The Pharmaceutical Benefits Scheme, operating in Australia under the National Health Act 1953, provides citizens equal access to subsidised pharmaceuticals. With ever-increasing costs of medicines and global financial pressure on all commodities, the sustainability of the PBS is of crucial importance on many social and political fronts. Direct-to-consumer advertising (DTCA) of prescription medicines is fast expanding, as pharmaceutical companies recognise and reinforce marketing potentials not only in healthcare professionals but also in consumers. DTCA is currently prohibited in Australia, but pharmaceutical (...) companies continuously lobby for the ban to be lifted. There is evidence that such marketing strategies influence consumer behaviour and concerns have been raised about whether DTCA could affect government expenditure on the PBS in Australia. This pharmacy-based study explored Australian consumer attitudes towards DTCA and whether consumer attitudes regarding DTCA differ based on socioeconomic status, measured in terms of income and education. Consumers from different socioeconomic areas in Sydney were asked to respond to a survey about an advertisement created specifically for the promotion of a mock prescription medicine. Their views about the intent, value and reliability of the advertisement were explored. The study found that consumers of lower socioeconomic status were more likely to perceive DTCA as a source of valuable and reliable medical information, and that they were more likely to request an advertised medication from their physician. If DTCA of prescription medicines was to be introduced in Australia, an increase in government expenditure on the PBS would be anticipated. Findings of this study also expose a deficit in respect for patients’ right to autonomy and informed consent which should be based on evidence-based, unbiased, information rather than advertisements. (shrink)

Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases (...) Society of America (IDSA). Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future. (shrink)

Knowledge of mechanisms is critical for causal reasoning. We contrasted two possible organizations of causal knowledge—an interconnected causal network, where events are causally connected without any boundaries delineating discrete mechanisms; or a set of disparate mechanisms—causal islands—such that events in different mechanisms are not thought to be related even when they belong to the same causal chain. To distinguish these possibilities, we tested whether people make transitive judgments about causal chains by inferring, given A causes B and B causes C, (...) that A causes C. Specifically, causal chains schematized as one chunk or mechanism in semantic memory led to transitive causal judgments. On the other hand, chains schematized as multiple chunks led to intransitive judgments despite strong intermediate links. Normative accounts of causal intransitivity could not explain these intransitive judgments. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

Management plays an important role in reinforcing ethics in organizations. To support this aim, managers must use incentive and goal programs in ethical ways. This study examines experimentally the potential ethical costs associated with incentive-driven and goal-induced employee behavior from a managerial perspective. In a quasi-experimental setting, 243 MBA students with significant professional work experience evaluated a hypothetical employee’s ethical behavior under incentive pay systems modeled on a business case. In the role of the employee’s manager, participants evaluated the ethicality (...) of the employee’s incentive-driven and goal-induced ethical/unethical behavior and the outcomes of behavior, with consequences that were either favorable or unfavorable to the organization. The results indicated that participants discounted the ethical considerations of incentive-driven and goal-induced behavior when consequences were favorable to the organization. Participants’ morals and outcome orientations were also significantly related to their ethical judgments and intentions to intervene. The implications of these findings for research and practice are discussed. (shrink)

Conviction Narrative Theory (CNT) is a theory of choice underradical uncertainty– situations where outcomes cannot be enumerated and probabilities cannot be assigned. Whereas most theories of choice assume that people rely on (potentially biased) probabilistic judgments, such theories cannot account for adaptive decision-making when probabilities cannot be assigned. CNT proposes that people usenarratives– structured representations of causal, temporal, analogical, and valence relationships – rather than probabilities, as the currency of thought that unifies our sense-making and decision-making faculties. According to CNT, (...) narratives arise from the interplay between individual cognition and the social environment, with reasoners adopting a narrative that feels “right” to explain the available data; using that narrative to imagine plausible futures; and affectively evaluating those imagined futures to make a choice. Evidence from many areas of the cognitive, behavioral, and social sciences supports this basic model, including lab experiments, interview studies, and econometric analyses. We identify 12 propositions to explain how the mental representations (narratives) interact with four inter-related processes (explanation, simulation, affective evaluation, and communication), examining the theoretical and empirical basis for each. We conclude by discussing how CNT can provide a common vocabulary for researchers studying everyday choices across areas of the decision sciences. (shrink)

Doctors form an essential part of an effective response to the COVID-19 pandemic. We argue they have a duty to participate in pandemic response due to their special skills, but these skills vary between different doctors, and their duties are constrained by other competing rights. We conclude that while doctors should be encouraged to meet the demand for medical aid in the pandemic, those who make the sacrifices and increased efforts are owed reciprocal obligations in return. When reciprocal obligations are (...) not met, doctors are further justified in opting out of specific tasks, as long as this is proportionate to the unmet obligation. (shrink)

ABSTRACT:Despite widespread attention to corruption and organizational change in the literature, to our knowledge, no research has attempted to understand the linkages between these two powerful organizational phenomena. Accordingly, we draw on major theories in ethics, sociology, and management to develop a theoretical framework for understanding how organizational change can sometimes generate corruption. We extend anomie theory and ethical climate theory to articulate the deinstitutionalization of the normative control system and argue that, through this deinstitutionalization, organizations have the potential to (...) become incubators for corruption. We qualify this process by proposing conditions more ripe for anomie and under which this deinstitutionalization is more likely to occur, propounding moderating relationships that influence organizational reconfiguration. Examples of turbulence in the contemporary business environment that can trigger change highlight our discussion. We conclude with managerial implications, offering means by which the deleterious effects of corruption may be arrested or controlled. (shrink)

An interruption. Rethinking the first three chapters of this book, I have come to suspect that, not unlike Iris Murdoch and Emmanuel Levinas, the way I imagine ‘ethics’ floats on an idea that any ethical substantive position or ethical theory is always shaped through our existential condition and our embodied encounter with others. To Murdoch, existence is the disposition for our responses to the ways in which we perceive reality, and yet, although these responses are always part of who we (...) are, they are not always part of what we do, and so, we set ourselves ethical tasks when we desire to act ethically. As scholar Bridget Clarke argues, “to attend to something [for Murdoch] is to approach it with a just and loving eye, and therewith to perceive it in its unbounded particularity and complexity, and so, as it truly is.” Or as I argue, to attend to the other ‘justly and lovingly’, Murdoch would instruct, is not merely to accurately collect details about the other and then arrive at an approximation of its being, but also to apprehend the other as ‘distinctly singular’ and ‘distinctly foreign’ from oneself–which at once forgoes any assimilation of the other into oneself, incidentally. The recognition of the other as ‘one who embodies human otherness and dignity’ becomes the condition for and coherent way of imagining and accessing moral reality. Moreover, for Diane Davis, this “being-for-the-other names a pre-originary obligation to respond to the other [and] it is in this response that both the self and the other emerge as existents” whose ethical projects are each challenged by the markedly different and infinitely other being. This obligation, Levinas might also say, is an ‘authority’ that is experienced like the effect of the other upon me, so that I am subsequently motivated to enact ethical task-making. I am not, therefore, “pulling everything other into the same, the known, the comprehended,” nor am I looking to any normative theories as authoritative templates from which I act ethically. And so, unlike Husserl, I am not “joining the philosophical tradition in its fundamental disrespect for all things other,” but instead, by dispositioning myself between these theories in responsible Levinasian fashion, I will be tracking them in response to their confronting me, and not as normative theories that are applicable to real and lived experiences. (shrink)

To Aaron Pacitti and Michael Cauvel–whose journal article, “Rent-Seeking Behavior and Economic Justice: A Classroom Exercise” broadly argues that “understanding the [complexities] of rent-seeking behavior helps fill the gap between economics and politics”–the varieties of rent are wide and, therefore, can only be described in their category-specific positions. I will discuss three of these categories in more detail below, but for now, I propose that a useful working grasp of economic rent involves “the amount paid to the owner of a (...) factor of production over the cost that is to be necessarily incurred on utilizing such elements in the production process.” In math terms, ‘economic rent’ equals the agreed-upon-amount paid by the consumer (when that amount far exceeds the market value of the product) minus the cost spent by the producer to make the product (when that cost is far below the typical amount to produce the product). Originally, the concept of economic rent concerned land ownership and the production of natural goods. Two major economists, Adam Smith and David Ricardo, offered insights into the general makeup and logic of what they called, the rent of land and simply rent, respectively. (shrink)

An investigation is presented in which a computer simulation model (DIAGNOSER) is used to develop and test predictions for behavior of subjects in a task of medical diagnosis. The first experiment employed a process‐tracing methodology in order to compare hypothesis generation and evaluation behavior of DIAGNOSER with individuals at different levels of expertise (students, trainees, experts). A second experiment performed with only DIAGNOSER identified conditions under which errors in reasoning in the first experiment could be related to interpretation of specific (...) data items. Predictions derived from DIAGNOSER's performance were tested in a third experiment with a new sample of subjects. Data from the three experiments indicated that (1) form of diagnostic reasoning was similar for all subjects trained in medicine and for the simulation model, (2) substance of diagnostic reasoning employed by the simulation model was parable with that of the more expert subjects, and (3) errors in subjects' reasoning were attributable to deficiencies in disease knowledge and the interpretation of specific patient data cues predicted by the simulation model. (shrink)

The 2010 Quinnipiac cheerleading case raises interesting questions about the nature of both cheerleading and sport, as well as about the moral character of each. In this paper we explore some of those questions, and argue that no form of college cheerleading currently in existence deserves, from a moral point of view, to be recognized as a sport for Title IX purposes. To reach that conclusion, we evaluate cheerleading using a quasi-legal argument based on the NCAA’s definition of sport and (...) conclude that cheerleading fails to qualify as a legitimate sport. A philosophical argument leads to the same conclusion, primarily because of the essential entertainment-aspect of cheerleading. We then examine a consequentialist moral case for making cheerleading an intercollegiate sport and argue that the balance of moral reasons is against doing so. Finally, we look at cheerleading’s newest offspring – Acrobatics and Tumbling, and STUNT – and express our moral reservations about their current claims to be worthy of Title IX recognition. While we would not claim that any single one of our arguments is decisive, we are convinced that the cumulative weight of the arguments against granting intercollegiate sport status to any of the forms of cheerleading or its derivatives is, at present, irresistible. (shrink)

This article investigates the moderating effects of organizational social consciousness on the natural environmental competency and innovativeness relationship. Organizational social consciousness reflects the organization’s awareness of its place and contribution to the larger system in which it exists and is developed through an organization’s social responsibility, ethics, culture, corporate values, and the view of its stakeholders. Through our study of key strategic decision makers from organizations located in the USA, we operationalize organizational social consciousness and demonstrate the efficacy of this (...) construct in relation to the organizational-level constructs of environmental management competency and innovativeness. Our results reveal that organizational social consciousness positively strengthens the natural environmental competency to organizational innovativeness relationship. (shrink)

Lyme disease is one of the most controversial illnesses in the history of medicine. In 2006 the Connecticut Attorney General launched an antitrust investigation into the Lyme guidelines development process of the Infectious Diseases Society of America (IDSA). In a recent settlement with IDSA, the Attorney General noted important commercial conflicts of interest and suppression of scientific evidence that had tainted the guidelines process. This paper explores two broad ethical themes that influenced the IDSA investigation. The first is the growing (...) problem of conflicts of interest among guidelines developers, and the second is the increasing centralisation of medical decisions by insurance companies, which use treatment guidelines as a means of controlling the practices of individual doctors and denying treatment for patients. The implications of the first-ever antitrust investigation of medical guidelines and the proposed model to remediate the tainted IDSA guidelines process are also discussed. (shrink)

In the coming weeks and months SARS-CoV-2 may ravage countries with weak health systems and populations disproportionately affected by HIV, tuberculosis, and other infectious diseases. Without safeguards and proper attention to global health equity and justice, the effects of this pandemic are likely to exacerbate existing health and socio-economic inequalities. This paper argues that achieving global health equity in the context of COVID-19 will require that notions of reciprocity and relational equity are introduced to the response.

The promises of precision medicine are often heralded in the medical and lay literature, but routine integration of genomics in clinical practice is still limited. While the “last mile” infrastructure to bring genomics to the bedside has been demonstrated in some healthcare settings, a number of challenges remain — both in the receptivity of today's health system and in its technical and educational readiness to respond to this evolution in care. To improve the impact of genomics on health and disease (...) management, we will need to integrate both new knowledge and new care processes into existing workflows. This change will be onerous and time-consuming, but hopefully valuable to the provision of high quality, economically feasible care worldwide. (shrink)

The psychedelic psilocybin has shown promise both as treatment for psychiatric conditions and as a means of improving well-being in healthy individuals. In some jurisdictions (e.g., Oregon, USA), psilocybin use for both purposes is or will soon be allowed and yet, public attitudes toward this shift are understudied. We asked a nationally representative sample of 795 US Americans to evaluate the moral status of psilocybin use in an appropriately licensed setting for either treatment of a psychiatric condition or well-being enhancement. (...) Showing strong bipartisan support, participants rated the individual’s decision as morally positive in both contexts. These results can inform effective policy-making decisions around supervised psilocybin use, given robust public attitudes as elicited in the context of an innovative regulatory model. We did not explore attitudes to psilocybin use in unsupervised or non-licensed community or social settings. (shrink)

: According to the long orthodox interpretation of Kant's theory of motivation, Kant recognized only two fundamental types of motives: moral motives and egoistic, hedonistic motives. Seeking to defend Kant against the ensuing charges of psychological simplism, Andrews Reath formulated a forceful and seminal repudiation of this interpretation in his 1989 essay “Hedonism, Heteronomy and Kant's Principle of Happiness.” The current paper aims to show that Reath's popular exegetical alternative is untenable. His arguments against the traditional view miss the mark, (...) and his revisionist interpretation of Kant's theory of motivation cannot bear the considerable weight of the countervailing evidence. (shrink)

Although the target article emphasizes the important role of prediction in language use, prediction may well also play a key role in the initial formation of linguistic representations, that is, in language development. We outline the role of prediction in three relevant language-learning domains: transitional probabilities, statistical preemption, and construction learning.

Whereas most commentators agree about the centrality of narratives in decision-making, the commentaries revealed little consensus about the nature of radical uncertainty. Here we consider thirteen objections to our views, including our characterization of the uncertain decision environment and associated cognitive, affective, and social processes. We conclude that under radical uncertainty, narratives rather than probabilities are the currency of thought.

Fertility preservation has become more common for various populations, including oncology patients, transgender individuals, and women who are concerned about age-related infertility. Little attention has been paid to fertility preservation for patients with differences/disorders of sex development (DSD). Our goal in this article is to address specific ethical considerations that are unique to this patient population. To this end, we present a hypothetical DSD case. We then explore ethical considerations related to patient’s age, risk of cancer, concern about genetic transmission (...) of a DSD condition to children, co-occurring gender dysphoria, and access to experimental fertility preservation procedures. Given the limitations of current technologies, we recommend offering fertility preservation to individuals living with DSD using an informed decision-making approach that instills realistic expectations and minimizes the potential for false hope. Finally, we conclude with practical recommendations for this case based on the ethical considerations. (shrink)

Rewards are reinforcement mechanisms that organizations use to shape desirable employee behaviors. However, rewards may also have unintended consequences, such as building expectations for receiving extra benefits and weakening employee barriers to unethical acts. This article investigates the dark side of the reward–behavior association, and exploring what is referred to as the reward–theft parity effect (RTPE). The authors hypothesize that receiving rewards induces a corresponding type of theft. In Study 1, survey results (n = 634) show initial support for the (...) RTPE between rewards and same‐category theft, and that perceptions of procedural justice attenuate this association. Study 2 involved a 2 (reward) × 2 (theft opportunity) between‐subjects experimental design (n = 300) and provides further support for the RTPE by revealing greater theft under a reward–theft parity condition than under a reward–theft disparity condition. Study 3 replicates these findings in a field experiment (n = 285) and finds that the RTPE is exacerbated when the reward–behavior task is perceived as unjust. Collectively, these findings provide new theoretical insights while also giving managers a more complete understanding of the dark side of behavioral reinforcement mechanisms. (shrink)

Business Ethics, the Environment &Responsibility, Volume 31, Issue 3, Page 846-858, July 2022.

Chater & Loewenstein have done a service to the field by raising the fundamental issue of how the political process distorts well-intentioned efforts at behavioral public policy. We connect this argument to broader research on government failure, particularly public choice theory in economics. We further suggest ways that behavioral research can help identify and mitigate such failures.