In thinking about how to expand insurance coverage, the issue that matters is whether insurance enables sick and high-risk people to get medical care. Over the course of three decades, market-oriented insurance reforms have shifted more costs of illness onto people who need and use medical care. By making the users of care pay for it , cost-sharing discourages sick people from getting care, even if they have insurance, and for people with low-incomes and tight budgets, cost-sharing can effectively deny (...) them access to care. Thus, covering or not covering sick people is the core issue of health insurance reform, both as a determinant of support and opposition to proposals, and as the proper yardstick for evaluating reform ideas. (shrink)

In most other nations, insurance for medical care is called sickness insurance, and it covers sick people. In the United States, we have “health insurance,” and its major carriers — commercial insurers, large employers, and increasingly government programs — strive to avoid sick people and cover only the healthy. This perverse logic at the heart of the American health insurance system is the key to reform debates.Focusing on sick people versus healthy people might seem a strange way to view the (...) coverage issue. Most discussions of insurance categorize people into other groupings: the insured versus the uninsured; Caucasian whites versus other racial and ethnic groups; men versus women; poor and low-income people versus everybody else; children, adults, and the elderly; or citizens versus immigrants and undocumented aliens. More recently, health researchers have begun talking about “vulnerable populations,” using most of the same demographic groupings and adding other illness-inducing factors such as social isolation, stress, and impoverished neighborhoods. But as I will show, insurance plans now use premiums, cost-sharing, and other design features in ways that indirectly divide each of these groups into the sick and the healthy, to the detriment of the sick. By shifting the costs of illness onto people who use medical care — that is, sick people — market-oriented reforms of the last few decades have eroded insurance in the name of strengthening it. (shrink)

This article examines a series of Greek myths which establish a structural equivalence between two motifs, stoning and blinding; the two penalties either substitute for one another in alternative versions of a single story, or appear in sequence as repayments in kind. After reviewing other theories concerning the motives behind blinding and lapidation, I argue that both punishments-together with petrifaction and live imprisonment, which frequently figure alongside the other motifs-are directed against individuals whose crimes generate pollution. This miasma affects not (...) only the perpetrator of the deed, but risks spreading to the community at large, and prompts measures aimed at containing the source of the disease. Both blinding and lapidation are designed to cordon off the contaminant by removing him from all visual and tactile contact with other men. But it is not only the nature of the crimes that explains the kinship between the two penalties. I further argue that the attributes Greek thinking assigned to stones, repeatedly characterized as unseeing, mute, immobile, and dry, and symbolic of the condition of the dead, elucidate the connections and clarify the antagonism that myth suggests between lapidation and sight. Stoning, blinding, imprisonment, and petrifaction all consign the criminal to an existence exactly parallel to that of the stone, stripping him of the properties that distinguish the living from the dead, and making him both unseeing and unseen. Three examples drawn from archaic and classical literature provide examples of these interactions between stones, blindness, invisibility, and death: the snake portent sent by Zeus in Book 2 of the Iliad, the Perseus myth, and Hermes' activity in both the Homeric Hymn to Hermes and Aeschylus' Choephoroe. (shrink)

Pulling from theories of social exchange, deonance, and fairness heuristics, this study focuses on the relationship between overall justice climate and both the prosocial and deviant behaviors of groups. Specifically, it considers two contextual boundary conditions on this effect—corporate social responsibility and group moral identity. Results from a laboratory experiment are presented, which show a significant effect for overall justice climate and a two-way interaction between overall justice climate and CSR on group-level prosocial and deviant behaviors, and a marginally significant (...) interaction of group moral identity with overall justice climate on group deviance. The implications of contextual influences on workplace ethics and justice are discussed. (shrink)

Individuals often describe objects in their world in terms of perceptual dimensions that span a variety of modalities; the visual (e.g., brightness: dark–bright), the auditory (e.g., loudness: quiet–loud), the gustatory (e.g., taste: sour–sweet), the tactile (e.g., hardness: soft vs. hard) and the kinaesthetic (e.g., speed: slow–fast). We ask whether individuals use perceptual dimensions to differentiate emotions from one another. Participants in two studies (one where respondents reported on abstract emotion concepts and a second where they reported on specific emotion episodes) (...) rated the extent to which features anchoring 29 perceptual dimensions (e.g., temperature, texture and taste) are associated with 8 emotions (anger, fear, sadness, guilt, contentment, gratitude, pride and excitement). Results revealed that in both studies perceptual dimensions differentiate positive from negative emotions and high arousal from low arousal emotions. They also differentiate among emotions that are similar in arousal and valence (e.g., high arousal negative emotions such as anger and fear). Specific features that anchor particular perceptual dimensions (e.g., hot vs. cold) are also differentially associated with emotions. (shrink)

Much of the legal literature discusses regulation and regulatory forms with a seemingly implicit assumption that "those to be influenced" are inherently self-interested and thus motivated to comply with legal structures only when there are sufficient external incentives to do so. This view of the person is inconsistent with recent perspectives in the field of psychology. A law and morality perspective, coupled with insights from the field of psychology, asserts that influence, compliance, and motivation are far more complex than this (...) legal literature would suggest. In this Article, we map the varying influence structures, motives, psychological needs, emotional mechanisms, and levels of moral reasoning that various forms of regulation, from hard law to soft law, might appeal to. We provide examples from global banking and one soft law initiative, the Equator Principles, to illustrate reasons psychology would suggest why soft law may be more effective in some circumstances in influencing behavior within the firm than hard law, while recognizing important limits to such influence. (shrink)

Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently (...) in the analysis as a high‐level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health‐care providers in spaces called ‘wait times’, where it is systematically rendered ‘unknowable’. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. (shrink)

Subtle bodily sensations such as itching or fluttering that occur in the absence of any external trigger may serve to locate the spatial boundaries of the body. They may constitute the normal counterpart of extreme conditions in which body-related hallucinations and perceptual aberrations are experienced. Previous investigations have suggested that situations in which the body is spontaneously experienced as being deformed are related to the ability to perform own-body transformations, i.e., mental rotations of the body requiring disembodiment. We therefore decided (...) to consider whether the perception of SPS might relate to embodiment as assessed through the ability to perform own-body transformations and schizotypal traits, since high degrees of schizotypy in the general population have been associated with more vivid perceptions and aberrant perceptual experiences. Then participants completed a standard SPS task. Our analysis revealed that the slower the response time in the OBT task, the more frequent the perception of SPS. This suggests that difficulties in disembodying and mentally transforming one’s own body facilitate feeling oneself. Furthermore, a greater number of correct responses in the OBT task was associated with less frequent perception of SPS. This suggests that finding it easier to disembody and perform mental own-body transformations interferes with the ability to sense oneself. The results also show that higher schizotypal traits, as assessed through the SPQ, are associated with more frequent perception of SPS. Taken together, these results provide a coherent picture and suggest that embodiment is required in order to correctly feel oneself, as expressed through the perception of SPS. The ability to easily experience disembodiment reduces the sense of feeling oneself, and proneness to schizotypal traits produces body misperceptions that enhance and amplify this feeling. The results are discussed in the light of current knowledge and theories about body representations, taking into account attention and interoception as factors that influence body awareness. We offer explanations for perceptual aberrations, body-related delusions, and hallucinations based on misperceived or misinterpreted SPS, and we discuss possible mechanisms that may contribute to feeling and misperceiving oneself. (shrink)

This book provides a reconstructive and critical interpretation of Sartre’s mature dialectical ethics. Taken together, as Sartre intended, the posthumously published key texts demonstrate that the ultimate goal of praxis is “integral humanity” and that “making the human” is always possible because the means to humanity can always be invented.

Cell line immortalisation is a growing component of African genomics research and biobanking. However, little is known about the factors influencing consent to cell line creation and immortalisation in African research settings. We contribute to addressing this gap by exploring three questions in a sample of Xhosa participants recruited for a South African psychiatric genomics study: First, what proportion of participants consented to cell line storage? Second, what were predictors of this consent? Third, what questions were raised by participants during (...) this consent process? 760 Xhose people with schizophrenia and 760 controls were matched to sex, age, level of education and recruitment region. We used descriptive statistics to determine the proportion of participants who consented to cell line creation and immortalization. Logistic regression methods were used to examine the predictors of consent. Reflections from study recruiters were elicited and discussed to identify key questions raised by participants about consent. Approximately 40% of participants consented to cell line storage. The recruiter who sought consent was a strong predictor of participant’s consent. Participants recruited from the South African Eastern Cape, and older participants, were more likely to consent; both these groups were more likely to hold traditional Xhosa values. Neither illness nor education were significant predictors of consent. Key questions raised by participants included two broad themes: clarification of what cell immortalisation means, and issues around individual and community benefit. These findings provide guidance on the proportion of participants likely to consent to cell line immortalisation in genomics research in Africa, and reinforce the important and influential role that study recruiters play during seeking of this consent. Our results reinforce the cultural and contextual factors underpinning consent choices, particularly around sharing and reciprocity. Finally, these results provide support for the growing literature challenging the stigmatizing perception that people with severe mental illness are overly vulnerable as a target group for heath research and specifically genomics studies. (shrink)

A diagnosis of dementia often comes with difficulties in understanding a conversational context and expressing how one feels. So far, research on how to facilitate advance care planning for people with dementia focused on defining relevant themes and topics for conversations, or on how to formalize decisions made by surrogate decision makers, e.g., family members. The aim of this review is to provide a better scope of the existing research on practical communication aspects related to dementia in ACP conversations. In (...) November 2020, seven databases were searched to select papers for inclusion. This search was updated in December 2021. The search strategy consisted of three tiers, intersected by using the Boolean term “AND,” and resulted in 787 studies. Two researchers followed explicit criteria for two sequential levels of screening, based on titles and abstracts and full papers. A total of 22 studies were included for data analysis. Seven topics emerged clustered around two themes. This scoping review provides practical suggestions for healthcare professionals to improve ACP communication and uncovered gaps in research on communication aspects related to dementia in ACP conversations, such as non-verbal behavior, timing and implementation, and personal preferences. (shrink)

In the social sciences and in everyday speech we often talk about groups as if they behaved in the same way as individuals, thinking and acting as a singular being. We say for example that "Google intends to develop an automated car", "the U.S. Government believes that Syria has used chemical weapons on its people", or that "the NRA wants to protect the rights of gun owners". We also often ascribe legal and moral responsibility to groups. But could groups literally (...) intend things? Is there such a thing as a collective mind? If so, should groups be held morally responsible? Such questions are of vital importance to our understanding of the social world. In this lively, engaging introduction Deborah Tollefsen offers a careful survey of contemporary philosophers? answers to these questions, and argues for the unorthodox view that certain groups should, indeed, be treated as agents and deserve to be held morally accountable. Tollefsen explores the nature of belief, action and intention, and shows the reader how a belief in group agency can be reconciled with our understanding of individual agency and accountability. _Groups as Agents_ will be a vital resource for scholars as well as for students of philosophy and the social sciences encountering the topic for the first time. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

Germund Hesslow has argued recently [2] that a probabilistic theory of causality as advocated by Patrick Suppes [4] has two problems that a deterministic theory avoids. In this paper, I argue that Suppes' probabilistic causal calculus is free of each of these problems and, moreover, that several broader issues raised by Hesslow's discussion tend to support a probabilistic conception of causes.

Economists and other social scientists in this century have often supported economic arguments by referring to positions taken by philosophers of science. This important new book looks at the reliability of this practice and, in the process, provides economists, social scientists, and historians with the necessary background to discuss methodological matters with authority. Redman first presents an accurate, critical, yet neutral survey of the modern philosophy of science from the Vienna Circle to the present, focusing particularly on logical positivism, sociological (...) explanations of science (Polanyi, Fleck, Kuhn), the Popper family, and the history of science. She then deals with economic methodology in the twentieth century, looking at a wide range of methodological positions, especially those supported by positions from the philosophy of science. She considers the myth of the feasibility of falsification in economics and, within the context of its significance for economics, discusses the interpretation of Kuhn's philosophy of science as consensus and the danger such a view represents to science. Appendices review the history of the is-ought dispute and list economists whose first works deal with methodological topics. Comprehensive, readable, and accessible to those with little background knowledge, Redman's book will appeal to a wide range of social scientists and philosophers of science. (shrink)

This guide leads readers systematically through the arguments of Mary Shepherd's two books. Chapters 1-4 cover the arguments in the Essay Upon the Relation of Cause and Effect (1824), where Shepherd argues that causal principles can be known by reason to be necessary truths and that causal inferences can be rationally justified. Shepherd's primary target in this work is Hume, but she also addresses the views of Thomas Brown and William Lawrence. Shepherd considered her second book, Essays on the Perception (...) of an External Universe, and Other Subjects Connected with the Doctrine of Causation (1827), to be an extension of the earlier project on causation; here she appeals to the causal principles established in the first book to argue that we can know through reason that an external world of continually-existing objects must exist independently of us, as the causes of our sensations. Chapter 5 of this Guide addresses Shepherd's accounts of sensation and reasoning; Chapters 6-9 lead the reader through the arguments of the Essays, as well laying out Shepherd's views on skepticism and Berkeleyan idealism, her accounts of mind and body, her philosophy of religion, and the solutions she offers to two puzzles about vision. (shrink)

The Well-Ordered Universe argues that Cavendish's natural philosophy, social and political philosophy, and medical theory share an underlying concern with order. This reveals interesting connections among Cavendish's natural philosophy and her views on gender, animals and the environment, and human health, and explains her commitment to monarchy and social hierarchy.

Biological kin share up to half of their genetic material, including predisposition to disease. Thus, variants of clinical significance identified in each individual’s genome can implicate an exponential number of relatives at potential risk. This has renewed the dilemma over family access to research participant’s genetic results, since prevailing US practices treat these as private, controlled by the individual. These individual-based ethics contrast with the family-based ethics – in which genetic information, privacy, and autonomy are considered to be familial – (...) endorsed in UK genomic medicine and by participants in a multi-method study of US research participants presented here. The dilemma reflects a conflict between US legal and ethical frameworks that privilege “the individual” and exclude “the family” versus actual human genetics that are simultaneously individual and familial. Can human genetics succeed in challenging bioethics’ hegemonic individualism to recognize and place the family at the center of the room where bioethics happens? (shrink)

During the past decade there has been a very effective campaign against any explanation of remembering whose basic concept is that of a causally mediating trace. This paper attempts to provide such an explanation by presenting an explicit deductive argument for the existence of the memory trace. The conclusion is shown to follow from reasonable, empirical assumptions of which the most interesting is a spatiotemporal contiguity thesis. Set-theoretic techniques are used to provide a framework of analysis and probabilistic definitions of (...) some causal notions, as that of a causal chain, are presented. (shrink)

The authors' model reduces the literature on conceptual representation to a single node: “encyclopedic knowledge.” The structure of conceptual knowledge is not so trivial. By ignoring the phenomena central to reasoning about living things, the authors base their dismissal of semantic systems on inadequate descriptive ground. A better descriptive account is available in the conceptual development literature. Neuropsychologists could import the insights and tasks from cognitive development to improve their studies.

Background: Genomic analysis may reveal both primary and secondary findings with direct relevance to the health of probands’ biological relatives. Researchers question their obligations to return findings not only to participants but also to family members. Given the social value of privacy protection, should researchers offer a proband’s results to family members, including after the proband’s death? Methods: Preferences were elicited using interviews and a survey. Respondents included probands from two pancreatic cancer research resources, plus biological and nonbiological family members. (...) Hypothetical scenarios based on actual research findings from the two cancer research resources were presented; participants were asked return of results preferences and justifications. Interview transcripts were coded and analyzed; survey data were analyzed descriptively. Results: Fifty-one individuals (17 probands, 21 biological relatives, 13 spouses/partners) were interviewed. Subsequently, a mailed survey was returned by 464 probands, 1,040 biological family members, and 399 spouses/partners. This analysis highlights the interviews, augmented by survey findings. Probands and family members attribute great predictive power and lifesaving potential to genomic information. A majority hold that a proband’s genomic results relevant to family members’ health ought to be offered. While informants endorse each individual’s choice whether to learn results, most express a strong moral responsibility to know and to share, particularly with the younger generation. Most have few concerns about sharing genetic information within the family; rather, their concerns focus on the health consequences of not sharing. Conclusions: Although additional studies in diverse populations are needed, policies governing return of genomic results should consider how families understand genomic data, how they value confidentiality within the family, and whether they endorse an ethics of sharing. A focus on respect for individual privacy—without attention to how the broad social and cultural context shapes preferences within families—cannot be the sole foundation of policy. (shrink)

A comprehensive bibliography of economic methodological works since 1860, this volume includes 2,244 entries divided into two primary sections. The first section covers works on economic methodology while Part Two deals with works on the philosophy of science. Many of the entries are annotated, including the classics in economic methodology, almost all of the books, and general works in the philosophy of science section. All other sections include an introduction to the topic and the articles collected under that heading.

This essay explores the relationships between labour and community formation in order to think through how, where, and when diasporic solidarities are imagined or refused. I draw on ethnographic research among Jamaican women contracted for seasonal work in US hotels to situate diasporic calls and responses in relation to specific contexts and a changing global political economy. I show how global geopolitical shifts not only shape the processes of identity formation and social reproduction, but also condition the perpetuation of notions (...) of nationalized racial hierarchies and ideologies of progress. I also show that hotel workers’ notions of ‘America’ and their commitment to the ‘American Dream’ shapes their subjectivities as migrant workers/consumers and, in their assessment, differentiates them from African-Americans, particularly those most immediately affected by Hurricane Katrina. In doing so, I demonstrate that one of the ideological hegemonies of diaspora is the idea that an individual's capacity to affect their own social mobility and that of their social network always outstrips the ‘locals’ in diasporic elsewheres. (shrink)

The present study examined the role of father sensitivity and couple coparenting quality in the first 2 years of life in relation to the development of externalizing behavior problems in middle childhood, focusing on the unique role of fathers. In this study, 125 mothers, fathers, and their first-born children were followed from 8 months to age 7 years. Paternal sensitivity was rated when infants were 8 and 24 months old. Fathers were videotaped at home playing, feeding, and changing their 8-month-old (...) infants’ clothes. They also were videotaped in a lab playing with their 24-month-olds and solving a variety of challenging tasks. At 24 months, competitive coparenting was assessed via videotaped triadic family interactions at home in which families participated in a variety of tasks. Teachers rated externalizing behavior problems when the children were age 7. Continuity in paternal sensitivity was documented from 8 to 24 months, and paternal sensitivity at 8 months predicted externalizing behavior in middle childhood through father sensitivity at 24 months. Moreover, paternal sensitivity at 8 months predicted competitive coparenting which, in turn, forecast externalizing behavior problems in middle childhood, even after controlling for maternal sensitivity at 8 and 24 months. These findings highlight the unique role of paternal caregiving quality during the first year of life on couple coparenting and children’s subsequent development of externalizing problems and have implications for creating effective interventions to prevent children from developing externalizing disorders. (shrink)