Individual Choice (individual + choice)

Distribution by Scientific Domains

Selected Abstracts

Food and Poverty: Insights from the ,North'

Elizabeth Dowler
The role that food and nutrition play in the material definitions of poverty are contrasted with the social construction of malnutrition and poverty, drawing largely on British experience. The consequences for poor health and premature death are briefly examined; in particular, the connection is made to the world-wide growth in obesity, and in cardio-vascular disease, cancers and diabetes. The lived experience of those defined as poor in the North, and the implications of contemporary policy initiatives and responses by state, private and voluntary sectors, are explored. The challenges of the dominant policy framework remain consumer and individual choice, rather than public health and citizenship, which militates against the realisation of true food security. [source]

Childlessness and Women Managers: ,Choice', Context and Discourses

Glenice J. Wood
Childlessness is increasing and might reflect acceptance of diversity, scope for individual choice and a creative ,social imaginary' about being feminine without being a mother. Childlessness also appears to have a contextual manifestation arising from the recognition that the long-hours work culture in many organizations does not support appropriate parenting. A qualitative study of Australian managers reveals the contradictory discourses of childlessness around enlightened equality, maternalism, an elusive, ideal ,work,life balance' and individualism. The article explores a contextually nuanced, dynamic, generative theory of agency which does not hinge on the mother,child dyad, in explaining women managers' choices to remain childless. [source]

Valuing health: a new proposal

Daniel M. Hausman
Abstract After criticizing existing systems of health measurement for their unargued commitment to evaluating health states in terms of preferences or well-being, this essay argues that public rather than private values of health states should help guide the allocation of health-related resources. Private evaluation of health states is relative to a prior individual choice of specific activities and goals, while public evaluation is relative to the whole range of important activities and goals. Public evaluation is concerned with securing a wide range of choices as well as with success given one's choice. A reasonable simplification from the public perspective is to focus on just two features of health states: the subjective feelings attached to health states and the limitations that health states imply on the range of important activities that individuals can pursue. Focusing on just these two dimensions permits the construction of a parsimonious classification of health states with regard to what matters most from the public perspective. This classification, which resembles those in the HALex and the Rosser and Kind Disability and Distress Index, might best be built on top of existing health-state classifications, by mapping the health states they define to activity-limitation/feeling pairs. To assign values to these pairs, I propose relying on deliberative groups to make comparisons among the pairs with respect to the relation ,is a more serious limitation on the range of objectives and good lives available to members of the population'. A ranking according to this property, is not a preference ranking, because it is not a ranking in terms of everything that matters to individuals. Working back from the weights attached to the activity-limitation/feeling pairs, one can impute weights for the health states in other classification systems that were mapped to those pairs. If those weights coincide roughly with current weights, then one legitimizes current weights and provides a vehicle for their public discussion and possible revision. If those weights do not coincide, then one has both an argument for revising current views of the cost effectiveness of treatments and policies and a method to carry out such a revision. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Regulated competition and citizen participation: lessons from Israel

David Chinitz PhD
Objective To investigate the relationship between health system structure and citizen participation, in particular whether increased reliance on competition encourages or depresses citizen involvement. Setting The case of Israel's ongoing health reform, based on regulated competition among sick funds, is examined. Design Interviews with government officials and representatives of consumer groups; analysis of policy documents, judicial rulings, public surveys and journalistic accounts. Results The Israeli reform is based in large measure on a regulated competition model, in which citizens have free choice among highly regulated competing sick funds. At the same time, the reform process has been accompanied by legal, institutional and political frameworks, as well as significant interest group activity, all aimed at increasing public input into processes of health policy making and implementation. The Israeli case, it is argued, lends support to the proposition that citizen participation (voice) and individual choice (exit) are complementary, rather than alternative, modes of ensuring citizen influence over health services. The question is whether the development of multiple avenues for citizen involvement represents disarray or a healthy social learning process regarding the running of the health system. Conclusion This paper expresses cautious optimism that citizen participation is a projection of a healthy social learning process, and suggests directions for public policy to encourage this outcome. [source]

Political consumerism between individual choice and collective action: social movements, role mobilization and signalling

Boris HolzerArticle first published online: 9 AUG 200
Abstract The notion of political consumerism has two implications. First, consumers wield some kind of power that they can use to effect social change through the marketplace. Second, political consumerism refers to and somehow combines the rationalities of two subsystems, politics and the economy. Yet regarding their everyday, individualized shopping decisions, consumers do not appear to command a great deal of power. What kind of influence, then, can individual economic decisions have on producers? Is that influence robust enough to attribute power to consumers? And if consumers do indeed have power, how can we conceive the implied translation of political concerns into the monetary logic of the economy? An answer to those questions needs to take into account the societal context of political consumerism. This paper analyses how political consumerism relates to the functional differentiation of modern society and how social movements are fundamental to understanding it. Through what I shall call role mobilization, social movements turn the role sets of their supporters into transmission belts for political objectives, and by authoritatively communicating those objectives, they provide signals to producers, who otherwise would not know a great deal about their consumers' preferences. [source]

Contrasting Role Morality and Professional Morality: Implications for Practice

Kevin Gibson
Investigating role morality is important, since the mentality of role morality may allow agents to believe they can abdicate moral responsibility when acting in a role. This is particularly significant in the literature dealing with professional morality where professionals, because of their special status, may find themselves at odds with their best moral judgments. Here I tell four stories and draw out some distinctions. I conclude that role morality is a genuine and useful distinction. However, I suggest that the purported distinction between role morality and professional morality is over-determined. Therefore, alleged conflicts between the demands of role and profession (such as the different pressures on Pinto designers as employees and as engineers) are not conflicts between different kinds of demands, but rather conflicts arising from divergent roles that most workers will encounter regularly. Another analytical perspective is to look at moral choices at work in terms of power and the ability to bring about change. Finally, I draw the implication that we should stress moral awareness at a fairly abstract level for all employees and reinforce the moral primacy of individual choice. [source]

Building sustainable societies: A Swedish case study on the limits of reflexive modernization

ABSTRACT Environmental problems have inspired a wide range of responses from citizens and states alike. My research focuses on Swedish individuals' attempts to minimize perceived environmental risks via consumption practice. The growth of "sustainable consumerism" is often explained by generalized theories of reflexive modernization, but the Swedish case illustrates that many citizen-consumers acting in the interest of sustainability are misunderstood by these popular explanations. Their perspectives and actions support the need for a more historically and locally grounded approach to sustainable consumerism in Sweden and elsewhere, one that not only recognizes individual choice but also takes into account considerations of power and history. [source]


This rationale for assessment of social justice equally applies to legally optional or informal social practices. But it does not apply to individual conduct. Indeed, it follows that principles of social justice cannot provide a basis for the assessment and guidance of individual choice. The paper develops this practice-based conception of the subject of justice by rejoining G. A. Cohen's influential critique of Rawls' focus on the "basic structure" of society. [source]

Informal Self-Employment in Developing Countries: Entrepreneurship or Survivalist Strategy?

Some Implications for Public Policy
A central debate around labor market informality, which has enormous implications for the design and implementation of public policy, relates to the nature of informal employment. Is informal employment and, in particular, informal self-employment, a symptom and, at the same time, a reproductive factor of precariousness and inequality, as well as social and individual poverty? Or is it, on the contrary, a space of individual and social action that reflects economic initiative and business potential which, if channeled and fostered properly, could contribute to social and economic development and, consequently, to the reduction of inequality and poverty? In this article, the findings of the 2005 edition of the Mexican version of the World Value Survey,concerning relevant values and attitudes of informal participants in the labor force in Mexico,are used to assess whether informal self-employment is a reflection of incipient entrepreneurship and individual choice or, rather, a survival strategy forced on individuals by their precarious circumstances. This article explores the public policy implications of the results obtained. [source]


BIOETHICS, Issue 3 2010
ABSTRACT Despite the wide and daunting array of cross-cultural obstacles that the formulation of a global policy on advance directives will clearly pose, the need is equally evident. Specifically, the expansion of medical services driven by medical tourism, just to name one important example, makes this issue urgently relevant. While ensuring consistency across national borders, a global policy will have the additional and perhaps even more important effect of increasing the use of advance directives in clinical settings and enhancing their effectiveness within each country, regardless of where that country's state of the law currently stands. One cross-cultural issue that may represent a major obstacle in formulating, let alone applying, a global policy is whether patient autonomy as the underlying principle for the use of advance directives is a universal norm or a construct of western traditions that must be reconciled with alternative value systems that may place lesser significance on individual choice. A global policy, at a minimum, must emphasize respect for patient autonomy, provision of medical information, limits to the obligations for physicians, and portability. And though the development of a global policy will be no easy task, active engagement in close collaboration with the World Health Organization can make it possible. [source]

Childbearing in U.S. Military Hospitals: Dimensions of Care Affecting Women's Perceptions of Quality and Satisfaction

BIRTH, Issue 1 2005
Erica M. Harriott MHSA
Information is lacking about how well the military health system has adopted patient-centered approaches for promoting individual choice and preference in a bureaucratically structured military hospital. The purpose of this study was to examine women's evaluations of maternity care with respect to decision-making, confidence, trust in health care providers, and treatment within the military hospital. Methods: The Department of Defense Inpatient Childbirth Survey was mailed to a simple stratified random sample of beneficiaries who received maternity care at a military hospital between July 1 and September 30, 2001. Data for 11 dimensions of women's care and experiences were examined from self-reported assessments of 2,124 respondents who gave birth at one of 44 military hospitals. A multiple logistic regression model was estimated to determine which dimensions of care predicted beneficiaries' likelihood to recommend the military hospital to family and friends. Result: Less than 50 percent of respondents would recommend the military hospital to family and friends. Significantly associated with women's willingness to recommend their specific military hospital to others were courtesy and availability of staff, confidence and trust in provider, treatment with respect and dignity, information and education, physical comfort, involvement of friends and family, continuity and transition, and involvement in decision-making. Conclusions: In a military population, obstetric patients who are treated with respect, courtesy, and dignity, are involved in decisions about their care, and have established trusting relationships with their practitioners are significantly more likely to recommend the military hospital to others. It is important for military health care leaders to establish a proactive program of patient-centered maternity care. Continuous care, education, support services, and a multidisciplinary approach should be integrated to retain and recapture obstetric patients who are served in military hospitals in the United States. [source]

Alternative approaches to obtain optimal bid values in contingent valuation studies and to model protest zeros.

Estimating the determinants of individuals' willingness to pay for home care services in day case surgery
Abstract The use of day case surgery has increased rapidly as an alternative to inpatient surgery. Little is known, however, about the value of day case surgery to patients. The aim of this paper was to develop a contingent valuation survey to investigate how individuals value the costs of shifting from inpatient to day case surgery based on home care services. Using the willingness to pay (WTP) approach, two kinds of sequential experiments are compared: the maximum likelihood recursion (MLR) method and the C-optimal sequential procedure. The goal of sequential experimentation is to find bid values that provide the maximum possible information about the parameters of the WTP distribution, especially when the sample size is small. The C-optimal sequential procedure is shown to be an improvement, in terms of the statistical precision in small samples, over the MLR method. In addition, the paper presents a double hurdle (DH) approach for modelling the determinants of individuals' WTP. Using data from a contingent valuation survey conducted in 1996 on patients selected from the Day Case Surgery Unit in a hospital in the region of Catalonia, we argue that participation in the market offered and the level of consumption, that is, people's WTP, should be treated as individual choices. The results show that income and sex are related to WTP. Also, in this study, a clear presence of starting-point bias, introduced by the bid offered, was found. It is concluded that the WTP technique is potentially useful in evaluating health care programmes, although it is important to note that the criteria used to find an optimal design (in our model to minimize the asymptotic variance of the estimator used) may be restrictive from an economic point of view. Copyright © 2001 John Wiley & Sons, Ltd. [source]

The ethics of evidence-based patient choice

Michael Parker BEd PhD
In this paper I analyse the ethical implications of the concept of ,evidence-based patient choice' in the light of criticism of the ,individualism' of patient-centred medicine. I argue that individualism in the sense used by the critics of patient centred medicine is not an inevitable consequence of an emphasis on patient choice and that a concern with the promotion of individual choices is not incompatible with ,communitarian' values. Indeed, I argue that any ethical approach to decision-making in health-care must be capable of taking seriously both the moral status of the individual (and of his or her choices) and the moral significance of the social dimensions of such choices. The best way to ensure respect for the principle of autonomy, I suggest, is to facilitate and encourage social interactions of a particular, deliberative, kind. This is also the best way to ensure that the broader public interest is taken into account in decision-making. [source]

Who will win Wimbledon?

The recognition heuristic in predicting sports events
Abstract Goldstein and Gigerenzer (2002) described the recognition heuristic as a fast, frugal, and effective decision strategy. However, most studies concerning the recognition heuristic have been conducted in static domains, that is, in domains where it could plausibly be argued that relevant variables stay relatively constant. Yet the question is whether the heuristic would also work in dynamic environments where the quality of the actors rises and falls, such as in sports. We tested performance of the recognition heuristic in a dynamic environment and used it to predict the outcomes of tennis matches in Wimbledon 2003. Recognition data of amateur tennis players and laypeople was used to build recognition rankings. These rankings correlated with official rankings and led to at least as good predictions. Simulations of individual choices showed high recognition validities of both amateurs (0.73) and laypeople (0.67). In a second study the recognition heuristic correctly predicted 90% of actual individual choices. Overall, the recognition heuristic may be effectively generalized to dynamic environments. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Public Special Services Provided to People With Intellectual Disabilities in Sweden: A Life-Span Perspective

Ơie Umb-Carlsson
ABSTRACT This study describes public special services, support, and health care provided to an administratively defined county sample of people with intellectual disabilities from early childhood to adult age. Comparisons were made on the variables year of birth, sex, and assessed level of intellectual disabilities in 1974. Information was obtained from case files and included the period from year of birth of the participants (between 1959 and 1974) to 2005. All participants were provided public special services, support, and health care either periodically or throughout the study period. Changes in legislation were reflected in the type of services, support, and health care provided to the target group. Type and amount of special services and support were related to year of birth. Only a few differences were related to sex and level of intellectual disabilities. These results indicate that public special services, support, and health care provided to people with intellectual disabilities reflect disability policy, legislation, and professional attitudes over different periods. It is suggested that measures were tailored to meet general needs considered to be shared by all people with intellectual disabilities rather than individual choices and wishes. The interaction among professionals emerged only to a limited extent. However, deficient information in the case files does not imply absence of contact between professional groups, but, if continuity in services, support, and health care is to be attained, significant improvement in documentation is required. [source]

Is Neoclassical Economics still Entrepreneurless?

Milo Bianchi
Summary The paper reviews and evaluates some recent contributions on modeling entrepreneurship within a neoclassical framework, analyzing how, and to what extent, the fundamental ingredients suggested in the social science literature were captured. It is shown how these approaches are important in stressing the main elements of a complex picture, without being able to fully describe it. Each modeling attempt focuses only on one specific feature of entrepreneurship, and the entrepreneurial function, broadly perceived, eludes analytical tractability. As a consequence, the models can be useful in analyzing the effect of entrepreneurial behavior at an aggregate level, but not at explaining individual choices. From these observations, it is highlighted how a simplistic interpretation of the existing mainstream approaches incorporating entrepreneurship runs the risk of leading to distortionary policy interventions. [source]

Globalisation, governance and post-structural political economy: Perspectives from Australasia

Richard Le HeronArticle first published online: 23 MAR 200
Abstract: The paper argues that post-structural political economy (PSPE) offers geography and geographers interesting potential for the development of a style of geographic inquiry that has qualities that may be constitutive of progressive spaces. This new style of inquiry is seen as adding to the repertoire of political strategies and potential geographies of responsibility and extending notions of ethical behaviours. Issues relating to the assemblage of PSPE as a distinctive approach to knowledge production are considered and situated in the Australasian context. Discussion focuses especially on insight about the use of PSPE derived from three illustrative research case studies (a project on learning challenges in sheep meat and dairy supply chain realignment, tensions around fisheries management in New Zealand and an international workshop series on the topic of governmentality). The case studies provide a lens on the socio-spatial relationships between globalisation and governance and interrogate the value of PSPE for understanding the connections between individual choices, governing practices and the construction of the globalising economy. The PSPE approach if actively incorporated into research processes may have important implications for future relationships between social responsibility, national economic development and globalisation. [source]

Organic purchasing motivations and attitudes: are they ethical?

M.G. McEachern
Abstract Despite the increased documentation of consumers' purchases of organic food products, the motivations for such purchases are relatively under-researched. An individual's choice of food products can be linked clearly to ethical stances, but ethical choices can also vary from individual to individual, from industry to industry and among countries. Consequently, this paper investigates the degree to which ethical beliefs influence Scottish consumer perceptions, beliefs, attitudes and purchasing decisions, with regard to organic dairy products. Consumer purchasing motivations are revealed as being self-interest-centred (i.e. better tasting, safer), rather than altruistic. Therefore, to achieve future market development, organic dairy producers cannot rely upon the minority of hardcore green consumers to sustain growth, but must aim to modify perceptions and attitudes of larger consumer segments by implementing educational marketing campaigns that reinforce the ethical, environmental and societal benefits of organic production. [source]

Chinese values, health and nursing

Yu-chih Chen PhD RN
Chinese values, health and nursing Purpose.,To describe the roots of Chinese values, beliefs and the concept of health, and to illustrate how these ways have influenced the development of health care and nursing among Chinese in the Republic of China (ROC) and the People's Republic of China (PRC). Scope.,Based on the literature and direct observation in the PRC and ROC, this is an introduction to Chinese philosophies, religion, basic beliefs, and values with a special meaning for health and nursing. Chinese philosophies and religion include Confucian principles, Taoism, theory of ,Yin' and ,Yang', and Buddhism. Beliefs and values include the way of education, practice of acupuncture, herbal treatments and diet therapy. How people value traditional Chinese medicine in combination with western science, and the future direction of nursing and nursing inquiry are also briefly addressed. Conclusion.,Chinese philosophies and religions strongly influence the Chinese way of living and thinking about health and health care. Nurses must combine information about culture with clinical assessment of the patient to provide cultural sensitive care. A better way may be to combine both western and Chinese values into the Chinese health care system by negotiating between the traditional values while at the same time, respecting an individual's choice. The foundation of China's philosophical and aesthetic tradition, in combination with western science is important to the future advancement of nursing research that will be beneficial to the Republics, Asia, and the world. [source]

Maternal experiences of peanut avoidance during pregnancy/lactation: An in-depth qualitative study

Joanna Turke
In 1998 the Department of Health Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment issued a report to British general practitioners, which advised that pregnant mothers with a family history of atopy may wish to avoid peanuts during pregnancy/lactation. To explore the lived-in experience of mothers who avoided/did not avoid peanuts during pregnancy/lactation in the light of the information issued. A qualitative approach, using unstructured in-depth interviews to explore what it was like for mothers to have a particular experience. A purposive sample frame was designed to ensure a maximum variation of participants. Forty-two interviews were conducted: 25 participants avoided peanuts; 15 with a family history of atopy and 10 with no such history. Seventeen participants did not avoid peanuts; 10 with a family history of atopy and seven with no such history. Emergent themes included: variations in information provision, a lack of clarity in relation to information and advice about peanut avoidance, the risks entailed and the introduction of peanuts to the developing child's diet; the importance of atopy in influencing participants' decisions to avoid peanuts and the importance of individual's choice in the decision making process. There was a significant difference in family size with respect to avoidance behaviour with ,avoider' families being smaller (p = 0.007). Avoidance was more likely in single child families (71% vs. 53%) although this difference was not significant. Improvements to the experience of avoidance and/or non-avoidance were primarily focused around provision of information and advice. In particular, a need for clear, consistent factual information and advice about the real risks associated with peanut consumption during pregnancy/lactation, and to whom these risks apply. [source]

Think twice before you book?

Modelling the choice of public vs private dentist in a choice experiment
Abstract This study concerns the choice of primary dental service provider by consumers. If the health service delivery system allows individuals to choose between public-care providers or if complementary private services are available, it is typically assumed that utilisation is a three-stage decision process. The patient first makes a decision to seek care, and then chooses the service provider. The final stage, involving decisions over the amount and form of treatment, is not considered here. The paper reports a discrete choice experiment (DCE) designed to evaluate attributes affecting individuals' choice of dental-care provider. The feasibility of the DCE approach in modelling consumers' choice in the context of non-acute need for dental care is assessed. The aim is to test whether a separate two-stage logit, a multinomial logit, or a nested logit best fits the choice process of consumers. A nested logit model of indirect utility functions is estimated and inclusive value (IV) constraints are tested for modelling implications. The results show that non-trading behaviour has an impact on the choice of appropriate modelling technique, but is to some extent dependent on the choice of scenarios offered. It is concluded that for traders multinomial logit is appropriate, whereas for non-traders and on average the nested logit is the method supported by the analyses. The consistent finding in all subgroup analyses is that the traditional two-stage decision process is found to be implausible in the context of consumer's choice of dental-care provider. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Factors Influencing the Choice of Initial Qualifications and Continuing Development in Australia and Britain

Linda Miller
This article presents the outcomes of an exploratory study into the factors that influences individuals' choice of different types of qualification at stages throughout their employment history. The survey of individuals in Australia and Britiain sought information on individuals' training and education decisions between school and employment; after gaining employment; and of their future intentions for further study. There were few differences between Australians and British respondents at the school-leaver stage, but once in work differences emerged between the two countries. Few differences were observed between males and females. Comparison of those opting into academic and vocational programmes indicated that those who choose academic programmes are motivated by a cluster of mainly internal factors while those opting for the vocational route were more likely to have been influenced by their manager and the possibility of funding. Implications for the marketing of qualifications are discussed. [source]

Competition and Cost Accounting: Adapting to Changing Markets,

Ranjani Krishnan
Abstract The relation of competition and cost accounting has been the subject of conflicting prescriptions, theories, and empirical evidence. Practitioner literature and textbooks argue that higher competition generally requires more accurate product costing. Theoretical economic analysis, in contrast, predicts that the optimal level of product-costing accuracy is sometimes higher at lower levels of competition. Results of survey research are inconsistent, suggesting a need for further identification of conditions under which higher competition leads to more accurate product costing. This study shows experimentally that individuals' choices of the level of product-costing accuracy depend not only on the current level of competition but also on the previous level of competition , that is, on an interaction between market structure (monopoly, duopoly, and four-firm competition) and market history (increasing versus decreasing competition). In the experiment, subjects decide on the quantity of data to collect at a pre-set price per datum to support more accurate product-cost estimates. Subjects collect the most cost data (i.e., choose the most accurate product costing) in monopoly, collect the least in duopoly, and an intermediate amount in the four-firm market, consistent with the pattern of optimal cost-data collection in Hansen's 1998 model. The process of convergence to the optimum differs significantly across market types and market histories, however. Subjects who begin in four-firm competition adapt more successfully to change than those who begin in monopoly. The lowest levels of decision performance occur when ex-monopolists face their first competitor: they overreact to this first encounter with competition and overspend on cost data. [source]

IX,Responsibility and the Consequences of Choice

Serena Olsaretti
Contemporary egalitarian theories of justice constrain the demands of equality by responsibility, and do not view as unjust inequalities that are traceable to individuals' choices. This paper argues that, in order to make non-arbitrary determinate judgements of responsibility, any theory of justice needs a principle of stakes, that is, an account of what consequences choices should have. The paper also argues that the principles of stakes seemingly presupposed by egalitarians are implausible, and that adopting alternative principles of stakes amounts to fleshing out the demands of responsibility rather than imposing limits on them. [source]