In 1902, the Calabrian brigand Giuseppe Musolino was tried on several counts of murder and many crimes of lesser magnitude. While the tale of the brigand’s 1898 false conviction, imprisonment, escape and then revenge sparked a national debate about the political and cultural meaning of brigandage, the trial came to focus on Musolino’s emotional state at the time of his crimes. Was he a cold-blooded and calculating killer who manipulated southerners into believing he was a folk hero? Or was he (...) an angry, passionate and insane murderer victimized by his own feelings? Both jurists and scientists weighed in to determine his culpability. By turning a political question of banditry or brigandage into a psychological question of morbid or criminal emotions, the trial politicized the criminal character. This article examines the perspectives on emotions that shaped Musolino’s trial, and how psychiatric knowledge came to challenge legal notions of insanity and culpability. It argues that the determination of emotions as motives served to de-legitimize the rationale and political motives of the defendant, in turn politicizing his emotions and character. At the same time, the cause of Musolino’s crime and his culpability represented the failures of national unification and the ongoing tensions between the North and South of Italy. The introduction of psychiatric expertise into the criminal court pushed judgement and punishment to examine increasingly who a person was as opposed to what that person had done. The court’s definition of who a person ‘was’, was a matter of how that person felt. (shrink)

It may be most convenient to respond to Dr Andreae’s points in turn. Unless the claim that a child should determine its own genetic characteristics before it is conceived or born is intended to be flippant, it is logically incoherent. Conception is a decision that only a prospective parent can make. The editorial argument is that denial of choice of sex contributes to preventable maternal mortality and morbidity, particularly in developing countries. ….

Respiratory illness continues to be a leading cause of paediatric morbidity and mortality in Indonesia. The Indonesian government is moving towards a more managed care-based approach as it reforms its health care system following the 1997 financial crisis. In order to better design contractual relationships between the payor and different providers, there needs to be a better understanding of the patterns and predictors of health services utilization for respiratory illness. This study uses the Indonesia Demographic and Health Survey to (...) study the determinants of private, public and non-formal provider utilization for respiratory illness. Multinomial logistic regression models for predicting use were constructed using the Andersen Behavioural Model as the conceptual framework. The findings indicate that age, household size, maternal education, religion, the asset index, location and illness severity play a role in determining use of private, public or non-formal providers. The results indicate that from a policy perspective, the Indonesian government needs be inclusive rather than exclusive in the choice of providers that are contracted by the managed care plans, in order to safeguard the health of the under-five population. (shrink)

Context: Comparing the Covid-19 related experiences of vulnerable groups can help to improve public health.?The United States and the United Kingdom are both characterized by underfunded public health in the context of racist systems. We reviewed differences in Covid-19 outcomes between groups in the US and UK and compared intergroup differences between the two countries. Methods: The scoping review analyzed articles published in English during the Covid-19 pandemic focusing on the US or the UK. Using Scopus and PubMed, research articles (...) were chosen based on titles, abstracts, and relevance to the research question. Certain demographic groups known to be differentially affected by Covid-19 were chosen a priori for inclusion. Data was extracted by the first author and reviewed by senior authors. 63 studies met the inclusion criteria. Results: Two studies compared the US and UK. One found that minority status is an important social determinant of health (SDOH) of Covid-19 related health outcomes in both countries, likely through association with other SDOH. Another found that the risk of confirmed infection was higher in African-Americans, Hispanic Americans, and Asian Americans in the US and in African-Caribbean/Black-Africans, South-Asians, and Mixed-race people in the UK, compared with their respective White peers. Asian ethnicity is subject to different definitions in the US and the UK. Individual articles focusing on either the US or the UK also found that, in both countries, essential workers were impacted; those with disabilities were more often affected by Covid-19 related comorbidities in both countries. In addition, in both the US and the UK, people living in multigenerational families were more susceptible to Covid-19. Misclassification of causes of morbidity and mortality was noted in both countries. Discussion and conclusion: A limited literature indicates that, in both the US and UK, non-White populations were more affected by the Covid-19 pandemic, possibly due to association of SDOH with racist systems. Racial definitions differ between these countries and this needs further research. In both countries, data focused on LGBTQ+ groups and people with disabilities is lacking. (shrink)

The article analyzes the key issues of the theology of the modern Greek theologian Chrysostomos Stumulis. Emphasizing the need for the development of Orthodox thought and a clear definition of its place and role in the modern world, the theologian raises issues that are a definite taboo not only for Orthodoxy, but for Christianity as a whole. The problem of the correlation of Eros love and Agape love acquires a new interpretation from theologian, which reveals new horizons for the creation (...) of the latest Christian anthropology. In this context, the view of the theologian is revealed on the relationship between the key anthropological categories of Christianity - faith, love and freedom. Violation of their interaction generates a distorted embodiment of these qualities, which necessitates degradation both of society and of man. The theologian emphasizes that the inability of the Church for millennia to boldly raise the question of the nature of Eros and give him a worthy place in the nature of incarnation limits both the Church and the understanding of Christ. Modern theological thought must respond to problems that are too acute in society, despite the fact that they can be a challenging task for Orthodoxy. The ability of theology to respond to them, generates a "high risk" theology, which has the determination to speak and show the morbidity of an idealized past, dare to point out that some aspects of universally accepted truths are obsolete. The formation of a culture of embodiment is the basis upon which the theologian develops the Theology of the Word of the Flesh. Spirituality, which denies incarnation, in the opinion of the author, appears as pastoral idolatry and leads to dehumanization of society. Understanding the culture of theology as a manifestation of the culture of the flesh, as an expression of all aspects of human life in the perspective of their transformations through the Person of the Incarnate, appears as a continuation and expansion of creation. Love requires the adoption of matter and the human body. Only in this sense disclosure of a human as a Person, in the full extent of his creative spirit. Holistic understanding and a fair assessment of love - eros describes it as an opportunity for revelation and knowledge of both human personality and divine. Violating questions of love, sexuality, desire and satisfaction, the theologian indicates that they have not only anthropological nature, but are a holistic manifestation of the essence of the church body. Consequently, the accusation of Eros by Orthodox theologians points to an inhuman society, full of objections and accusations in human existential self-consciousness. The theologian draws attention to the need for theological discourse in the 21st century in the context of the formation of modern anthropology, in the aspect of disclosure of its completeness, which was lost in the abolition of theology. (shrink)

We discuss our surgical philosophy concerning the subtle interplay between the size of the surgical margin taken and the resultant morbidity from ablative oncological. procedures, which is ever more evident in the treatment of head and neck malignancy. The extent of tissue resection is determined by the "trade off" between cancer control and the perioperative, functional and aesthetic morbidity and mortality of the surgery. We also discuss our dilemmas concerning recent minimally invasive endoscopic microsurgical. techniques for the trans-oral (...) laser removal. or co-ablation of aero-digestive tract tumours, which result in a minimal. surgical margin of oncological clearance. By a process of inductive argument as to the nature of the surgical margin, we consider whether the risks of taking a lesser margin with adjuvant therapy is justified by the attendant gain in reduced surgical morbidity and the possible costs in tumour control. (c) 2006 Elsevier Ltd. All rights reserved. (shrink)

Healthcare workers are at a high risk of psychological morbidity in the face of the COVID-19 pandemic. However, there is significant variability in the impact of this crisis on individual healthcare workers, which can be best explained through an appreciation of the construct of resilience. Broadly speaking, resilience refers to the ability to successfully adapt to stressful or traumatic events, and thus plays a key role in determining mental health outcomes following exposure to such events. A proper understanding of (...) resilience is vital in enabling a shift from a reactive to a proactive approach for protecting and promoting the mental well-being of healthcare workers. Research in the past decade has identified six areas that provide promising leads in understanding the biological basis of individual variations in resilience. These are: the key role played by the monoamines noradrenaline and serotonin, the centrality of the hypothalamic-pituitary-adrenal axis in influencing stress vulnerability and resilience, the intimate links between the immune system and stress sensitivity, the role of epigenetic modulation of gene expression in influencing the stress response, the role played by certain neuropeptides as a natural “brake” mechanism in the face of stress, and the neurobiological mechanisms by which environmental factors, such as exercise, diet, and social support, influence resilience to subsequent life events. Though much of this research is still in its early stages, it has already provided valuable information on which strategies – including dietary changes, lifestyle modification, environmental modification, psychosocial interventions, and even pharmacological treatments – may prove to be useful in fostering resilience in individuals and groups. This paper examines the above evidence more closely, with a specific focus on the challenges faced by healthcare workers during the COVID-19 pandemic, and provides suggestions regarding how it may be translated into real-world interventions, as well as how the more tentative hypotheses advanced in this field may be tested during this critical period. (shrink)

This essay examines narratives about cadaver dissection through the lens of psychoanalytic theory in order to better understand the nature of medical students’ socialization into medicine and its implications for physician-patient communication. The theoretical framework provided by Julia Kristeva focuses attention on the nature of subject-formation in relation to abjection – that which reveals the contingent nature of the speaking self. Analysis of memoirs and other narratives by medical students demonstrates that students encounter the abject in the process of dissecting (...) a corpse, but are rigorously trained to map over this experience using the technical tools of biomedicine. Other students rely on dark and morbid forms of humor to develop a sense of emotional distance from their cadaver. This analysis reveals new insights about the nature of the gap between physicians and their patients. In particular, it indicates that this gap is not fixed or static but fluid and malleable. Physicians are always shifting between the symbolic realm of biomedicine and the affective, semiotic mode of encountering the abject. This malleability provides the key to training and educating medical students, socializing them in such a way that they are reflexive about this process of oscillation. How physicians handle the reality of their fluctuation between the semiotic and the symbolic is what will determine their ability to engage with patients. (shrink)

The emergency department (ED) serves as the primary gateway for acute care and the source of health care of last resort. Emergency physicians are commonly expected to rapidly assess and treat patients with a variety of life–threatening conditions. However, patients do refuse recommended therapy, even when the consequences are significant morbidity and even mortality. This raises the ethical dilemma of how emergency physicians and ED staff can rapidly determine whether patient refusal of treatment recommendations is based on intact decision–making (...) capacity and how to respond in an appropriate manner when the declining of necessary care by the patient is lacking a basis in informed judgment. This article presents a case that illustrates the ethical tensions raised by the refusal of life–sustaining care in the ED and how such situations can be approached in an ethically appropriate manner. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Close Enemies: The Relationship of Psychiatry and Psychology in the Assessment of Mental DisordersPhilippe Le Moigne, PhDAs Peter Zachar rightly points out in his comment, the assessment of mental disorders underwent new developments with the release of the Diagnostic and Statistical Manual of Mental Disorders-V in 2013 (American Psychiatric Association, 2013). Whereas in 1980, the manual had been thought of in a rigorously categorical way, on the basis of (...) distinct and closed syndromic entities, this new version advocated the development of a radically dimensionalist approach, with the diagnosis aiming this time to restore the whole symptomatological picture of the patient on a spectrum of ratings are supposed to cover the entirety of psychiatric semiology (American Psychiatric Association, 2013).For its part, my article aimed to show how standardized assessment, guided by the return of psychiatry’s authority and the assertion of its legitimacy in the diagnostic field, gave the ascendancy in the 1980s to the classificatory tradition and thus to the categorical model, to the detriment of personality approach and test psychology which offered a competing solution here. This perspective, historically dated, may have led the reader to think that there is an antagonism that cannot be overcome here. Rather, it should be seen as a form of structuring opposition, or even a “complementarity inscribed in rivalry,” between psychiatry and psychology, which is naturally susceptible to change over time.Indeed, the reversal operated by the Diagnostic and Statistical Manual of Mental Disorders-V is not total because it cannot be total. The defense of the dimensionalist approach, dear to the psychological testing tradition, was intended here to allow the identification of co-morbidities, present in most patients but poorly apprehended by the categorical approach, and to open up diagnosis to prevention by screening for minor manifestations of psychopathology when they suggest the [End Page 259] development of a manifest episode of the disease in the more or less long term. The risk here is that we end up with overdiagnosis and thus an over-representation of false positives (Wakefield, 2015). In other words, this type of approach does not escape the obligation to determine threshold scores, likely to indicate the lower limit of the disorder, and thus to resort to a categorical approach. There is a first affinity between the two perspectives which obeys, beyond the divergences in principle, a technical requirement.But the two approaches have even more in common when we look at their epistemological background: they share the idea that the representation and the intervention on mental disorder, to use Ian Hacking’s expression (1983), must be based on the model proposed by the physical and natural sciences. And as Greta Kaluzeviciute aptly points out in her comment, this orientation leads to the idea of measuring mental disorder in particular to conduct elaborate quantification operations to determine, for example, whether two entities are statistically distinct or whether a drug has a significant effect on the evolution of a pathology.This is in fact an old question that can be formulated as follows, to use the expression of the psychometrician Joel Michell (1999): are psychological dimensions metric? In other words, if we want to apply the language of numbers to mental disorders, they must share its properties, two of which seem essential: it must be possible to establish that each mental disorder, in the same way as qualities attributable to length for example, has a zero and can be divided by means of gradients (or degrees of intensity) whose interval is constant (Le Moigne, 2018; Michell, 1999). For lack of space, let us only address the second condition. This one has already been denied by many, starting with Bergson at the end of the nineteenth century (1889). He does not believe in the quantification of psychological expressions, starting with sensations. What is the common point, he wrote, between the feeling of a mild pain, as one feels a stiffness, and the sensation of a needle being hammered into your flesh? For him, one and the other of these intensities are incomparable, so that they do not belong to a similar register of sensations that one could stage from a 0 toward a... (shrink)

> Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change The 2022 report of the Intergovernmental Panel on Climate Change paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction and climate hazards such as heatwaves and floods.1 These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these (...) catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to <1.5°C compared with pre-industrial levels. While the Paris Agreement of 2015 outlines a global action framework that incorporates providing climate finance to low-income and middle-income countries, this support has yet to materialise.2 COP27 is the fifth Conference of the Parties (COP) to be organised in Africa since its inception in 1995. Ahead of this meeting, we—as health journal editors from across the continent—call for urgent action to ensure it is the COP that finally delivers climate justice for Africa and vulnerable countries. This is essential for the health of those countries, and for the health of the whole world. The climate crisis has had an impact on the environmental and social determinants of health across Africa, leading to devastating health effects.3 Impacts on health can result directly from environmental shocks and indirectly through socially mediated effects.4 Climate change-related risks in Africa include flooding, drought, heatwaves, reduced food production and reduced labour productivity.5 Droughts in sub-Saharan Africa …. (shrink)

Universal health coverage (UHC) is the condition in which every member of a certain community have access to essential, effective care without financial hardship. Increasing older adults suffering from chronic morbidities and/or social isolation struggle to receive the care they need precisely when they need it most. These patients need care personalization, multidisciplinary integration and professional cooperation more than high-tech biomedical treatment, as plenty of social determinants frequently hamper the effectiveness of each single treatment received. If the health inequalities (...) resulting from suboptimal organization of care can be reduced, taking action becomes a question of social justice. This paper aims to 1) describe some relevant determinants of health that prevent many older adults from receiving the care they need, 2) outline some policies to avoid ageism and minimize rationing. (shrink)

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Although the characteristics and advantages of interorganizational governance models based on extensive collaboration are well established in the literature, inquiry has only recently extended to sustainable supply chain management, highlighting the potential benefits of combining the integration of social and environmental issues concerning the supply chain with governance models based on joint decision making and extensive cooperation. Yet, firms still differ in both the pervasiveness of such collaborative approaches along the value chain and the extent to which sustainability issues are (...) addressed to the advantage of all parties involved. In an attempt to predict variety in the governance models related to sustainability along the value chain, we propose a theoretical model that identifies and frames four sustainable supply chain governance (SSCG) models, resulting from combinations of supply chain network density and centrality of the focal organizations. We show how, as centrality increases, firms are able to exert influence over their network, coordinating integrated approaches along the value chain. Moreover, as high centrality combines with increasing interconnectedness of the actors within a supply chain network, instrumental approaches are progressively replaced by more relational attitudes aimed at joint value creation among partners. Conditions for SSCG models' success and the main benefits gained by firms in different structural contexts are also discussed. (shrink)

Previous literature has shown contradictory results regarding the relationship between economic liberalism at the country level and firms’ engagement in corporate social action. Because liberalism is associated with individualism, it is often assumed that firms will engage in mostly symbolic rather than substantive social and environmental actions; in other words, they will practice “greenwashing.” To understand how cultural beliefs in the virtues of liberalism affect the likelihood of greenwashing, we disentangle the effects of the distinct and co-existing beliefs in the (...) virtues of economic liberalism. We begin by conducting an exploratory qualitative analysis of managers’ sentiments on this matter, based on a focus group methodology. We then use these investigative elements to articulate a comparison of the conflicting theoretical arguments: in liberal contexts, are firms, as social entities, inherently selfish or pro-active when it comes to CSA? We empirically test our hypotheses on a large-scale dataset. Finally, we show paradoxically that in countries where beliefs in the virtues of competition are strong, firms are more likely to greenwash, while in countries where beliefs in the virtues of individual responsibility are prominent, firms are more likely to focus on concrete actions. These findings suggest that in contexts where weak governments are seen as ideal, firms might feel the need to step into fill institutional voids, in contexts in which competitive mindsets dominate, this tendency is counterbalanced. (shrink)

During recent years we have seen and assisted at a significantly increased number of twin births. The main reason for this increase in the frequency of twin births is the increasing number of so called “induced pregnancies”, whether through hormonal stimulation or artificial insemination techniques.It is well known1 that twins have high mortality and morbidity rates during the perinatal and the following period. The characteristics of conception and pregnancy can determine the development of several pathologies, including prematurity and intrauterine (...) growth retardation, …. (shrink)

This paper presents an overview of the dimensions of unsafe motherhood, contrasting data from economically developed countries with some from developing countries. It addresses many common factors that shape unsafe motherhood, identifying medical, health system and societal causes, including women's powerlessness over their reproductive lives in particular as a feature of their dependent status in general. Drawing on perceptions of Jonathan Mann, it focuses on public health dimensions of maternity risks, and equates the role of bioethics in conscientious medical care (...) to that of human rights in public health care. The microethics of medical care translate into the macroethics of public health, but the transition compels some compromise of personal autonomy, a key feature of Western bioethics, in favour of societal analysis. Religiously‐based morality is seen to have shaped laws that contribute to unsafe motherhood. Now reformed in former colonizing countries of Europe, many such laws remain in effect in countries that emerged from colonial domination. UN conferences have defined the concept of ‘reproductive health’ as one that supports women's reproductive self‐determination, but restrictive abortion laws and practices epitomize the unjust constraints to which many women remain subject, resulting in their unsafe motherhood. Pregnant women can be legally compelled to give the resources of their bodies to the support of others, while fathers are not legally compellable to provide, for instance, bone‐marrow or blood donations for their children's survival. Women's unjust legal, political, economic and social powerlessness explains much unsafe motherhood and maternal mortality and morbidity. (shrink)

Do unobservable CEO characteristics predict corporate social performance and are they significantly correlated with CEO compensation? How meaningful is stock-based CEO compensation as a predictor of CSP? To answer these questions, the author empirically examines the relationship between stock-based CEO compensation and CSP while accounting for unobservable CEO characteristics. This study finds that CEO fixed effects account for a significant variance in CSP and that these fixed effects are correlated with CEO compensation variables in a statistically significant manner. The findings (...) suggest that unobservable CEO characteristics should be accounted for when examining the effect of CEO compensation variables on CSP. The findings also highlight the usefulness of stock-based compensation instruments for shareholders and other stakeholders who care about CSP and intend to promote CEO attention to social and ethical issues. (shrink)

The article presents the construction and structuring phases of an action research project, which involves indigenous populations, approved by the Abdias Nascimento Academic Development Program. The proposal aims to foster national and international cooperation, aimed at emancipatory and intercultural education and the promotion of racial equality and inclusion, focusing on social vulnerability and valuing the sociocultural and linguistic specificities of indigenous populations. The intention is to analyze the relationship between traditional care practices in the pregnancy-puerperal cycle of indigenous women and (...) the behaviors adopted at different levels of health care; identify social determinants of indigenous maternal and infant mortality; validate simple and digital sociocultural educational technologies; and provide evidence for the formulation of inclusive and affirmative public policies that contribute to the reduction of indigenous maternal and child morbidity and mortality. Methodologically, it is an action research, of a collaborative nature, with characteristics of social technology that seeks to bring the researcher closer to the participants and the object of investigation, producing knowledge through the active participation of researchers in the investigation and intervention. Therefore, this essay shows the potential of this research project, which is to encourage discussion and development of actions that promote social inclusion and emancipatory education for indigenous peoples. (shrink)

The number of women occupying male-dominated blue-collar jobs continues to be very low. This study examines segregation in the blue-collar trades, taking into consideration both structural and individual factors. Using nationally representative data for 25 countries, the study shows that segregation in the blue-collar sector does not vary with the strength of vocational education and training programs. At the individual level, findings reveal higher degrees of social reproduction among working-class families, but parental background alone does not fully account for the (...) gender composition of the sector in which children end up working. Overall, the findings point to the existence of a socializing mechanism that entrenches horizontal segregation in the blue-collar sector. The study indicates that to reduce segregation in the blue-collar fields, policies must address this prior mechanism, both at the structural and individual level. (shrink)

People in extraordinary situations are vulnerable. As research participants, they are additionally threatened by abuse or exploitation and the possibility of harm through research. To protect people against these threats, informed consent as an instrument of self-determination has been introduced. Self-determination requires autonomous persons, who voluntarily make decisions based on their values and morals. However, in nursing research, this requirement cannot always be met. Advanced age, chronic illness, co-morbidity and frailty are reasons for dependencies. These in turn lead to (...) limited abilities or opportunities for decision-making and self-determination. Exclusion of vulnerable people from research projects would disadvantage them by not covering their needs, which would violate the ethical principles of justice and beneficence. Commonly, vulnerability is attributed to social groups. The consequence for individuals, attributed as belonging to such a vulnerable group, is that the principles of respect for autonomy, justice and beneficence are subordinated to the principle of non-maleficence, understood as avoiding the risk to cause more harm than good. In addition, group-specific attribution could lead to stigmatizing because labelling a person as deviation from a norm violates integrity. For clinical nursing research, the question arises how the protection of vulnerable people could be granted without compromising ethical principles. The concept of relational ethics provides a possible approach. It defines vulnerability as the relation between a person’s health status and the extent to which this person is dependent on the researcher and the research context. Vulnerability is not attributed solely to a person but to a situation, meaning the person is viewed in context. By combining vulnerability as a context-related and situational concept with existing approaches of informed consent, the different ethical principles can be balanced and preserved at every step of the research process. (shrink)

Inadequate diet is the leading risk factor for morbidity and mortality worldwide. However, approaches to identifying inadequate diets in clinical practice remain inconsistent, and dietary interventions frequently focus on facilitating ‘healthy choices’, with limited emphasis on structural constraints. We examine the ethical implications of introducing a routine question in the medical history about ability to access food. Not collecting data on food security means that clinicians are unable to identify people who may benefit from support on an individual level, (...) unable to consider relevant dietary risk factors for disease and disease progression and unable to monitor population trends and inequalities in dietary access in order to design effective policy interventions. We argue that the current lack of routine screening for food insecurity is inconsistent with our approach to other health behaviours, as well as with doctors’ frequent informal role as gatekeepers to the food aid system, and recent calls for governmental action on food insecurity and health inequalities from individual clinicians and professional bodies. Potential ethical barriers to asking patients about food security are addressed, including concerns about stigma, limiting autonomy, fair resource allocation, unclear professional remits and clinicians’ ability to offer effective interventions. We suggest that there is an ethical imperative for doctors to ask patients about their ability to access healthy food. Gathering this data provides a valuable first step in re-framing the social determinants of health as modifiable risks, rather than inevitable inequities. No data are available. (shrink)

Definition of the problem: While the main focus of the discussion on medical ethics concerns the physician’s conflicts as a result of rationing medical care, this paper postulates that resource allocation with indirect impact on the level of morbidity and mortality of a population also provides an important topic in medical ethics. In particular, increasing social inequalities in health are observed in many of the economically most advanced societies. Arguments: The social gradient of mortality in midlife is widening despite (...) increasing health expenditures and medical progress. Five explanations for this widening social gradient are briefly discussed. Of particular interest is the last one of these explanations, pointing to a higher prevalence of exposure to chronically stressful material and psychosocial environments, particularly work environments, among lower socio-economic status groups. One such type of stressful psychosocial work environment is characterized by violations of the norms of social reciprocity and distributive justice. The model of effort-reward imbalance has been developed by the author to test adverse effects on health produced by these violations. Selected results from three large epidemiological studies on cardiovascular morbidity and mortality in midlife are presented that support the model. Conclusion: To reduce social inequalities in health, health policy decisions about resource allocation are needed that address these specific working and living conditions that act as determinants of unequalities in health. (shrink)

One understanding of health conceives of it as a state of freedom from pathology, achieved by an individual, through the mediation of a doctor. On this view, improvements in health flow from the application of science to specific ills of the body, and access to medical care is the chief determinant of health. This “medicalized” view of health underlies the current debate over medical care payment reform. This is the dominant way of talking about health.An alternative is the view of (...) health commonly associated with the practice of public health. On this view, health is an attribute of communities in social and physical environments. Health takes its shape in large numbers—in morbidity and mortality statistics—and, ideally, includes not just a high level of well-being for some, but also its even distribution throughout a society. Improvements in health are seen to arise from healthful changes in the environment. (shrink)

The question of whether problems with the social determinants of health that might impact decision-making justify denying eligibility for assisted dying has recently come to the fore in debates about the legalisation of assisted dying. For example, it was central to critiques of the 2021 amendments made to Canada’s assisted dying law. The question of whether changes to a country’s assisted dying legislation lead to descents down slippery slopes has also come to the fore—as it does any time a (...) jurisdiction changes its laws. We explore these two questions through the lens of Canada’s experience both to inform Canada’s ongoing discussions and because other countries will confront the same questions if they contemplate changing their assisted dying law. Canada’s Medical Assistance in Dying law has evolved through a journey from the courts to Parliament, back to the courts, and then back to Parliament. Along this journey the eligibility criteria, the procedural safeguards, and the monitoring regime have changed. In this article, we focus on the eligibility criteria. First, we explain the evolution of the law and what the eligibility criteria were at the various stops along the way. We then explore the ethical justifications for Canada’s new criteria by looking at two elements of the often-corrosive debate. First, we ask whether problems with the social determinants of health that might impact decision-making justify denying eligibility for assisted dying of decisionally capable people with mental illnesses and people with disabilities as their sole underlying medical conditions. Second, we ask whether Canada’s journey supports slippery slope arguments against permitting assisted dying. All data relevant to the study are included in the article. (shrink)

In the paper “Translational Neuroethics: A Vision for a More Integrated, Inclusive, and Impactful Field,” Wexler and Sullivan provide an insightful analysis of challenges within the field and how t...

Giving money to others feels good. It is now standard to use the label ‘warm glow feelings’ to refer to the pleasure people take from giving. But what exactly are warm glow feelings? And why do people experience them? To answer these questions, we ran two studies: a recall task in which participants were asked to remember a donation they made, and a donation task in which participants were given the opportunity to make a donation before reporting their affective states. (...) Correlational and experimental results converge towards the conclusion that, if the nature of the warm glow is straightforward, its source is multifaceted. Regarding the nature of the ‘warm glow’, the pleasure people took in giving was mainly predicted by one particular type of positive emotion and was indeed described by participants as ‘warm’. Regarding the underlying psychological mechanisms, warm glow feelings were elicited by positive appraisals regarding the donor’s moral character, positive appraisals regarding the actual impact of the donor’s donation on the welfare of others and a feeling of communion with others. We discuss the theoretical implications of our findings. (shrink)

Energy poverty is a problem that affects developed and developing economies, and its mitigation is of great significance to social welfare. EP affects Latin American countries, and policymakers have recently attempted to address this issue, particularly in the aftermath of the recent economic crisis. It is essential to measure and evaluate EP to implement strategies and policies effectively. Using a panel quantile regression approach, we investigate the heterogeneous impact of green finance, renewable energy, and energy efficiency on EP for 33 (...) Latin American countries from 2000 to 2018. Furthermore, certain associated control variables are incorporated into our model to avoid an omitted variable bias. According to empirical results, the impact of independent variables on EP is heterogeneous. Specifically, green finance is an essential source of alleviating EP, and it has a significant positive effect across all quantiles, but it is especially strong in the middle quantiles. RE and EE significantly mitigate EP, with the strongest effects occurring at higher quantiles. By including green finance, RE, and EE as the main explanatory determinants of EP, the findings urge policymakers in Latin American countries to design a comprehensive energy conservation policy to minimize the effects of massive EP. (shrink)

This article analyses whether benefits arising for human resource management from environmental management activities drive environmental management system implementation. Focusing on employee satisfaction and recruitment/retention, it tests this for German manufacturing firms in 2001 and 2006 and incorporates a rare longitudinal element into the analysis. It confirms positive associations of the benefit levels for both variables with environmental management system implementation on a large scale. Also it provides evidence that increasing levels of environmental management system implementation result from higher economic (...) benefits in the human resource domain. In doing so the article supplies needed quantitative evidence on important aspects of how sustainability relates to human resource management. (shrink)

The scarcity of human organs requires the transplant community to make difficult allocation decisions. This process begins at individual medical centers, where transplant teams decide which patients to place on the transplant waiting list. Each transplant center utilizes its own listing criteria to determine if a patient is eligible for transplantation. These criteria have historically considered preexisting affective and psychotic disorders to be relative or absolute contraindications to transplantation. While attitudes within the field appear to be moving away from this (...) practice, there is no data to confirm that eligibility criteria have changed. There are no nationwide guidelines detailing the manner in which affective and psychotic disorders should impact transplant eligibility. Individual transplant centers thus form their own transplant eligibility criteria, resulting in significant inter-institution variability. Data from the 1990s indicates that the majority of transplant programs considered certain psychiatric illnesses, such as active schizophrenia, to be absolute contraindications to transplantation. A review of literature reveals that no comprehensive data has been collected on the topic since that time. Furthermore, the limited data available about current practices suggests that psychiatric illness continues to be viewed as a contraindication to transplantation at some transplant centers. In light of this finding, we review psychiatric literature that examines the impact of affective and psychotic disorders on transplant outcomes and conclude that the presence of these disorders is not an accurate predictor of transplant success. We then discuss the requirements of justice as they relate to the creation of a just organ allocation system. We conclude that transplant eligibility criteria that exclude patients with affective and psychotic disorders on the basis of their psychiatric diagnosis alone are unjust. Just listing criteria must incorporate only those factors that have a causative effect on posttransplant morbidity and mortality. Justice also demands that we eliminate current inter-institution practice variations in favor of national transplant eligibility criteria. Given the limited data available about current practices, we call for an updated study investigating the manner in which affect and psychotic disorders impact transplant eligibility determinations. (shrink)

Giving money to others feels good. In the past years, this claim has received strong empirical support from psychology and neuroscience. It is now standard to use the label ‘warm glow feelings’ to refer to the pleasure people take from giving, and many explanations of apparently altruistic behavior appeal to these internal rewards. But what exactly are warm glow feelings? Why do people experience them? In order to further our understanding of the phenomenon, we ran two studies: a recall task (...) in which participants were asked to remember a donation they made, and a donation task in which participants were given the opportunity to make a donation before reporting their affective states. In both studies, correlational and experimental evidence converge towards the conclusion that, if the nature of the warm glow is straightforward, its source is multifaceted. Regarding the nature of ‘warm glow’, the pleasure people took in giving was mainly predicted by one particular positive emotion (‘joyful feelings’) and was indeed described by participants as a ‘warm’ sensation. Regarding the underlying psychological mechanisms, ‘warm glow’ feelings were elicited both by positive appraisals regarding the donor’s moral character and positive appraisals regarding the actual impact of the donor’s donation on the welfare of others. We discuss the implications of these findings for the role of positive emotions in explaining why people give. (shrink)