Principle Of Need Research Articles

Time to pay the piper: Fossil fuel companies’ reparations for climate damages

Time to pay the piper: Fossil fuel companies’ reparations for climate damages

Weakly institutionalized, heavily contested: Does support for contemporary welfare reforms rely on norms of distributive justice?

AbstractThree reforms each appealing to a different logic of (re)distribution are strongly politicized in contemporary welfare states: means-tested benefits, demanding activation policies and basic income schemes. While the policy design of means-tested benefits relies on the distributive justice principle of need, demanding activation policies are intrinsically related to the principle of equity and basic income schemes depend on equality. Based on the moral economy and policy feedback literatures, which assume that public opinion adapts to the normative conceptions of justice encapsulated by institutions, attitudes towards these welfare reforms are expected to be grounded on these distributive logics. However, as these reforms are weakly institutionalized and their underlying principles are politically contested, the normative foundation of their public support remains unclear. This study investigates how distributive justice preferences shape support for these proposals by applying structural equation modelling on data from the CRONOS panel linked to the European Social Survey round 8 (2016/2017). Results indicate that only basic income schemes and demanding activation policies are to some extent connected to each of the justice principles. Overall, this study nevertheless indicates that the justice principles have limited explanatory power, which confirms that attitudes towards contemporary welfare reforms rely weakly on justice norms.

Fairness perceptions regarding in-work benefits: a survey experiment

PurposeIn many countries, individuals can receive welfare support whilst simultaneously being employed. The level of earned income that welfare recipients are allowed to keep has long been a subject of debate. Core issues include whether in-work benefit regulations provide incentives for individuals to expand labour market participation and are thus also socially effective and whether the population perceives welfare benefits for individuals who earn own income as fair. This article contributes to the debate about the social legitimacy of in-work benefit regulations by shedding light on the principles guiding judgements about an adequate amount of in-work benefit receipt.Design/methodology/approachThe authors use a factorial survey experiment to investigate which factors guide judgements about an adequate level of in-work benefit receipt. In the authors' factorial survey, the household composition, health status, and monthly earnings of a hypothetical in-work benefit recipient were varied experimentally. The study investigates Germany's basic income support programme, a means-tested social policy programme that targets both unemployed and employed individuals.FindingsThe results show that respondents consider higher earnings retention rates for lower-income earners to be fair. This preference mirrors the German legislation, which is based on the principle of need. Furthermore, the presence of children and of physical as well as mental health impairments are associated with support for higher earnings retention rates.Originality/valueThe findings suggest that citizens support the core features of in-work benefit regulations but do not consider in-work benefit recipients as a homogenous group when assessing the adequate level of benefit receipt.

The Influence of Individual and Situational Factors on Teachers' Justice Ratings of Classroom Interactions.

Teachers, as role models, are crucial in promoting inclusion in society through their actions. Being perceived as fair by their students is linked to students’ feelings of belonging in school. In addition, their decisions of resource allocations also affect students’ academic success. Both aspects underpin the importance of teachers’ views on justice. This article aims to investigate what teachers consider to be just and how teacher characteristics and situational factors affect justice ratings of hypothetical student-teacher-interactions. In an experimental design, we randomly varied the description of the interacting student in text vignettes regarding his/her special educational need (SEN) (situational factor). We also collected data on teachers’ attitudes toward inclusion and experiences with persons with disabilities (individual factors). A sample of in-service teachers in Germany (N = 2,254) rated randomized versions of two text vignettes. To also consider the effect of professional status, a sample of pre-service teachers (N = 275) did the same. Linear mixed effect models point to a negative effect of the SEN on justice ratings, meaning situations in which the interacting student is described with a SEN were rated less just compared to the control condition. As the interacting student in the situations was treated worse than the rest, this was indicative for the application of the need principle. Teachers with more positive attitudes toward inclusion rated the vignettes as significantly less just. Professional status also had a negative effect on justice ratings, with in-service teachers rating the interactions significantly lower than the pre-service teachers. Our results suggest that the teachers applied the principle of need in their ratings. Implications for inclusive teaching practices and future research are discussed further.

Justice perceptions of occupational training subsidies: findings from a factorial survey

Workers whose jobs are affected by structural change and digitization are required to continuously adapt their vocational skills to the requirements of the labor market. This adaptation is also essential for the competitiveness of their employer firms. The German legislature addressed this issue with investive measures for unemployment insurance, one of which is the Qualification Opportunities Act (Qualifizierungschancengesetz). Funds taken from unemployment insurance can now be used to provide financial help for employers in a more direct way and on a broader scale than before. It became possible that not only unemployed individuals but also workers in companies receive state assistance. This paper analyses the extent to which citizens accept such public support programs for further training and which principles of justice they apply when assessing a just amount of training subsidies. We conducted two factorial surveys. First, we investigated the justice assessments of training subsidies for different types of firms. The results showed that citizens are inclined to subsidize companies by receiving social security funds for further training of their employees. However, when doing so, the principle of needs-based justice should be complied with. Second, we analyze whether citizens think it is just or unjust to provide training subsidies to different workers, as we present them with changing characteristics of workers. The findings confirmed that in addition to the principle of need, views on performance justice, as well as economic considerations are relevant in assessments of whether training subsidies co-financed by unemployment insurance are just.

Genetic information, insurance and a pluralistic approach to justice

The use of genetic testing has prompted the question of whether insurance companies should be able to use predictive genetic test results (GTRs) in their risk classification of clients. While...

Respect for persons and the allocation of lifesaving healthcare resources.

Many ethicists argue that we should respect persons when we distribute resources. Yet it is unclear what this means in practice. For some, the idea of respect for persons is synonymous with the idea of respect for autonomy. Yet a principle of respect for autonomy provides limited guidance for how we should distribute scarce medical interventions. In this article, however, I sketch an alternative conception of respect for persons-one that is based on an ethic of mutual accountability. I draw in particular upon Stephen Darwall's writings on respect and the second-person standpoint. I consider the implications of this conception of respect for the distribution of scarce, lifesaving healthcare resources. A second-personal account of respect rules out aggregative approaches to distribution, and instead requires that we give individual consideration to the claims that persons in need make on the resources in our control. The principles that we use to govern our allocation of resources, furthermore, should be principles that are acceptable to all reasonable agents. Building on this insight, the final section of this paper considers how a principle of need can be used as a means to make decisions about the allocation of lifesaving resources.

ABOUT INTERNATIONAL COOPERATION IN THE FIELD OF FORENSIC SCIENCE

This article outlines general trends of international cooperation development in the field of forensic expert activity and positive experience for use in the practice of Ukrainian forensic science institutes activity. Also the main principles for international cooperation are universal and fixed in the Charter of the United Nations Organization and in the Declaration on the Principles of International Law, namely: principle of need for mutual cooperation between states, principle of sovereign equality of states; principle of faithful fulfillment of obligations according to requirements of international law; principle of respect of human rights and common freedoms are considered. Main attention is paid to the fact that results of the analysis of the state and dynamics of international cooperation in the field of forensic science demonstrate that currently main trends in various field have been formed, namely: organization of international forensic expert cooperation; scientific, methodological and technical support of forensic expert activity and provided them with a description. Author emphasis paid special attention to fact that the requirement for recognizing results of research at the international level is becoming relevant today. Consequently, any laboratory should meet requirements of international standards for the international recognition of the results of measuring activities. According to requirements of network of forensic institutes all laboratories of the European Community should be accredited according to international standard МСО 17025 (МСО 9001). Further strict adherence to this provision will allow the effective realization of cooperation elements while performing comprehensive many object examinations, increasing dynamics of methodological development through the differentiation of research results, organizing a wide exchange of information (in particular, information and reference arrays of samples) on a single methodological basis.Author concluded that introduction of international standards in activity of Ukrainian forensic science institutes is an urgent issue and the key to the recognition of Ukrainian forensic expert conclusions at the international level.

Liver transplants and organ allocation in Brazil: from Rawls to utilitarianism

The process of liver donations and transplants in Brazil reveals major inequalities between regions and states of the country, ranging from uptake of the organs to their transplantation. In 2006, the MELD score (Model for End-stage Liver Disease), inspired by the U.S. model and based on the principle of need, was introduced in Brazil for liver transplant allocation. However, Brazil's inequalities have partially undermined the initiative's success. Other countries have already benefited from growing discussion on the benefits of models that seek to harmonize utilitarianism and need. The current article reviews the relevant literature with a special focus on the Brazilian reality.

Self-admission in psychiatry: The ethics.

Self-admission to inpatient treatment is a novel approach that aims to increase agency and autonomy for patients with severe psychiatric illness and a history of high utilization of inpatient care. By focusing on brief, preventive hospital admissions in times of increased risk of relapse, self-admission seeks to reduce the need for prolonged episodes of inpatient treatment. Participants are generally satisfied with the model, which is not surprising given that self-admission programs allocate a scarce resource-hospital beds-to a select group. However, the patients targeted by these programs are not necessarily those in most need of hospital admission, which may compromise the commonly accepted 'principle of need' in allocation of public healthcare resources. In light of the current lack of consistent evidence of the usefulness and cost-effectiveness of the model, several aspects need to be further studied in order to guide any large-scale implementation of self-admission in psychiatry.

Principles of Need and the Aggregation Thesis

Principles of need are constantly referred to in health care priority setting. The common denominator for any principle of need is that it will ascribe some kind of special normative weight to people being worse off. However, this common ground does not answer the question how a plausible principle of need should relate to the aggregation of benefits across individuals. Principles of need are sometimes stated as being incompatible with aggregation and sometimes characterized as accepting aggregation in much the same way as utilitarians do. In this paper we argue that if one wants to take principles of need seriously both of these positions have unreasonable implications. We then characterize and defend a principle of need consisting of sufficientarian elements as well as prioritarian which avoids these unreasonable implications.

Indeterminacy and the principle of need

The principle of need—the idea that resources should be allocated according to need—is often invoked in priority setting in the health care sector. In this article, I argue that a reasonable principle of need must be indeterminate, and examine three different ways that this can be dealt with: appendicizing the principle with further principles, imposing determinacy, or empowering decision makers. I argue that need must be conceptualized as a composite property composed of at least two factors: health shortfall and capacity to benefit. When one examines how the different factors relate to each other, one discovers that this is sometimes indeterminate. I illustrate this indeterminacy in this article by applying the small improvement argument. If the relation between the factors are always determinate, the comparative relation changes by a small adjustment. Yet, if two needs are dissimilar but of seemingly equal magnitude, the comparative relation does not change by a small adjustment of one of the factors. I then outline arguments in favor of each of the three strategies for dealing with indeterminacy, but also point out that all strategies have significant shortcomings. More research is needed concerning how to deal with this indeterminacy, and the most promising path seems to be to scrutinize the position of the principle of need among a plurality of relevant principles for priority setting in the health care sector.

Uterine transplantation is not a good use of limited resources: AGAINST: It is a highly effective infertility treatment.

Infertility is, according to the World Health Organization, ‘a disease of the reproductive system’ and ‘generates disability and access to health care falls under the Convention on the Rights of Persons with Disability’. After the medical breakthroughs of in vitro fertilisation and intracytoplasmic sperm injection, absolute uterine factor infertility (AUFI) remained the only untreatable, major infertility subgroup. In the UK there are >12 000 women with AUFI (Sieunarine et al. Int Surg 2005;90:249–56). Gestational surrogacy has until now been a way for women with AUFI to acquire genetic motherhood. The procedure is prohibited in most countries because of legal, religious or ethical concerns. The first livebirth after uterus transplantation (UTx) in 2014 [Brännström et al. 2015;385(9968):607–16] has been followed by four births (our unpublished observations). Naturally, these healthy livebirths have led to a substantial increase in the quality-of-life of these couples. In the UTx trial (Brännström et al. Fertil Steril 2014;101:1228–36; Johannesson et al. Fertil Steril 2015;103:199–204) there is a high (87%) clinical pregnancy rate, indicating that it is a highly effective infertility treatment. Importantly, UTx will stay at the clinical experimental stage for several years, as will ovarian autotransplantation. Hence, all new attempts of human UTx should be performed within clinical trials to acquire all possible data. All the active UTx groups worldwide met in January 2016 to form an international society. Three important goals of this society will be: to form a compulsory registry with data from all new cases, to establish mandatory requirements that would apply for teams performing human UTx, and to perform yearly audits at centres that are conducting UTx. These regulations and the registry will be beneficial for the efficiency and safety of the procedure. Hence, the UTx-related assisted reproductive technologies and surgical procedures will be optimised. It is not until we have data from several studies and the registry that the health authorities in each country can decide whether this procedure should be a clinical infertility treatment. The cost of the procedure will differ between countries, just as the price for a live-donor renal transplantation differs by a factor of at least four. In some countries the public health insurance will most probably pay for UTx whereas others will consider that the procedure should be paid for by the patient, just like cosmetic surgery. The introduction of new medical treatments may raise important ethical conflicts that often have conflicting effects, for example the principle of human dignity that states that ‘all people are equal in dignity regardless of their personal characteristics’ and the principle of need and solidarity, which states that ‘resources should be committed to the person more in need’. In conclusion, patients with AUFI should in the future be offered UTx as an alternative treatment to surrogacy. Surrogacy after in vitro fertilisation has been practised for more than 20 years. However, the possible effects on offspring and families after gestational surrogacy are not clear (Söderström-Anttila et al. Hum Reprod Update 2015). The cost of a UTx procedure is markedly less than of other types of transplantations, because the expensive immunosuppression is for only a few years. Moreover, UTx will not only increase the quality of life of the infertile couple but also create new life. None declared. Completed disclosure of interests form available to view online as supporting information.■ Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Measuring needs for priority setting in healthcare planning and policy

Much research aimed at developing measures for normative criteria to guide the assessment of healthcare resource allocation decisions has focused on health maximization, equity concerns and more recently approaches based on health capabilities. However, a widely embraced idea is that health resources should be allocated to meet health needs. Little attention has been given to the principle of need which is often mentioned as an alternative independent criteria that could be used to guide healthcare evaluations. This paper develops a model and indicator of need satisfaction that aggregates the health needs of a population in a particular time period into a single measure that weights individual health needs by the severity of their ill health. The paper provides a first step towards formalizing the principle of need as a measurable objective for healthcare policy and we discuss some challenges for future research, including incorporating the duration of time into need-based health evaluations.

Lexicographic multi-period resources allocation problem with weighted substitutable resources

Lexicographic multi-period resources allocation problem with weighted substitutable resources is concerned with the allocation of m resources among n users during t periods such as certain weighted substitution between resources is possible in the objective to minimise lexicographically the performances functions vector. In this work, we point that there is proportional answered of the minmax approach to the principle of need. We propose the lexicographic approach to avoid this problem and realise fairness in the allocation of limited resources. For this reason, we study some variants of lexicographic resources allocation problem (LRAP) and we propose the model to formulate the lexicographic multi-period resources allocation problem with weighted substitutable resources (LMRAPWSR). Also, we propose an exact algorithm to solve our formulated model and we apply this algorithm to treat a case study that concerns the allocation of eight fertilisers among six agri-agricultures during three periods.

Welfare or Workfare?: The Principle of Activation in the Finnish Post-War Disability Policy, Early 1940s to late 1980s

This article analyzes the post–Second World War Finnish discussion on disability pension and vocational rehabilitation policies. It argues that the principle of activation, which has been linked to the recent neoliberal workfare turn in social policy, has in fact remained as one of the guiding principles of disability policy during the entire post-war period. During the 1940s, the Finnish disability policy was established on the principles of compensation and activation, as the disability pension scheme was limited to those who had participated in working life and vocational rehabilitation to those who were evaluated to have the potential to do so in the future. At the turn of the 1960s, the compensation principle was overtaken by the principle of need as the newly adopted goal of constructing the Finnish welfare state materialized in the demands for a universal pension policy and extending vocational rehabilitation to those who had previously been labeled as unprofitable targets. However, the traditional disability policies began to receive criticism during the 1980s as the conception of disability changed from being viewed as an individual defect raising a need for segregated services and environments to a minority status entitling a person to supportive measures enabling him or her to participate in the normal society. This also problematized the traditional divide between the need-based and work-based systems of distribution by raising the question on disability pensioners’ entitlement to participate in the labor market.

Cognitive Enhancement and the Principle of Need

In this article we argue that (i) the principle of need, on some interpretations, could be used to justify the spending of publically funded health care resources on cognitive enhancement and (ii) that this also holds true for individuals whose cognitive capacities are considered normal. The increased, and to an extent, novel demands that the modern technology and information society places on the cognitive capacities of agents, e.g., regarding good and responsible decision-making, have blurred the line between treatment and enhancement. More specifically, it has shifted upwards. As a consequence, principles of need on their most reasonable interpretations can be used to support publically funded cognitive enhancement. At least this is so, if broader aims than curing and ameliorating diseases are included in the goals of health care. We suggest that it would be plausible to see health care as accepting such broader goals already today.

For the Sake of Justice: Should We Prioritize Rare Diseases?

This article is about the justifiability of accepting worse cost effectiveness for orphan drugs, that is, treatments for rare diseases, in a publicly financed health care system. Recently, three arguments have been presented that may be used in favour of exceptionally advantageous economic terms for orphan drugs. These arguments share the common feature of all referring to considerations of justice or fairness: the argument of the irrelevance of group size, the argument from the principle of need, and the argument of identifiability. It is argued that all of these arguments fail to support the conclusion that orphan drugs should be subsidized to a larger extent than treatments for common diseases. The argument of the irrelevance fails to distinguish between directly and indirectly relevant considerations of fairness or justice. The recent attempt to revive the moral relevance of identifiability has provided no novel reasons to think that identifiability is morally relevant in itself or due to considerations of fairness and justice. The argument from the principle of need does not fail due to any inherent flaw in the principle as such. Rather, this principle can be interpreted in different ways, and none of these interpretations support exceptionally advantageous terms economically for treating rare diseases specifically. It is concluded that we are awaiting justice based reasons for the preferential treatment of orphan drugs.

Relationships Between Fathers and Adult Children

New data from a national Dutch survey are used to examine the effects of divorce and repartnering on the relationships that fathers have with their adult children. Compared with divorced fathers who live alone, repartnered fathers have less frequent contact with their children, they exchange less support with them, and the quality of the relationship is poorer. Divorce and repartnering thus have cumulative negative effects. These findings primarily apply when the divorce occurred when the child was young. Interpretations are given in terms of the reduced need for support that fathers have when they have a new spouse, the problems children may have with a stepmother, and the tendency of fathers to shift their investments to a new family after divorce (“swapping families”). Indirect evidence especially supports the “swapping families” hypothesis although the principle of need plays a role as well.

Ethical Obligations of Wealthy People: Progressive Taxation and the Financial Crisis

The Financial Crisis in Europe puts pressure on welfare states and its tax systems as well as on considerations of social justice. In this paper, we would like to explore the status of the idea of progressive taxation and its justification (especially the ‘ability-to-pay’ principle) in times of a financial crisis. We will discuss it within a social justice framework following David Miller—using the principles of (i) need, (ii) merit, and (iii) equality. We will conclude that progressive taxation can be justified in the light of these three principles, even more so in the situation of a financial crisis that undermines decent living conditions for millions. The principle of need has to be given priority even if this move violates the principles of equality and desert.