Social Effort Research Articles

Relationships and the social brain: Integrating psychological and evolutionary perspectives

Psychological studies of relationships tend to focus on specific types of close personal relationships (romantic, parent-offspring, friendship) and examine characteristics of both the individuals and the dyad. This paper looks more broadly at the wider range of relationships that constitute an individual's personal social world. Recent work on the composition of personal social networks suggests that they consist of a series of layers that differ in the quality and quantity of relationships involved. Each layer increases relationship numbers by an approximate multiple of 3 (5-15-50-150) but decreasing levels of intimacy (strong, medium, and weak ties) and frequency of interaction. To account for these regularities, we draw on both social and evolutionary psychology to argue that relationships at different layers serve different functions and have different cost-benefit profiles. At each layer, the benefits are asymptotic but the costs of maintaining a relationship at that level (most obviously, the time that has to be invested in servicing it) are roughly linear with the number of relationships. The trade-off between costs and benefits at a given level, and across the different types of demands and resources typical of different levels, gives rise to a distribution of social effort that generates and maintains a hierarchy of layered sets of relationships within social networks. We suggest that, psychologically, these trade-offs are related to the level of trust in a relationship, and that this is itself a function of the time invested in the relationship.

Social income transfers and poverty: A cross‐country analysis for OECD countries

Caminada K, Goudswaard K, Koster F. Social income transfers and poverty: a cross‐country analysis for OECD countriesPoverty alleviation is an important policy objective in developed welfare states. This article reports on a study of the association between social transfer policies and poverty. It has been claimed in several studies that based on a simple bivariate approach, high social effort goes along with low poverty levels. Empirical studies have also found that factors such as demographic and economic conditions may also have an influence on poverty, affecting the relationship between social spending and poverty. In the present study, we empirically analysed the impact of social expenditure on poverty for the period 1985–2005, and in contrast to previous research, demographic and macroeconomic differences across countries were controlled for. Quite a strong negative relationship was still found between the level of social expenditure and poverty. Ageing and unemployment rates were found to have some explanatory power but without affecting the association between social transfers and poverty. Thus, the multivariate approach chosen in this study confirms the results of earlier research.

Organizational and Command Aspects for Coordinating the Public Health Response to an Outbreak of Acute Renal Failure, Republic of Panama, 2006

The Ministry of Health of Panama (MINSA) received several reports of ill persons who had clinical presentations of acute renal insufficiency or failure during September and October 2006. On 01 October 2006, the MINSA formally asked the Pan-American Health Organization (PAHO) and the US Centers for Disease Control and Prevention (CDC) to assist with the investigation. Additional agencies involved in the response included the US Food and Drug Administration (FDA), the Gorgas Institute for Health Studies (GIHS), and the Social Security Health System (SSHS) of Panama. Through a joint effort, the MINSA, CDC, FDA, GIHS, SSHS, and PAHO were able to characterize the illness, identify the etiological agent, identify the population-at-risk, and launch an unprecedented media and social mobilization effort to prevent additional cases.International outbreak responses may require familiarity with basic emergency management principles beyond technical or scientific considerations. The management, logistical capabilities, team interaction, and efficiency of outbreak investigations can be enhanced substantially by having staff already familiar with common operational frameworks for incident responses. This report describes the inter-agency coordination and organizational structure implemented during an international response to identify the cause of an outbreak of acute renal failure in Panama.

“Allegiance and land go together”: Automatic Naturalization and the Changing Nature of Immigration in Nineteenth-Century America

This article discusses the long-neglected early period (1790–1906) of American naturalization. The article maintains that lax naturalization procedures dominated this period because of a conscious social effort to facilitate territorial expansion and because an unconscious schema of automatic naturalization of rural immigrants guaranteed that newcomers would invariably become loyal and productive citizens. This naturalization regime was questioned in the mid-nineteenth century and ultimately abandoned in the early twentieth century amidst the closing of the American frontier and a massive influx of labor migrants who were not only urban and industrial, but also showed more interest in work than in citizenship. As a result, the naturalization process became centralized and the federal government adopted a new naturalization schema that emphasized civic education and an expectation that “enlightened” immigrants would assimilate into American society.

Understanding Users’ Continuance of Facebook

The purpose of this study is to develop an integrated model designed to examine users’ continuance of Facebook based on the unified theory of acceptance and use of technology (UTAUT), the expectation disconfirmation model (EDM), and flow theory. Empirical data collected from 482 users who have experience with Facebook are subjected to structural equation modeling based on the proposed research model. Results show that users’ continuance intention of Facebook is determined by social influence, performance expectancy, effort expectancy, flow experience, and satisfaction. Satisfaction is significantly affected by flow experience and disconfirmation. Results also suggest that effort expectancy is positively related to flow experience. Based on the findings, managerial implications are discussed in this paper and directions for future research are also highlighted.

What Shapes Public Reactions to Climate Change? Overview of Research and Policy Implications

This article first briefly reviews some theoretical perspectives that have been applied to environmental behavior. Next, a theoretical model is proposed to help organize the broad range of research findings. The effects of specific variables in this model on psychological and behavioral outcomes are then discussed. Research indicates that environmental messages need to be framed in the context of the characteristics, values, and loyalties of the audience, as well as in the context of their interests. Programs to combat climate change should be structured so that individuals see their actions as part of a shared social effort.

Leading and Organizing Social Change for Companion Animals

ABSTRACTGovernmental agencies and shelters are charged with controlling the animal overpopulation problem, and historically they have accomplished this by euthanizing companion animals. Community-wide efforts in diverse locations, however, have implemented creative strategies that have dramatically lowered the number of animals entering shelters and subsequently being euthanized. This paper, using a case study methodology, examines how an animal-focused grassroots coalition in Hillsborough County, Florida organized, developed, and led initiatives for change while enlisting the community's support in developing and implementing programs to solve the problem of companion animal overpopulation. This social change effort encountered five types of challenges: performance metrics, coalitions and collaboration, integrating professional and volunteer animal protection organizations, the handling of stray cats, and community leadership.

Empiricism, Pragmatism, and the Settlement Movement

Empiricism, Pragmatism, and the Settlement Movement Tom Burke This article examines the so-called settlement movement (a social reform movement in the United States and elsewhere during the Progressive Era, roughly 1890-1920) in order to illustrate what pragmatism is and what it is not. In 1906, Mary Kingsbury Simkhovitch proposed an analysis of settlement house methods as part of an explanation of what the settlement movement was and how a settlement house functioned in its respective neighborhood. Because of her emphasis on interpretation and action, and because of the very nature of the settlement movement as a concrete social reform effort with vitally important consequences for anyone directly or indirectly involved, it might be thought that her analysis would be pragmatist in character. I argue that her analysis is decidedly empiricist, not pragmatist, and offer an alternative pragmatist sketch of settlement house methodology. Empiricism vs. Pragmatism A longer version of this article would dwell on what empiricism and pragmatism are and how they differ as alternative philosophical "attitudes" or stances. We want to be clear about what the difference is—a difference that Simkhovitch's analysis of settlement house methods is supposed to nicely illustrate. So what is the difference? A quick-and-dirty account of the difference goes something like the following. It is basically a matter of how and where action fits into the picture. Empiricism is an epistemological stance that takes for granted a view of human experience whereby sensory impressions are introduced to the thinking mind and are processed by way of existing conceptual systems whereby bodily actions in the world are respectively generated and managed in accordance with one's beliefs. This is, more or less, a circular process insofar as bodily actions [End Page 73] make changes in the immediate environment and thus, in turn, influence subsequent sensory inputs. Such a brief sketch of empiricist psychology is, of course, overly simple; but the point is that even more sophisticated versions are based on the same three-step core template: (1) sensory inputs are followed by (2) internal processing of such inputs as informative data, followed by (3) subsequent outputs in the form of bodily actions. More simply still: inputs are followed by internal processes which then yield outputs. Sensation informs thinking which leads then to action. We may wave our hands quickly or slowly in big or small circles as we describe this picture; but that is the basic empiricist picture of the arc of experience that has come down to us from seventeenth-and eighteenth-century British empiricism, that was put to use in the psychophysical methodology of the "New Psychology" in the nineteenth century (see Fechner; Wundt), and that constrained the verificationist presuppositions of logical positivism (see Carnap) early in the twentieth century. Pragmatism, originally formulated as a method for clarifying the meanings of one's terms, is a philosophical stance with a view of human experience that gives actions a more fundamental role than does an empiricist stance. Arguably, Peirce's pragmatic maxim (EP 1:132) is the key to understanding what pragmatism is; and there are at least two ways to read this maxim (so that there are multiple ways to characterize pragmatism, depending on how one weighs and relates these different readings). Namely, the pragmatic maxim may be given either an operationalist or an inferentialist reading. This ambiguity is the reflection of a view of human experience that, on one hand, is grounded in an interactive account of "sensory" inputs. On the other hand, human experience is answerable to systemic consequences of holding particular beliefs, calling for continual management of one's beliefs and their bearings on changing circumstances. These are two different conceptions of action—one that pertains to our capabilities to detect what our circumstances are by virtue of a vital interactive embeddedness in the world, and one that pertains to our capacity to alter our circumstances as the need arises. The one conception of action emphasizes interactions with objects falling under given concepts—looking for operational, evidence-oriented accounts of word meaning (for example, saying what the word "hard" means by saying how hard things would react to various interactions with them, etc.). The other...

From voicing your opinion to politicised voice: a youth-led social justice class at an urban continuation high school

This article examines the work of three urban youths as they designed and taught a social justice class at an urban continuation high school in California, USA. Drawing from a two-year ethnographic study of the project, it shows that youth participants constructed a set of imagined binaries to frame teachers, schoolwork and coercion in opposition to students, voice and liberation. The article examines how the youths distinguished ordinary coercive teaching from their own liberatory teaching, creating a coercive/liberatory binary that served as metaphor for a series of binaries shaping their approach to social justice education: teacher/student, adult/youth and schoolwork/voice. It concludes that although the social justice class accomplished many important aims, the reconstruction of and reliance on a coercive/liberatory binary within the project ultimately limited its effectiveness as a social justice education effort.

Elite Status and Social Change: Using Field Analysis to Explain Policy Formation and Implementation

Integrating an analysis of fields into studies of social change provides a better understanding of the outcomes achieved by challengers. We demonstrate the value of field analysis through a case study of a social change effort regarding urban land use. An organization led by wealthy and well-connected individuals pressed city government and a powerful for-profit developer to incorporate progressive social goals into a new urban development project. We show how the organization was able to achieve success in the policy formation field but faced significantly more obstacles when trying to enter another field (policy implementation), despite its elite status. Thus, using fields to study the case can bolster scholars' understanding of elite power and status, as well as help explain outcomes. The advantages enjoyed by elites can be field specific rather than universal, and so do not translate automatically into successful challenge results.

A Social Movement History of Title VII Disparate Impact Analysis

The U.S. Supreme Court’s recent opinion in Ricci v. DeStefano suggests trouble ahead for disparate impact analysis under Title VII of the Civil Rights Acts of 1964 and 1991. Commentators, too, have begun to question the policy bases for this doctrine. Part of the current tenuousness surrounding disparate impact analysis, which the Court first approved in its 1971 opinion in Griggs v. Duke Power Company, stems from assumptions that the EEOC pursued this theory as a last-minute, ill-conceived afterthought that was not in keeping with Congress’s intent when it passed Title VII in 1964. In this Article I use the methodology of social movements theory to cast a different light on the history of disparate impact analysis. Disparate impact analysis asks employers to evaluate whether their employment practices pose barriers to the employment opportunities of traditionally excluded outsiders and, if so, to replace such practices with alternative effective practices with less exclusionary effect. Disparate impact analysis thus augments federal employment anti-discrimination law by introducing a structural approach alongside an intent-based standard that focuses exclusively on detecting invidious motives buried in individual decision-makers’ hearts. In this Article I trace concerns about tackling structural race discrimination in employment to the early history of civil rights activism. I locate the origins of disparate impact analysis in civil rights activists’ long-held understandings about the structural nature of racial employment subordination. Throughout a long historical period, employment subordination based on race was pervasive and unremitting, enforced by a complex of institutions including law, tradition, and white violence insisting on a “whites only” rule for desirable jobs. These forces imposed a tight structural block on the employment advancement of persons of color, and civil rights activists therefore aimed their efforts at achieving broad-scale reform of these institutional barriers. Law also shaped the strategies of these early civil rights activists. In the late nineteenth and early twentieth centuries, the relevant legal question had nothing to do with the intent versus effects tests so heatedly debated today. Instead, two lines of the Court’s jurisprudence were important: its Post Reconstruction civil rights jurisprudence, which limited the reach of anti-discrimination law to state actors; and its Lochner Era employment law jurisprudence, which recognized a natural law “freedom of contract” right barring most forms of state regulation of the employment relationship. These two lines of caselaw defined the sphere of private employment as largely unreachable through federal or state law. Activists accordingly concentrated their efforts on inducing employers to voluntarily reform their workplace hiring and promotion practices. The end of the Lochner Era paved the way for New York State’s passage of the first employment anti-discrimination statute to reach the private sector. State agency officials charged with the statute’s enforcement, some recruited from the ranks of the activists responsible for the statute’s enactment, continued to experiment with methods of inducing employers – now with the background threat of legal action to encourage compliance – to make broad-scale institutional change by examining traditional employment practices to find ways to eliminate barriers to racial inclusiveness. By the time Congress began to debate Title VII’s passage, at least several prototypical disparate impact cases had emerged from state fair employment agencies. After the legislation’s enactment, the EEOC followed in the footsteps of state fair employment agencies by focusing its efforts on promoting broad-scale institutional reform. The EEOC encouraged employers in targeted industries to engage in self study to identify employment practices, such as testing and other selection devices, that could be reformed to increase employment opportunities for racial minorities. At the same time, the NAACP and others successfully litigated a number of disparate impact cases in the lower courts. At all these stages, civil rights activists and those charged with implementing statutes enacted as a result of these activists’ efforts developed and passed on ideas now embedded in the current statutory articulation of the disparate impact doctrine. Disparate impact analysis thus was not a last-minute afterthought, unwittingly endorsed by the U.S. Supreme Court, but the product of a sustained social movement effort over decades of theorizing and experimentation. In sum, my account adds important historical context to the current debate about the continued viability of Title VII disparate impact analysis and also illustrates the potential substantive payoff of a social movement focus on the development of public law.

Social Income Transfers and Poverty Alleviation in OECD Countries

Poverty alleviation is an important policy objective in developed welfare states. This paper analyzes the effect of social transfer policies on poverty. A vast literature claims that high social effort goes along with low poverty levels across countries. This paper systematically analyzes this claim. We employ several social expenditure ratios (as a proxy for social effort) and correct for the impact of the tax system and for private social arrangements, using OECD methodology. Also, we control for emographic and macro-economic differences across countries. We performed several tests with the most recent data (LIS, OECD, and SOCX) for the period 1985-2005. Our results are less clear-cut than earlier findings. We still find quite a strong negative relationship between the level of public social expenditure and poverty among 28 OECD countries. However, for non-EU15 countries this relationship is stronger than for the EU15. The results alter considerably if private social expenditures are included as well. For non-EU15 countries in our sample, we do not find evidence for a negative correlation between the level of total social spending and the incidence of poverty. In contrast, for the group of EU15 countries private social arrangements do matter as far as poverty alleviation is concerned. Demographic and macro-economic (control) variables are important as well. We developed and employed multiple linear regression models to control for these complex interrelationships. Our results point at one direction: gross social spending is the driving force as far as differences in poverty levels across countries are concerned, although the ageing of the population and unemployment rates have some explanatory power, both for non-EU15 countries and for EU15 countries. Our analyses captures another effect as well. It is essential to control for the impact of taxes on the social expenditure ratios used. By doing so, the linkage between social effort and poverty levels across countries becomes insignificant. In view of the fact that with these corrections on expenditure statistics, we have a much better - although still not perfect - measure of what governments really devote to social spending, the familiar claim that higher social expenditure goes along with lower poverty levels does not hold across the 28 examined countries examined. We believe that our comparison of the impact of several social expenditure ratios on poverty levels has emphasized that taking into account both the public/private-mix and the impact of the tax system on social expenditure ratios really matters for comparative welfare state research and for policy makers who want to reduce poverty.

Interactions among the Effects of Head Orientation, Emotional Expression, and Physical Attractiveness on Face Preferences

Previous studies have shown that preferences for direct versus averted gaze are modulated by emotional expressions and physical attractiveness. For example, preferences for direct gaze are stronger when judging happy or physically attractive faces than when judging disgusted or physically unattractive faces. Here we show that preferences for front versus three-quarter views of faces, in which gaze direction was always congruent with head orientation, are also modulated by emotional expressions and physical attractiveness; participants demonstrated preferences for front views of faces over three-quarter views of faces when judging the attractiveness of happy, physically attractive individuals, but not when judging the attractiveness of relatively unattractive individuals or those with disgusted expressions. Moreover, further analyses indicated that these interactions did not simply reflect differential perceptions of the intensity of the emotional expressions shown in each condition. Collectively, these findings present novel evidence that the effect of the direction of the attention of others on attractiveness judgments is modulated by cues to the physical attractiveness and emotional state of the depicted individual, potentially reflecting psychological adaptations for efficient allocation of social effort. These data also present the first behavioural evidence that the effect of the direction of the attention of others on attractiveness judgments reflects viewer-referenced, rather than face-referenced, coding and/or processing of gaze direction.

스포츠시설 안전증진을 위한 법제도적 개선방안

우리나라는 선진대열 진입 무렵부터 '스포츠'의 긍정적 효과에 대한 유용성을 경험해 왔다. 이를테면 올림픽 등 국제대회 개최는 국가 내외적 발전을 추동하였다. 국가홍보에 기여한 바도 매우 크다. 우리나라의 인지도를 향상시킨 매개체로서 스포츠 이상의 경쟁력 있는 콘텐츠는 드물다. 실제로 스포츠는 국가발전을 리드하는 중요한 역할을 수행해왔다. 그 결과 우리나라에서는 스포츠에 대한 투자확대와 수요증대라는 선순환 구조가 체계화될 수 있었다. 그간 스포츠의 육성과 진흥에 대한 노력은 산업적 부가가치의 창출로 이어지는 경향을 갖추게 되었다고 할 수 있다. 이러한 스포츠 생산성에는 다른 분야들과 구별되는 장점이 있다. 비교적 균형 있게 성과를 국가 전반으로 환원시킨다는 점이다. 이상의 관점에서 본고는 우리나라 스포츠 시설의 안전성 증진을 위한 법제도적 측면의 발전방안을 제언하고자 하였다. 국가는 스포츠 시설을 체계적이고 적극적으로 관리할 책임과 의무가 있다. 여기에는 국가 및 공공의 스포츠 시설만이 아니라 민간 스포츠 시설도 포함된다고 할 수 있다. 스포츠 발전과 국가 발전의 공진화적인 관계는 앞으로 더욱 넓게 확대될 것이므로 그에 대한 철저한 준비가 필요하다. South Korea had experienced the great of sports since entered in advanced country group. International sports game such as Olympic developed nation. Sports is intermediate that improve Korean public information level in community of nations. It's difficult to find another contents. Also, sports is important means between south and north Korea in branch situation. Sports is expected to practical improvement of country more than ever. In this way, sports had become real means of nation development. Therefore, social effort about promotion of sports need to be engaged in continuous and various form. This research proposed legal improvement for safety promotion of sports equipment. Sports facilities utilization activation may be ended by country sports competitive power.

Work time regulation as a sustainable full employment strategy: the social effort bargain

Introduction 1. The Origins of the Work and Growth Fetish 2. Rethinking the Work Fetish and the Growth Consensus 3. Work Time Regulation as a Macroeconomic Policy Tool 4. The Ecological and Social Sustainability of Work Time Regulation 5. The Employment Effects of Work Time Reduction 6. A Proposal for Reform 7. Conclusion

Effectiveness of Poverty Reduction in the EU: A Descriptive Analysis

AbstractThe European Union coordinates and encourages Member State actions to combat poverty, and to reform their social protection systems on the basis of policy exchanges and mutual learning (‘best practices’). This paper analyses the effectiveness of welfare state policies and especially social transfers in EU‐countries in alleviating poverty. To indicate whether European economic integration may have had any impact on poverty reduction, we also include several non‐EU15 countries as a benchmark into our analysis. We analyze on a cross‐country basis the relationship between poverty rates and social effort, as measured by social expenditure ratios. We also correct these expenditure ratios for the impact of the tax system and for private social arrangements, using OECD methodology. Next, we compare poverty rates at the levels of market and disposable incomes; that is, before and after transfers, in order to analyze the effect of tax and transfer policies in reducing poverty, i.e., to determine the target efficiency of social transfers. We perform several tests with the most recent data. Our results are less clear cut than earlier findings. We still find a quite strong negative relationship between the level of social expenditure and poverty among OECD countries. However, for EU‐countries this relationship is weaker and there are substantial differences within the EU15. After correcting for the impact of taxes and for private social arrangements, the linkage between social effort and poverty levels becomes even weaker. Also, we do not find a strong relationship between levels of social spending and antipoverty effects of social transfers and taxes. At the program level, family programs and child support alleviate poverty to a large extent.

A Theory of Status-Mediated Inequity Aversion

We introduce a new social utility function which relates inequity aversion to social status, effort, and ability. The basic idea is as follows: Actors do not suffer from inequality but from inequity relative to a fair share that reflects some normative orientation the actors have internalized. In this regard we advocate the rule of proportionality which states that rewards should be proportional to some standard of comparison. We apply this social utility function to various games from non-cooperative and cooperative game theory and interpret the results with respect to the effects of social status on behavioral outcomes.

범죄 피해자의 초상권보호 개선방안

전통적 형사법체계에서 범죄피해자는 실체적 진실을 파악하기 위한 심리의 대상으로 전락되어, 범죄로 인하여 인간의 기본적인 인권을 침해당했음에도 불구하고 범죄피해자의 권리는 간과되고 말았다. '잊혀진 존재' 또는 '주변적인 존재'에 불과 하던 범죄피해자에 대한 피해자학의 연구과제는 형사법체계에서 범죄 피해자가 인격적 자율성과 인간의 존엄성을 향유하는 것일 것이다. 우리나라에서 피해자에 대한 논의가 처음 등장한 것은 헨티히(Hans Von Hemtig)가 1948년 피해자 연구의 필요성을 역설한지 23년이 지난 후이며 최근에 와서 '범죄피해자 구조법', '성폭력범죄의 처벌 및 피해자 보호 등에 관한 법률', '범죄피해자 보호법'등 범죄피해자의 인권보장과 보호를 위한 제도의 보완이 계속되어 왔다. 그러나 현실에서 보면 제한적 범죄 내에서 피해자 보호를 위한 제도적 장치를 마련하는 성과가 있었지만 현실적인 권리 구제와 보호는 아직 미흡하다고 생각한다. 이에 본 연구는 범죄피해자의 초상권 보호 개념을 살펴보고, 그 문제점과 현행 구제 제도를 검토하여 그 개선방안을 찾고자 한다. Became large a problem we were productive movement of information became large and occurring to diffusions of development of public media and Internet use. While the Internet became a generalization, public media had more influences and risks, and a crime to abuse anonymity became large in cyber space. In addition, damage is becoming expanded reproduction that infringe of ' crime victim's rights of portrait'. The point that is most important in order to improve these points is recognition regarding the special situation of crime victim, and the ethic consciousness and independent operation regulation and regulation system that these point was taken into consideration in the public media and Internet operation that are an information producer is necessary, and Internet portal shall be included like Internet newspapers to the arbitration object of the Press Arbitration Commission. Also, a legal system regarding personal responsibility shall have for protection of a crime victim's rights of portrait by personal information activity for protection in cyber space. Suggest to a portrait of a crime victim, and an individual and social rights security effort are required for activation regarding an infringement relief system.

Community-Based Participatory Research: The College as the Focal Community

This article describes one small BSW program's engagement in community-based participatory research (CBPR) in which the college community was the focus of the social change effort and social work undergraduates were the research partners. Over a 3-year period students engaged college community stakeholders, collected data, and presented findings on student alcohol use and abuse to promote discussion and inclusion of harm reduction strategies in the college response to this issue. The project resulted in an ongoing dialogue among the student researchers and administration regarding revisions to the campus alcohol policy. Written from the perspectives of a student researcher and faculty mentor, an overview of CBPR as a research method is presented, associated challenges discussed, a case study using the method summarized, and suggestions for implementing this pedagogy are presented. CBPR conceptualized this way offers opportunities for students to engage more fully with research concepts while promoting social change on their campuses.

Assisted suicide and euthanasia: an old and tragic debate, with a guarded prognosis

The basic effort in "regulation of help in dying" is a cultural one. The social and professional energies must above all be directed towards a renovated "organisation of care in dying" that, far from breaking off our relationships, strengthens them. That, besides providing dignity to dying, facilitates "living" it humanely inasmuch as possible, attending to the bio-psycho-socio-emotional (and spiritual) dimension. At the individual level the desire to die rather than to continue living is a drama that requires mobilising the moral effort of everyone, according to the corresponding responsibility for exploring and evaluating the situation in the search for alternative plans. And, at the social level, the fact of not providing an open outcome to those highly exceptional situations (between 01-2%) can be a tragedy. But the basic social effort does not lie at the end, in providing or not proving a way out, for a few patients (although the accumulated data for Oregon indicate that there is no slippery slope and in Holland there has been a change of attitude towards a fall in euthanasia facing the rise of the alternative of terminal sedation). The cultural, social, organisational, professional and individual effort from which we will all benefit comes much earlier, and involves changing our paradigm of care in particular at the end of life. Although death is inevitable, dying badly should not be so unavoidable.