This article looks at some of the moral implications of the radical reforms in the United Kingdom since the Griffiths Report was first published in 1988. It is suggested that, among others, two outcomes are particularly problematic. These are firstly, findings that care managers (the preferred name in the UK for social workers dealing mainly with adults and older people who require social care support in the community) no longer spend much time with clients, and secondly, suggestions that many (...) aspects of care management practice promote forms of inequality, especially amongst already disadvantaged groups. The article also considers recent studies regarding the opinions of social work practitioners, and it is concluded that ultimately the care management hegemony is difficult to defend from an ethical perspective. (shrink)

John Rawls's work (1971) has greatly contributed to rehabilitating equality as a basic social value, after decades of utilitarian hegemony,particularly in normative economics, but Rawls also emphasized that full equality of welfare is not an adequate goal either. This thesis was echoed in Dworkin's famous twin papers on equality (Dworkin 1981a,b), and it is now widely accepted that egalitarianism must be selective. The bulk of the debate on ‘Equality of What?’ thus deals with what variables ought to be submitted for (...) selection and how this selection ought to be carried out. (shrink)

Several allocation rules allow for possible violations of the ‘independence of irrelevant alternatives’ axiom in cooperative bargaining game theory. Nonetheless, there is no conclusive evidence on how contractions of feasible sets exactly affect bargaining outcomes. We have been able to identify a definite behavioral channel through which such contractions actually determine the outcomes of negotiated bargaining. We find that the direction and the extent of changes in bargaining outcomes, due to contraction of the feasible set, respond to (...) the level of agent asymmetry with a remarkable degree of regularity. Alongside, we conclude that the validity of the IIA axiom is only limited to symmetric games. (shrink)

This article introduces the concept of a Moment of Equal Opportunity (MEO): a point in an individual’s life at which equal opportunity must be applied and after which it need not. The concept of equal opportunity takes many forms, and not all employ an MEO. However, the more egalitarian a theory of equal opportunity is, the more likely it is to use an MEO. The article discusses various theories of equal opportunity and argues that those that employ an MEO are (...) problematic. Unjust inequalities, those that motivate the use of equal opportunity, occur throughout people’s lives and thus go unrectified after an MEO. However, it is not possible to abandon the MEO approach and apply more egalitarian versions of equal opportunity throughout a person’s life, since doing so entails problems of epistemology, efficiency, incentives, and counter-intuitive results. The article thus argues that liberal egalitarian theories of equality of opportunity are inconsistent if they support an MEO and unrealizable if they do not. (shrink)

Part of the equation in sub-section “Key findings” is missing in the original publication of the article. The error was caused by the fact that the equation, due to its length, exceeded the page width. The missing part of the equation is given below.

How do people respond to others' accidental behaviors? Reward and punishment for accidents might be depend on the actor's intentions, or instead on the unintended outcomes she brings about. Yet, existing paradigms in experimental economics do not include the possibility of accidental monetary allocations. We explore the balance of outcomes and intentions in a two-player economic game where monetary allocations are made with a "trembling hand": that is, intentions and outcomes are sometimes mismatched. Player 1 allocates $10 (...) between herself and Player 2 by rolling one of three dice. One die has a high probability of a selfish outcome, another has a high probability of a fair outcome, and the third has a high probability of a generous outcome. Based on Player 1's choice of die, Player 2 can infer her intentions. However, any of the three die can yield any of the three possible outcomes. Player 2 is given the opportunity to respond to Player 1's allocation by adding to or subtracting from Player 1's payoff. We find that Player 2's responses are influenced substantially by the accidental outcome of Player 1's roll of the die. Comparison to control conditions suggests that in contexts where the allocation is at least partially under the control of Player 1, Player 2 will punish Player 1 accountable for unintentional negative outcomes. In addition, Player 2's responses are influenced by Player 1's intention. However, Player 2 tends to modulate his responses substantially more for selfish intentions than for generous intentions. This novel economic game provides new insight into the psychological mechanisms underlying social preferences for fairness and retribution. (shrink)

Background: Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students’ perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. Research design: An Italian national cross-sectional study design was performed in 2015–2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous (...) clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 – ‘never’ to 3 – ‘very much’). Participants and research context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. Findings: Overall, 4707 (49%) perceived to have discussed ethical issues ‘much’ or ‘very much’; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, ‘enough’ or ‘never’ ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues. Conclusion: Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice. (shrink)

Background 300 million operations and procedures are performed annually across the world, all of which require a patient’s informed consent. No standardised measure of the consent process exists in current clinical practice. We aimed to define a core outcome set for informed consent for therapy. Methods The core outcome set was developed in accordance with a predefined research protocol and the Core OutcoMes in Effectiveness Trials methodology comprising systematic review, qualitative semi structured interviews, a modified Delphi process and consensus (...) webinars to ratify outcomes for inclusion in the final core outcome set.. Participants from all key stakeholder groups took part in the process, including patients and the public, healthcare practitioners and consent researchers. Results 36 outcome domains were synthesised through systematic review and organised into a consent taxonomy. 41 semi-structured interviews were performed with all consent stakeholders groups. 164 participants from all stakeholder groups across 8 countries completed Delphi Round 1 and 125 completed Round 2. 11 outcomes met the ‘consensus in’ criteria. 6 met ‘consensus in’ all stakeholder groups and were included directly in the final core outcome set. 5 remaining outcomes meeting ‘consensus in’ were ratified over two consensus webinars. 9 core outcomes were included in the final core outcome set: Satisfaction with the quality and amount of information, Patient feeling that there was a choice, Patient feeling that the decision to consent was their own, Confidence in the decision made, Satisfaction with communication, Trust in the clinician, Patient satisfaction with the consent process, Patient rated adequacy of time and opportunity to ask questions. Conclusion This international mixed-methods qualitative study is the first of its kind to define a core outcome set for informed consent for intervention. It defines what outcomes are of importance to key stakeholders in the consent process and is a forward step towards standardising future consent research. (shrink)

We see unique opportunities to advance emotional research by studying an overlooked environmental problem. The biodiversity crisis is caused by land use, in particular by reducing and damaging habitats, such as deforestation for cattle grazing. Biodiversity processes are proximate and personally moving, like when a person is causing or experiencing changes to livelihood-providing ecosystems, and we suggest this affect-rich context is useful for studying social and psychological processes. In contrast, much research on far-away populations thinking about climate change effects (...) involves more abstract and distant cognitions. We also suggest biodiversity-related emotions have consequential outcomes for health and behavior, and provide advice for shaping research programs on specific populations and wildlife interactions. (shrink)

In this paper, I provide an analysis of equal opportunity. I argue that equal opportunity occurs where two or more persons with equal natural abilities and willingness to work hard have chances at various jobs that are in the aggregate of equal value. I then argue that equal opportunity is neither valuable nor something that the government ought to pursue. First, it is not clear why we should value opportunities rather than outcomes. Second, the value of equal opportunity (...) rests on the value of interest satisfaction. However, if interest satisfaction is relatively constant across different jobs and different job opportunities, then the concern for interest satisfaction will not ground the value of equal opportunity. Third, equalizing opportunities is not in itself valuable because persons are not equally valuable. Fourth, even if equal opportunity were valuable, the government can pursue it only by trespassing on individual rights. (shrink)

The theory of equal opportunity as I have expounded it in Roemer uses a language comprising five words: objective, circumstance, type, effort, and policy. The objective is the kind of outcome or well-being or advantage for whose acquisition one wishes to equalize opportunities, in a given population. Circumstances are the set of environmental influences, beyond the individual’s control, that affect his or her chances of acquiring the objective. A type is the group of individuals in the population with a (...) given set of circumstances. Effort is autonomously chosen action—within the individual’s control—which, if expended in greater amounts, will increase the degree to which the individual acquires the objective. A policy is a social intervention that is used to influence the degree to which individuals acquire the objective. The equal-opportunity policy is the one from the set of feasible policies that will make it the case that the degree to which individuals acquire the objective is independent of their circumstances, and sensitive only to their effort. I propose a way of computing the equal-opportunity policy in any given situation, given the appropriate data, and a decision as to what environmental aspects should be taken to constitute circumstances. This quick summary leaves out many details, which will be focused upon in what follows. (shrink)

ABSTRACTAccording to difference-based models of causal judgement, the epistemic state of the agent should not affect judgements of cause. Four experiments examined opportunity chains in which a physical event enabled a subsequent proximal cause to produce an outcome. All four experiments showed that when the proximal cause was a human action, it was judged as more causal if the agent was aware of his opportunity than if he was not or if the proximal cause was a physical event. The first (...) two experiments showed that these preferences could not be explained in terms of differences in perceived conditional probability, social controllability or perceptions of the causal sequence as forming a single unit. The third experiment showed that awareness affected the perceived deliberateness with which the action brought the outcome about but not its perceived voluntariness. The fourth experiment showed that... (shrink)

Liberalism has often been viewed as a continuing dialogue about the relative priorities between liberty and equality. When the version of equality under discussion requires equalization of outcomes, it is easy to see how the two ideals might conflict. But when the version of equality requires only equalization of opportunities, the conflict has been treated as greatly muted since the principle of equality seems so meager in its implications. However, when one looks carefully at various versions of equal (...) opportunity and various versions of liberty, the conflict between them is, in fact, both dramatic and inescapable. Each version of the conflict poses hard choices which defy anysystematicpattern granting priority to one of these basic values over the other. In this essay, I will flesh out and argue for this picture of fundamental conflict, and then turn to some more general issues about the kinds of answers we should expect to the basic questions of liberal theory. (shrink)

Progress in transplantation outcomes depends on continuing research into both donor and recipient factors that may enhance graft and patient survival. A system of licencing for transplantation research, introduced by the Human Tissue Act 2004, which separates it from the transplantation process (then exempt from licencing), has damaged this vital activity by a combination of inflexible interpretation of the 2004 Act and fear of criminal liability on the part of researchers. Now, following the European Union (EU) Directive (2010) on (...) standards of quality and safety of human organs intended for transplantation, new UK Regulations have been drafted, which are intended to implement it. These Regulations impose a compulsory licencing system, similar to that for research, on the whole transplantation process. This goes beyond what is required by the Directive and may even have an inhibitory effect similar to that already seen in research. Initial draft Regulations went further, imposing criminal sanctions for breaches. However, following a public consultation process, the Department of Health (DH) has recently stated that, as a result of the overwhelming view of respondents that the proposed licencing system was unnecessary, all sanctions under the final Regulations are now decriminalised, with the sole exception of operating without a licence. While this does not eliminate the negative effect of licencing, it does suggest an awareness of the DH that excessive regulation unnecessarily harms the transplantation process. An opportunity thus arises for the Human Tissue Authority (the regulatory body for both the new licences and research licences under the 2004 Act) to end the current illogical and harmful separation of transplantation and transplantation research by ensuring that all centres licenced for organ donation, retrieval and transplantation are also fully licenced for related research. (shrink)

Fair equality of opportunity, a principle that governs the competition for desirable jobs, can seem irrelevant in our actual world, for two reasons. First, parents have broad liberty to raise their children as they see fit, which seems to undermine the fair equality of opportunity–based commitment to eliminating the effects of social circumstances on that competition. Second, we already have a well-established principle for distributing jobs, namely meritocracy, thereby leaving no theater in which fair equality of opportunity can operate. I (...) argue that we can solve both of these problems by conceding, in contrast to previous fair equality of opportunity defenders, that there’s no unique good associated with the right job, while insisting that there is a unique bad associated with the wrong job and holding that fair equality of opportunity should govern the competition to avoid that bad by attaining the right job. This move enables new responses to the two problems previously mentioned. In response to the meritocracy problem, I propose simply accepting that that principle should guide the distribution of jobs and all the associated goods while maintaining that there is room for a separate, non-consequentialist principle whose function is to ensure a fair distribution of chances to avoid the unique bad just identified. In response to the parental liberty problem, I argue that, for any given person, which job will deliver the unique bad I identify is contingent on her skills, and therefore, the way she is raised determines what would constitute a bad employment outcome for her, but doesn’t affect her chances of avoiding that outcome. (shrink)

After reviewing the basis for urgency of assuring that nations reduce their ghg emissions to their fair share of safe global emissions, this paper examines the outcome of UNFCCC COP-20 in Lima in regard to getting traction for ethics and justice in national formulation of climate change commitments. In light of what is actually known about how nations have considered ethics and justice in formulating national climate change policies, this paper critically reviews elements of a Lima decision on what information (...) nations must include when they submit their emissions reductions commitments, now known as Intended Nationally Determined Commitments. The paper argues that some developing countries seeking to preserve distinctions between duties of developed versus developing countries set out in the UNFCCC may have inadvertently undermined a mechanism that had some significant potential to improve the compliance of high-emitting nations on the basis of equity and justice. Relying on recent research on the.. (shrink)

If we cross-classify the absolutist-consequentialist distinction with an intuitive-analytical one we can see that economists probably attract the hostility of those in the other three cells as a result of being analytical consequentialists, as much as because of their concern with “costs”. Suggesting that some sources of utility are to be regarded as rights cannot, says the analytical consequentialist, overcome the fact that fulfilling and respecting rights is a resource-consuming activity, one that will inevitably have consequences, in resource-constrained situations, for (...) the fulfilment of the rights of others. Within the analytical consequentialist framework QALY-type measures of health outcome have the unique advantage of allowing technical and allocative efficiency to be addressed simultaneously, while differential weighting of QALYs accruing to different groups means that efficiency and equity can be merged into the necessary single maximand. But what if such key concepts of the analytical consequentialist are not part of the discursive equipment of others? Are they to be disqualified from using them on this ground? Is it ethical for intuition to be privileged in ethical discourse, or is the analyst entitled to “equal opportunities” in the face of “analysisism”, the cognitive equivalent of “racism” and “sexism”? (shrink)

In recent decades, economists have developed methods for measuring the country-wide level of inequality of opportunity. The most popular method, called the ex-ante method, uses data on the distribution of outcomes stratified by groups of individuals with the same circumstances, in order to estimate the part of outcome inequality that is due to these circumstances. I argue that these methods are potentially biased, both upwards and downwards, and that the unknown size of this bias could be large. To argue (...) that the methods are biased, I show that they ought to measure causal or counterfactual quantities, while the methods are only capable of identifying correlational information. To argue that the bias is potentially large, I illustrate how the causal complexity of the real world leads to numerous non-causal correlations between circumstances and outcomes and respond to objections claiming that such correlations are nonetheless indicators of unfair disadvantage, that is, inequality of opportunity. (shrink)

Globalisation develops at a staggering pace that envelopes and infiltrates local South African communities in various ways. Through technology a person can have access to anything today. Should the church try to keep up, or compete with such a reality? This article aims to encourage the church to develop a responsible missional character, which embraces the opportunities globalisation offers – to be a participative forum in a community comprising of more than religious people. Through re-evaluating the church’s missional intent, (...) by shifting the paradigm away from self-centred outcomes, the church should contribute to such a community’s articulation of faith. (shrink)

Outcomes research is topical in discussions about health-related research. Its emphasis on effectiveness creates an important opportunity for nurse researchers to strengthen the linkages between theory, outcomes research and nursing practice but, before care can be more effective, it is logical to establish patients’ desired outcomes. A thorough review of the implications of this requirement for the care of hospice patients is needed, but is lacking in the literature. Therefore, the literature on a ‘good death’ is reviewed (...) as a step towards assisting hospice patients to achieve what they regard as an acceptable death. The starting point is to define more clearly what it means to die a good death. The relationship between hospice care and achieving a good death is then examined. (shrink)

The aim of this study was to explore patients’ experiences of using the Integrated Palliative care Outcome Scale (IPOS) during specialized palliative home care. The study adopted a qualitative approach with an interpretive descriptive design. Interviews were performed with 10 patients, of whom a majority were diagnosed with incurable cancer. Our findings suggest that the use of IPOS as a basis for conversation promotes safe care by making the patients feel confident that the care provided was adapted to them which (...) gives them a sense of safety. IPOS facilitated discussions between patients and nurses about care needs. The patients believed that using IPOS enabled reflection on their well‐being and life situation. In conclusion, the study finds that using IPOS is beneficial and provide ways to enable person‐centered care and with advantage could be used in specialized palliative home care. The results may help overcome barriers and facilitate the use of patient‐reported outcome measures (PROMs). To enable the use of PROMs such as IPOS in palliative home care, nurses need education and opportunities to develop routines that enable patients’ voice to be heard and thereby compose a basis for care. (shrink)

A recent theory (Roese & Summerville, 2005) has suggested that regret is intensified by perceptions of future opportunity. In this work, however, it is proposed that feelings of regret are more likely elicited by perceptions of lost opportunity: People regret outcomes that could have been changed in the past but can no longer be changed and for which people experience low psychological closure. Consistent with the lost opportunity principle, Study 1 revealed that regretted experiences in the most commonly regretted (...) life domains are perceived as offering the least opportunity for improvement in the future, Study 2 indicated that people experience the most regret for outcomes that are not repeatable, and Study 3 revealed that perceptions of higher past than future opportunities and low psychological closure predict regret intensity. Discussion focuses on the hope inducing yet ephemeral nature of perceived future opportunity and on the relationship between dissonance reduction and closure. (shrink)

Sharply in focus in the United States right now is the disproportionate COVID‐19 infection, hospitalization, and mortality rates of Black, Indigenous, Hispanic, and Pacific Islanders living in the United States in contrast to White people. These COVID‐19 disparities are but one example of how systemic racism filters into health outcomes for many Black, Indigenous, and other People of Color (BIPOC). With these issues front and center, more attention is being given to the ways that White medical professionals contribute to (...) these disparities, including their socialization to ignore or deny inequities. As such, the present study sought to understand how educating White health‐care pre‐professionals about systemic racism might influence their understanding of and responsibility for disrupting White supremacy. Data were drawn from 49 White‐identified nursing students who participated in a mapping project that uncovered instantiations of systemic racism in the United States. Participant written reflections were analyzed using thematic analysis. Findings revealed that mapping projects can develop White people's knowledge and understanding of systemic racism. We introduce the construct, transformative dissonant encounters, to describe how this project precipitated shifts in world view necessary for White people to confront systemic racism. Implications for nursing educators, psychological researchers, and antiracist activists are discussed. (shrink)

Despite spending more on health care than every other industrialized country, the U.S. ranks 37th in health outcomes. These differences cannot be explained away with differences in age and income, or even with quality of care. And, the rate of growth in health care spending in the U.S. continues to increase. The share of the Gross Domestic Product attributable to health care grew from 9% in 1980 to more than 17% in 2011. Health care costs are projected to account (...) for more than one-fifth of our economy by 2021. Despite spending more and more, the U.S. does not have better health outcomes than other countries. Worse, our increasing spending is largely attributable to preventable conditions. More than 85 cents of every dollar spent on health in the U.S. are spent on the treatment and management of chronic diseases, such as those caused by preventable conditions related to obesity and tobacco use. (shrink)

In this article, I examine a case involving an equity-minded parent caught in a quandary about which school to select for her child, knowing that her decision may have consequences for others. To do so, I heuristically construct a fictional portrait and explore the deliberative process a parent might have through a dialogue taking place among ‘friends’, where each friend personifies a different set of ethical considerations. I then briefly consider two competing philosophical assessments but argue that neither position helpfully (...) assists in resolving the quandary. To conclude, I ask the provocative question whether parental motives – but also their school choices – actually matter if the inequitable outcomes seem to remain unchanged. (shrink)

Family migration often disadvantages women’s careers. Yet, we know little about the decision-making processes that lead to such outcomes. To address this gap, I conducted a longitudinal interview study of 21 heterosexual young adult couples who were deciding whether to move for early career opportunities. Analyzing 118 interviews, I detail how partners negotiate their desired work and family arrangements given structural and cultural constraints. On one negotiation trajectory, partners maintained their egalitarian desires by performing practical labor to make (...) equal work–family arrangements. On another pathway, couples changed their desires by doing emotion work to justify neotraditional roles. On the last pathway, men deferred to women’s desires, unintentionally leaving women the emotional and practical work of coordinating two careers and the couple’s life. These pathways show how couples contest and reproduce gendered work and family roles during the stalled gender revolution. (shrink)

BackgroundCervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status. Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like ‘equity’. Equity is a poorly defined and understood concept. We aimed to explain experts’ perspectives on how cervical screening programs might justifiably respond to ‘the underscreened’.MethodsThis paper reports (...) on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing.ResultsMost experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines.ConclusionsExperts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to ‘improving equity’ taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage. (shrink)

How do we know if people are equal? Contemporary philosophers consider a number of issues when determining if the goals of egalitarian distributive justice have been achieved: defining the metric of equality; determining whether the goal is equality, or simply priority or sufficiency; establishing whether there should be conditions, e.g. bad brute luck, for the amelioration of inequality. In all this, most egalitarians contend that what is to be equalized is not people’s actual shares of the good in question, but (...) rather, the opportunities to have such shares. I counter this view with an ‘egalitarian flourishing’ approach that, in seeking to make people equal in actual well-being, takes exception to the role of opportunity in contemporary argument. The flourishing view means a focus on outcomes, on how people live, in order to enable people to live equally flourishing lives. I argue that if we consider the complex dynamics of choice and circumstance, the role of nonmaterial considerations and the ideal of an egalitarian community, equality of opportunity proves to be an inadequate approach to the realization of the egalitarian ideal. (shrink)

Authoritarian governments are characterised by political systems with concentrated and centralised power. Healthcare is a critical component of any state. Given the powers of an authoritarian regime, we consider the opportunities they possess to derive good health outcomes. The 2019 Varsity Medical Ethics Debate convened on the motion: ‘This house believes authoritarian government is the route to good health outcomes’ with Oxford as the Proposition and Cambridge as the Opposition. This article summarises and extends key arguments made (...) during the 11th annual debate between medical students from the Universities of Oxford and Cambridge. By contrasting the principles underlying authoritarianism and democracy, it enables a discussion into how they translate into healthcare provision and the outcomes derived. Based on the foundation of said principles, an exploration of select cases represents examples of applications and the results. We analyse the past, present and future implications on the basis of fundamental patient-centred care. (shrink)

We analyse three moral dilemmas involving resource allocation in care for HIV-positive patients. Ole Norheim and Kjell Arne Johansson have argued that these cases reveal a tension between egalitarian concerns and concerns for better population health. We argue, by contrast, that these cases reveal a tension between, on the one hand, a concern for equal *chances*, and, on the other hand, both a concern for better health and an egalitarian concern for equal *outcomes*. We conclude that, in these cases, (...) there is much less tension than Norheim and Johansson claim between egalitarian concerns and concerns for better population health. (shrink)

If one is an egalitarian, what should one want to equalize? Opportunities or outcomes? Resources or welfare? These positions are usually conceived to be very different. I argue in this paper that the distinction is misconceived: the only coherent conception of resource equality implies welfare equality, in an appropriately abstract description of the problem. In this section, I motivate the program which the rest of the paper carries out.

Australia, being a successful example of using sports for foreign policy, has significantly improved its international influence in the Pacific region. Yet, political, cultural, and economic peculiarities can doubt the similar application of sports by other countries. This article examines Australia’s use of sports and sports diplomacy as key instruments of its international strategy. The purpose of the article is to analyze Australia’s use of sports within soft power efforts, explore its methods, principles, and frameworks, and evaluate whether this framework (...) can be applied by other countries to achieve similar soft power objectives. This study performs a comprehensive review of literature, official Australian government publications, and specific case studies to understand the outcomes and applicability of the approach. The novelty of the research lies in its detailed examination of the specific conditions and strategies that have made Australia’s sports diplomacy successful. Key research findings highlight that Australia’s effective use of sports diplomacy is rooted in its effect of sports on national identity, strong sports culture, advanced infrastructure, strategic partnerships, and connections with communities, particularly within the Pacific region. The article proves that the 2015-18 and 2030 Sports Diplomacy Strategies have successfully fostered cultural, sports, and people-to-people connections and enhanced Australia’s influence and presence globally. The article concludes that while Australia’s sports diplomacy model is highly effective, its application by other countries may be challenging. The reasons refer to varying levels of national perception of sports, sports culture, financial resources, and international influence. For actors with similar conditions, a comprehensive approach is applicable, whereas for emerging and developing nations it may be best to adopt specific elements of the strategies depending on the needs and resources. (shrink)

Entrepreneurship has flourished in recent years; however, since education on how to raise funds has received little attention from scholars, obtaining funds remains a difficult task. The development of crowdfunding has provided new opportunities to entrepreneurs, thus solving the funding, marketing, and distribution problems they previously faced. The main purpose of this study is to organize crowdfunding literature and to develop a crowdfunding curriculum grounded on output-based education. Students are asked to develop a product and a crowdfunding plan within (...) the span of one semester. This study explains the teaching content separately from the crowdfunding plan competition, course elements, and timetable. (shrink)

This article examines the contribution of a sectoral approach to understanding gender constraints on economic success in the informal sector, using the example of self-employed women in home-based garment production in Ahmedabad, India. The author assesses whether all the constraints laid out in the gender and microenterprise development literature affect women in this sector and, if not, suggests how theory on gender inequality in the microenterprise sector needs to be rethought to address variation by sector. Constraints are disaggregated into women (...) intensive, women exclusive, and sector specific. The results show that the women-exclusive constraints all hold within this sector, that there is variation among the women-intensive constraints in their differential gender effect, and that some sector-specific constraints tend to be more intense for women relative to men. The latter two results suggest that variation by economic activity must be accounted for in understanding the sources and extent of gender inequality in economic outcomes. (shrink)

This article examines how the ideology of white injury both conceals and sustains inequitable social relations in turn‐of‐the‐millenium California. Understanding the political and economic context of California in the early 1990s in relation to media, law, and culture helps explain why Californian citizens passed the unconstitutional initiative, Proposition 187, in 1994. Targeting undocumented Mexican immigrants, this ‘color‐blind’ Proposition functioned to conflate economic insecurities with racial anxieties. An analysis of culture, law, and media discloses how racial anxieties limit our understandings (...) of exploitative capitalist relations, serving to artificially augment the white middle‐class ‘ wealth, opportunities, and power, while making vulnerable populations in the United States even more open to exploitation. (shrink)

Measures are designed to evaluate the processes and outcomes of care associated with the delivery of clinical (and non-clinical) services. They allow for intra- and interorganizational comparison to be used continuously to improve patient health outcomes. The use of performance measures always means to abstract the complex reality (medical scenarios and procedures) in order to provide an understandable and comparable output. Measures can focus on global performance. The more detailed data are available the more specific judgements with respect (...) to the appropriateness of clinical decision-making and implementation of evidence are feasible. Externally reported measures are intended both to inform and lead to action. By providing this information, deficiencies in patient care and unnecessary variations in the care process can be uncovered. Such variations have contributed to disparities in morbidity and mortality. The developments in information technology, especially world-wide interconnectivity, standards for electronic data exchange and facilities to store and manage large amounts of data, offer the opportunity to analyse health-relevant information in order to make the delivery of healthcare services more transparent for consumers and providers. Global performance measures, such as the overall life expectancy (mortality) in a country, can give a rough orientation of how well health systems perform but they do not offer general solutions nor spe-cific insights into care processes that have to be improved. In contrast to population-based measures, case-based performance measures use a defined group of patients depending on specific patient characteristics and features of disease. By means of these measures we are able to compare the number of patients that receive a necessary medical procedure against those patients who do not. The use of case-based measures is a bottom-up approach to improve the overall performance in the long run. They are not only a tool for global orientation but can offer a straightforward link to the areas of deficient care and the underlying procedures. Performance measures are relevant to providers as well as consumers, from their own individual perspective. Cased-based measures focus on the management of individual patient. This approach to performance measurement can inform physicians in a meaningful and constructive way by monitoring their individual performance and by pointing out possible areas of improvement. (shrink)

One of the most commonly observed peculiarities of the instrumental conception of rationality is that when applied in contexts of social interaction it sometimes prescribes actions that will predictably result in suboptimal outcomes. Often these outcomes could be avoided if agents were able to credibly commit themselves to refraining from exercising certain options available to them. The prisoners’ dilemma is the classic example. This problem has generated a small growth industry of attempts to modify the instrumental model in (...) order to incorporate commitments. The reason that philosophers are so attracted to this project is that it seems to offer them an opportunity to finish off the job that Socrates began, viz. to refute moral skepticism of the ‘rational egoist’ variety.1 None of this has worked very well, but enthusiasm for the project appears to continue unabated. (shrink)

This article represents a comprehensive study of transition peculiarities from a latent stage to the open demonstration of conflict, drawing on the concepts of base trigger, trigger situation, and crucial episode (L. Boltanski, L. Thévenot). The trigger situations of urban conflicts were studied on the broad empirical material of the Novosibirsk urban agglomeration over the last decade. The research authors created a geoinformation database containing a structured description of more than two hundred cases of urban conflict. The trigger is presented (...) as a complex mechanism that contributes to the aggravation of tension (risk trigger) or the manifestation and/or escalation of conflict, which can be launched only when the addressee perceives the situation of change initiated by the addresser as a threat — which, in turn, creates the conditions for changing of actions, order of involvement and register. This opens up opportunities for influencing and managing the situation of change. A morphological analysis of triggers of the unfolding conflict made it possible to identify several groups determined by investment, institutional, normative, and value regulations. In a modern actively changing city, the investment-type trigger was empirically shown to be the most conflict-generating, with the first steps of project publicizing and proclamation having the greatest trigger potential. However, an analysis of the relationship between the nature of the trigger and the outcome of the conflict showed that conflicts caused in particular by the investment-type triggers have a higher probability of settlement. As a rule, private investors are more flexible in meeting the demands of the protesters than the authorities, especially if the investors do not rely on the unconditional support of the authorities. This does not negate the important issue of the poor quality of decision-making in conflict regulation. Just a few conflict actors aim to fix the balance, which is why only a small part of the conflicts ends with the search for a compromise; mostly the conflicts end with a complete victory of one of the parties or the cancellation of the project in favor of the protesters. (shrink)

Stephen Kershnar (2004) recently argues that under its most plausible interpretation, equality of opportunity is simply not something worth pursuing; at least, not for itself. In this paper I try to show that even if we accept Kershnar's characterisation of equality of opportunity in terms of weighted aggregate chances, none of his objections succeed. Opportunities, not outcomes, are the appropriate focus of EO advocates; hedonic treadmills are irrelevant to the issue; we do not need to assume general equality (...) in some attribute to ground equality of opportunity; finally, it is possible to show that it is permissible to promote EO at some cost to other independent values. (shrink)

A successful entrepreneur and internet marketer discusses opportunity, how to find and create it, and how to develop great opportunities in business, investing, health, relationships, personal development, and other areas of life.

As architecture intersects with computer science to engage with large-scale data sets and informational systems, this demands new skills, competencies and commitments. Informed by the findings of an online survey, this article explores how, who and to what extent those in the profession of architecture are investing in technology knowledge and skills, and under what material conditions this occurs. Survey data collected from five large-scale architecture practices in Sydney, Australia finds that while technology-related skills are highly valued in the profession, (...) more men than women are engaging with computationally intensive software and technology skills building remains a largely unstructured and often self-directed enterprise. Drawing on feminist technology studies and digital labour perspectives, it is argued that the drive to computationalise the profession of architecture rests heavily on discretionary, aspirational and invisible labour practices that disadvantage employees with lesser reserves of economic and social capital, and particularly women. This further contributes to revealing neo-liberalism’s influence on the concrete practices of the architecture workplace and highlights how the diminished structural role of employers breeds uneven opportunities and inequitable working conditions. (shrink)

In this essay I discuss a person’s freedom to choose whatever that person may reasonably prefer to choose. This type of freedom of choice may be regarded as a candidate for a social good, being a hybrid between freedom of choice and preference satisfaction utility. To separate this preference dependent freedom of choice from other types, we may call it opportunity. The essay is concerned with the question of how opportunity should be identified and measured. I discuss what conditions an (...) opportunity measure should satisfy and propose that an opportunity measure should satisfy at least four specific conditions. I then present a new class of measures which satisfy the four conditions (the Root measures). Last I prove that these measures are the only ones that satisfy the conditions, given the extra assumption that the measures are analytic functions with non-zero partial derivatives. (shrink)

Can you recognize an opportunity when it comes your way? Even though the concept seems fairly basic, most people harbor regrets about missed opportunities that in retrospect might have significantly improved their lives. This book will give you the critical tools to sort through the complexities that often obscure the perception of an opportunity and help you take full advantage of what author Donald Morris calls high-end opportunities - pivotal situations that can change your life for the better.Morris (...) begins by developing a model of opportunity in the abstract, analyzing its elements and the contexts and frameworks that affect our recognition of opportunities. Drawing from a wide range of applications, including investing, business, law, criminology, gambling, and even religion, he shows how opportunities can be defined in various contexts. He also examines highly undesirable situations, where opportunity is lacking, such as poverty and historical instances of slavery, to further illustrate, by way of contrast, the defining characteristics of opportunity.How does a significant opportunity differ from a simple option? How does taking advantage of opportunities differ from being an opportunist? Does our ability to predict the future affect our opportunities? What do we mean by equality of opportunity? By addressing these and other probing questions, Morris shows how to develop more critical perceptions of real opportunities.Donald Morris, CPA, Ph.D., is professor of accounting and chair of the Accounting, Finance, and CIS Department at Eastern New Mexico University. The former owner of an accounting firm and a onetime instructor of philosophy, he is the author of Dewey and the Behavioristic Context of Ethics. (shrink)