The aim of cooperative game theory is to suggest and defend payoffs for the players that depend on a coalition function (characteristic function) describing the economic, social, or political situation. We consider situations where the payoffs for some players are determined exogenously. For example, in many countries, lawyers or real-estate agents obtain a regulated fee or a regulated percentage of the business involved. The aim of this article is to suggest and axiomatize two values with exogenous payments, an (...) unweighted one and a weighted one. (shrink)

Different evaluators typically disagree how to rank different candidates due to their idiosyncratic concerns for the various qualities of the candidates. Our ranking mechanism asks all evaluators to submit individual bids assigning a monetary amount for each possible rank order. The rules specify for all possible vectors of such individual bids the collectively binding rank order of candidates and the payments, due to the different evaluators. Three requirements uniquely determine procedurally fair ranking rules as a game form. Only when (...) additionally assuming exogenously given true evaluations of collective rankings, which may be commonly or only privately known, and—in case of private information—beliefs concerning the evaluations by others, this game form determines proper games and allows for equilibrium analysis. After an illustration, the approach is adjusted to situations where one wants to rank only acceptable sets of candidates thus rendering the mechanism even more attractive. (shrink)

We study the effect of scarcity on decision making by low income Swedes. We exploit the random assignment of welfare payments to study their borrowing decisions within the pawn and mainstream credit market. We document that higher educated borrowers borrow less frequently and choose lower loan to value ratios when their budget constraints are exogenously tighter. In contrast, low-educated borrowers do not respond to temporary elevated levels of scarcity. This lack of response translates into a significantly higher probability to (...) default and an 11.6% increase in borrowing cost. We show that a difference in access to liquidity and/or buffer stocks cannot explain our results. Instead a framework, where the awareness of self-control problems is positively correlated with education can explain that high-educated consumers choose a lower LTV as a commitment device to increase their likelihood to repay. Analogously, low-educated with less awareness of their future self-control problems, do not tie themselves to the mast and thus ignore the consequences of their credit decisions when focusing on solving acute liquidity problems. Our findings highlight that increased levels of scarcity risk reinforcing the conditions of poverty through overborrowing. (shrink)

The idea that pushing for more equality comes at a cost in terms of economic efficiency is widely accepted. Underpinning this idea is the premise that some of the most productive members of society will work less if we lower their pay. If this is true, some argue, it justifies paying the most productive a premium to work, provided doing so benefits everyone. This chapter argues that the standard version of the incentives argument suffers from two important blind spots. First, (...) it assumes that the comparative advantage of the most productive members of society is rooted in their natural talents, that is, in a factor exogenous to the production process. Second, it adopts a static framework to analyze the bargaining process in which incentive payments are negotiated, where static means taking all informational inputs from the same moment in time. The chapter uses the debate between John Rawls (1999) and G.A. Cohen (2008) to illustrate the normative repercussions of making these two assumptions. The chapter qualifies as unjust incentive payments that reward individual productivity due to specialization rather than to natural talent. In addition, it argues that individuals would not be in a position to obtain such incentive payments if bargaining took place before rather than after the acquisition of specialized skills. Finally, the chapter discusses the objection that eliminating this type of incentive payments would be inefficient. (shrink)

When randomly assigning participants to experimental roles and the according payment prospects, participants seem to receive “manna from heaven.” In our view, this seriously questions the validity of laboratory findings. We depart from this by auctioning off player roles via the incentive compatible random price mechanism thus avoiding the selection effect of competitive second price auctions. Our experiment employs the generosity game where the proposer chooses the size of the pie, facing an exogenously given own agreement payoff, and the responder (...) is the residual claimant. We find that entitlement crowds out equality seeking and strengthens efficiency seeking. More generally, we find that inducing entitlement for the roles in which participants find themselves makes a difference. Interpreting participants’ willingness to pay for their role as their aspiration level further allows to test satisficing and explore “mutual satisficing.” We find that responder participants apparently do not anticipate proposer generosity in aspiration formation. (shrink)

Ce commentaire critique, basé sur une analyse des insatisfactions partagées avec un Commissariat aux plaintes, présente des enjeux éthiques, cliniques et organisationnels découlant des restrictions des visites des personnes proches aidantes dans les établissements de santé et milieux de vie au début de la pandémie de la COVID-19 à Montréal. Dans cette optique, le rôle et les défis du Commissaire aux plaintes et à la qualité des services sont présentés en tant que médiateur entre les gestionnaires de soins, les usagers (...) et les personnes proches aidantes pour assurer le respect des droits des usagers. (shrink)

Au Québec, le régime d’examen des plaintes dans le réseau de la santé et des services sociaux contribue à l’amélioration continue des soins en permettant aux usagers de partager leur insatisfaction auprès d’une instance indépendante pouvant émettre des recommandations aux établissements. Le régime permet ainsi de renforcer la participation active de l’usager et donc de démocratiser les soins et services. En plus de sa parenté évidente avec cet objectif d’autonomisation, la bioéthique est omniprésente dans le travail des instances responsables de (...) l’application du régime, soit les commissariats aux plaintes. Cet article met en lumière l’usage implicite de concepts issus de la bioéthique dans le travail quotidien des commissariats aux plaintes. Nous y abordons l’autonomie, sous l’angle de l’autodétermination et de la confidentialité dans l’analyse de la recevabilité des plaintes. Nous y abordons également la justice, sous l’angle de l’équité dans l’allocation des ressources et de la justice épistémique dans le traitement des plaintes. Ensuite, nous abordons les similitudes entre les méthodologies de la bioéthique et du régime d’examen des plaintes, nommément les grilles d’analyse en éthique clinique et la narrativité. Finalement, nous abordons l’importance de l’impartialité, de l’indépendance et de la transparence dans le travail des commissariats aux plaintes. Nous concluons en offrant des pistes de réflexion en vue d’une mise à jour des connaissances empiriques concernant la concrétisation des objectifs de renforcement de la participation de l’usager dans ses soins et de démocratisation des soins et services. (shrink)

Recognising that offers of payment to research participants can serve various purposes—reimbursement, compensation and incentive—helps uncover differences between participants, which can justify differential payment of participants within the same study. Participants with different study-related expenses will need different amounts of reimbursement to be restored to their preparticipation financial baseline. Differential compensation can be acceptable when some research participants commit more time or assume greater burdens than others, or if inter-site differences affect the value of compensation. Finally, it may be permissible (...) to offer differential incentive payments if necessary to advance the goals of a study. We encourage investigators and Institutional Review Boards to think about whether to offer payment, in what amounts and for what purpose, and also to consider whether differential payment can help promote the scientific and ethical goals of clinical research. (shrink)

Recognizing that offers of payment to research participants can serve various purposes—reimbursement, compensation, and incentive—helps uncover differences between participants that can justify differential payment of participants within the same study. Participants with different study-related expenses will need different amounts of reimbursement to be restored to their pre-participation financial baseline. Differential compensation can be acceptable when some research participants commit more time or assume greater burdens than others, or if inter-site differences affect the value of compensation. Finally, it may be permissible (...) to offer differential incentive payments if necessary to advance a study’s goals. We encourage investigators and Institutional Review Boards to think not only about whether to offer payment, in what amounts, and for what purpose, but also to consider whether differential payment can help promote the scientific and ethical goals of clinical research. (shrink)

The idea that payment for research participation can be coercive appears widespread among research ethics committee members, researchers, and regulatory bodies. Yet analysis of the concept of coercion by philosophers and bioethicists has mostly concluded that payment does not coerce, because coercion necessarily involves threats, not offers. In this article we aim to resolve this disagreement by distinguishing between two distinct but overlapping concepts of coercion. Consent-undermining coercion marks out certain actions as impermissible and certain agreements as unenforceable. By contrast, (...) coercion as subjection indicates a way in which someone’s interests can be partially set back in virtue of being subject to another’s foreign will. While offers of payment do not normally constitute consent-undermining coercion, they do sometimes constitute coercion as subjection. We offer an analysis of coercion as subjection and propose three possible practical responses to worries about the coerciveness of payment. (shrink)

Payment for research participation has raised ethical concerns, especially with respect to its potential for coercion. We argue that characterising payment for research participation as coercive is misguided, because offers of benefit cannot constitute coercion. In this article we analyse the concept of coercion, refute mistaken conceptions of coercion and explain why the offer of payment for research participation is never coercive but in some cases may produce undue inducement.

The practice of paying prisoners to for their participation in research has long been debated, and the controversy is reflected in the differing policies in the U.S. prison systems. Empirical study of financial payments to inmates who enroll in research has focused on whether this practice is coercive. In this study, we examined whether monetary incentives have the potential to be unduly influential among fifty HIV‐positive prisoners. The majority of prisoners surveyed believed that inmates should receive some compensation for (...) their involvement in research and disagreed with statements suggesting that the offer of payment constitutes undue influence. However, a sense of potentially being susceptible to undue influence was significantly higher among participants who had spent a longer time in prison and had less education. Overall, our findings suggest that most prisoners feel that they would be able to make a decision about research enrollment that is not solely based on an offer of monetary payment. (shrink)

What I call ‘the standard view’ claims that IRBs should not regard financial payment as a benefit to subjects for the purpose of risk/benefit assessment. Although the standard view is universally accepted, there is little defense of that view in the canonical documents of research ethics or the scholarly literature. This paper claims that insofar as IRBs should be concerned with the interests and autonomy of research subjects, they should reject the standard view and adopt ‘the incorporation view.’ The incorporation (...) view is more consistent with the underlying soft-paternalist justification for risk-benefit assessment and demonstrates respect for the autonomy of prospective subjects. Adoption of the standard view precludes protocols that advance the interests of subjects, investigators, and society. After considering several objections to the argument, I consider several arguments for the standard view that do not appeal to the interests and autonomy of research subjects. (shrink)

The presumption is that a broker executing a stock trade for a retail investor will get the investor the best possible price execution for the transaction. In fact, the broker often sells the retail investor’s trade to an intermediary for cash payment. The broker’s motivation to generate dealer profits seems to overcome the broker’s fiduciary responsibility to obtain the best execution price for the customer, raising ethical questions. Purchasers and internalizers of order flow in the market may cause prices quoted (...) on the NYSE to deteriorate, making all investors worse off. (shrink)

Metabolic dysfunction is a ubiquitous underlying feature of many neurological conditions including acute traumatic brain injuries and chronic neurodegenerative conditions. A central problem in neurological patients, in particular those with traumatic brain injuries, is an impairment in the utilization of glucose, which is the predominant metabolic substrate in a normally functioning brain. In such patients, alternative substrates including ketone bodies and lactate become important metabolic candidates for maintaining brain function. While the potential neuroprotective benefits of ketosis have been recognized for (...) up to almost a century, the majority of work has focused on the use of ketogenic diets to induce such a state, which is inappropriate in cases of acute disease due to the prolonged periods of time (i.e., weeks to months) required for the effects of a ketogenic diet to be seen. The following review seeks to explore the neuroprotective effects of exogenous ketone and lactate preparations, which have more recently become commercially available and are able to induce a deep ketogenic response in a fraction of the time. The rapid response of exogenous preparations makes their use as a therapeutic adjunct more feasible from a clinical perspective in both acute and chronic neurological conditions. Potentially, their ability to globally moderate long-term, occult brain dysfunction may also be relevant in reducing lifetime risks of certain neurodegenerative conditions. In particular, this review explores the association between traumatic brain injury and contusion-related dementia, assessing metabolic parallels and highlighting the potential role of exogenous ketone and lactate therapies. (shrink)

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

The payments industry – the business of transferring value through public and corporate infrastructures – is undergoing rapid transformation. New business models and regulatory environments disrupt more traditional fee-based strategies, and new entrants seek to displace legacy players by leveraging new mobile platforms and new sources of data. In this increasingly diversified industry landscape, start-ups and established players are attempting to embed payment in ‘social’ experience through novel technologies of accounting for trust. This imagination of the social, however, is (...) being materialized in gated platforms for payment, accounting, and exchange. This paper explores the ambiguous politics of such experiments, specifically those, like Bitcoin or the on-demand sharing economy, that delineate an economic imaginary of ‘just us’ – a closed and closely guarded community of peers operating under the illusion that there are no mediating institutions undergirding that community. This provokes questions about the intersection of payment and publics. Payment innovators’ attenuated understanding of the social may, we suggest, evacuate the nitty-gritty of politics. (shrink)

Background Payment of research participants helps to increase recruitment for research studies, but can pose ethical dilemmas. Research ethics committees (RECs) have a centrally important role in guiding this practice, but standardisation of the ethical approval process in Ireland is lacking. Aim Our aim was to examine REC policies, experiences and concerns with respect to the payment of participants in research projects in Ireland. Method Postal survey of all RECs in Ireland. Results Response rate was 62.5% (n=50). 80% of RECs (...) reported not to have any established policy on the payment of research subjects while 20% had refused ethics approval to studies because the investigators proposed to pay research participants. The most commonly cited concerns were the potential for inducement and undermining of voluntary consent. Conclusions There is considerable variability among RECs on the payment of research participants and a lack of clear consensus guidelines on the subject. The development of standardised guidelines on the payment of research subjects may enhance recruitment of research participants. (shrink)

The burdens of resource constraints in publicly funded healthcare systems urge decision makers in countries like Sweden, Norway and the UK to find new financial solutions. One proposal that has been put forward is co-payment—a financial model where some treatment or care is made available to patients who are willing and able to pay the costs that exceed the available alternatives fully covered by public means. Co-payment of this sort has been associated with various ethical concerns. These range from worries (...) that it has a negative impact on patients' wellbeing and on health care institutions, to fears that co-payment is in conflict with core values of publicly funded health care systems. This article provides an overview of the main ethical issues associated with co-payment, and ethical arguments both in support of and against it will be presented and analyzed. (shrink)

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

Offering cash payments to research subjects is a common recruiting method but there is significant debate about whether and in what amount such payments are appropriate. This paper is concerned with exploitation and whether there should be a lower limit on the amount researchers can pay their subjects. When subjects participate in research as a way to make money, fairness requires that researchers pay them a fair wage. This call for the establishment of a lower limit meets resistance (...) in two places: (1) denial that the payments offered by researchers are wages for participation; and (2) concern about undue inducement. This paper critically examines these arguments for and against a lower limit. It shows that the need for a lower limit cannot be avoided by adopting a non-wage payment model and that concerns about undue inducement are unjustified in all trials except those that present greater than minimal risk. This analysis suggests the following compromise position: there should be an unconditional lower limit on payment amounts so that researchers cannot offer less than a fair wage, and when researchers cannot satisfy this limit because fairness requires a problematically large payment, then researchers should offer no payment at all. (shrink)

Clinical investigators must engage in just subject recruitment and selection and avoid unduly influencing research participation. There may be tension between the practice of keeping payments to participants low to avoid undue influence and the requirements of justice when recruiting normal healthy volunteers for phase 1 drug studies. By intentionally keeping payments low to avoid unduly influenced participation, investigators, on the recommendation or insistence of institutional review boards, may be targeting or systematically recruiting healthy adult members of lower (...) socio-economic groups for participation in phase 1 studies. Investigators are at risk of routinely failing to fulfill the obligation of justice, which prohibits the systematic targeting and recruiting of subjects for reasons unrelated to the nature of the study. Insofar as we take seriously the obligation to engage in just subject recruitment and selection, I argue that we must acknowledge the implications low payments might have for subject recruitment and selection and examine the effect of low payments. If low payments de facto target the less well-off for phase 1 studies, we must defend the priority ranking of the obligation to avoid undue influence over the obligation of justice or adopt an alternative recruitment approach. This paper identifies a number of alternatives to the current system of low-value payments to research participants. (shrink)

This study examines the degree of state ownership on corporate bribery. Integrating the theories of state ownership and corporate corruption, we propose that state ownership influences bribery propensity and bribery intensity in different ways; it lowers a firm’s tendency to pay bribes but increases the relative amount of bribery payment. Building on the control rights/bargaining hypotheses, we demonstrate that state ownership shields firms from bribery demands by reducing administrative hurdles that include bureaucratic requirements of obtaining licenses or settling taxes in (...) business operations. However, state ownership elevates the level of bribes by weakening their capital mobility. Using a sample of 23,018 firms from 54 countries covering 2006 to 2013, we find evidence to support our hypotheses. This article contributes to corruption research by drawing attention to an important channel of corruption and by highlighting the importance of considering not only the propensity but also the intensity of bribe payments. (shrink)

This paper applies Israel Kirzner’s theory of entrepreneurship and the Austrian theory of capital to the theory of the firm. In particular, it explores why some firms are better able to react to exogenous change than others, especially when that change is negative. The argument is that firms that have structures of physical and human capital that are more “flexible” are better able to adapt to exogenous change. In this context, flexibility is understood in terms of Lachmann’s notions (...) of the substituability and complementarity of capital. Flexible capital structures are ones in which elements can be more easily substituted for. Such flexibility carries a trade-off in terms of lost productivity from using less specific capital, but it is argued that this trade-off might be worthwhile in an environment of heightened structural uncertainty.Cet article applique la théorie entrepreneuriale d’Israel Kirzner et la théorie Autrichienne du capital à la théorie de la firme. Plus particulièrement, il explore pourquoi certaines entreprises sont plus à même de réagir face à des changements exogènes que d’autres, spécialement quand ces changements sont négatifs. L’argument est que les firmes qui possèdent des structures de capital physique et humain plus “flexibles” sont plus aptes à s’adapter à des changements exogènes. Dans ce contexte, la flexibilité est comprise au sens lachmanien de substituabilité et de complémentarité du capital. Les structures de capital flexibles sont celles dans lesquelles la substitution entre les composantes est plus aisée. Une telle flexibilité entraîne un compromis en termes de perte de productivité découlant d’un usage de capitaux moins spécifiques, mais il est suggéré que ce compromis en vaut la peine dans un environnement encore plus structurellement incertain. (shrink)

The philosophy of Gilles Deleuze has, in recent decades, occupied the attention of Anglophone continental philosophy and cultural theory largely in light of the perceived political significance of his work. In particular, his analysis of capitalism in the texts co-authored with Felix Guattari, and his articulation of the logic of control — a logic which, he claimed, could be found emerging in the wake of those societies that Michel Foucault had characterized according to the logic of discipline — have served (...) as the basis of an increasingly large body of extension and commentary. In this essay, I intend to highlight one particularly important aspect of the logic of control: the mechanism by which control captures practices of communication. This mechanism can be described, I argue, by reference to a concept that is familiar to statisticians, economists, and practitioners of ‘numerical’ social sciences: exogeneity. Additionally, I want to challenge the notion that antagonism to the logic of control can coincide with the affirmation of logics of ‘plurality’ or ‘multitude.’ The logic of control, insofar as it relies on exogeneity, is already a logic of radical plurality. (shrink)

The paper by Lynch et al. argues that payments to research participants in biomedical research can be divided into three different categories, reimbursement, compensation, and incentive and...

Health reform debate understandably focuses on large system design. We should not omit attention to the “last mile” problem of physician payment theory. Achieving fundamental goals of integrative, patient-centered primary care depends on thoughtful financial support. This commentary describes the nature and importance of innovative primary care payment programs.

Previous research in the visual domain suggests that exogenous attention in form of peripheral cueing increases spatial but lowers temporal resolution. It is unclear whether this effect transfers to other sensory modalities. Here, we tested the effects of exogenous attention on temporal and spectral resolution in the auditory domain. Eighteen young, normal-hearing adults were tested in both gap and frequency change detection tasks with exogenous cuing. Benefits of valid cuing were only present in the gap detection task (...) while costs of invalid cuing were observed in both tasks. Our results suggest that exogenous attention in the auditory system improves temporal resolution without compromising spectral resolution. (shrink)

Should egg donors be paid? A negative answer might be offered on the ground that payment for egg donation is coercive. But is this viewpoint tenable? Is the offer of payment for egg donation really coercive? Even if not coercive, might payment for egg donation nonetheless be seen as exploitative? And if so why? The central argument of this paper focuses on the question whether the offer of payment for egg donation is an exploitative inducement and therefore an undue inducement. (...) Another question raised in this paper is whether, given that it is commodifying, payment for egg donation constitutes a failure to recognize the giftedness and true value of human life. (shrink)

The aim of this paper is to evaluate the extent of the practice of using informal payments for accessing the services of public clinics or hospitals across Europe and to explain the prevalence of this corrupt practice using the framework of institutional theory. To achieve this, a multi-level mixed-effect logistic regression on 25,744 interviews undertaken in 2020 with patients across 27 European Union countries is conducted. The finding is that the practice of making informal payments remains a prevalent (...) practice, although there are large disparities in the usage of this practice in different European countries. However, informal payments by patients are more likely when there is a lower institutional trust and a higher degree of asymmetry between formal and informal institutions. The resultant proposal is that policy makers need to address the institutional environment to tackle such informal payments. How this can be achieved is outlined. (shrink)

Volume 19, Issue 9, September 2019, Page 35-36.

To solve the current privacy leakage problems of cloud storage services, research on users’ payment intention for cloud storage services with privacy protection is extremely important for improving the sustainable development of cloud storage services. An evolutionary game model between cloud storage users and providers that considers privacy is constructed. Then, the model’s evolutionary stability strategies via solving the replication dynamic equations are analyzed. Finally, simulation experiments are carried out for verifying and demonstrating the influence of model parameters. The results (...) show that the evolutionary stable strategies are mainly affected by the privacy protection profit growth coefficient of both parties, input costs, free-riding gains, and other factors. If the profit growth coefficient is very small, users will not choose to pay and providers will not choose to actively protect user information. As the profit growth coefficient increases, both parties will promote the development of privacy protection with a higher probability. The results are beneficial for cloud storage providers to increase the number of paid users and thus to achieve the sustainable development of cloud storage service. (shrink)

Paying research participants in developing countries like Uganda raises ethical concerns over potential for undue inducement. This article, based on an exploratory study, reviewed 49 research protocols from a national HIV/AIDS research ethics committee database. Payments mainly adhered to the reimbursement and compensation payment models. Offers made were diverse but basic in order to limit undue inducement. Implications in terms of undue inducement and possible impact on participants and research are discussed. We end by recommending standardization across comparable studies (...) in the interests of promoting high-quality research, altruism, voluntariness, and restraining unfair reimbursement practices in research. (shrink)

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

There is strong opposition in bioethics to paying research subjects. This paper, building on earlier work, gives arguments on behalf of the permissibility of payment. It develops an analogy between payment to research subjects. And payment and regulation in the labour market Few seriously oppose payment in the labour market, and the reasons to allow payment carry over to payment to research subjects. The paper then considers and rejects an alleged disanalogy, that research is special in that it involves subjects’ (...) bodies. At greater length, it assesses the argument from the gift relationship: that the value of giving is good reason not to extend market norms into research. This argument has some force in pointing out the unattractiveness of some market motivations, but those who offer it usually overlook the coordination advantages of the market. Still, the gift relationshp argument against payment has something going for it, which is more than can be said for virtually all the other major anti-payment arguments. (shrink)

The Centers for Medicare & Medicaid Services has initiated bundled payments for hip and knee total joint replacement in an effort to decrease healthcare costs and increase quality of care. The ethical implications of this program have not been studied. This article considers the ethics of patient selection to improve outcomes; specifically, screening patients by body mass index to determine eligibility for total joint replacement. I argue that this type of screening is not ethically defensible, and that the bundled (...) payment program as structured is likely to lead to unfair restrictions on who receives total joint replacements. (shrink)

This paper draws on ideas about policy innovation and adaptation to assess the extent to which ‘payments for ecosystem services’ (PES) can be seen as a challenge to traditionally more bureaucratic, state-centered ways of paying for the provisioning of environmental goods from agricultural landscapes through agri environmental policy (AEP). Focussing on recent experience in the United States and the UK, the paper documents the extent to which PES is now an established term of reference in AEP research and debate (...) in both countries and postulates that this may usher in a new discourse of environmental provisioning in agriculture. The PES landscape is, however, currently highly fragmented and largely experimental, with ‘PES-like’ approaches being piloted in the field through partnerships between state agencies and localized private and charitable interests. State-supported AEP programs remain substantially intact, and rather than any displacement of state action, there appears to be a more gradual insertion of PES approaches and metrics into standard AEP operating procedures. This institutional stickiness is partly due to the continuing difficulty of agreeing the metrics necessary for measuring outcomes but may also be due to the politically well defended nature of traditional AEP entitlements and associated policy networks. We conclude by suggesting a need for further research to better understand these specifically political constraints and sources of resistance to PES and the ambiguous consequences for institutions, policy networks, rural communities and environment. (shrink)

Causal models show promise as a foundation for the semantics of counterfactual sentences. However, current approaches face limitations compared to the alternative similarity theory: they only apply to a limited subset of counterfactuals and the connection to counterfactual logic is not straightforward. This article addresses these difficulties using exogenous interventions, where causal interventions change the values of exogenous variables rather than structural equations. This model accommodates judgments about backtracking counterfactuals, extends to logically complex counterfactuals, and validates familiar principles (...) of counterfactual logic. This combines the interventionist intuitions of the causal approach with the logical advantages of the similarity approach. (shrink)

The last decade has seen great progress in the study of the nature of crossmodal links in exogenous and endogenous spatial attention . Exogenous spatial cuing studies of human crossmodal attention and multisensory integration. In C. Spence, & J. Driver , Crossmodal space and crossmodal attention . Oxford, UK: Oxford University Press.], for a recent review). A growing body of research now highlights the existence of robust crossmodal links between auditory, visual, and tactile spatial attention. However, until recently, (...) studies of exogenous and endogenous attention have proceeded relatively independently. In daily life, however, these two forms of attentional orienting continuously compete for the control of our attentional resources, and ultimately, our awareness. It is therefore critical to try and understand how exogenous and endogenous attention interact in both the unimodal context of the laboratory and the multisensory contexts that are more representative of everyday life. To date, progress in understanding the interaction between these two forms of orienting has primarily come from unimodal studies of visual attention. We therefore start by summarizing what has been learned from this large body of empirical research, before going on to review more recent studies that have started to investigate the interaction between endogenous and exogenous orienting in a multisensory setting. We also discuss the evidence suggesting that exogenous spatial orienting is not truly automatic, at least when assessed in a crossmodal context. Several possible models describing the interaction between endogenous and exogenous orienting are outlined and then evaluated in terms of the extant data. (shrink)

Recent policy developments in the general area of disability have presented a whole range of ethical dilemmas for everyone involved in the development and delivery of services for disabled people at the national and local levels. This is almost certainly due to government acceptance of the principles of independent living and the social model of disability, and greater user involvement and control of support services, in particular ?direct payments?. This paper will centre on the ethical concerns that arise from (...) recent government policy regarding the latter. (shrink)

This paper deals with causal analysis in the social sciences. We first present a conceptual framework according to which causal analysis is based on a rationale of variation and invariance, and not only on regularity. We then develop a formal framework for causal analysis by means of structural modelling. Within this framework we approach causality in terms of exogeneity in a structural conditional model based which is based on (i) congruence with background knowledge, (ii) invariance under a large variety of (...) environmental changes, and (iii) model fit. We also tackle the issue of confounding and show how latent confounders can play havoc with exogeneity. This framework avoids making untestable metaphysical claims about causal relations and yet remains useful for cognitive and action-oriented goals. (shrink)

One way to test vaccines is through human challenge trials in which participants are intentionally infected with a contagious organism to expedite the process of assessing the vaccine’s effectiveness. Some experts believe challenge trials may play an important role in fighting COVID-19, especially if the vaccines under current study do not demonstrate sufficient efficacy, if spread of COVID-19 is controlled to a point that radically slows down traditional trials, or if new vaccines need to be rapidly developed for specific subpopulations.1 (...) Challenge trials involve significant time, burden and risk, requiring participants to spend 3–6 weeks in legal quarantine for 24 hours a day in a high-security facility. During this time, no inperson visitors will be allowed, except for very limited inperson contact from researchers collecting necessary data and checks. Following the quarantine period, participants will be asked to attend numerous outpatient follow-up visits over the course of months, to further monitor their response to the vaccine. Participation involves being away from family who may themselves become sick during the global pandemic, as well as potential fear and mental anguish around being a ‘first’ subject. Because there is no definitive treatment for COVID-19, participants could experience serious illness. But even with milder illness, medical experts know very little about the long-term consequences of COVID-19 infection. This raises the question of how much people should be paid for their participation in COVID-19 challenge trials. Most think participants should be paid something, but many contend that we should be …. (shrink)

Modern payment cards encompass a bewildering array of consumer technologies, from credit and debit cards to stored-value and loyalty cards. But what unites all of these financial media is their connection to recordkeeping systems. Each swipe sends data hurtling through invisible infrastructures to verify accounts, record purchase details, exchange funds, and update balances. With payment cards, banks and merchants have been able to amass vast archives of transactional data. This information is a valuable asset in itself. It can be used (...) for in-house data analytics programs or sold as marketing intelligence to third parties. This research examines the development of payment cards in the United States from the late 19th century to present, drawing attention to their fundamental relationship to identification, recordkeeping, and data mining. The history of payment cards, I argue, is not just a history of financial innovation and computing; it is also a history of Big Data and consumer surveillance. This history, moreover, provides insight into the growth of transactional data and the datafication of money in the digital economy. (shrink)

The goal of this study is to characterize observers’ abilities to discriminate between endogenous and exogenous changes. To do so, we developed a new experimental paradigm. On each trial, participants were shown a dot pattern on the screen. Next, the pattern disappeared and participants were to reproduce it. Changes were surreptuously introduced in the stimulus, either by presenting participants anew with the dot pattern they had themselves produced on the previous trial or by presenting participants with a slightly different (...) dot pattern . We analyzed awareness of the changes and behavioral adaptation to them in a dynamical manner. We observe signal attenuation in the presence of endogenous change, dissociation between self-attribution reports and behavioral effect of agency. We discuss the source of this sensitive attenuation as well as the relation between a minimal or core self and an extended, narrative or autobiographical self. (shrink)