Mainstream environmental groups have long been criticized by more radical activists as being too willing to compromise with industry and development interests. Radical groups such as Earth First! and Earth Liberation Front were formed as a reaction explicitly against perceived failures of mainstream groups. Although the radical activism employed varied from direct action in the form of aggressive civil disobedience coupled with eco sabotage, the tactics of the radical groups suggest two strands of movement. For example, the actions and (...) demands of Earth First! seemingly fit their conviction that compromise is a betrayal of their moral convictions and results only in further deterioration of environmental protection, and the radical activism of this group can be seen to fit well within historically accepted norms of protest movements within constitutional democracies. In contrast, Earth Liberation Front does engage in what might be called ecoterrorism, a form of political violence. This article addresses the following emerging questions: Is an uncompromising approach an effective strategy for radical environmental activism in fostering positive environmental change? What is required of constructive democratic action? Can radical environmental activism be a resource for cooperative practices and coalition building? These questions relate to ecological justice, which is growing in importance as a paradigm that combines social concerns about the environment with issues of nature protection, thereby underlying the need for coordination of strategies and cooperation in order to bring about a positive change In this paper, we examine the positions and arguments of some radical environmental activists and their detractors, and analyse their moral beliefs and political attitudes. We claim that “No Compromise” is not an acceptable strategy for environmental activism. In the analysis that follows, we are not suggesting naively that only warm fellow-feelings, congeniality, and an overt willingness to compromise are reasonable responses to powerful contravening force. We argue instead that when used, strong - and even perhaps sometimes illegal - direct action can be conceptualized and carried out in a way that does not hinder all opportunities for effective compromise, coalition building, and the like, that are ultimately essential elements of most successful protest movements. We build on Martin Benjamin’s claim that compromise need not always involve moral capitulation or failure, but can be integrity-preserving. It can, we believe, be an effective means of moving a pro-environmental agenda forward. Key to our argument are the distinctions between moral and political compromise, and the interrelations between moral and political community. Seeing oneself as a part of a larger community in which decisions must be made, and recognizing responsibility towards the members of a moral community is essential to a full appreciation and effective use of compromise. These considerations are anchored in an approach that constructively links participatory democracy and radical activism. (shrink)

Deliberative democracy entails a commitment to deciding political questions on their merits. To that end, people engage in an exchange of reasons in a shared endeavour to arrive at the right answer or the best judgement they can make in the circumstances. Of course, in practice a shared judgement may be impossible to reach. Yet while compromise may seem a natural way of dealing with the disagreement that deliberation leaves unresolved – for example, some deliberative theorists argue that a (...) willingness to compromise manifests respect for the considered views of others, even as we continue to disagree with them – the relationship between deliberation and compromise is not as straightforward as one might think. To explain why, this paper contrasts conflicts of judgement with conflicts of preference, interest and value to show why greater attention needs to be paid to the character of the decision to be made. (shrink)

Public surveys conducted in many countries report widespread willingness of individuals to donate a kidney while alive to a family member or close friend, yet thousands suffer and many die each year while waiting for a kidney transplant. Advocates of financial incentive programs or “regulated markets” in kidneys present the problem of the kidney shortage as one of insufficient public motivation to donate, arguing that incentives will increase the number of donors. Others believe the solutions lie—at least in part—in (...) facilitating so-called “altruistic donation;” harnessing the willingness of relatives and friends to donate by addressing the many barriers which serve as disincentives to living donation. Strategies designed to minimize financial barriers to donation and the use of paired kidney exchange programs are increasingly enabling donation, and now, an innovative program designed to address what has been termed “chronologically incompatible donation” is being piloted at the University of California, Los Angeles, and elsewhere in the United States. In this program, a person whose kidney is not currently required for transplantation in a specific recipient may instead donate to the paired exchange program; in return, a commitment is made to the specified recipient that priority access for a living-donor transplant in a paired exchange program will be offered when or if the need arises in the future. We address here potential ethical concerns related to this form of organ “banking” from living donors, and argue that it offers significant benefits without undermining the well-established ethical principles and values currently underpinning living donation programs. (shrink)

Cities and local governments loom large on the sustainability agenda. Networks such as Fair Trade Towns International (FTT) and the Organic Cities Network aim to bring about global policy change from below. Given the new enthusiasm for local approaches, it seems relevant to ask to what extent local groups exercise power and in what form. City networks present their members as “ethical places” exercising _power with_, rather than _power over_ others. The article provides an empirical analysis of the power of (...) FTT and Organic Cities in Germany. In both cases, we found cities that are eager to emphasize their inclusive potential. Their willingness to compromise is demonstrated most illustratively by the fact that several cities are members of both networks: While the FTT campaign aims to address problems of international trade but does not abandon it, Organic Cities advocate for a new localism based on food supply from farmers in the same region. In both cases, city networks use their purchasing power to increase the share of certified products. By doing so, the city networks reproduce privileged positions of consumers benefitting from the global capitalist order (_power over_). However, our analysis revealed that networks also make citizens reflect upon agri-food challenges and allow developing alternatives for more sustainable systems (_power with_). (shrink)

A long-standing puzzle for moral philosophers and psychologists alike is the concept of psychopathy, a personality disorder marked by tendencies to defy moral norms despite cognitive knowledge about right and wrong. Previously, discussions of the moral deficits of psychopathy have focused on willingness to harm and cheat others as well as reasoning about rule-based transgressions. Yet recent research in moral psychology has begun to more clearly define the domains of morality, en- compassing issues of harm, fairness, loyalty, authority, and (...) spiritual purity. Clinical descriptions and theories of psychopathy suggest that deficits may exist primarily in the areas of harm and fairness, although quantitative evidence is scarce. Within a broad sample of participants, we found that scores on a measure of psychopathy predicted sharply lower scores on the harm and fairness subscales of a measure of moral concern, but showed no relationship with authority, and very small relationships with ingroup and purity. On a measure of willingness to violate moral standards for money, psychopathy scores predicted greater willingness to violate moral concerns of any type. Results are further explored via potential mediators and analyses of the two factors of psychopathy. (shrink)

How should politicians act? When should they try to lead public opinion and when should they follow it? Should politicians see themselves as experts, whose opinions have greater authority than other people's, or as participants in a common dialogue with ordinary citizens? When do virtues like toleration and willingness to compromise deteriorate into moral weakness? In this innovative work, Andrew Sabl answers these questions by exploring what a democratic polity needs from its leaders. He concludes that there are (...) systematic, principled reasons for the holders of divergent political offices or roles to act differently. Sabl argues that the morally committed civil rights activist, the elected representative pursuing legislative results, and the grassroots organizer determined to empower ordinary citizens all have crucial democratic functions. But they are different functions, calling for different practices and different qualities of political character. To make this case, he draws on political theory, moral philosophy, leadership studies, and biographical examples ranging from Everett Dirksen to Ella Baker, Frances Willard to Stokely Carmichael, Martin Luther King Jr. to Joe McCarthy. Ruling Passions asks democratic theorists to pay more attention to the "governing pluralism" that characterizes a diverse, complex democracy. It challenges moral philosophy to adapt its prescriptions to the real requirements of democratic life, to pay more attention to the virtues of political compromise and the varieties of human character. And it calls on all democratic citizens to appreciate "democratic constancy": the limited yet serious standard of ethical character to which imperfect democratic citizens may rightly hold their leaders--and themselves. (shrink)

Individual questions of the institutional reforms of the representative-democratic parliamentary system, such as issues of electoral law, party law, and parliamentary law, are frequently discussed. But all these reflections - and this is the principal thesis of this article - must eventually remain without success, if they do not address the preceding basic problem concerning the democratically indispensable conditions of the mental constitution of the active citizen, the „civis“. There, a key role, consciously experienced like a paradox, falls upon the (...) renunciation of the claim to absolute truth of one’s own political convictions with regard to equally „relative-absolute“ claims for validity of others. On this base the psychological presuppositions of a modern pluralistic democracy are discussed, which thereupon are to be institutionalized: e. g. the capacity to compromise, the obligation of state neutrality in religious matters, the renunciation of hate speech, the rejection of „denial of reality“, and of allegedly „finalizing“ ideologies of history. (shrink)

Insufficiently radical environmentalism is inadequate to the problems that confront us; but overly radical environmentalism risks alienating people with whom, in a democracy, we must find common cause. Building on Paul Ricoeur’s work, which shows how group identity is constituted by the tension between ideology and utopia, this essay asks just how radical effective environmentalism should be. Two “case studies” of environmental agenda—that of Michael Schellenberger and Ted Nordhaus, and that of David Brower—serve to frame the important issues of cooperation (...) and confrontation. The essay concludes that environmentalism must lead with its utopian aspirations rather than its willingness to compromise. (shrink)

The representative institutions of democratic government require the public sphere; but this in turn rests on the fellow‐feeling of citizens. In this article, I explore some recent ways of fleshing out Mill’s thought that patriotic fellow‐feeling is instrumental for a form of trust that the public sphere requires. Deliberation, argument and negotiation in the public sphere require a willingness to discuss, alter one’s position, compromise with others, and do so in good faith and in the belief that other (...) participants are broadly also taking part in the same fashion. Since politics is a realm in which interests and identities clash, we have at least a prima facie reason to worry that others may in fact not be trustworthy in the desired way. Some potential for distrust is inherent in political deliberation, since it presupposes that there is some important conflict or disagreement that needs to be overcome through discussion: in other words, that I cannot simply rely on others to further my interests for the right reasons, or at all. While trust seems inherently problematic, political dialogue in the public sphere seems to require it from those who take part. I look at four accounts of the basis of democratic trust, viz. the communitarian, the ‘societal culture’ account, the public culture account, and what is known as the ‘constitutional patriotism’ account. In outline, my argument is that all four accounts fail to explain the basis of trust in the democratic sphere. I conclude that sharing a national identity still leaves the politics of trust to be negotiated by the participants concerned. (shrink)

Democratic civility is a core civic virtue of persons engaged in democratic deliberation. It is a complex trait that includes tolerance of diverse political views, openness regarding civic matters to reasons offered by others, willingness to seek compromise in an effort to find workable political solutions, and willingness to limit one’s individual interests for the public good when there are adequate reasons for doing so. Various writers have noted a tension between rights and civility. Insofar as rights (...) trump general considerations of community welfare and entail claims that can be demanded, an emphasis on individual rights and standing on one’s rights can undermine the sort of civility required for political compromise. Similarly an emphasis on civility might require not standing on rights when doing so is at the expense of the welfare of the community. Notwithstanding this tension, I argue that human rights and democratic civility have a symbiotic relationship. In particular, I argue that democratic civility is important for determining the scope of human rights as they are implemented in institutional structures, and that human rights have an important role to play in shaping the virtue of democratic civility. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eclecticism and Adolf Meyer’s Functional Understanding of Mental IllnessD. B. Double (bio)KeywordsAdolf Meyer, eclecticism, functionalism, biopsychosocial modelGhaemi’s Commentary and Meyer’s ‘Eclecticism’I am not against humanism. How could anyone be against the humanistic wisdom rooted in the worthy writings of Socrates, Hippocrates, Shakespeare, Cervantes, Osler, and the others listed by Nassir Ghaemi? Psychiatry should recognize the dignity and value of all people. The problem is that it may not always (...) do so, coming from a reductionist paradigm as it so often does.Ghaemi appreciates that Meyer’s compromising attitude meant that he was “unable to inoculate psychiatry from biological dogmatism.” My emphasis is on the challenge of Meyer’s psychobiology to biomedicine. In the same way, Engel’s biopsychosocial model acknowledged the need to neutralize the power of an impersonal and mechanical medicine. Doctors tend to overemphasize physical abnormalities at the expense of dealing with difficult personal issues.At the risk of oversimplification, I am juxtaposing biopsychosocial and biomedical models in psychiatry. Or in other terms, for our modern understanding, I am asserting a neo-Meyerian approach in contrast to neo-Kraepelinianism. Merely restating the Meyerian perspective will not do, because of Meyer’s ‘give and take,’ and his consequent failure to follow through the implication of his position. At least the ethical ramifications of his conceptual framework need to be acknowledged.Neo-Meyerianism also needs to be realized in the context of the reaction to anti-psychiatry. After anti-psychiatry’s attack, our modern understanding of mental illness has tended to be been subsumed into the binary opposition of ‘pro-psychiatry’ and ‘anti-psychiatry.’ But neo-Meyerianism is as much pro-psychiatric as biomedical psychiatry. It is in this sense that biopsychological approaches have been undermined by the biomedical reaction to anti-psychiatry. [End Page 355]I also agree with Ghaemi that there is a way in which the failures of the biopsychosocial model allowed the development of anti-psychiatry. For example, even though Laing quoted favorably from psychologically minded psychiatrists such as Manfred Bleuler, as far as I know he never made any reference to Meyer. There was never a systematic Meyerian theory to which Laing could refer. In fact, Laing wished to move beyond an interpretative understanding to abandon the metaphor of pathology (Double 2006). Perhaps if the biopsychosocial model had been more clearly defined, Laing would not have felt he needed to take this step. Or, at least in doing so, he would have been clearer about where he stood on this issue. When labeling Laing’s views as ‘anti-psychiatry,’ biomedical psychiatry would have had to state more precisely how Laing’s position was anti- rather than pro-psychiatric.My main disagreement with Ghaemi is his view of Meyer as eclectic. Meyer’s willingness to allow ‘anything goes’ in psychiatry meant that he did not oppose or challenge too much the views of those with whom he disagreed. Nonetheless, he did not combine together different sources to create an unintegrated philosophical and conceptual understanding. His theoretical position is internally consistent.Modern American psychiatry studied by participant observation is “of two minds,” in that there is a divided consciousness created between the practices of drug therapy and psychotherapy (Luhrmann 2000). In this sense, it is eclectic because there is no consistent theory that combines the two practice modes. True, psychiatry often claims that the foundation for this mixture is the biopsychosocial model. It asserts that everyday psychiatry is not as purely biomedical as is often maintained because it takes into account psychosocial factors that may precipitate mental disorders. It, therefore, says that it bring together the biological and psychosocial. This compromise avoids the adoption of any one model and was proposed to neutralize the dogmatism engendered by the anti-psychiatry debate (Clare 1980). I agree with Ghaemi that such eclecticism has outlived its usefulness.Where I think Ghaemi is mistaken is that he sees Meyer and Engel as the originators of this eclecticism. I regard the Meyerian approach as more genuinely pragmatic than Ghaemi suggests. Meyer’s dynamic psychology sought an integration of mind and brain as a way of dealing with the philosophical dilemma of the mind–body... (shrink)

Giant bones unearthed throughout the Mesoamerican countryside provoked early modern thinkers to grapple with the earth’s ages, partially syncretizing Nahua histories of human conquest with Spanish colonial medicinal and natural historical knowledge. European naturalists’ willingness to accept the giant remains required them to embrace localized Mesoamerican cosmologies. The fossilized landscape provided evidence that conquest and eradication had happened before at the hands of the peoples whom the Spaniards had conquered in turn. Lost from early modern collections and failing to (...) translate far beyond New Spain during the sixteenth century, the giant remains highlight the possibilities and challenges of integrating Mesoamerican knowledge into the global history of science, with an emphasis on emplaced thinking, medicine and the body, and deeper temporal frameworks. Moving beyond itinerary histories to globalizing cosmologies in the history of science can better explain the compromises Europeans and Mesoamericans were required to make to enter into a syncretic intellectual contract, as well as the non-European concept of time that came with local reckonings with the human and more-than-human natural world. (shrink)

This article argues that philosophers and laypeople commonly conceptualize moral truths or justified moral beliefs as discoverable through intuition, argument, or some other purely cognitive or affective process. It then contends that three empirically well-supported theories all predict that this ‘Discovery Model’ of morality plays a substantial role in causing social polarization. The same three theories are then used to argue that an alternative ‘Negotiation Model’ of morality—according to which moral truths are not discovered but instead created by actively negotiating (...) compromises—promises to reduce polarization by fostering a progressive willingness to ‘work across the aisle’ to settle moral issues cooperatively. This article then examines potential methods for normatively evaluating polarization, arguing there are prima facie reasons to favor the Negotiation Model over the Discovery Model based on their hypothesized effects on polarization. Finally, I outline avenues for further empirical and philosophical research. (shrink)

John Rawls rejected modus vivendi political outcomes as normatively deficient because he believed that the participants are not motivated by moral reasons. Contemporary defenders of modus vivendi reject the importance of distinguishing between moral and nonmoral reasons for constructing terms of peaceful coexistence. Theorists have highlighted peace and security as values that are integral to a modus vivendi. I argue that the idea of mutuality ought to be included in an account of how a modus vivendi emerges between parties who (...) have opposed views about how to decide jointly a matter of common concern.A modus vivendi is a compromise, and the creation of a modus vivendi requires the parties to understand themselves as facing a situation to which they ought to respond together. I argue that mutuality is a value that is presupposed in their effort to create a modus vivendi. How and why parties regard each other as having standing to shape the resolution of a political conflict remains unexplored in the literature on modus vivendi. Although parties to a modus vivendi are unlikely to regard each other as deserving equality of standing, they nevertheless recognize each other in a manner that is morally salient. Mutuality involves viewing people whom one opposes or considers to be a rival as nevertheless having standing to participate in a shared political life.Inquiry into the origin of a shared commitment to mutuality can help scholars understand what conditions facilitate willingness to coexist and to participate in a modus vivendi. (shrink)

Finding ways to foster intellectual humility (IH)—the willingness to own one’s limitations—is an important goal for facilitating effective learning. We report the results of a longitudinal, quasi-experimental study, conducted across six undergraduate, culturally diverse (58% racial/ethnic minority) introductory philosophy courses, that evaluates how social perceptions and cross-cultural reasoning change following a course on epistemology and social ethics. Critically, we manipulated whether each class received a standardized lesson in IH at the start of the course or not. Participants provided self-ratings (...) of IH, gave round-robin judgments of their classmates, and completed a wise-reasoning writing exercise focusing on a cultural conflict at both the beginning and end of the summer course session. Results revealed no change in self-reported IH, but an increase in perceived peer IH and conscientiousness within classes where IH was taught. Moreover, an analysis of the participants’ writing suggested greater levels of compromise-seeking when dealing with a cultural conflict among the students taught about IH, relative to those in the control classes. This study provides initial insights regarding the relationship between IH and cultural humility, as well as the efficacy of facilitating the development of IH among undergraduate students. (shrink)

As a consequence of the world’s present ecological crisis, the potential for political protest has increased and a demand for technologies of conflict resolution has arisen. One method, favored by Ortwin Renn, applies the ethics of open discourse to negotiations between politicians, experts, and citizens. The ethical appeal of this method can easily lead to an undervaluation of its shortcomings and risks-a problem which I will try to help amend in this article. Above all, it has to be noticed that (...) the participation in open discourse can tranquilize grass-root protests even in areas where the willingness to engage in a compromise might hurt the true public interest. And who should choose which technology of conflict resolution is applied? The citizens themselves and not just the experts of discourse should probably decide. (shrink)

Background Respect for human rights and bioethical principles in prisons is a crucial aspect of society and is proportional to the well-being of the general population. To date, these ethical principles have been lacking in prisons and prisoners are victims of abuse with strong repercussions on their physical and mental health. Methods A systematic review was performed, through a MESH of the following words (bioethics) AND (prison), (ethics) AND (prison), (bioethics) AND (jail), (ethics) AND (jail), (bioethics) AND (penitentiary), (ethics) AND (...) (penitentiary), (prison) AND (human rights). Inclusion and exclusion criteria were defined and after PRISMA, 17 articles were included in the systematic review. Results Of the 17 articles, most were prevalence studies (n.5) or surveys (n.4), followed by cross-sectional studies (n.3), qualitative studies (n.1), retrospective (n.1) and an explanatory sequential mixed-methods study design (n.1). In most cases, the studies associated bioethics with prisoners’ access to treatment for various pathologies such as vaccinations, tuberculosis, hepatitis, HIV, it was also found that bioethics in prisons was related to the mental health of prisoners, disability, ageing, the condition of women, the risk of suicide or with the request for end-of-life by prisoners. The results showed shortcomings in the system of maintaining bioethical principles and respect for human rights. Conclusions Prisoners, in fact, find it difficult to access care, and have an increased risk of suicide and disability. Furthermore, they are often used as improper organ donors and have constrained autonomy that also compromises their willingness to have end-of-life treatments. In conclusion, prison staff (doctors, nurses, warders, managers) must undergo continuous refresher courses to ensure compliance with ethical principles and human rights in prisons. (shrink)

Critical thinking skills have associated critical thinking virtues, and the internal motivation to carefully examine an issue in an effort to reach a reasoned judgment, what I call the “willingness to inquire”, is the critical thinking virtue that stands behind all skilled and virtuous thinking that contributes to critical thinking. In this paper, I argue that the willingness to inquire is therefore a more primary critical thinking virtue than charity, open-mindedness, or valuing fallacious-free reasoning.

Documented ethical violations and empirical research have demonstrated that, despite professional standards and formal training in ethical principles, some psychotherapists engage in unethical behaviors that compromise the welfare of clients. It appears that competing values and interests that emerge in the therapeutic endeavor can interfere with therapists' considerations of ethical standards and their willingness to act ethically. Expanding current models of ethical decision making, this article offers a hermeneutic model that recognizes that in addition to moral reasoning, the (...) context of the therapeutic relationship and the therapist's subjective responses are fundamental considerations in the interpretation and application of ethical interventions. Implications for understanding and training of ethics in psychotherapy in this broader context are explored. (shrink)

The far reaching effects of the genetic revolution on our lives as a whole make it difficult to separate the secular and sacred issues involvedIn accepting this opportunity to comment on Dr Polkinghorne’s Templeton Prize lecture, I recognise that there is a significant division between those who would see religious beliefs as irrelevant in the ethical debates concerning new biotechnologies and those who, with Dr Polkinghorne, are willing to look to the major faith traditions for insight into the nature of (...) human identity and selfhood. In secular discourse, the intrusion of religious language has long been resisted on many grounds: that sound ethical principles do not need transcendent ratification; that those who presume a privileged moral discernment derived from their religion frequently fail to appreciate the complexity of genetic and medical science; and that internecine disputes within faith communities and historically rooted incommensurabilities between them seriously compromise any prospect of consensus. This problem is tacitly acknowledged by Dr Polkinghorne himself when he notes that his willingness to accept the 14 day threshold before which certain forms of experimentation on embryos are deemed permissible would not be congenial to Roman Catholic officialdom, for whom the destruction of one life cannot be condoned even if it were to make possible the creation of another.Dialogue traversing a secular/sacred divide can be thwarted for other reasons. Those sympathetic to religious voices may concede that claims for privileged discernment are unhelpful but still insist that secular ethicists too readily fail to appreciate that religious beliefs can be constructive in strengthening motivation and in deepening commitment on ethical issues. Theologians who have served on ethics committees have sometimes expressed a sense of frustration accompanying their attempts to explain that they are starting from a different point, and working from different presuppositions, than those who …. (shrink)

Objectives: The introduction of the living donation in organ transplantation introduces important new psychological conflicts and ethical questions in the transplantation process. Operation related risks, as well as dependencies in the family structure, generate considerable pressure on potential donors. The aim of the study was to reconstruct the determinants of willingness to donate before transplantation.Methods: Evaluation of 20 taped and transcribed interviews oriented to current approaches in qualitative interview research. The approach used is based on grounded theory, qualitative content (...) analysis, and the concept of the ideal type.Results: Before surgery, “openly motivated” donors push for an operation, leaving no room for ambivalence in the evaluation process. They idealise the relationship with the recipient, and link their donation with the individual—partly in subconscious expectations and wishes. In contrast, “openly ambivalent” donors formulate their anxieties and express arguments against donation.Conclusions: Statements that claim ambivalence towards donation or utterance of arguments against donation indicate earlier coercion. Before transplantation, potential donors should have the opportunity to discuss their emotional situation to help their decision making process. (shrink)

Background The Constitutional Court of South Korea declared that an abortion ban was unconstitutional on April 11, 2019. The National Health Care System will provide abortion care across the country as a formal medical service. Conscientious objection is an issue raised during the construction of legal reforms. Methods One hundred sixty-seven perioperative nurses responded to the survey questionnaire. Nurses’ perception about conscientious objection, support of legislation regarding conscientious objection, and intention to object were measured. Logistic regression was used to explore (...) the factors associated with support of the legislation and the intention to conscientiously object. Results Only 28.8% of the responding nurses were aware of health care professionals’ conscientious objection. The majority felt that patients’ rights should be prioritized over health care professionals’ conscientious objection. On the other hand, 45.8% supported the legislation on conscientious objection to abortion, and 42.5% indicated a willingness to refuse to participate in an abortion case if conscientious objection was permitted. Religion, awareness of conscientious objection, and prioritizing of nurses’ right to conscientious objection were significantly associated with supporting the legislation. Moreover, religion and prioritizing nurses' rights were significantly associated with the intention to conscientiously object. Conclusions This study provides information necessary for further discussion of nurses’ conscientious objection. Nursing leaders, researchers, and educators should appeal to nurses and involve them in making policies that balance a women's right to non-discrimination and to receiving appropriate care with nurses' rights to maintain their moral integrity without compromising their professional obligation. (shrink)

By means of minimal assumptions on the individual preferences, I show that the Willingness To Pay (WTP) for both a FSD and SSD reduction of risk is the sum of a mean effect, a pure risk effect and a wealth effect. As a result, the WTP of a risk-averse decision maker may be lower than the WTP of a risk-neutral one, for a large class of individual preferences’ representation and a large class of risks.

Two studies document that people are more willing to express emotions that reveal vulnerabilities to partners when they perceive those partners to be more communally responsive to them. In Study 1, participants rated the communal strength they thought various partners felt toward them and their own willingness to express happiness, sadness and anxiety to each partner. Individuals who generally perceive high communal strength from their partners were also generally most willing to express emotion to partners. Independently, participants were more (...) willing to express emotion to particular partners whom they perceived felt more communal strength toward them. In Study 2, members of romantic couples independently reported their own felt communal strength toward one another, perceptions of their partners’ felt communal strength toward them, and willingness to express emotions to each other. The communal strength partners reported feeling toward the participants predicted the participants’ willingness to express emotion to those partners. This link was mediated by participants’ perceptions of the partner’s communal strength toward them which, itself, was a joint function of accurate perceptions of the communal strength partners had reported feeling toward them and projections of their own felt communal strength for their partners onto those partners. (shrink)

Moses Maimonides was a rare kind of radical. Being a genuine Aristotelian, he recommended following the middle path and avoiding extremism. Yet, within the sphere of Jewish philosophy and thought, he created a school of philosophical radicalism, inspiring Rabbis and thinkers to be unwilling to compromise their integrity in searching for the truth, regardless of where their arguments might lead. Both Spinoza and Salomon Maimon inherited this commitment to uncompromising philosophical inquiry. But of course, such willingness to follow (...) a philosophical argument to any length is a fine prescription for getting into trouble with community and political leaders. In this paper I will trace the story of one such collision, which took place between the radical philosopher Salomon Maimon and the bourgeois Enlightenment politician, Moses Mendelssohn. (shrink)

The concept of community integrated pest management (IPM), which is well developed in Indonesia and Vietnam, was recently introduced in Nepal. However, it has not been widely practiced, due mainly to lack of financial and technical support. This study determined an individual’s willingness to pay (WTP) for community IPM training. Determinants of WTP were identified; and sample average estimates, opportunity costs of training, and probability values were used to estimate WTP for a group of households. Estimated WTP revealed that (...) individuals were in favor of community IPM, hence it could be implemented with the support of local villagers. Community IPM demand functions showed that individuals’ knowledge and awareness of pesticide pollution are crucial for implementation. The annual welfare gained by providing five days community IPM training was calculated to be US $25.23 per household. (shrink)

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study investigated (...) the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)

We have investigated attitudes towards the use of health data among the Swedish population by analyzing data from a survey answered by 1645 persons. Health data are potentially useful for a variety of purposes. Yet information about health remains sensitive. A balance therefore has to be struck between these opposing considerations in a number of contexts. The attitudes among those whose data is concerned will influence the perceived legitimacy of policies regulating health data use. We aimed to investigate what views (...) are held by the general public, and what aspects matter for the willingness to let one’s data be used not only for one’s own care but also for other purposes. We found that while there is a broad willingness to let one’s data be used, the possibility to influence that use is considered important. The study also indicated that when respondents are required to balance different interests, priority is typically given to compulsory schemes ensuring that data are available where needed, rather than voluntary participation and data protection. The policy implications to be drawn from this are not self-evident, however, since the fact that a majority has a certain attitude does not by itself determine the most adequate policy. (shrink)

As guidelines for neonatal resuscitation evolve from a growing evidence base, clinicians must ensure that practice is closely aligned with the available evidence, based on methodologically sound and ethically conducted research. This paper reviews ethical, legal and risk-management issues arising during the design of a quality-assurance project to make video recordings of neonatal resuscitations after high-risk deliveries. The issues, which affect patients, researchers, staff and the hospital at large, include the following: 1) Informed consent for research involving emergency procedures is (...) often not possible, for lack of time to provide sufficient information. The mental capacity of the subject or parent may be compromised by the impending emergency, and freedom of choice is threatened by the time pressure to consent. 2) Video recording of the inevitable medical errors raises issues of whether participating staff may be identifiable and accountable, affecting their willingness to participate in such research. The approach to staff participation and identification is reviewed. 3) The use of video data for education threatens the privacy of research subjects. The ethics of maintaining privacy is balanced with the ethics of using the data to improve practice of resuscitation. 4) The research subjects (patients, or the staff whose performance is being monitored) must be defined. 5) There are legal and ethical aspects of management and ownership of data. 6) The role of the Human Research Ethics Committee in protecting the research subject and possibly the medicolegal interests of the hospital is discussed. This paper reviews the literature and discusses the issues. (shrink)

BackgroundFew studies have identified the willingness rate of developing countries population to be enrolled in clinical trials.MethodsAll participants including patients, healthy volunteers and doctors completed a questionnaire to examine factors affecting the consent to participate in medical research.ResultsOverall, 80 % of the included population agree to participate in health research. This rate was lower for trials dealing with life-threatening diseases. Altruism and perceived risk of harm were the main reason to respectively accept or refuse to participate in clinical trials. (...) Factors significantly associated with willingness were: age <40 years 1.6 [95 % Confidence Interval 1.2-2.1]) and prior history of blood donation.ConclusionMost participants expressed their willingness to be included in medical research especially if they are young or if they have history of blood donation. However, consent to participate is low when medical research required acute care. (shrink)

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study investigated (...) the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)

The main aim of this paper is to investigate the micro and macro predictors of Portuguese willingness to pay (WTP) more taxes to bolster funds channelled to the National Health Service (NHS). An online questionnaire was used to collect data from 584 Portuguese citizens. The statistical analysis was performed through the application of logistic regressions. The research shows that willingness to support increasing taxes depended on socioeconomic, behavioural, and psychological factors. The WTP more taxes to finance the NHS (...) were associated with younger ages, life satisfaction and dispositional optimism, satisfaction with the NHS performance, current perceived risk exposure, and risk orientation. Identifying and understanding the main influencing factors associated with WTP more taxes for NHS is essential to assist policy-makers in developing healthcare reforms. Decision-makers may take this opportunity to improve the NHS since those who ultimately benefit from the measures can provide an additional source of health financing. (shrink)

As one of the low-carbon products, remanufactured products are being paid more attention in more and more countries. But the low willingness of Chinese consumers to pay for them makes it difficult for remanufactured products companies to move forward in the Chinese market. This study explores the factors that affect consumers’ willingness to pay for remanufactured goods, through the hierarchical linear regression method, based on questionnaires. The results show that demographic variables (age, education, occupation, and income), individual subjective (...) variables (environmental awareness, secondhand preferences, and Chinese quality trust) and product perception variables (MP4 quality perceived risk, face risk, and product impact on the environment) have a significant impact on the willingness to pay for remanufactured goods. (shrink)

In this paper I argue that underlying phronêsis is the more foundational virtue of a willingness to be rationally persuaded. A WTBRP is a virtue in the sense that it fulfills the doctrine of the mean by falling between two vices – never sticking to your position and never giving it up. Articulating a WTBRP in this way also helps address problems phronêsis faces in light of implicit bias research.

Rooted in theory of planned behavior (TPB) supplemented with self-determination theory (SDT), this study explores determinants of willingness to receive and provide resources in Europe's non-remunerated and remunerated collaborative consumption (CC). The exploration was conducted within a single research model by assessing the role of (a) TPB constructs reflecting attitude towards participation in CC, perceived social pressure to engage, and perceived level of difficulty that engagement requires and (b) SDT constructs of environmental, social, and economic motives for participation. The (...) data were collected through an online questionnaire, and the structural relationships were analyzed using structural equation modeling. Willingness to consume in non-remunerated and remunerated CC was positively directly influenced by social pressure to engage in CC and participation being perceived as pleasant, negatively by the level of difficulty that engagement requires, as well as positively indirectly influenced by environmental concern and sociability. Additionally, environmental concern had positive direct effect on willingness to consume only in the remunerated context. Willingness to provide in non-remunerated CC was positively directly influenced by perceiving participation as pleasant and indirectly by environmental concern and sociability. Resource provision in remunerated CC was not explained by any of the determinants. (shrink)

Recent research suggests holding a structural, rather than interpersonal, understanding of racism is associated with greater impetus to address racial disparities. We believe greater acknowledgment of structural racism also functions to mitigate against empathic failures in response to structural injustices. Given South Africa’s situatedness as a country characterized by historical racialized oppression and continuing unjust legacies, it is appropriate to examine these ideas there. Across three studies, we tested the hypotheses that members of advantaged groups’ perspective taking and empathic concern (...) may be compromised in response to people challenging the unequal status quo, and that a priori perceptions about the impact of structural racism may mitigate or exacerbate such empathic failures. In Study 1, a national sample of White South Africans endorsed perceptions of interpersonal racism more readily than perceptions of structural racism, and expressed high levels of competitive victimhood for perceived anti-White structural racism. Studies 2 and 3 showed that White participants at a historically White university responded with impaired perspective taking and intergroup empathy bias in response to people challenging structural disparities. Finally, reduced recognition of continuing structural racism predicted greater intergroup empathy bias, which, in turn, was associated with reduced willingness to engage in intergroup discussions about past harm. We propose that greater acknowledgment of structural racism is necessary not only to surmount intergroup empathic failures, but also to transcend the socioeconomically unequal legacies of apartheid and beyond. (shrink)

This study analyzed consumers’ willingness to pay (WTP) for non-pirated computer software and examined how attitudes toward intellectual property rights and perceived risk affect WTPs. Two commonly used software products, Microsoft Windows and Microsoft Office, were used in the study as objects to reveal consumer assessed values. A consumer survey was administered in Taiwan and the total valid samples were 799. Respondents in this study included students from senior high schools, colleges, and graduate schools, and general consumers who were (...) no longer full-time students. The estimated average WTP for Windows was USD 58.55 and for Office was USD 53.49, much lower than the respective suggested retail prices in the market. Social norms had strong positive influences on willingness-to-pay for software products. The prosecution risk did not significantly increase WTPs for software products due to the reason that individuals who used pirated software were not at a high risk of being prosecuted. Performance risk was positively correlated to WTPs for software products. The respondents segmented into the low-WTP cluster were more likely to use pirated software than those in the high-WTP segment. Source reliability, legitimacy, technical support, and customer service were emphasized in decisions of respondents in the high-WTP segment and could be used in marketing strategies. (shrink)

Sexually dimorphic mate selection strategies were examined in 200 university students reporting their willingness to engage in casual sexual encounters with hypothetical individuals of the opposite sex. Using a questionnaire format, the possibility of forming a long-term relationship was manipulated, while risk of disease, pregnancy, and detection was eliminated across all conditions. In addition, potential partners varied in level of attractiveness, and in personality and behavioral characteristics. As expected, men reported a greater anticipated willingness to engage in sexual (...) intercourse across all conditions compared with women. The possibility of forming a long-term relationship elevated women’s, but not men’s, willingness for sexual intercourse. While a potential partner’s attractiveness had a significant positive overall effect on responses, reducing their relative attractiveness had a greater negative impact on men’s responses. Reference to the parental qualities of a potential partner significantly increased women’s, but not men’s, anticipated willingness for sexual intercourse. Describing a hypothetical partner as non-aggressive marginally increased women’s willingness and did not affect men’s responses. The wording of items relevant to this condition may have resulted in the potential partner sounding "wimpy" rather than nonaggressive, and this may have reduced the expected effect of this manipulation. The possibility that women may trade off personality and behavioral characteristics with attractiveness to a greater degree than men when assessing potential mates is considered. (shrink)

The study analyzes the influential factors of consumers’ willingness to purchase gray-market smartphones by considering the model of novelty seeking, status consumption, integrity, and perceived risk. Attitude toward counterfeit is used as mediation in the model. The causalities in the model of problematic willingness of consumer to purchase gray-market smartphones are hypothesized. A total sample of 350 respondents with 238 effective samples is collected by interviewing with questionnaires at the service counters of telecommunications operators. Structure equation modeling (SEM) (...) is adopted in the analysis. Consumers’ attitude toward counterfeit goods is found to be positively related to the willingness of consumers to purchase gray-market smartphones, but perceived risk is negatively related to consumers’ willingness to purchase. As for personality constructs, integrity and status consumption are found to be negatively related to consumers’ attitude toward counterfeit goods, but novelty seeking is positively related to the attitude. Further, managerial implications for branded smartphone manufacturers and telecommunications regulators are provided by the research. (shrink)

November 17 was a grand day in the career of Bill Clinton, the day when he proved that he is a man of firm principle, and that his "vision" -- the term has become a journalistic reflex -- has real substance. "President Emerges As a Tough Fighter," the New York Times announced on the front page the next day. Washington correspondent R.W. Apple wrote that Clinton had now silenced his detractors, who had scorned him for his apparent willingness to (...) back down on everything he claimed to stand for: "Mr. Clinton retreated early on Bosnia, on Haiti, on homosexuals in the military, on important elements of his economic plan [namely, the minuscule stimulative package]; he seemed ready to compromise on all but the most basic elements of his health-care reforms. Critics asked whether he had a bottom line on anything. On NAFTA, he did, and that question won't be asked much for a while.". (shrink)

Background: In modern healthcare, the role of solidarity, altruism and the natural response to moral challenges in life-threatening situations is still rather unexplored. The COVID-19 pandemic provided an opportunity to obtain a deeper understanding of nurses’ willingness to care for patients during crisis. Objective: To elucidate clinical expressions of ontological situational ethics through nurses’ willingness to work during a pandemic. Research design, participants and context: A qualitative study with an interpretive design was applied. Twenty nurses who worked in (...) intensive care unit at two Swedish hospitals during the first, second, and third waves of the COVID-19 pandemic were interviewed. The analysis was interpretative and applied a theoretical ethics perspective. Ethical considerations: The study was approved by the Swedish Ethical Review Authority and informed consent was obtained from all participants. Findings: From a philosophical perspective, the nurses expressed sovereign life expressions of mercy and compassion, which arose spontaneously in response to seeing vulnerable fellow humans. They referenced ‘‘the nurse inside me’’ and their choice of profession as motives to provide care. Ontological situational ethics in culture and norms were noted in the constructs of competence, responsibility, solidarity with colleagues and organization; and interest and learning were driving forces. Ethical demand was evident when nurses expressed ideas of meaningfulness in helping their fellow humans; but themes of ambiguity, exhaustion and unwillingness were also present. Conclusions: The nurses showed a high willingness to care for patients during a crisis. Responding to the ethical demand and to care for vulnerable human beings while risking their own health and lives could be interpreted as an inter-human vocation. These spontaneous altruistic actions saved the lives of many patients during the pandemic and need to be understood and supported. (shrink)

Several experimental studies have reported that an otherwise robust regularity—the disparity between Willingness-To-Accept and Willingness-To-Pay—tends to be greatly reduced in repeated markets, posing a serious challenge to existing reference-dependent and reference-independent models alike. This article offers a new account of the evidence, based on the assumptions that individuals are affected by good and bad deals relative to the expected transaction price (price sensitivity), with bad deals having a larger impact on their utility (`bad-deal’ aversion). These features of preferences (...) explain the existing evidence better than alternative approaches, including the most recent developments of loss aversion models. (shrink)

With the rise of live streaming commerce, the relationship between consumers and content creators on the short-video platforms has become closer, forming a peculiar culture and language in each consumer community, which promotes the short-video platforms to become a natural breeding ground for forming consumer communities. While such communities give birth to its own language and culture from the interaction between content creators and consumers, this kind of co-creation can not only enhance the consumers’ trust to improve commodity premium space, (...) but also strengthen the ties within the community and spread the information outside the communities, and consequently, expand community scale. Based on the view of the value co-creation from the language and culture among content creators and consumers in the communities, this study starts from the point of product type, employs consumers’ Willingness to pay premium as a proxy variable of brand advocacy in the co-creation of cultural and language values in consumer communities, and conducts three single-factor experiments between two groups. By analyzing the experimental results, this study identified the influence under the potential relationship mechanism, social comparison, and found another variable that can moderate the relationship, consumer trust, portrays the relationship between the product types of the live streaming commerce and the consumers’ WoPP, and explores the mediating effect of social comparison and the moderate effect of consumer trust effect. This paper also analyzes and discusses the WoPP caused by the co-creation of cultural and language values co-created by creators and consumer communities. (shrink)

Welfare science has built its foundations on veterinary medicine and thus measures of health. Since bottlenose dolphins (Tursiops truncatus) tend to mask symptoms of poor health, management in captivity would benefit from advanced understanding on the links between health and behavioural parameters, and few studies exist on the topic. In this study, four representative behavioural and health measures were chosen: health status (as qualified by veterinarians), percentage of daily food eaten, occurrences of new rake marks (proxy measure of social activity), (...) and willingness to participate (WtP) in Positive Reinforcement Training sessions as qualitatively measured by their caretakers. These data were collected multiple times a day, every day over the course of a year from a multi-facility, large sample size (ndolphins= 51), allowing powerful analyses of the relationships between measures. First, it was found that dolphins with a higher WtP score also had a significantly better health status, ate a higher percentage of their daily food, and a lower occurrence of new rake marks. In addition, the WtP score was significantly lower up to 3 days before the weekly veterinary diagnosis of a decrease in health state; the percentage of daily food eaten and new rake mark measures did not show any significant change before such a diagnosis. These results suggest that WtP in training sessions is a potential behavioural measure of dolphin welfare, and an indicator of early changes in the dolphins’ health state. We therefore suggest measurement of WtP as a more practical and non-invasive tool to support veterinary care and general management. More work needs to be conducted to elucidate the influence of social behaviour on health, and to identify other potential welfare indicators, but this long-term study has shown that qualitative measures can be both practical and valid when assessing dolphin welfare. (shrink)

Applications of willingness to pay have shown the difficultly to discriminate between various options. This reflects the problem of embedding in both its specific sense, of options being nested within one another, and its more general sense, whereby respondents cannot discriminate between close substitutes or between more-disparate rivals for the same budget. Furthermore, high proportions of reversals between WTP-value and simple preference based rankings of options are often highlighted. Although an incremental WTP approach was devised to encourage more differentiated (...) answers and a higher degree of consistency among respondents, a theoretical basis for this approach has not been elucidated, and there is little evidence to show that this approach might indeed achieve greater consistency between explicit and implicit rankings inferred from WTP values. We address both these issues. Following our theoretical exposition, standard and incremental approaches were compared with explicit ranking in a study assessing preferences for different French emergency care services. 280 persons, representative of the French adult population, were interviewed. Half received the incremental version, the other half the standard version. Results suggest that the incremental approach provides a ranking of options fully in line with explicit ranking. The standard approach was reasonably consistent with explicit ranking but proved unable to differentiate between the five most preferred providers, as predicted by theory. Our findings suggest that the incremental approach provides results which can be used in priority-setting contexts. (shrink)

An experimental survey was undertakento explore the links between thecharacteristics of a moral issue, the degree ofmoral intensity/moral imperative associatedwith the issue, and people'sstated willingness to pay for policy toaddress the issue. Two farm animal welfareissues were chosen for comparison and thecontingent valuation method was used to elicitpeople's wtp. The findings of the surveysuggest that increases in moral characteristicsdo appear to result in an increase in moralintensity and the degree of moral imperativeassociated with an issue. Moreover, there was apositive (...) link between moral intensity/moralimperative associated with an issue andpeople's stated wtp for policy to address theissue. The paper discusses the relevance of thefindings of the survey in the context of thedebate concerning the relationship betweenmoral and economic values and the use of thecontingent valuation method to estimatepeople's wtp of policy options with moraldimensions. (shrink)

This study aims to describe and compare nurses' willingness to provide care for patients with HIV/AIDS and factors associated with this in three countries. An international cross-sectional survey was conducted among nurses working in medical, surgical and gynaecology units in Finland (n =427), Estonia (n =221) and Lithuania ( n =185) in early 2006. The response rates were 75% (n = 322) in Finland, 54% (n =119) in Estonia and 86% (n = 160) in Lithuania. A modified version of (...) a scale developed in 1994 by Dubbert et al. was applied. Our findings showed a general willingness of the nurse participants to provide care for patients with HIV/AIDS. However, this willingness varied both among and within countries and was also related to specific nursing interventions. The results underline the importance of providing education on ethical issues related to HIV/AIDS care in Europe and tailoring the content of this education to meet nurses' national educational needs. (shrink)

Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers’ views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers’ willingness to share electronic health information for healthcare and (...) research. This study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant associations of each explanatory variable with the outcome variable. The odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46–0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94]. Consumers’ choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems. (shrink)

This paper argues that independent auditors have lost sight of their obligation to be truly impartial, and have increasingly adopted an attitude of client advocacy. We argue that auditors have a professional obligation to go beyond merely passing judgment on whether client accounting methods are acceptable under GAAP, and to judge whether the principles adopted are the most appropriate under the circumstances. We then review recent evidence which suggests that auditors have abandoned this objective in favor of advocating client-preferred principles. (...) The results of a survey of public accountants employed by small CPA firms indicates that, in a scenario in which an auditor did not feel that the client's accounting treatment was the most appropriate under the circumstances but it was recognized as an acceptable alternative under GAAP, advocacy of the client-preferred approach is considered appropriate and is very likely to occur in practice. In less subtle cases (e.g., when the auditor did not feel that the client's treatment provided the best reflection of the economic substance of the underlying transactions), survey participants as a group were ambivalent regarding the appropriateness of client advocacy, and felt that subordination of judgment was likely to occur in practice. The results also indicate that engagement risk, or the risk that the firm will be harmed by aggressive behavior, affects judgments of both the appropriateness and likelihood of subordination of judgment. These findings suggest that auditors have adopted an ideology of client advocacy, within the constraints of engagement risk. (shrink)