre imaginative cartoon elements, occasional aliens, a pterodactyl or two, biological mishaps, nuclear meltdowns, celebrity (...) politicians, and an endless stream of adult behavior that can only be classified as stranger than weirdness. Death is the great equalizer, which the boys are just old enough to sense. (shrink)

Qu’en est-il de la transmission généalogique de la honte? Après avoir rappelé la différence entre avoir, être et porter la Honte, l’auteur présente la notion de scénario généalogique porte-la-Honte en particulier à propos de la conception d’un enfant. Il décrit, en l’illustrant à partir d’un exemple de thérapie familiale psychanalytique et de traumatisme catastrophique communautaire, l’importance de la figuration narrative dans la clinique de la honte dans une perspective psychanalytique des liens.

Qu’en est-il de la transmission généalogique de la honte? Après avoir rappelé la différence entre avoir, être et porter la Honte, l’auteur présente la notion de scénario généalogique porte-la-Honte en particulier à propos de la conception d’un enfant. Il décrit, en l’illustrant à partir d’un exemple de thérapie familiale psychanalytique et de traumatisme catastrophique communautaire, l’importance de la figuration narrative dans la clinique de la honte dans une perspective psychanalytique des liens.

Socioeconomic inequalities are functions not only of intrinsic differences between persons or groups, but also of the dynamics of their interactions. Inequalities can arise and become stabilized if there are advantages (such as generalized wealth including “human capital”) which are self-enhancing, whereas depletion of limiting resources is widely distributed. A recent theory of biological pattern formation has been generalized, adapted and applied to deal with this process. Applications include models for the non-Gaussian distribution of personal income and wealth, for (...) overall economic growth in relation to inequalities and for effects of uncoupling strategies between developing and developed countries. Note added after publication: The equations (14) for the model of the income distribution, with its characteristic non-Gaussian extension towards higher incomes (fig.4), are closely related to the Fokker-Planck equation that is widely applied in many fields of physics. (shrink)

In infancy, maternal socioeconomic status is associated with real-time language processing skills, but whether or not this relationship carries into adulthood is unknown. We explored the effects of maternal SES in college-aged adults on eye-tracked, spoken sentence comprehension tasks using the visual world paradigm. When sentences ended in highly plausible, expected target nouns, higher SES was associated with a greater likelihood of considering alternative endings related to the action of the sentence. Moreover, for unexpected sentence endings, individuals from higher (...) SES backgrounds were sensitive to whether the ending was action-related or unrelated, showing a benefit for plausible endings. Individuals from lower SES backgrounds did not show this advantage. This suggests maternal SES can influence the dynamics of sentence processing even in adulthood, with consequences for processing unexpected content. These findings highlight the importance of early lexical experience for adult language skills. (shrink)

There are concerns that the socioeconomic consequences of COVID-19, including unemployment and financial insecurity, are having adverse effects on the mental wellbeing of the population. One group particularly vulnerable to socioeconomic adversity during this period are those employed freelance within the cultural industry. Many workers in the sector were already subject to income instability, erratic work schedules and a lack of economic security before the pandemic, and it is possible that COVID-19 may exacerbate pre-existing economic precarity. Through interviews (...) with 20 freelancers working within the performing arts, visual arts, and film and television industries, this article explores the impact of the pandemic on their working lives. Findings suggest the pandemic is affecting the psychological wellbeing of freelancers through employment loss, financial instability and work dissonance, and illustrates the need for urgent economic and psychosocial support for those employed within the cultural sector. (shrink)

In this paper a critique to philosophical approaches that presuppose invariant knowledge for policy purposes is carried out. It is shown that socioeconomic processes do not fit to the logic of stable causal factors, but they are more suited to the logic of "open-ended results". On the basis of this ontological variation it is argued that ex-ante interventions are not appropriate in the socioeconomic realm. On the contrary, they must be understood in a “dynamic” sense. Finally, derivational robustness (...) analysis is proposed as a useful tool for overcoming the problem of “overconstraint”, a typical problem of economic models. (shrink)

ObjectiveTo examine subjective and objective socioeconomic status as predictors, cognitive abilities as confounders, and personal control perceptions as mediators of health behaviours.DesignA cross-sectional study including 197 participants aged 30–50 years, recruited from the crowd-working platform, Prolific.Main Outcome MeasureThe Good Health Practices Scale, a 16-item inventory of health behaviours.ResultsSSES was the most important predictor of health behaviours. Among the OSES indicators, education, but not income, predicted health behaviours. Intelligence and memory were negatively correlated with health-promoting behaviours, and the effect of (...) memory was upheld in the multivariate model. Personal control perceptions did not act as mediators.ConclusionSSES predicted health behaviours beyond OSES. The effect of socioeconomic indicators was not confounded by cognitive abilities. Surprisingly, cognitive abilities were negatively associated with health-promoting behaviours. Future research should emphasise SSES as a predictor of health behaviours. Delineating the psychological mechanisms linking SSES with health behaviours would be a valuable contribution toward improved understanding of socioeconomic disparities in health behaviours. (shrink)

Suicide is complex; yet suicide research is dominated by ‘psy’ disciplines which can falter when seeking to explain social patterning of suicide rates, and how this relates to individual actions. This article discusses a multidisciplinary report which aimed to advance understandings of socioeconomic inequalities in suicide rates in the UK. Contrasts are drawn between health psychology and sociology. Important intersections are highlighted, including a lack of attention to socioeconomic inequalities, and an emphasis on adverse life experiences and emotions (...) to understand inequalities and suicide. There are also curious disconnects, both within and between relevant psychological and sociological perspectives. The article argues that there are significant gaps in existing theorization regarding suicide, which can only be addressed through meaningful inter-disciplinary collaborations between sociologists, psychologists and others. Current theorization in mainstream suicide research is limited by its failure to engage with enduring, yet vitally important sociological debates regarding structure and agency, nature and culture. (shrink)

A growing number of researchers in the business ethics field have used scenarios as a data gathering technique in their empirical investigations of ethical issues. This paper offers a review and critique of 26 studies that have utilized scenarios to elicit inferences of ethical reasoning, decision making, and/or intended behavior from managerial or student populations. The use of a theoretical foundation, the development of hypotheses, various characteristics germane to the use of scenarios, population and sampling issues, and (...) the use of statistical measures are explored and assessed. In the interest of improving scenario-based research, ten recommendations are presented to guide future scenario research. (shrink)

On a common view of scenario-based sceptical arguments sceptical scenarios are error-possibilities, i.e. their point is to introduce the possibility of having only false beliefs. However, global error is impossible for purely logical/conceptual reasons: Even if one’s beliefs are consistent, the negations of one’s beliefs need not be consistent as well. My paper deals with the question of what the consequences of this result are. Two attempts at repairing scenario-based sceptical arguments within the framework of understanding sceptical scenarios (...) as error-possibilities are found wanting. Instead, what should be given up is the assumption that sceptical scenarios are error-possibilities. What is thought-provoking about the scenario of the brain in a vat is not that none of its empirical beliefs are true, but that all of its empirical beliefs fall short of knowledge at the same time. Hence, sceptical scenarios are not error-possibilities, but ignorance possibilities. If this is so, both the closure argument and the underdetermination argument commit a subtle mistake and should be replaced by slightly different arguments. The principle of excluded ignorance-possibilities turns out to be an epistemological principle that is faithful to scepticism’s tenets without misinterpreting sceptical scenarios as error-possibilities. (shrink)

This study investigates whether couples' income and occupational status covary with wife and child abuse. The author interviewed 365 battered and nonbattered women about different facets of family violence and finances and obtained reports from one of their children about abuse in the home. The author compares the relative influence of overall family resources to resource disparity between women and their partners. Asymmetry in income favoring women, rather than total family income, predicted the men's frequency and severity of abuse toward (...) their wives. Overall combined occupational status of the couple also predicted wife abuse, but disparity in occupations did not. These findings suggest that income disparity rather than overall poverty contributes to wife abuse. Class standing as indexed by membership in lower-status occupations also is a risk factor for wife battering. Fathers or stepfathers who harm women are also more likely to abuse the children, with few effects of income and occupation after partialing out wife abuse. The author suggests that a proportion of these men use the children in a policy of coercion against the mothers. Further gender-based interpretations of economic roles and family dynamics are needed to illuminate the complex reasons for men's abuse of women and children. (shrink)

Despite worldwide attention given to food access, very little progress has been made under the current model. Recognizing that individual engagement is likely based on individual experiences and perceptions, this research study investigated whether or not a correlation exists between one’s socioeconomic status (SES) and perceived personal responsibility for food access. Discussion of results and implications provide fresh insight into the ongoing global debate surrounding food access. Outcomes also provide insight into willing and able participants and point to least-cost (...) solutions which may be better suited to implement and initiate change. Results indicate that the issue of food access is more complex than simply lobbying for better decision-making among individuals and populations, highlighting the importance of unit of analysis considerations. (shrink)

BackgroundThe aim of this study is to explore the association of family socioeconomic status and internal and external schoolwork support with adolescents’ school satisfaction and whether schoolwork support modifies these associations.MethodsData come from the cross-sectional Health Behavior in School-aged Children study collected in 2018 from Slovak 15-year-olds. SES was measured by Family Affluence Scale. School satisfaction was measured via school engagement and attitudes toward education. Schoolwork support was measured regarding two groups of sources inside and outside the family, separately. (...) Logistic regression models were used to explore the associations of SES and schoolwork support with school satisfaction as well as the moderating effect of schoolwork support.ResultsAdolescents with low SES were more likely to feel indifferent toward school and education, and similarly, adolescents who did not have schoolwork support inside or outside the family. Schoolwork support moderated the associations of SES with school satisfaction. Adolescents with low and middle SES without support inside or outside the family were more likely to feel indifferent than satisfied.ConclusionAdolescents from low and middle SES without schoolwork support inside or outside the family are more likely to feel indifferent toward school and education. (shrink)

This article raises the question of whether standard economics with the general equilibrium model at its core applies situational analysis in a Popperian sense. Contrary to Popper's own view, the authors come to the conclusion that this is not the case. Standard economics fails to represent elements essential to any social situation in an adequate manner. It comprises uncertainty, time and space, social interaction, unintended effects, as well as culture and institutions. The authors suggest, therefore, the socioeconomic context as (...) an alternative approach to analyzing social situations. It consists of four basic elements: (1) dominant worldviews, (2) institutions and technologies, (3) relative prices, and (4) political instruments. The alternative approach was applied with some success to analyzing inter alia problems of unemployment as well as of transformation. (shrink)

BackgroundImplementation of quarantine and lockdown to COVID-19 pandemic has created dramatic negative psychological impact mainly the general population’s health worldwide. We aimed to assess the prevalence and predictors of anxiety and stress severity among the Palestinian population.MethodsA cross-sectional web-based survey was conducted. An anonymous online questionnaire and snowball recruiting technique were used to target the general public in Palestine between 6 and 16 April, 2020 during COVID-19 pandemic lockdowns. Multivariate logistic regression models were developed for the outcome variables.ResultsOf the 2819 (...) individuals who completed the questionnaire, more than two thirds of them were females. Nearly, were residing at the West Bank. The mean age of participants was 29.47 years. The anxiety prevalence was with had mild/moderate severity. The stress prevalence was with had mild/moderate severity. The prevalence of both anxiety and stress was. In multivariate analysis, exposure to confirmed case of COVID-19, inadequacy of food supply and jobs that acquire leaving home during lockdown were significantly related to higher anxiety degree. As for stress, low monthly income, cohabitation with a person of a high-risk group and inadequacy of food supply were significantly related to higher stress degree.ConclusionYoung adults with low socioeconomic status and inadequate food supply were more likely to have a higher degree of stress and/or anxiety. Providing alternative economical sources for those in need, and spreading more awareness regarding the pandemic, supporting the population’s psychological wellbeing, community connection and the availability of specialist mental health services are crucial to overcome the mental impacts of COVID-19 in Palestine. (shrink)

Risk-taking behavior is particularly widespread during adolescence, and negatively impacts the healthy growth and social adaptation of adolescents. Utilizing problem-behavior theory and the family stress model, the current study examined the relationship between socioeconomic status and adolescents’ risk-taking behavior, as well as the mediating role of psychological capital and self-control. A total of 1,156 Chinese adolescent students completed a series of questionnaires anonymously. The results showed that: Socioeconomic status was negatively correlated with adolescents’ risk-taking behavior; Both psychological capital (...) and self-control mediated the relationship between SES and adolescents’ risk-taking behavior independently; and Psychological capital and self-control also mediated the relationship between SES and the risk-taking behavior of adolescents sequentially. This study reveals the internal mechanism of risk-taking behavior during adolescence and provides theoretical support and empirical evidence for preventing and reducing such behavior in this age group. (shrink)

Van Koppen and Mackor offer a scenario‐approach analysis of the case. They first explicate their approach, linking it to inference to the best explanation and theories of explanatory coherence. An important distinction in their analysis is between explaining known facts and predicting novel facts. They claim that their approach is cognitively feasible and stays close to descriptive theories of evidential reasoning. They want to keep it informal, so that legal professionals can apply it.

There is a vast amount of evidence across countries that the use of health care services (including hospitalizations, physician services, and clinical preventive services) is positively associated with income, education and other markers of socioeconomic position. In some analyses, lower socioeconomic status (SES) is associated with greater physician and hospital use, although it appears that these findings are primarily driven by higher rates of poor health status or medical need in socioeconomically disadvantaged populations. Three general sets of explanations (...) have been investigated to explain SES differences in health care use: (1) financial access or affordability differences (e.g. the poor use fewer services because they have fewer financial means); (2) knowledge, attitudinal and cultural differences in seeking care (e.g. the poor use fewer services because they value and/or understand the benefits of health care less than other people); and (3) health care system factors (e.g. the poor use fewer services because of ways in which the health care system is organized). The empirical evidence from a number of countries suggests that health care system variables, especially non-financial components of access, offer the greatest explanatory power regarding SES differences in utilization. The policy implications of such findings are important, for they suggests that providing universal coverage or offering free health services to the poor is not a panacea for reducing social inequalities in health care utilization. Research across countries also suggests that, although SES differences in the use of health care services may contribute to some portion of observed SES disparities in health status, the contribution here is likely to be small. Social inequalities in health status are driven by myriad factors other than access to and use of personal health services. (shrink)

In recent years Vietnam has experienced a high sex ratio at birth SRB) amidst rapid socioeconomic and demographic changes. However, little is known about the differentials in SRB between maternal socioeconomic and demographic groups. The paper uses data from the annual Population Change Survey (PCS) in 2006 to examine the relationship of the sex ratio of the most recent birth with maternal socioeconomic and demographic characteristics and the number of previous female births. The SRB of Vietnam was (...) significantly high at 111.4 (95% CI 109.7–113.1) for the period 1st April 2000 to 31st March 2006. Multivariate analysis reveals that sex of the most recent birth is strongly related with the number of previous female births. This association is consistent across different socioeconomic and demographic groups of women. Given the high SRB in Vietnam, further research into the reasons for high SRB in these groups is required, as are intervention programmes such as those raising the public awareness of its negative consequences. © Cambridge University Press, 2010. (shrink)

Age at marriage is one of the factors that influence the fertility behaviour of women, particularly in a society like Nepal where contraceptive use is low. Socioeconomic and cultural factors, particularly religion and ethnicity, are important variables in determining age at marriage in Nepal. Fertility was negatively related with age at marriage. Marriage duration had a greater influence on fertility than age at marriage, although these were strongly correlated.

Changes in the productive forces and, consequently, in the economic structure of socialist society as a whole are being prepared by the current relationships of production. We refer particularly to the influence of socioeconomic processes under the conditions of the revolution in science and technology on the development of the individual as a factor in the productive forces and as subject in production relationships.

This article investigates structural aspects of source domains in metaphorical mappings with regard to their manifestation in public discourse data. Specifically, it analyses the organization of source concepts into mininarratives or "scenarios" that dominate the discourse manifestations of source domains. The material consists of examples from a bilingual corpus of British and German public debates about the &European Union.& The data show that while the two national samples share some basic mappings between the source and target domains, they each (...) are characterised further by specific scenarios that provide focal points for conceptualizing the target topic. The scenarios can also be shown to carry evaluative and attitudinal biases that are related to particular political dispositions and preferences of the respective national discourse communities. In conclusion, it will be argued that the analysis of scenarios is a necessary complement to the study of source domains and of domain-mappings in metaphorical language use. (shrink)

Promoting respect for the four principles remains of great practical importance in ordinary medicineThe following are four “scenarios” with brief outlines of how Raanan Gillon has analysed them using the “four principles” approach. These are the four cases that the commentators were asked to analyse.Professor Gillon has for many years advocated the use of the Beauchamp and Childress four principles approach as a widely and interculturally acceptable method for medical ethics analysis . At present there seems to be a (...) backlash by some bioethicists against this approach, with among others, adherents of feminist ethics, narrative ethics, virtue ethics, and various varieties of regional ethics claiming to offer better approaches to medical ethics.At Raanan Gillon’s request this special issue of the Journal of Medical Ethics is intended to focus on this aspect of his work, with a view not only to discussing the issue of how different approaches to medical ethics are and/or are not compatible with the four principles approach but also to make clear to JME readers what alternative ethics analysis method is preferred and used by the various commentators.THE “STANDARD” JEHOVAH’S WITNESS CASEIn the first scenario, that of the “standard” Jehovah’s Witness case, a competent adult patient loses a massive amount of blood from a blood vessel bleeding in an acute duodenal ulcer. The best chance of …. (shrink)