Principle Of Need Research Articles

Challenges for Principles of Need in Health Care

What challenges must a principle of need for prioritisations in health care meet in order to be plausible and practically useful? Some progress in answering this question has recently been made by Hope, Østerdal and Hasman. This article continue their work by suggesting that the characteristic feature of principles of needs is that they are sufficientarian, saying that we have a right to a minimally acceptable or good life or health, but nothing more. Accordingly, principles of needs must answer two distributive questions: when do we have sufficient and how should we prioritise among those who do not yet have a sufficiency? Furthermore, it is argued that Roger Crisp's theory of need, which combines sufficientarianism with prioritarianism below the threshold of need, is better equipped than alternatives to answer these questions as well as meeting the challenges formulated by Hope, Østerdal and Hasman. However, Crisp's theory faces two major challenges. First, it has to say something about the currency of distribution: a principle of need must be complemented either with a theory on the human good or a theory about the proper goals of health care. Second, it has to say something about where the threshold should be set. However, any attempt to set a threshold seems morally arbitrary in the light of the sufficientarian idea that those just above the threshold never should be given priority over those just below the threshold.

Responsibility in a globalised environment: a charter of human responsibilities

PurposeThe purpose of this paper is to explore how one can prevent the flaws or dark sides of the globalisation process from leading to ever‐greater decay of responsibility. By decay of responsibility, is meant the threat that globalisation poses to what is referred to by philosophers such as David Harvey, John McMurtry and Paul Ricoeur, as the longing for being and solidarity with the other(s).Design/methodology/approachTo put a stop to the decay of responsibility, the urgency of a broader ethical dimension in globalisation is more apparent than ever before. The threat the globalisation process poses to the longing for being and solidarity with the other(s), increasingly necessitates an appropriate responsible global institution.FindingsOf central importance are the principles of merit and need as possible basis of a responsible institution. The intrinsic logic of the merit principle incorporated in the growth process of globalisation, induces a series of impermissible side effects. Therefore, the traditional correction of democracy giving priority to the principle of need instead of merit, no longer appears to counteract the market economy to be able to provide guarantees for a responsible globalisation process.Research limitations/implicationsPolitics needs to assure the survival of the social community, all the more so if its future is under considerable threat. The acceptance of responsibility implies also the care for the most fragile.Practical implicationsThe paper explains the need of an ethics of responsibility that transcends the excessive ego‐centric globalised society. Therefore, participatory or responsible justice is considered to be of the utmost importance. Participation should be broadly interpreted and include policy makers, environmentalists, scientists, economists, lawyers, ethicists, consumers, farmers and other representatives of civil society.Originality/valueThe present worldwide economic, social and ecological crises have created fertile ground for claiming the need for an internationally recognized charter setting out human responsibilities. The concept of a Charter of Human Responsibilities can be an original elaboration of the concern with institutionalising responsibility.

The relationship between organizational justice and organizational efficacy in higher education institutes

The purpose of this study is to survey the relationship between organizational justice and organizational efficacy in higher education institutes in Iran. The research methodology used is mapping studies research tools comprising the standard questionnaires of organizational justice. Niehoff-Morfen and Pearsons organizational efficacy also confirm its validity and their reliability was measured by Cronbach test as 81 and 89% respectively. The statistical population (862) was divided into two subgroups: academic board members and all recruited office staff in higher education institutes of North Khorasan. The sampling group (286) was randomly chosen based on Morgan Table from the classified recruited employees of higher education institutes in Bojnord. The main hypothesis was confirmed with 99% reliability by using correlation tests, and a significant relationship was observed between organizational justice components namely: justice principles of distributive equity and distributive justice equality with organizational efficacy by 99% reliability. But the relationship between the principle of need to distributive justice and organizational efficacy and the impact of distributive justice other than interactionaljustice on organizational efficacy was not confirmed. Lisrel output shows no indirect impact of organizational justice on organizational efficacy and occupational and personal factors. Therefore, we can say, ‘Efficacy For’ is regarded by many groups including the people who work in higher education organizations as a critical parameter which depends on many factors. The findings show that organizational justice is a way to improve efficacy and it requires, mostly, full identification of effective attitudes on organizational justice and a consideration of its parameters. Key words: Organizational justice, organizational efficacy, distributive justice,interactional justice, occupational - personal factors.

Anthropocentrism: Existence against essence

Anthropocentrism apsolutizes existence in relation to human essence. In this, it may downgrade generic essence of human and its primeval need for nature. Principles of sustainable development are challenged. The way of life and work are out of step with these principles. Therefore, central question of sustainable development is: where are the causes of modern man alienation from principles of sustainable development. We have to search for the answers in human nature and nature of human community. Their synthesis can direct socioantropogenesis of modern man in direction of accepting principles of sustainable development, in which principle of need is more important than need itself.

Basing Transport Planning on Principles of Social Justice

Transport modeling and cost-benefit analysis are two key tools used in trans- port planning. Both tools have been adapted substantially to cope with the challenges posed by the goal of sustainable development. However, the changes have primarily focused on the negative environmental impacts of the transport sector. Hardly any attention has been paid to another key dimension of sustain- able development: social justice. This paper critically analyzes the two tools from this perspective. It concludes that transport modeling is implicitly based on the distributive principle of demand. Given the importance of mobility in current society, it is suggested to replace current demand-based approaches by transport modeling that is based on the principle of need. Likewise, cost- benefit analysis has a built-in distributive mechanism that structurally favors transport improvements for highly mobile groups. This problem could be solved by replacing travel time savings by so-called accessibility gains as the key benefit taken into account in cost-benefit analysis. If the suggested changes were realized, both transport modeling and cost-benefit analysis could become key tools for promoting sustainable transport.

Priorities and determinants of priorities of Swedish social workers

Priority setting is an integrated part of social work, in Sweden as well as internationally. In this article we explore Swedish social services and how social workers make priorities and what these priorities involve. By use of regression analysis we also study what circumstances are of importance for allocative precedence and what impact different distributive principles have. One primary result is that priorities are made frequently by social workers—mostly on what cases to work with next and how much time to spend on every client. Another somewhat expected result is a manifest area bias, suggesting that respondents tend to see to the interests of their own professional domain. The principle of need proved to be the most important of the distributive principles studied, while principles of capacity to benefit and economy were more endorsed by officials working with elderly and disabled than those in other sectors.

Decisions on Inclusion in the Swedish Basic Health Care Package—Roles of Cost-Effectiveness and Need

Inclusion or not of a treatment strategy in the publicly financed health care is really a matter of prioritisation. In Sweden priority setting decisions are governed by law in which it is stated that decisions should be guided by firstly the principle of need and secondly the principle of cost-effectiveness. The purpose of the paper is to discuss and illustrate the roles of need and cost-effectiveness in decisions on inclusion or not of treatment strategies in the publicly financed health care. The theoretical backgrounds of need and cost-effectiveness are discussed in short, both with respect to their meaning and to their potential roles in decisions on priority setting. Four treatment strategies, Viagra, Rivastigmine, statins, and lung transplants, are analysed with respect to whether either cost-effectiveness or need, or both, seem to have played a role in the decisions of inclusion or not in the basic health care package. Both need and cost-effectiveness are important and should be important aspects when making decisions on priority setting. From the examples of the four treatment strategies it seems that decisions are almost exclusively made with reference to the principle of need. The most evident conclusion to be drawn from this study is that decisions on priority setting are almost solely based on the principle of need. This implies that the principle of cost-effectiveness is given very little space, which is a problem as this means an obvious risk of inefficient resource use.

The significance of the goal of health care for the setting of priorities.

The purpose of the article is to argue for the significance of a clarified goal of health care for the setting of priorities. Three arguments are explored. First, assessment of needs becomes necessary in so far as the principle of need should guide the priority-setting. The concept of health care need includes a goal component. This component should for rational reasons be identical with the goal of health care. Second, in order to use resources efficiently it is necessary to assess the effects of health care. It is not, however, a question of assessing whether there is an effect but a question of assessing whether there is the right effect. And what constitutes the right effect can only be determined in relation to the goal of the enterprise. Third, the health sector involves several groups of actors such as politicians, administrators, doctors, nurses, physiotherapists, occupational therapists, educationists and patients. It is common knowledge that successful teamwork requires an understanding of a common goal. The article ends with an example of a goal chosen from ethics.

Changing Principles in European Social Security

The provision of social security benefits rests on normative principles of social justice. Most strongly manifest in earnings-related social insurance, the principle of reciprocity has been increasingly questioned on grounds of equity, adequacy and fiscal viability, in the wake of socio-economic changes (e.g. post-industralisation, globalisation) and political developments (e.g. Europeanisation). Universalist programmes seem extraordinarily expensive under tight public budgets, and could be criticised as inequitable at a time when middle classes increasingly rely on individual and occupational forms of income security. The principle of need appears to have become more prominent within modern European social security systems keen on targeting resources. Is there empirical evidence which would reflect these alleged trends? Concentrating on three principles inherent in social security transfers (need, universalism and reciprocity) the major concerns of this article are conceptual and empirical. First, it addresses the problem of operationalising social security principles and delineating indicators of change over time. Second, it applies two of these indicators in order to identify and compare the extent to which the three principles have gained or lost prominence since the early 1980s, with empirical evidence taken from the Netherlands, United Kingdom, Germany and Scandinavia. The article argues first that, applying either indicator, there is no cross-national trend towards squeezing reciprocity-based social insurance, but that a convergence between erstwhile strong (Bismarckian) and weak (Beveridgean) principled programmes can be identified. Second, a clear trend towards needs-based social security can be identified within the ‘legal’ but not within the ‘volume’ perspective, at least in some programmes and some claimant groups. This is due to both policy changes and favourable labour market conditions. Third, two countries indicate very diverse trends. British social security is distinctive in terms of the erosion of Beveridgean reciprocity, as well as the growing strength of the needs principle. In the Netherlands, there have been considerable shifts in principles underlying certain programmes, but no general trend in either direction can be observed. On the whole, Dutch social security continues to exhibit a strong mix of principles.

The dynamics of elderly support

This paper analyses the support given to the handicapped elderly by their children on the basis of a large survey done in France where both the elderly and their middle-aged children were interviewed. These data allow us to address such questions as: "Who helps?", "Who receives help?" and "According to what principles?". Besides the principle of need which is at work, the results show that there is also the principle of equity, which functions through reciprocity. This study highlights two main processes in the dynamics of support for the elderly, its redistributive effects (family support mainly benefits the poorest elderly), and its complementarity with the state health care systems (family support is mainly directed towards those who also receive public help). Can we make the deduction that the more generous the welfare state, the more developed family solidarity is? Nevertheless, some difficulties arise: support is mostly given by women. Furthermore there are a small number of people on whose shoulders it falls to take care of everybody else in the family. One sign of these difficulties is that the carers are more often in less good health than the non-carers of the same age. Comparisons from one generation to the other, including the youngest (the children of the middle generation who were also interviewed) shows that the younger generation will not want to be so completely involved in parental care at the expense of their own private time and life. Most probably family involvement will be maintained in the future, but to a lesser extent.

Anomalies and Issues in Welfare Pluralism: Financing Residential Care for the Elderly in Hong Kong

This article looks at the anomalies and issues in welfare pluralism from the case of financing residential care for the elderly in Hong Kong. It examines a number of policies on the provision of social welfare services in relation to comprehensiveness, relative standards, respective public-private roles and the principle of need. A number of unintended effects and policy dislocations are identified. Also, the reasons underlying the limits to privatization of this service at a comparable quality standard and an affordable price are addressed. The conclusion is that the present arrangements for related provisions are less than rational and equitable.