Moral atrophy in the welfare state

The welfare state is often accused of being counterproductive: as the scope of public responsibility expands, private morality (especially altruism and benevolence) atrophies. This essay surveys psychological findings for evidence, which turns out to be broadly consistent with either of two models of moral development, each bearing distinct policy implications. The model of morally keeping in practice that is implicit in the term moral atrophy suggests the need for frequent opportunities to exercise moral skills, which would seem inconsistent with the welfare state. Alternatively, the model of moral character-building favoured by both philosophers and ordinary discourse would require only occasional reminders of one's moral principles. On this model, benevolence could usefully supplement the welfare state.     

The median and the competitive equilibrium in one dimension

Two alternative models of legislative outcomes are the minimum winning coalition and the competitive equilibrium (Koford, 1982). In a unidimensional setting, the outcome under the former is the median, while the outcome under the latter is the highest net demand location.This paper describes the competitive equilibrium in a unidimensional model, and shows that under some common conditions it coincides with the median, in particular for pure redistributive issues. However, for distributive issues, the two equilibria will differ. Finally, the comparative statics of the two models are examined; while the winning coalition is sensitive only to changes in the location of the median, for distributive issues the competitive equilibrium has the standard economic comparative statics that the outcome adjusts in the direction of the change in preferences.     

The need to know versus the right to know: privacy of patient medical data in an information-based society

"Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret."(1) "Safeguards to privacy in individual health care information are imperative to preserve the health care delivery relationship and the integrity of the patient record."(2) As early as the fourth and fifth centuries B.C., Hippocrates contemplated the importance of medical information to the care and treatment of patients. His oath suggests that privacy of a patient's medical information creates the foundation upon which a patient reposes trust in his or her physician. While defining the earliest version of the physician-patient privilege, the oath does not envision the extent of modern day access to healthcare information. A patient's relationship with the modern healthcare delivery system often includes a team of physicians, nurses, and other clinical support personnel. This relationship extends beyond direct caregivers and may include healthcare administrators, payor organizations, and persons unfamiliar with a patient's identity, such as researchers and public health officials. Accessing a patient's medical information links these participants to the patient's healthcare delivery relationship. The Hippocratic Oath does not contemplate such broad access, nor does it contemplate the emerging privacy crisis resulting from the application of computer technology to medical record storage and retrieval. The combination of broad access, individual privacy rights, and computer technology requires a rethinking of measures designed to protect the realities of the modern medical information society.     

Practice-Relevant Research in Mediation: Toward a Reflective Research Paradigm

Donald Schön has advanced the notion that a systematic understanding of professional practice can be built on the reflective insights of skilled practitioners. The reflective practitioner paradigm is well suited to mediation research. A study of divorce mediation illustrates how Schön's seminal ideas can be translated into research procedures with broad applicability to a variety of mediation settings.