Compared with non-union workers, union workers take more of their compensation in the form of insurance. This may be because unions choose democratically, and democratic choice mitigates adverse selection in group insurance. Relative to individually-purchased insurance, we show that group insurance chosen by an ideal profit-maximizing employer can be worse for every employee, while group insurance chosen democratically can be much better. The reason is that democracy can fail to represent the preferences of almost half the group.

According to agency theory, agents base their economic decisions on self-interests when adverse selection conditions exist. However, cognitive moral development theory predicts that ethics/morals may influence decision-makers not to behave egoistically. Rutledge and Karim, 173-184) find both the moral reasoning level of the managers and an adverse selection condition affect a manager's project evaluation decisions significantly. Since prior studies have shown that national culture might influence the application of agency theory in project evaluation, this current study (...) uses a different moral development measurement to reexamine Rutledge and Karim's hypotheses in another culture. A total of 73 Taiwanese executive MBA students with an average of 12.17 years work experience participated in this study. We found that both moral development level and adverse selection conditions significantly affect managers' project continuance decisions. The interaction effect of these two factors indicates that, when adverse selection conditions exist, participants with a high level of moral development exhibit less of a tendency to continue an unprofitable project than those with a low level of moral development. With subjects from a different culture, our results confirm the findings of Rutldege and Karim. That is, the effects of moral development and adverse selection conditions on managers' project continuance decisions are robust and can be generalized to different cultures. Implications of the findings of this study to multinational firms are also discussed. (shrink)

According to agency theory, agents base their economic decisions on self-interests when adverse selection conditions exist. However, cognitive moral development theory predicts that ethics/morals may influence decision-makers not to behave egoistically. Rutledge and Karim (1999; Accounting, Organizations and Society 24(2), 173–184) find both the moral reasoning level of the managers and an adverse selection condition affect a manager’s project evaluation decisions significantly. Since prior studies have shown that national␣culture might influence the application of agency theory in (...) project evaluation, this current study uses a different moral development measurement to reexamine Rutledge and Karim’s hypotheses in another culture. A total of 73 Taiwanese executive MBA students with an average of 12.17 years work experience participated in this study. We found that both moral development level and adverse selection conditions significantly affect managers’ project continuance decisions. The interaction effect of these two factors indicates that, when adverse selection conditions exist, participants with a high level of moral development exhibit less of a tendency to continue an unprofitable project than those with a low level of moral development. With subjects from a different culture, our results confirm the findings of Rutldege and Karim. That is, the effects of moral development and adverse selection conditions on managers’ project continuance decisions are robust and can be generalized to different cultures. Implications of the findings of this study to multinational firms are also discussed. (shrink)

The debate on whether insurance companies should be allowed to use results of individuals’ genetic tests for underwriting purposes has been both lively and increasingly relevant over the past two decades. Yet there appears to be no widely agreed upon resolution regarding appropriate and effective regulation. There exists today a gamut of recommendations and actual practices addressing this phenomenon ranging from laissez-faire to voluntary industry moratoria to strict legal prohibition. One obvious reason for such a variance in views and approaches (...) is that there are competing bases for evaluating the outcomes of restricting insurers’ use of such information. For example, an outright ban on the use of genetic test results may seem the best method for protecting against unfair discrimination, while allowing their use may seem to be the best way to foster efficiency in the market for insurance. However, there is also a lack of understanding about how restricting the use of genetic information would play out in the market through the so-called phenomenon of adverse selection. Using economic analysis, we discuss how the type of adverse selection that occurs in insurance markets affects various arguments both in favour and against an outright ban on insurers’ use of genetic tests for pricing insurance. We review arguments based on moral principles . Practical concerns from the insurance industry based on actuarial principles and economic efficiency are also compared. Each perspective is shown to lead to a range of conflicting recommendations about how genetic information should be regulated and these conclusions depend critically on whether one conducts the analysis from the ex ante temporal perspective , from the interim temporal perspective , or from the ex post temporal perspective. (shrink)

This study investigated the effect of ACEs and COVID-19 on grit and whether this effect is mediated by mindfulness. Although current scholarship has found that adverse childhood experiences have harmful consequences to individuals across the life span, less is known about the relationship between ACEs and grit. Grit is predictive of educational success and subjective wellbeing. A cross-sectional online survey administered to junior and senior students from 12 universities spread across China was conducted from September 20, 2020 to October (...) 5, 2020. The universities were selected from geographically diverse regions of China to ensure a diverse sample. We received 1,871 completed responses from 2,229 invited students. The survey response rate was 83.9%. The results indicated that ACEs had significantly negative effects on grit, while mindfulness had significantly positive effects on grit. Once controlling for level of mindfulness, the effects of ACEs on grit largely reduced and became insignificant. The findings of this research indicate that mindfulness has a significant mediational effect on the relation between ACEs and grit and call for mindfulness-based interventions for enhancing grit for the population at risks. (shrink)

The coastal zone of Bangladesh is endowed with dynamic ‘Terrestrial’ and ‘Coastal and Marine ecosystem’. The zone confronts with declined environmental quality owing to unethical anthropogenic interventions. Few studies regarding ethical attitudes of local communities to conserve the coast were conducted earlier. Two objectives, such as (i) heavy metal concentration, and (ii) physio-chemical quality of sample soil and water were selected to reveal the environmental state of study area. Five heavy metals like- Cadmium, Copper, Iron, Lead, and Zinc; and four (...) physio-chemical parameters such as, the pH, Electrical Conductivity, Temperature, and Turbidity of sample soil and water were measured. The average concentration of Pb in soil is 10 times higher than world average (0.03 mg/g), while Cd concentration in soil is two times more than world average (0.11 mg/L). The concentration of Fe at Inani beach water is 1.54 mg/g more than world average (3.4 mg/g). The physio-chemical parameters are within standard range. Unethical discharge of toxic effluents from shrimp hatcheries, and municipal garbage are main sources of pollution, which ensue into environmental degradations. Concentration of five heavy metals and Calcium Carbonate (CaCO3) in sample mollusk shells exhibit biodiversity deterioration. The mollusk shells from Inani beach contains 0.04 mg/L Cd,0.08 mg/L Cu, 0.42 mg/L Fe, 0.38 mg/L Pb, and 0.07 mg/L Zn. The CaCO3 content in mollusk shells at Inani beach is 49.5%, which indicates the degradation of the mollusks, as shells normally are made with 95% - 97% Calcium Carbonate. Hence, the Department of Environment (DOE), Bangladesh (GoB) declared the area as an ‘Ecologically Critical Area’ (ECA). The concerned stakeholders, like- CPP volunteers and officials, Forest Division, Fisheries Research Institute, Bangladesh Water Development Board, Union Chairman and Journalists of Cox’s Bazar recommended insertion of moral values among local stakeholders through trainings, motivational lectures, demonstrations and dramas, as well as, incorporation of lessons about consequences of unethical activities upon geo-environment into text books. Though least practice has been found regarding moral values during survey, the present research advocates in developing ‘Knowledge pool’ about coastal environment, creating awareness, and developing moral ethics among the local, regional and national stakeholders. (shrink)

Anti-selection occurs when information asymmetry exists between insurers and applicants. When an applicant knows they are at high risk of loss, but the insurer does not, the applicant may try to use this knowledge differential to secure insurance at a lower premium that does not match risk.

Capitalizing on a 15-year longitudinal dataset of 9–12 years old children in rural China, this study adopts a life course perspective and analyzes cumulative childhood adversity and its associations with mental health problems from childhood to adulthood. Four domains of childhood life are selected to construct cumulative childhood adversity: socioeconomic hardship, family disruption, physical issue, and academic setback. Overall, cumulative childhood adversity significantly associates with children’s internalizing and externalizing problems as well as adults’ depression and self-esteem. However, cumulative childhood adversity (...) has no significant relationship with internalizing and externalizing problems in adolescence. Furthermore, different domains of childhood adversity matter differently for mental health problems in different life stages. Physical issue and academic setback have the strongest association with internalizing and externalizing problems in childhood, while only socioeconomic hardship has a significant relationship with depression and self-esteem in adulthood. The relationship between cumulative childhood adversity and adult mental health problems is fully mediated by educational attainment. Finally, there is no gender difference in either the occurrence of cumulative childhood adversity or the association between cumulative childhood adversity and mental health problems. (shrink)

PurposeThis paper is an exploratory study to investigate possible remedial measures accounting for a relatively favorable prognosis of health sector workers who have experienced physical WPV in Zhejiang province, China.MethodsFollowing a proportionate stratified sampling strategy, five tertiary hospitals, eight secondary hospitals, and thirty-two primary care facilities were conveniently selected. Among 4,862 valid respondents out of 6,089 self-conducted questionnaires, 224 health sector workers who have been directly exposed to physical WPV in the past year were included in the present study.ResultsThe present (...) study has three major findings: Victims’ satisfaction with the resolution of the physical WPV conflict was directly associated with the favorable prognosis. Taking days off from work after the violence can promote victims’ satisfaction with the resolution of the physical WPV conflict. Knowing that relevant departments investigated the case can promote victims’ satisfaction with the resolution of the physical WPV conflict.ConclusionWe propose a combined gesture of “offering adequate days off work after physical WPV” and “every physical violence must be investigated” that should be taken by all medical institutions in China. Health sector workers who get involved in physical WPV incidents should prioritize their safety and avoid any behavior that may intensify the conflicts. (shrink)

Corneal transplantation is the most common form of organ transplantation performed globally. However, of all organs, eyes have the highest rate of refusal of donation. This study explored the reasons why individuals decide whether or not to donate corneas. Twenty-one individuals were interviewed who had made a donation decision (13 refused corneal donation and eight consented). Analysis was performed using Grounded Theory. Refusal of corneal donation was related to concerns about disfigurement and the role of eyes in memory and communication. (...) The request for donation therefore raised concerns about a potential adverse change in the ongoing relationship with the deceased, even in death. For those who refused donation, these concerns overshadowed awareness of need or benefit of transplantation. Adjusting the donation message to be more congruent with the real, lived experience of corneal donation may to some extent “prepare” individuals when the donation question is raised. (shrink)

BackgroundTitles and abstracts are the most read sections of biomedical papers. It is therefore important that abstracts transparently report both the beneficial and adverse effects of health care interventions and do not mislead the reader. Misleading reporting, interpretation, or extrapolation of study results is called “spin”. In this study, we will assess whether adverse effects of orthodontic interventions were reported or considered in the abstracts of both Cochrane and non-Cochrane reviews and whether spin was identified and what type (...) of spin.MethodsEligibility criteria were defined for the type of study designs, participants, interventions, outcomes, and settings. We will include systematic reviews of clinical orthodontic interventions published in the five leading orthodontic journals and in the Cochrane Database. Empty reviews will be excluded. We will manually search eligible reviews published between 1 August 2009 and 31 July 2019. Data collection forms were developed a priori. All study selection and data extraction procedures will be conducted by two reviewers independently. Our main outcomes will be the prevalence of reported or considered adverse effects of orthodontic interventions in the abstract of systematic reviews and the prevalence of “spin” related to these adverse effects. We will also record the prevalence of three subtypes of spin, i.e., misleading reporting, misleading interpretation, and misleading extrapolation-related spin. All statistics will be calculated for the following groups: (1) all journals individually, (2) all journals together, and (3) the five leading orthodontic journals and the Cochrane Database of Systematic Reviews separately. Generalized linear models will be developed to compare the various groups.DiscussionWe expect that our results will raise the awareness of the importance of reporting and considering of adverse effects and the presence of the phenomenon of spin related to these effects in abstracts of systematic reviews of orthodontic interventions. This is important, because an incomplete and inadequate reporting, interpretation, or extrapolation of findings on adverse effects in abstracts of systematic reviews can mislead readers and could lead to inadequate clinical practice. Our findings could result in policy implications for making judgments about the acceptance for publication of systematic reviews of orthodontic interventions. (shrink)

Em seus últimos anos de vida, Foucault empreendeu uma genealogia da parresia (do dizer-verdadeiro) no campo da política e na história da filosofia. Alicerçando suas análises nas fontes clássicas, gregas e romanas, Foucault descortinou um cenário no qual a coragem da verdade tem um lugar maior na experiência política desde sempre. O que pretendemos nesse trabalho é discutir alguns pontos que nos parecem problemáticos nessa genealogia foucaultiana, em especial, a referência à verdade na parresia democrática e a relação entre filosofia (...) e política. Palavras-Chave: Foucault. Parresia. Democracia. Filosofia. (shrink)

Normals display selective deficits in morphology and syntax under adverse processing conditions. Digit loads do not impair processing of passives and object relatives but do impair processing of grammatical morphemes. Perceptual degradation and temporal compression selectively impair several aspects of grammar, including passives and object relatives. Hence we replicate Caplan & Waters's specific findings but reach opposite conclusions, based on wider evidence.

BackgroundThe relatively young and inexperienced healthcare professionals in Mongolia faced with an unprecedent service demand in response to the COVID-19 pandemic. Due to the small size of the healthcare workforce the Mongolian Health Ministry had no choice but to mandate continuous and long workhours from the healthcare workforce. Many of the healthcare professionals exhibited signs and symptoms of mental health disorders. This study aimed to discern the prevalence various mental health concerns, i.e., depression, anxiety and stress, insomnia, and to discern (...) the factors that increased susceptibility to mental health disorders among frontline healthcare professionals providing healthcare services for COVID-19 patients in Mongolia.MethodsA Cross-sectional research design was implemented. We collected data from 965 healthcare professional, randomly selected from 18 government hospitals, in four regions of Mongolia. Data were collected using the Depression Anxiety Stress-21, the General Self-Efficacy Scale, and the Insomnia Severity Index instruments. We constructed the scale of Pandemic Response Symptoms which captured stress, depression, and anxiety. Data were analyzed using descriptive statistics, Kruskal–Wallis statistical test and multinominal logistic regression analysis.ResultsPrevalence of depression, anxiety, and stress was documented among Mongolian healthcare professionals. Perception of self-efficacy reduced susceptibility to PaReSy either at mild/moderate or severe/extremely severe level. Within each stratum of insomnia, the risk of experiencing PaReSy increased almost linearly both in the category of mild/moderate PaReSy and in the category of severe/extremely severe PaReSy.ConclusionImproving self-efficacy and sleeping quality can assist healthcare workers to manage depression, anxiety, and stress. Findings provide important evidence to implement measures and strategies to assist healthcare professionals in low- and middle-income countries to constructively address their mental health concerns and needs. (shrink)

The concept of Industry 4.0 refers to the Fourth Industrial Revolution, which started in the 18th century with the First Industrial Revolution in England and is accepted as the last stage of industrial revolutions reached today. Industry 4.0 is expected to influence all sectors in the economy, especially the industry sector, the emergence of new professions based on cyber physical systems and artificial intelligence (smart machines), the need for labor to decrease considerably and a qualified workforce to remain in the (...) market. Along with the Industry 4.0 process, the change and transformation that will occur in the structure and functioning of the professions will have major impacts both in the individual, social and economic fields. In the present case; career planning and career choice issues, which are already difficult due to educational system troubles, adverse environmental conditions, the level of economic and technological development of the country, etc. will become more complicated for individuals with Industry 4.0 process. In this study, it is aimed to investigate the career selection and the possible effects of change and transformation in professions. In the study in which literature review and editing methods were used; conditions affecting the development and emergence of Industry 4.0 were examined first. Next; career concepts and career choice issues were analyzed. In the last part; in the context of career phases, research and editing has been carried out to determine the effects of Industry 4.0 on career development in children, youth and adults. According to the research data in the study; in the industry 4.0 process, it was determined that some of the existing professions will disappear due to technological development, whereas new occupations that are not currently available will emerge, and the professions that will continue to exist will also change. As a result of all these data, industry 4.0 process is expected to significantly affect professions, career choice and career development. (shrink)

Although it is now fifteen years since G. Williams' thorough-going criticism of B. Axelson's Unpoetische Wörter, his discussion has failed to elicit the adverse response which might have been expected in view of the widespread influence exerted by the earlier work. The reason for this may be that Axelson's theory is so widely accepted that any refutation thereof may be disregarded. Yet surely Williams was right to point to the dangers of total reliance on statistics and to the necessity (...) of considering the contexts in which words occur in Latin poetry. In this respect, he was not so much rejecting Axelson's work as pointing to its inadequacies: whereas Axelson would be content to label a word that occurs only rarely in poetry as ‘unpoetisch’, it is necessary, as Williams demonstrates, to take the further step of determining the effect that such a word has in a given context. This approach will be particularly helpful, for example, in the case of parvulus at Virg. Aen. 4.328, where the heightened pathos achieved by Virgil's use of a diminutive is better appreciated by the reader who is aware of the scarcity of diminutive adjectives in poetry and in epic above all. To recognise parvulus as an ‘unpoetic word’, with Axelson, is the essential first step, but we should proceed a stage further to inquire what effect was intended by the employment of a form not normally found in elevated poetry. Of greater importance is Williams' rejection of the ‘hierarchy of genres’ theory, taken for granted by Axelson, that is, that Latin poetry may be divided into a number of higher- or lower-ranking genres and that the more elevated a genre the less unpoetic vocabulary it is liable to employ. (shrink)

Industrial development in recent decades has led to using information and communication technologies to support personnel selection processes. One of the most notable examples is game-related assessments, supposedly as accurate as conventional tests but which generate better applicant reactions and reduce the likelihood of adverse impact and faking. However, such claims still lack scientific support. Given practitioners’ increasing use of GRA, this article reviews the scientific literature on gamification applied to personnel selection to determine whether the current (...) state of the art supports their use in professional practice and identify specific aspects on which future research should focus. Following the PRISMA model, a search was carried out in the Web of Science and Scopus databases, identifying 34 valid articles, of which 85.3% are empirical studies that analyze five areas: validity; applicant reactions; design of GRA; personal characteristics and GRA; and adverse impact and faking. Together, these studies show that GRA can be used in personnel selection but that the supposed advantages of GRA over conventional tests are fewer than imagined. The results also suggest several aspects on which research should focus, which could help define the situations in which the use of GRA may be recommended. (shrink)

O objetivo do artigo é compreender alguns aspectos do republicanismo de Maquiavel concedendo atenção à sua teoria dos humores. Mais especificamente, trata-se de entender qual a natureza do desejo do povo e seu papel na vida política. A principal hipótese deste trabalho é a de que a função que Maquiavel atribui ao povo, o guardião da liberdade, exige, para seu cumprimento, a participação ativa do cidadão nos afazeres cívicos, isto é, sua inscrição no espaço público como agente político. Essa inscrição (...) não pode ser inteiramente compreendida se o desejo que caracteriza o povo carecer de qualquer determinação, isto é, se for tomado somente em uma perspectiva negativa. (shrink)

O objetivo deste trabalho é demonstrar que o pensamento de Maquiavel, ao colocar no centro da vida política um conflito insuperável entre as partes constituintes da cidade, lança as bases para uma nova compreensão da república e da liberdade. Esta teoria dos “humores”, como ele a denominava, também lança luz sobre o dinamismo das sociedades democráticas, como podemos constatar nos trabalhos de Claude Lefort.

Legal liabilities pertaining to the identification and selection of domain experts is an issue that could adversely impact expert systems developers. Problems pertaining to flawed knowledge, improperly defined expertise, and behavioural and psychological impediments are just some of the issues. This paper examines the torts of strict products liability and negligence that system developers could incur as a result of expert-related difficulties. Parallels from legal scholars and federal and state court decisions are discussed relevant to expert system projects and (...) developers. The paper concludes with a presentation of steps that systems developers can take to minimize potential legal liability. (shrink)

Aceitando o pressuposto de que política e guerra são domínios afins em Maquiavel, nós pretendemos neste artigo examinar a especificidade da arte da guerra em cotejamento com a arte do Estado. Se as homologias entre os dois campos são evidentes, resta investigar os pontos em que eles se diferenciam de modo decisivo. Para tanto, será preciso fazer duas coisas: por um lado, destacar as principais componentes da arte da guerra como conjunto de práticas; por outro lado, demonstrar que ela somente (...) pode alcançar seus objetivos se for capaz de produzir a união entre os integrantes do exército. (shrink)

Este artigo tem por objetivo mostrar que a crítica de Hannah Arendt ao social, formulada sobretudo em A condição humana, não deve obscurecer o fato de que sua teoria do político não apenas é compatível com a ideia de sociedade civil, mas a mobiliza em determinados contextos, o que pode ser comprovado quando retomamos seu livro sobre as revoluções e seu texto sobre a desobediência civil.

Background: Pulsed dye laser is the gold standard for treatment of port-wine stain birthmarks but multiple treatments are required and complete resolution is often not achieved. Posttreatment vessel recurrence is thought to be a factor that limits efficacy of PDL treatment of PWS. Imiquimod 5% cream is an immunomodulator with antiangiogenic effects. Objective: We sought to determine if application of imiquimod 5% cream after PDL improves treatment outcome. Methods: Healthy individuals with PWS were treated with PDL and then randomized to (...) apply posttreatment placebo or imiquimod 5% cream for 8 weeks. Chromameter measurements for 57 PWS sites were taken at baseline and compared with measurements taken 8 weeks posttreatment. The Δa and ΔE were measured to quantify treatment outcome. Results: Two patients developed minor skin irritation. Other adverse effects were not noted. Average a was 0.43 for PDL + placebo sites and 1.27 for PDL + imiquimod sites indicating a greater reduction in erythema with imiquimod. Average E was 2.59 for PDL + placebo and 4.08 for PDL + imiquimod, again indicating a greater color improvement with imiquimod. Limitations: Effects were evaluated after a single treatment and duration of effect is unknown. Conclusion: Combined selective photothermolysis and antiangiogenic therapy may enhance PWS treatment efficacy. © 2011 by the American Academy of Dermatology, Inc. (shrink)

The new class of anti-inflammatory drugs, the COX-2 inhibitors, have been commercially successful to the point of market dominance within a short time of their launch. They attract a price premium on the basis that they are associated with fewer adverse gastric events than traditional anti-inflammatory drugs. This marketing continues even though a pivotal safety study with one of the COX-2 inhibitors, rofecoxib, showed a significant increase in myocardial infarction with rofecoxib use compared with a traditional anti-inflammatory drug. This (...) finding has led to a series of publications containing pooled analyses of existing data that both support and refute the possibility of increased cardiovascular risk with COX-2 inhibitors.These medical journal publications have served to obfuscate rather than provide guidance for medical practitioners. Consideration of a research ethics committee approach to this issue suggests that it would deal with the controversy in a straightforward manner—namely, it would simply inform research participants of the trial results with rofecoxib. The certainty of this research ethics committee approach raises the issue of whether it should be applied in normal medical practice outside of the research environment. A consideration of the legal tests for disclosure of information suggests that therapeutic medical practice should mirror that within the research environment, in this case. (shrink)

RESUMO Neste artigo pretendemos mostrar as vantagens do modelo epistemológico coerentista quando aplicado ao universo moral. O ponto de partida será apontar que a justificação da crença moral é dada pela coerência com um sistema coerente de crenças que é consistente e que isso pretende resolver o problema da dicotomia entre fato e valor. Posteriormente, apresentam-se as características centrais do coerentismo holístico e investiga-se o método do equilíbrio reflexivo. O próximo passo será fazer referência a três conhecidas objeções ao coerentismo, (...) a saber: o problema do isolamento, os sistemas coerentes alternativos e a circularidade viciosa. Por fim, procuramos responder a essas objeções apelando para os seguintes argumentos: holismo social, razoabilidade e estabilidade social. ABSTRACT In this paper we aim to demonstrate the advantages of the epistemological coherentist model when applied to the moral sphere. The starting point will be to show that the justification of moral belief is a matter of how beliefs fit together with a coherent system of beliefs that is consistent and that it tries to solve the issue of the fact/value dichotomy. Following this, we shall point out the core characteristics of the holistic coherentism and we will investigate the reflective equilibrium method. Next step is to show three standard objections to coherentism, namely, the isolation problem, the alternative coherent systems objection and the vicious circularity. Finally, we shall then try to respond these criticisms with the following arguments: social holism, reasonableness and social stability. (shrink)

In Emotions, Values & Agency, Christine Tappolet develops a sophisticated, perceptual theory of emotions and their role in wide range of issues in value theory and epistemology. In this paper, we raise three worries about Tappolet's proposal.

Reviews issues in the ethics of access to health insurance based on health problems due to genetic inheritance.

The result of two key social developments in recent years are examined here: the partial dismantling of the welfare state and the progress of genetics. Genetic insights are increasingly valuable for risk assessment, and insurers would like to use these insights to help determine premiums. Combined with the fact that social welfare is being curtailed, this could potentially create an uninsured high-risk population. Along with considerations of autonomy and privacy, this is the basis for an ethical critique of insurer's access (...) to information. The result has often been regulation of such information; but the authors argues that due to adverse selection, regulation will not solve these problems, and this may jeopardize the survival of private personal insurance. Instead, we should look towards the resurrection of social insurance, a key component of the welfare state. This will interest academic researchers as well as professionals involved with genetics and insurance. (shrink)

There is a widespread feeling that health is special; the rules that are usually used in other policy areas are not applied in health policy. Health economists, for example, tend to be reluctant to offer economists’ usual prescription of competition and consumer choice, even though they have largely failed to justify this reluctance by showing that health economics involves special features such as public goods, externalities, adverse selection, poor consumer information, or unusually severe consequences. Similarly, while some philosophers (...) argue for bioethical conclusions based on very general ethical intuitions,1 many others rely on moral intuitions that are specific to health and medicine to draw conclusions that are meant to apply mainly in health and medicine. For example, many authors appear to start from the strong moral intuition that it typically seems wrong to deny poor people access to health care, and then seek moral principles that can both account for such intuitions and justify the claim that people have some sort of right to health care.2 In metaethics, opinions on moral intuitions range from an extreme intuitionism, which accepts all case-specific moral intuitions at face value as reliable moral guides, to an extreme foundationalism, which rejects such intuitions as evidence regarding correct general moral principles. Between these extremes, opinions vary on how severe the errors in our moral intuitions are. The practice of bioethics seems to favor the extreme intuitionist end of this spectrum, and thus implicitly expects mild errors.3 In contrast, this essay will suggest that common practice in bioethics has seriously underestimated the errors in our moral intuitions. In this essay, I consider the evolutionary origin of our moral intuitions, but avoid the extreme positions of moral skepticism and “whatever evolved must be good,” both of which are commonly associated with evolution-. (shrink)

There is a widespread feeling that health is special; the rules that are usually used in other policy areas are not applied in health policy. Health economists, for example, tend to be reluctant to offer economists' usual prescription of competition and consumer choice, even though they have largely failed to justify this reluctance by showing that health economics involves special features such as public goods, externalities, adverse selection, poor consumer information, or unusually severe consequences.

Under conditions with a low level of available genetic information, mutualistic private insurance markets will often create broadly just outcomes, even if by accident rather than by design. Normatively acceptable outcomes of this kind would come under threat if insurers were to have increased access to genetic information with substantial predictive content.1 As the availability of relevant individual genetic information grows, mutualistic forms of market-based insurance face a dilemma between either sacrificing individuals’ interests in genetic privacy, or creating conditions for (...) market failure due to adverse selection. My view is therefore that we have good reason to shift towards more solidaristic forms of ‘risk-sharing institutions’ with regard to functions such as life insurance and critical illness insurance, as a way of resolving normative tensions between values of equality, privacy, non-discrimination and autonomy. Such a position, I have argued, does not depend on endorsing any particular conception of social justice, but can be defended on the basis of a number of different plausible accounts of what justice demands.1 Jonathan Pugh argues against my endorsement of a shift towards solidaristic, non-market risk-sharing institutions, and instead argues broadly in favour of the status quo. He holds that it counts against my proposals that they ‘have wide-ranging and highly revisionary implications’, and argues that my approach is mistaken in relying on ‘a single contestable theory’. Pugh offers a purportedly less contestable account of the relevant normative considerations underlying insurance regimes, composed of three …. (shrink)

Moral choice, as a precursor to behaviour, has an important influence on the success or failure of business entities. According to Rest, 1983, Morality, Moral Behavior and Moral Development (John Wiley & Sons, New York), moral choice is prompted, amongst other things, by a motivational component. With this in mind, data obtained from a sample of four hundred financial sector operatives, employed in a rapidly developing region of China, was used to construct a relatively stable set of motivational typologies which (...) could be used to predict choice within an agency-based context. A non-egoist version of the agency theory was developed, which permitted the modelling of alternative heuristic patterns. Altruists and persons identified as bordering on the verge of being classified as psychological egoists, refused to reorganize their motives when responding to a problem that included both moral hazard and adverse selection criteria. It was also possible to identify certain personal and contextual issues which discriminated between the typologies. (shrink)