Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding research participation. (...) Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)

This article considers the ethical implications of prospective payment from the perspective of physicians and other health care practitioners. It focuses on the argument that prospective payment creates ethical conflict by giving physicians an economic incentive to do less for their patients. This argument is criticized in two respects. First, available evidence is reviewed which suggests that the incentives actually created by different prospective payment schemes and their effect on "optimal" patterns of practice is uncertain. Further, it is pointed out (...) that ethical conflict originates in the dual role of physicians as agents and suppliers of service. Recognizing that such conflict exists under any payment mechanism, a better focus for the ethical evaluation of prospective payment is suggested that considers whether the incentive to do less is likely to have adverse effects on physician decisions, relative to decisions made under other payment mechanisms. Keywords: incentives, utilization, conflict of interest, efficiency, justice, agent CiteULike Connotea Del.icio.us What's this? (shrink)

In the “olden days,” only a few years ago, physicians were free to order virtually any service they believed their patients needed, confident that virtually everything would be paid for. Reimbursernent was retrospective, fee-for-service and generous, essentially a cost-plus system in which insurers only rarely challenged medical decisions. That system is now gone. Uncontrolled escalations in the cost of health care have prompted those who pay its costs—primarily governments, businesses, and insurers—to initiate a broad array of cost controls in hopes (...) of at least restraining the rise of their expenditures, even if not actually reducing them. Among the most prominent cost-containment mechanisms is utilization review (UR).Insurers have always engaged in retrospective review, denying payment for services that are not medically necessary, or not covered by the patient's policy, or not documented in the patient's records. Recently, however, payers have added prospective review, in which physician and patient must secure advance payer approval for certain interventions if they wish to ensure reimbursement. (shrink)

In the target article “Promoting Ethical Payment in Human Infection Challenge Studies,” Fernandez Lynch et al. call for more information sharing about research payment amounts to study parti...

To prepare for potential human infection challenge studies involving SARS-CoV-2, we convened a multidisciplinary working group to address ethical questions regarding whether and how much SAR...

We largely agree with Grimwade et al ’s1 conclusion that challenge trial participants may ethically be paid, including for risk. Here, we add further arguments, clarify some points from the perspective of economics and indicate areas where economists can support the development of a framework for ethically justifiable payment. Our arguments apply to carefully constructed and monitored controlled human infection model trials that have been appropriately reviewed and approved. Participants in medical studies perform a service. Outside the domain of research (...) participation, there is nearly universal agreement that workers providing a service should be compensated fairly, and that work involving more discomfort and risk should be compensated more generously. Accordingly, labour regulations impose floors, not caps on compensation. Caps, even if intended to protect against undue inducement, also raise concerns about illegal price-fixing that disadvantages workers. Such limits on payment for egg donors have successfully been challenged in court.i Moreover, caps on compensation may harm everyone at risk of infection, not just potential participants. Insufficient compensation may impede the recruitment of enough suitable subjects, for example, when representativeness of the subject sample is required. Delays in vaccine development not only prolong disruption of social, educational and economic activity but also lead to excess infections and deaths. Unlike paid CHIM participants, individuals exposed to such infection do not accept it voluntarily, are not compensated for it, and are unlikely to receive the level of medical supervision afforded to closely monitored CHIM participants. Payment caps can lead to attempts to circumvent the regulation. For example, many countries …. (shrink)

Lifestyle-induced diseases are becoming a burden on healthcare, actualizing the discussion on health responsibilities. Using data from the National Association for Heart and Lung Diseases ’s 2015 Health Survey, this study examined the public’s attitudes towards personal and social health responsibility in a Norwegian population. The questionnaires covered self-reported health and lifestyle, attitudes towards personal responsibility and the authorities’ responsibility for promoting health, resource-prioritisation and socio-demographic characteristics. Block-wise multiple linear regression assessed the association between attitudes towards health responsibilities and individual (...) lifestyle, political orientation and health condition. We found a moderate support for social responsibility across political views. Respondents reporting unhealthier eating habits, smokers and physically inactive were less supportive of health promotion policies. The idea that individuals are responsible for taking care of their health was widely accepted as an abstract ideal. Yet, only a third of the respondents agreed with introducing higher co-payments for treatment of ‘self-inflicted’ conditions and levels of support were patterned by health-related behaviour and left-right political orientation. Our study suggests that a significant support for social responsibility does not exclude a strong support for personal health responsibility. However, conditional access to healthcare based on personal lifestyle is still controversial. (shrink)

Financial ties between physicians and pharmaceutical companies are pervasive and controversial. However, little is known about how patients perceive such ties. This paper describes an experiment examining how a national sample of U.S. adults perceived a variety of financial relationships between physicians and drug companies. Each respondent read a single scenario about a hypothetical physician and his financial ties to the pharmaceutical industry; scenarios varied in terms of payment type of and amount. Respondents then evaluated the physician on several dimensions (...) . Findings revealed that perceptions of the physician were more strongly influenced by payment type than by payment amount. Specifically, respondents were quite critical of doctors who owned drug company stock or received industry payments for meals and lodging, but were more forgiving of physicians who received free drug samples or consulting fees . Interestingly, physicians who received no payments, while seen as honest, were also viewed by some respondents as inexperienced or uninformed about new treatments. Implications for public policy and future research are discussed. (shrink)

Financial relationships and business transactions between physicians and the health care industry are common. These relationships take a variety of forms, including payments to physicians in exchange for consulting services, reimbursement of physician travel expenses when attending medical device and pharmaceutical educational conferences, physician ownership in life science company stocks, and the provision of free drug samples. Such practices are not intrinsic to medical practice, but as the Institute of Medicine described in its 2009 report, these relationships have the (...) potential to produce positive collaborations that improve patient care and public health, and most physicians view it as “ethically proper to accept items ranging from drug samples to a lucrative consultantship.”However, financial relationships between physicians and pharmaceutical, medical device and biotechnology companies can also create negative influences on physician judgment that compromise patient care and jeopardize the public’s trust. (shrink)

This paper explores food commoning through an ethnographic case study in Catalonia as our primary site while the Norwegian case is juxtaposed as a comparison, two agriculturally and economically different European countries. The ethnography analyses cooperation networks between organic food producers’ and consumers’ involving different nodes of community gardening initiatives, self-employed growers, local farmers and all of them under a unique cooperative integrating a community economy. The result it is a myriad of exchange practices ranging from reciprocity and barter to (...) market exchange without intermediaries through on-line platforms. Along these exchanges different options of currency intervene giving rise to novel social and cooperative relations. Similar initiatives in Norway show less variation and are less experimental regarding forms of payment but share similarities in relation to material articulations, concerns and forms of alternative practice. Although these novel forms do not represent a complete break from the more standardized supply chains, and hence from the oppositions/contradictions of production and consumption, the participants see themselves as contributing to a more general process of de-commodification of food. We explore the extent to which the meaning and moral values are mutually constituted in relation to socioeconomic exchanges and environmental caring that each person experiences based on different forms of cooperation and reciprocity. Food, we suggest, is more than a commodity on the market that we may influence through our role as consumers. It is a significant focal point connecting our lives to those of others that articulates one’s relations to society in a political manner. (shrink)

Some have argued that a proper account of prostitution shows it to be a morally neutral, commercial service ‘like any other’. This paper explores further the implications of this ‘service’ model and argues that it depends upon a weak conception of the kind of sex involved in such a practice and involves the objectification of both prostitute and customer. I argue that there is a moral view of sex which is not merely ‘romantic’, from which it is still possible to (...) view prostitution as morally objectionable; but that, nevertheless, this perspective itself may provide for a development of the idea of a service which would justify a limited practice of prostitution. Such a practice would, however, be very different from that which supporters of the putatively morally neutral model of prostitution have in mind and would depend for its plausibility on a comparison with other forms of caring for which payment is given. (shrink)

This paper explores food commoning through an ethnographic case study in Catalonia as our primary site while the Norwegian case is juxtaposed as a comparison, two agriculturally and economically different European countries. The ethnography analyses cooperation networks between organic food producers’ and consumers’ involving different nodes of community gardening initiatives, self-employed growers, local farmers and all of them under a unique cooperative integrating a community economy. The result it is a myriad of exchange practices ranging from reciprocity and barter to (...) market exchange without intermediaries through on-line platforms. Along these exchanges different options of currency intervene giving rise to novel social and cooperative relations. Similar initiatives in Norway show less variation and are less experimental regarding forms of payment but share similarities in relation to material articulations, concerns and forms of alternative practice. Although these novel forms do not represent a complete break from the more standardized supply chains, and hence from the oppositions/contradictions of production and consumption, the participants see themselves as contributing to a more general process of de-commodification of food. We explore the extent to which the meaning and moral values are mutually constituted in relation to socioeconomic exchanges and environmental caring that each person experiences based on different forms of cooperation and reciprocity. Food, we suggest, is more than a commodity on the market that we may influence through our role as consumers. It is a significant focal point connecting our lives to those of others that articulates one’s relations to society in a political manner. (shrink)

With increasing momentum for health care reform, attention is shifting to finance reform that will provide for direct methods for controlling health care spending. This article outlines the two principal paths to direct cost control and outlines a national plan that retains our multiple sources of payment, yet also contains a powerful direct cost control technique: a single fund to finance all health care.

Patients and their physicians frequently make important health care decisions with incomplete information. Memory fails; records are incomplete; the onset of significant events is confused with other life stories; and even the most basic information about medications, laboratory tests, allergies, and problems is often the result of guesswork. As providers and as patients, we suffer because information vital to health care is not available when and where it is needed. Data required for care are dispersed across various settings and represented (...) in a range of formats; incentives to bring these data together do not exist.In recent years, four specific approaches have emerged to address patient-centered information access. The first model attempts to consolidate all care into a single care delivery and financing system. This model — prevalent in many European countries — is to some degree extant at Kaiser-Permanente and other integrated care and financing systems. This model is ideal if and when one organization is responsible for all care delivery and financing. Such models present “one-stop shopping” for managing health information, coordinating care, communicating with providers and support groups, and ensuring both payment and accountability. (shrink)

The current Medicare prospective payment system has many positive incentives for hospitals to control costs. Hospitals are increasing outpatient surgery, decreasing admissions, decreasing length of stay, and decreasing use of ancillary services. These are just the effects that Congress and the Health Care Financing Administration hoped for to save the Medicare trust fund. However, there has been evidence of some adverse outcomes including premature discharge, “dumping” sicker patients and patients without insurance, and adverse impact on hospitals with specialty centers. We (...) examine these issues and present a possible solution based on a new Computerized Severity Index. (shrink)

How often our actions go awry because our perceptions are at odds with reality! This book examines the legal issues that arise when we seek to avoid the untoward consequences of an action by claiming that our perception was flawed. We all make mistakes. Some have unfortunate consequences: we might overpay a debt or make an unfavourable contract, or we might be sued or accused of a crime as a result of our mistake. Claims to alleviation on the grounds of (...) mistake are likely to arise wherever the law prescribes a state of mind as a prerequisite for the application of a legal rule. This book asks when the fact that a person made a mistake should entitle them to alleviation. This may involve the intention to enter into a contract or a payment, in which case a person could seek its reversal, or it might involve the intent to commit a tort or crime, in which case they could seek forgiveness for the offence. Farnsworth defines 'alleviating' mistakes as those which entitle a person to relief from untoward consequences of their mistake.There is no general 'law of mistake', and despite their similarities, few discussions of mistake in one setting pause to consider mistakes in other contexts. The goals of fields as disparate as contracts and criminal law are very different: how do these differences affect the treatment of mistakes? Farnsworth sets out a new taxonomy of mistakes. His analysis reveals that over the past century, there has been a remarkable increase in the receptivity of courts and scholars to claims for both reversal and forgiveness- a waxing of alleviating mistakes. (shrink)

The objective of this study was to take a closer look at defense-related expenses for medical malpractice cases over time. We conducted a retrospective review of medical malpractice claims reported to the Physician Insurers Association of America's Data Sharing Project with a closing date between January 1, 1985 and December 31, 2008. On average a medical malpractice claim costs more than $27,000 to defend. Claims that go to trial are much more costly to defend than are those that are dropped, (...) withdrawn, or dismissed. However, since the overwhelming majority of claims are dropped, withdrawn, or dismissed, the total amount spent to defend them surpasses that spent on claims that go to trial. Defense attorney expenses account for the majority of defense-related expenses (74%), while expert witness expenses and other expenses split the remaining 26%. A strong association was also found between the average indemnity payment and the amount it costs to defend individual claims by specialty. Our study found that defense-related expenses for medical malpractice claims are not an insignificant cost. As state and federal governments debate how to repair the malpractice system, addressing the high cost of defending claims should not be ignored. (shrink)

The peer commentaries on our Target Article, “Promoting Ethical Payment in Human Infection Challenge Studies,” offer a number of insights that will help advance the co...

Objectives Access to healthcare in most western societies is based on equality. Rapidly rising costs have fuelled debates about differentiation in access to healthcare. We assessed the public's perceptions and attitudes about differentiation in healthcare according to lifestyle behaviour. Methods A vignette study was undertaken in participants in a colorectal cancer screening pilot programme in the Netherlands. Screenees with a negative test result received a questionnaire in which nine hypothetical situations were described: three different healthcare settings (screening, lung cancer, chronic (...) obstructive pulmonary disease) combined with three forms of differentiation each: a difference in premium, waiting list ordering or copayment according to lifestyle. We evaluated the responses using a general hierarchical linear model. Results The percentage of participants in agreement with differentiation varied from 20% to 58% (overall mean of 40%). Significantly more participants were in favour of giving a premium discount to those who do not engage in unhealthy behaviour compared with supporters for higher payments for those who do. More differentiation was supported for non-smoking versus smoking cessation than for participation versus non-participation in screening. We observed in-group favouritism in smokers, but no significant effects of age or disease. There was no support for waiting list ordering based on lifestyle. Conclusions Results of this study show that Dutch citizens eligible for colorectal cancer screening are in favour of some form of financial differentiation in the distribution of healthcare, but that significant differences exist between type of setting and the type of behaviour. Our study can be used in the ongoing discussion about solidarity and behaviour in healthcare. (shrink)

Tort claims have been studied for various reasons. Several studies have found that most tort claims are not related to negligent adverse events and most negligent adverse events do not result in tort claims. Several studies have examined the disposition of tort claims to understand the likelihood of payment once a claim has been made. Still others have proposed that tort-claims trend analysis may help administrators target their quality-improvement efforts and identify problems with quality that would not otherwise be captured.In (...) this article, we conduct a tort-claims analysis to explore areas for quality improvement, specifically for patient safety, in the Veterans Health Administration. Patient safety is an increasingly highlighted aspect of health-care delivery. Failure to assure patient safety can result in bad clinical outcomes, additional costs of care, and a negative organizational image. Filing a tort claim is one way for an individual to express concern about an organization. For our analysis, we draw from resolved tort claims in the Veterans Health Administration from fiscal years 1989 to 2000. (shrink)

Tort claims have been studied for various reasons. Several studies have found that most tort claims are not related to negligent adverse events and most negligent adverse events do not result in tort claims. Several studies have examined the disposition of tort claims to understand the likelihood of payment once a claim has been made. Still others have proposed that tort-claims trend analysis may help administrators target their quality-improvement efforts and identify problems with quality that would not otherwise be captured.In (...) this article, we conduct a tort-claims analysis to explore areas for quality improvement, specifically for patient safety, in the Veterans Health Administration. Patient safety is an increasingly highlighted aspect of health-care delivery. Failure to assure patient safety can result in bad clinical outcomes, additional costs of care, and a negative organizational image. Filing a tort claim is one way for an individual to express concern about an organization. For our analysis, we draw from resolved tort claims in the Veterans Health Administration from fiscal years 1989 to 2000. (shrink)

Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest. This investigation: evaluates the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments and ProPublica’s Dollars for Docs and quantifies CoIs among authors of a publicly available point of care clinical support website which is used to inform evidence-based medicine decisions. Two (...) data sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors were then input into CMSOP and PDD and compensation and number of payments were determined for 2013–2015. The subset of highly compensated authors that also reported “Nothing to disclose” were further examined. There was a high degree of similarity between CMSOP and PDD for compensation and payment number. The amount received was 1.4% higher in CMSOP than in PDD. The articles where the authors had received the greatest compensation were in neurology, oncology, and endocrinology. Two authors reporting “Nothing to disclose” received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources. (shrink)

Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest. This investigation: evaluates the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments and ProPublica’s Dollars for Docs and quantifies CoIs among authors of a publicly available point of care clinical support website which is used to inform evidence-based medicine decisions. Two (...) data sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors were then input into CMSOP and PDD and compensation and number of payments were determined for 2013–2015. The subset of highly compensated authors that also reported “Nothing to disclose” were further examined. There was a high degree of similarity between CMSOP and PDD for compensation and payment number. The amount received was 1.4% higher in CMSOP than in PDD. The articles where the authors had received the greatest compensation were in neurology, oncology, and endocrinology. Two authors reporting “Nothing to disclose” received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources. (shrink)

Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest. This investigation: evaluates the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments and ProPublica’s Dollars for Docs and quantifies CoIs among authors of a publicly available point of care clinical support website which is used to inform evidence-based medicine decisions. Two (...) data sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors were then input into CMSOP and PDD and compensation and number of payments were determined for 2013–2015. The subset of highly compensated authors that also reported “Nothing to disclose” were further examined. There was a high degree of similarity between CMSOP and PDD for compensation and payment number. The amount received was 1.4% higher in CMSOP than in PDD. The articles where the authors had received the greatest compensation were in neurology, oncology, and endocrinology. Two authors reporting “Nothing to disclose” received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources. (shrink)

In response to widespread concern about illegal drug use and the associated risk of the spread of HIV/AIDS, a study was undertaken to examine whether it was, in principle, feasible to conduct a trial providing heroin to dependent users in a controlled manner. Such a trial involves real ethical issues which are examined in this paper. The general issues examined are: should a trial be an experiment or an exercise in public policy?; acts and omissions; countermobilization; termination of a trial, (...) and payment for drugs and for a trial. The specific issues examined are: selection of trial participants; privacy; issues for staff working on a trial; coupling the trial with other treatment, and issues for researchers. A number of alternative approaches to the various ethical issues are presented and discussed. (shrink)

Living organ donation in the UKThe prospect of new regulation is often met with reluctance and legitimate fears of additional bureaucracy for very little benefit. Changes to the approval procedure for living organ donation in the UK, however, appear to have made a real, and positive, difference to the practice. The Human Tissue Act 2004 abolished the Unrelated Live Transplants Regulatory Authority and handed responsibility for overseeing living donation to the newly established Human Tissue Authority. On paper, the new system (...) appeared to be a significant improvement on the old one. It removed the illogical disparity between related and unrelated donors. Previously only donations from unrelated individuals needed prior approval and evidence of a genetic link was a green light to proceed without further investigation, suggesting, erroneously, that donation within families was always voluntary and free from pressure and coercion. While the reasoning behind this distinction was obvious—coming as it did in the immediate aftermath of the uncovering of an international trade in human organs—the logic behind the distinction was lacking. Although the list of permitted relationships was broad, donation between spouses, long-term partners or friends was subject to the full and frequently drawn-out approval process designed to prevent surreptitious payment.Now all living organ donation needs prior approval but the system has been streamlined to avoid the long delays that became synonymous with the old system. Under the new regime: Applications are reviewed at a local level by a group of “independent assessors” who have been trained and accredited by the HTA.The independent assessor must be satisfied that the person consenting to the donation has been given and understood the necessary information and that there is no evidence of reward or coercion or evidence that the person has been subjected to pressure to consent. …. (shrink)

Numerous accounting and economics research studies employ an experimental research method requiring student participants to make representations about an individual characteristic (e.g., ability, cost) that provides a basis for payment of cash rewards. In response, many participants intentionally misrepresent the nature of that characteristic to receive a greater reward. Typically, such studies are deemed to be either exempt from review by institutional review boards (IRBs) or subject only to an expedited review. Moreover, investigators seldom debrief participants, purportedly to avoid contamination (...) of the participant pool. The authors question the ethics of inducing strategic misrepresentation and rewarding fraudulent behavior without appropriate debriefing. A theoretical framework of cognitive ethical development indicates that such research methods can be harmful to student participants. Furthermore, principles of operant conditioning suggest that the rewards reinforce fraudulent behavior. It is recommended that research studies inducing strategic misrepresentation should not be exempt from IRB review and should be required to include desensitization procedures for debriefing participants. (shrink)

In contrast to most publications on the ethics of paying research subjects, which start by identifying and analyzing major ethical concerns raised by the practice (in particular, risks of undue inducement and exploitation) and end with a set of—more or less well-justified—ethical recommendations for using payment schemes immune to these problems, this paper offers a systematic, principle-based ethical analysis of the practice. It argues that researchers have aprima faciemoral obligation to offer payment to research subjects, which stems from the principle (...) of social beneficence. This principle constitutes an ethical “spine” of the practice. Other ethical principles of research ethics (respect for autonomy, individual beneficence, and justice/fairness) make up an ethical “skeleton” of morally sound payment schemes by providing additional moral reasons for offering participants (1) recompense for reasonable expenses; and (2a) remuneration conceptualized as a reward for their valuable contribution, provided (i) it meets standards of equality, adequacy and non-exploitation, and (ii) it is not overly attractive (i.e., it does not constitute undue inducement for participation or retention, and does not encourage deceptive behaviors); or (2b) remuneration conceptualized as a market-driven price, provided (i) it is necessary and designed to help the study achieve its social and scientific goals, (ii) it does not reinforce wider social injustices and inequalities; (iii) it meets the requirement of non-exploitation; and (iv) it is not overly attractive. The principle of justice provides a strong ethical reason for not offering recompenses for lost wages (or loss of other reasonably expected profits). (shrink)

The paper by Lynch et al. raises interesting ethical questions regarding whether and how much SARS-CoV-2 Human Challenge Studies participants should be paid. We appreciate the timely e...

It was not long ago when technological emergence fundamentally changed the landscape of global businesses. Following that, business operations started shifting away from traditional to advance digitalized processes. These digitalized processes gave a further boost to the e-commerce industry, making the online environment more competitive. Despite the growing trend, there has always been a consumer market that is not involved in online shopping, and this gap is huge when it comes to consumers from developing countries, specifically Pakistan. On contrary, the (...) recent COVID-19 pandemic has brought drastic changes to the way consumers used to form their intention and behave toward digitalized solutions in pre COVID-19 times. Evidence shows that the global e-commerce industry has touched phenomenal growth during COVID-19, whereas Pakistan's e-commerce industry still holds a huge potential and has not fully boomed yet. These facts pave new avenues for marketers to cater to this consumer market for long-term growth. Hence, the study provides insights into how consumers' online buying behavior has transformed during the COVID-19 pandemic in the context of Pakistan. The study presents a framework based on the Technology Acceptance Model and Theory of Planned Behavior. Furthermore, the moderating role of gender and payment mode has also been examined. For the analysis of variables, the partial least squares method was used to conduct structural equation modeling by collecting data from 266 respondents. The results show a significant and positive impact of perceived benefits, perceived ease of use, perceived enjoyment, and social influence on consumers' intention, but they also show an insignificant impact of gender and payment mode as a moderating variable on PEOU-BI and BI-AB, respectively. The results are of utmost significance for Pakistani businesses, marketers, and e-traders to streamline their business practices accordingly. Lastly, the proposed framework demonstrates new directions for future research to work upon. (shrink)

This theory accords to volitions the status of basic mental actions, maintaining that these are spontaneous exercises of the will--a "two-way" power which ...

In order to analyze e-commerce from the perspective of theories of the philosophy of technology, first the characteristics of e-commerce are examined and then analyzed from the viewpoint of the philosophy of technology. In the first section of the article, topics such as definitions and models of e-commerce, electronic contracts, electronic payments, and electronic customs are investigated. In the second section, topics including the technology of e-commerce, requirements of e-commerce, ethics and e-commerce, identity and e-commerce, virtual reality of e-commerce, (...) and the power of aggregation in e-commerce are analyzed. (shrink)

The author presents and defends three theses: (1) "the first is that it is not profitable for us at present to do moral philosophy; that should be laid aside at any rate until we have an adequate philosophy of psychology." (2) "the second is that the concepts of obligation, And duty... And of what is morally right and wrong, And of the moral sense of 'ought', Ought to be jettisoned if this is psychologically possible...." (3) "the third thesis is that (...) the differences between the well-Known english writers on moral philosophy from sidgwick to the present day are of little importance." (staff). (shrink)

The field of Philosophy of Sport has been developing in Anglo-Saxon scholarship since the 1960s and since then has achieved considerable consolidation. However, this is a progressing field in Latin American countries like Brazil. This paper aims to analyse the trajectory of the Philosophy of Sport in Brazil, presenting an overview of its development since the 1980s and some prospects that have been generated since the turn of the century. In conclusion, the article points out that the field of Philosophy (...) of Sport in Brazil is in the process of disciplinary consolidation, presenting a plurality of agents, institutions and theoretical approaches in its structure. (shrink)

Derek Parfit’s view of personal identity raises questions about whether advance decisions refusing life-saving treatment should be honored in cases where a patient loses psychological continuity; it implies that these advance decisions would not be self-determining at all. However, rather than accepting that an unknown metaphysical ‘further fact’ underpins agential unity, one can accept Parfit’s view but offer a different account of what it implies morally. Part II of this article argues that contractual obligations provide a moral basis for honoring (...) advance decisions refusing life-saving and/or life-sustaining medical treatment; advance decisions have similarities to contracts, such as life insurance policies and will-contracts, that come into effect when the psychological discontinuity is through death. (shrink)

Scientific research and ethics -- Ethical theory and decision making -- Data acquisition and management -- Mentoring and professional relationship -- Collaboration in research -- Authorship -- Publication and peer review -- Misconduct in research -- Intellectual property -- Conflicts of interest and scientific objectivity -- The use of animals in research -- The use of human subjects in research -- The use of vulnerable subjects in research -- Genetics, cloning, and stem cell research -- International research.

It is a commonly accepted view that men think to live, and do not live to think, that conation, and not cognition, is the primary object of living. Impression, affect, and expression constitute the complete psychic process. The term philosophy, the love of wisdom, also suggests that man's thought has a practical and not a theoretical objective. In this connection, however, two errors must be avoided: on the one hand an exaltation of the intellect as in rationalism, and on the (...) other hand a depreciation of the intellect as in pragmatism. (shrink)

The poet’s words: “A man’s reach should exceed his grasp” are not merely a command of whatought to be, they are a description of what is. Man has always been stretching himself beyond his own measure. He has a sense of the Infinite: Eternity has been set in his heart: he has not been content to look only on the things seen, his gaze has ever been towards the Unseen. Whatever stage of development he may have reached, he seeks for, (...) and strives after, what is above and beyond himself and his world. In science he tries to get behind thephenomenalreality as his senses apprehend it, to thenoumenal, mind. In philosophy he endeavours to bring the multiplicity of his experience, outer and inner, into a unity that will evidence itself to his reason as coherent, and not contradictory. In morality he is not content with the customs and standards of the society of which he is a member; but conscious of their inadequacy, he conceives and aspires to realize an ideal adequate to his nature; hisought to beis always challenging hisis. The impulse or motive of progress in all spheres of human interest and activity is “the best is yet to be.”. (shrink)