Conflict of interest in clinical research: direct payment to the investigators for finding human subjects and health information

The recent death of teenager Jesse Gelsinger in a drug therapy trial has drawn attention to how financial conflicts of interest may compromise patient protection. While research institutions throughout the world have instituted a variety of conflict of interest guidelines, the potential conflicts associated with investigators receiving direct payment from private companies for both the recruitment of patients and the running of clinical trials in pharmaceutical research remains a relatively unexplored area. Clinical researchers undoubtedly deserve to be reasonably compensated for their participation. But these incentive mechanisms also have the potential to create conflicts of interest--both real and perceived.     

Nonsexual boundary violations: sauce for the gander

Numerous articles in the mental health literature concern sexual contact between therapists and patients, which is explicitly prohibited by all four mental health professions' ethical codes. There is relatively little about nonsexual boundary violations, which are often covert and much more difficult to recognize (particularly in their early stages) than sexual violations; what little there is assumes that the clinician has the power in the relationship and uses that power for personal advantage. In this article the authors discuss the situation, rare in civil mental health facilities but common in correctional and forensic mental health facilities, in which personality-disordered patients manipulate and coerce clinicians to cross appropriate professional nonsexual boundaries for the patients' benefit; this reversal of the usual power dynamics between treaters and patients requires recognition of the role reversals present and requires different strategies for preventing such violations (hence "sauce for the gander").     

Elite economic forecasts, economic news, mass economic expectations, and voting intentions in great britain

In order to test the notion that the electorate relies, derivatively, on professional economic forecasts, we consider the entire chain between elite economic expectations, economic news, mass economic expectations, and voter preferences. We find that while elite expectations are based on the objective economy, they are politically biased in the neighborhood of elections. Reports of economic news, while based on the objective economy and on elite expectations, have their own political rhythm in the form of election–related cycles. The pattern in news coverage, in turn, is mirrored by election–related cycles in personal and general expectations formed by the mass public. While the relevance of each of the linkages from elite expectations to news coverage to mass expectations is thus confirmed, our findings challenge the view that the link between mass expectations and voting intentions can be attributed mainly to the dissemination of elite forecasts to the general public. We conclude by discussing the implications of our findings for an understanding of the ability and functioning of mass electorates.     

Moral hazard in work organizations: A comment on Gaynor,Eswaran and Kotwal,and Holmström

A key question in the economics of organization is whether it is possible to induce a group of employees to produce some quota of labor desired by the director of their organization. Holmström (1982) argued that it is possible to achieve the desired result via a simple incentive scheme. The essence of the scheme is to pay the employees only if they reach the quota; if they fail, the director is allowed to take what they have produced and use it for his own compensation. In response, Eswaran and Kotwal (1984) pointed out that because the director's compensation is smaller if the employees succeed in reaching the quota than if they fail, he has an incentive to bribe an employee to shirk, thus guaranteeing that the quota is not reached. The director, in other words, is subject to moral hazard. In a recent issue of Public Choice, Gaynor (1989) criticized the Eswaran-Kotwal argument by suggesting that it is possible to design incentive schemes which eliminate the director's moral hazard problem. In this note, we defend the Eswaran-Kotwal argument, and raise further questions about the assumptions upon which Holmström's incentive scheme is based.     

Liberalisation in India: Does it Resolve or Aggravate Employment Problems?

ABSTRACT

This article discusses whether liberalisation has moderated or aggravated India’s employment problems. Since the Modi government’s election in 2014 and the introduction of the flagship “Make in India” policy, various government officials and academics have argued that India’s employment situation has improved and is showing promising signs of growth and development. However, in this article, it is argued that India’s liberalisation policies have generated numerous problems: employment has delinked from GDP growth due to the increasing financialisation of accumulation; job growth is equal to or below labour force growth; and informalisation is increasing. A structural shift is occurring in India and is causing rural–urban migration due to increased agricultural input costs, reverse tenancy and the mechanisation of agriculture without the creation of new employment. This has led to a redistribution of existing employment in the urban informal sector.     

The processing and disposition of incompetent mentally ill offenders

Pretrial hospitalization of mentally ill offenders has been increasing in recent years and a number of abuses have been noted with respect to competency to stand trial. This is a report on 431 male felony defendants who were found incompetent to stand trial, hospitalized, and returned to court for a final disposition. Approximately one-half of those brought back to the court gained release to the community, with one-half continuing to be held in a hospital or a prison, and with 70% continuing in treatment in one setting or another. Disposition was significantly related to race, criminal history, severity of charges, and the recommendations of mental health professionals. Offenders were found to have spent unnecessarily long periods of time in jail and in the hospital awaiting court processing, raising questions about the fairness and efficiency of current procedures.     

Evaluation of competency to stand trial in defendants who do not want to be defended against the crimes charged

Implicit but significant assumptions made in the criminal justice system include beliefs that criminals do not commit crimes to be tried and convicted and that, once arrested, defendants' primary motives are to avoid or minimize the legal consequences of the charges they face. When those assumptions are not correct, clinicians and legal decision makers are faced with difficult tasks. The authors present three cases of defendants who were not primarily concerned with defending themselves against the charges they faced, but rather with using the criminal justice procedures to further personal goals, and discuss the problems involved for forensic evaluators and courts.