The HealthyFood program offers members up to 25% cash back monthly on healthy food purchases. In this randomized controlled trial, we tested the efficacy of financial incentives combined with text messages in increasing healthy food purchases among HF members. Members receiving the lowest cash back level were randomized to one of six arms: Arm 1 : 10% cash back, no weekly text, standard monthly text; Arm 2: 10% cash back, generic weekly text, standard monthly text; Arm 3: 10% cash back, (...) personalized weekly text, standard monthly text; Arm 4: 25% cash back, personalized weekly text, standard monthly text; Arm 5: 10 + 15%NET cash back, personalized weekly text, standard monthly text; and, Arm 6: 10 + 15%NET cash back, personalized weekly text, unbundled monthly text. In the 10 + 15%NET cash back, the cash back amount was the baseline 10% plus 15% of the net difference between healthy and unhealthy spending. The generic text included information on HF and healthy eating, while the personalized text had individualized feedback on purchases. The standard monthly text contained the cash back amount. The unbundled monthly text included the amount lost due to unhealthy purchases. The primary outcome was the average monthly percent healthy food spending. Secondary outcomes were the percent unhealthy food spending, and the percent healthy and unhealthy food items. Of the members contacted, 20 opted out, and 2841 met all inclusion criteria. There were no between-arm differences in the examined outcomes. The largest mean difference in percent healthy spending was between Arm 1 and Arm 2, and the largest mean difference in percent unhealthy spending was also between Arm 1 and Arm 2, but no differences were statistically significant after correction for multiple comparisons. None of the tested financial incentive structures or text strategies differentially affected food purchasing. Notably, more than doubling the cash back amount and introducing a financial disincentive for unhealthy purchases did not affect purchasing. These findings speak to the difficulty of changing shopping habits and to the need for innovative strategies to shift complex health behaviors. NCT02486588 Increasing Engagement with a Healthy Food Benefit. The trial was prospectively registered on July 1, 2015. (shrink)

Ethical dilemmas arise when one must decide between conflicting ethical imperatives. One potential ethical dilemma is a manager’s decision of whether to engage in corporate social responsibility activities. This decision could pit the ethical imperative of honoring unwritten obligations to society against the ethical imperative of honoring contractual obligations to the firm. However, CSR activities might only be a minor ethical dilemma or none at all if they simultaneously benefit the firm and society. To examine this I test the association (...) between future-period employee productivity and current-period use of one type of CSR activity: employee volunteer programs. I use a unique sample of 1428 firm-years, hand-collected from sustainability reports of 373 firms. I find evidence that the current-period use of an employee volunteer program has a positive association with future-period employee productivity. I find this result in future periods up to 6 years after a firm uses an employee volunteer program. I also find a positive association between incentives that focus CEOs’ attention on long-term firm outcomes and more extensive employee volunteer programs. (shrink)

"The largest Ebola outbreak to date—first detected in December 2013 and still ongoing as of April 2015—has cast new light on the shortfalls of international public health systems.1 As in previous health crises, scrutiny has reemerged over the pharmaceutical industry’s ability and willingness to innovate new medicines for underserved disease areas. The public debate has intensified following revelations that promising drug candidates to treat Ebola had gone undeveloped despite compelling preclinical results.2 This lack of development is especially troubling because it (...) occurred after a recently implemented U.S. incentive scheme—the Food and Drug Administration’s (FDA) tropical disease priority review voucher program—designed to counteract exactly this problem. Taking Ebola as a case in point, it is useful to examine the short history and ongoing refinement of this voucher program, since it represents one of the most significant legislative efforts to systematically address the relative absence of com- mercial rewards for drugs targeting tropical diseases. This analysis evaluates the voucher program’s effectiveness for both stimulating private sector innovation and achieving positive health impacts among populations most severely burdened by tropical diseases. It then proposes specific recommendations for how law- makers can improve the program’s legislation to better achieve these objectives. ". (shrink)

Incentive programs have been criticized due to concerns that extrinsic rewards can ‘crowd out’ intrinsic motivation, and also that such programs might exert a corrupting influence on those receiving the incentive. Jonathan Wolff has argued that while these worries are in some instances well grounded, incentives can also operate by liberating people from social pressures that stand in the way of their intrinsic motivations. We further develop Wolff's insight by articulating a framework for assessing such incentives (...) and discussing several areas of public health where incentives may play a positive role. In so doing, we describe the limitations of Wolff's thesis as well as the opportunities it presents. Finally, we suggest that there is an additional attractive feature of incentives that has been overlooked, which is their capacity to serve as ‘conversation makers’. By providing people an occasion to discuss reasons for and against various health behaviors, incentives have the potential not only to impact the health behavior of individuals but to affect cultural change at the population level. (shrink)

An institutional auditing program typically consists of the following steps: a sample audit, the decision to move to the full audit, a settlement offer, and the full audit. Statistical sampling techniques are often used to estimate the overbilling percentage and amount. This paper discusses the optimal settlement offer, the net recovery through auditing, the condition for the auditors to move to the full audit, and how an auditing program can be truly cost-effective. This paper provides an evaluation for the statistical (...) sampling techniques to an auditing program. The economic incentives of a contractor to overbill are also identified. Finally, it presents the key metrics and the managerial implications for auditing managers to design or enhance their auditing programs. (shrink)

Introduction Financial incentive schemes have been commonly used by the hearing aid industry as a way of encouraging device sales. These schemes can lead to a conflict of interest as the hearing device dispenser is torn between personal reward over the best interests of their client. This conflict of interest has the potential for the dispenser to develop “moral distress”, a negative state of mind when an individual’s ethical values contrast with those of the employing organization. The purpose of (...) this study was to investigate if there was a relationship between financial incentives and moral distress in Australian audiologists and audiometrists. Methods An online survey was distributed to all members of Audiology Australia and the Australian College of Audiology via email. Participants rated their perceived moral distress from 0 to 10 on the Moral Distress Thermometer and answered four questions about financial incentives in their respective workplace. Results A total of 65 participants, 42 females and 23 males, completed the online survey. A quarter of participants rated their moral distress corresponding to levels of uncomfortable or above. A statistically significant association was found between financial incentives, sales target setting, and higher perceived moral distress in participants. Conclusions For our sample, the implementation of financial incentives created ethical challenges for practicing audiologists and audiometrists. Modifications to employee rewards programs as well as a regulation of device sales are recommended. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 53-64 [Access article in PDF] Incentives for Providing Organs Patricia Milmoe McCarrick and Martina Darragh After a contentious debate at its 2002 annual meeting, the American Medical Association's House of Delegates voted to endorse the opinion of its Council on Ethical and Judicial Affairs that the impact of financial incentives on organ donation should be studied (Josefson 2002). The shortage of organs (...) for transplantation has been an ongoing problem for more than 20 years. In June1981, Representative Philip Crane (R-IL) introduced legislation in the U.S. House of Representatives proposing a $25,000 income tax deduction and a $25,000 estate tax exclusion for donating an organ (Tax Incentives 1981). Still the National Organ Transplant Act enacted in October 1984 prohibited the offering of any "valuable consideration" in return for organs (United States 1984).The developments of a legal market for tissues in the United States and a black market for organs around the world have raised the question of whether donation without compensation is the only ethically viable option. Some critics of the current system claim reliance on donation actually promotes a black market in organs (Kaserman and Barnett 2002, p. 38; Palmer 1999, p. 36). In addition, a new set of compensation issues has arisen as living kidney donor transplantations begin to rival those performed with cadaveric organs (United States 2001).As a result, current suggestions for incentives go far beyond the traditional death benefit payment to include such ideas as medals of honor for donors, reimbursement for funeral expenses, exchange programs for organ donation, and special medical insurance for living organ donors. Numerous bills introduced into the 107th Congress have proposed such incentives (Delmonico et al. 2002.) In October 2002, the U.S. Department of Health and Human Services awarded $5.2 million in grants to study both clinical and behavioral interventions for increasing organ donations that do not involve incentives. The inspiration for some of the funded proposals comes from the successes of Spain's social services and the United Kingdom's clinical administration of organ procurement programs (Robeznieks 2002). [End Page 53]With a nod to evidence-based medicine, the underlying concern expressed in much of the current literature is that no idea for increasing the supply of organs should be discounted before it is studied. This bibliography provides a short introduction to the range of opinions expressed on the issue of incentives for providing organs.al-Mousawi, M.; Samhan, M.; al-Mezairee I.; Razzak, M.A.; and Khawari, F. Cadaver Organ Procurement in Kuwait. Transplantation Proceedings 31 (8): 3375-76, 1999.The authors describe a protocol that significantly increased cadaveric organ donation and credit it with fostering the expansion of an organ sharing program among the Arab Gulf states. Developed by Kuwaiti neurologists and anesthetists after a continuing education course on transplantation, the protocol places a special emphasis on the role of local transplant coordinators who facilitate the investigation of brain death cases by neurologists.Arnold, Robert; Bartlett, Steven; Bernat, James; et al. [Ethics Committee of the American Society of Transplant Surgeons] Financial Incentives for Cadaver Organ Donation: an Ethical Reappraisal. Transplantation 73 (8): 1361-67, 27 April 2002.To prepare for proposed studies of financial incentives for organ donation, the American Society of Transplant Surgeons convened a panel to develop a methodology for evaluating the ethics of such research. Comprised of organ procurement organization executives, physicians, surgeons, and ethicists, the panel generated a list of nine criteria for use in judging any incentives proposal. While opposed to direct payment or tax incentives for organ donation, a majority of the members support funeral expense reimbursement or charitable contributions as incentives that would not violate or undermine the ideal of altruism.Cameron, J. Stewart, and Hoffenberg, Raymond. The Ethics of Organ Transplantation Reconsidered: Paid Organ Donation and the Use of Executed Prisoners as Donors. Kidney International 55 (2): 724-32, February 1999.After reviewing arguments for and against payment for organ procurement, the authors apply these arguments to the specific case of obtaining organs from executed... (shrink)

This article presents an overview of traditional legal and regulatory incentives directed at achieving lawful corporate behavior, together with examples of more recent governmental incentives aimed at encouraging self regulation activities by corporations. These incentives have been differentiated into positive incentives that benefit corporations for actions that encourage or assist lawful behavior, and punitive incentives that only punish corporations for violations of legal or regulatory standards. This analysis indicates that traditional legal and regulatory incentives for lawful corporate behavior are overwhelmingly (...) punitive in their intended effects, while more recent governmental incentives to encourage voluntary corporate self regulation are much more positive in their intended effects.A prototype private compliance system containing typical features specified in governmental incentives for corporate self regulation was then analyzed applying the same positive/punitive analysis that was performed with the governmental incentives. This analysis suggests that corporate compliance programs that are structured to comply with Department of Defense regulations for defense contractors or the new Federal Organizational Sentencing Guidelines will reflect the same overwhelmingly punitive balance of incentives for lawful and ethical employee conduct as do the traditional legal and regulatory incentive systems for lawful corporate behavior. (shrink)

Policymakers use financial incentives to achieve a wide variety of public objectives, from pollution reduction to the employment of welfare recipients. Combining insights from economic theory with lessons learned from actual implementation, this article analyzes the implications of two such policies: first, subsidizing contraception, and second, offering financial incentives to individuals for sterilization or for using a long-term, semipermanent method of contraception such as the Intra-Uterine Device, Depo-Provera or Norplant. These subsidy and incentive policies achieve their goals through a (...) myriad of individuals who make their reproductive choices in response to particular costs and benefits. Such programs are ethically and politically controversial. In this paper, I address the question of whether they can be justified either economically or ethically.The first section of this article presents an economic theory to assess whether a subsidy, tax, or incentive is economically efficient, both generally and in the context of contraception. (shrink)

Organizations are faced with the question, not only whether to adopt an ethics program, but also which components to adopt when. This study shows that unethical behavior occurs less frequently in organizations that have an ethics program than in organizations that do not have an ethics program. Nine components of ethics programs were identified and examined. The results show that there is a direct relationship between the number of components adopted and the frequency of observed unethical behavior. No relationship (...) was found between pre-employment screening and unethical behavior, while the strongest relationship was discerned between accountability policies and unethical behavior. The study further reveals that the best sequence for adopting components of an ethics program is a code of ethics, ethics training and communication, accountability policies, monitoring and auditing, and investigation and correction policies—all of which are directly related to less unethical behavior—followed by an ethics office, ethics report line, and incentive policies—all of which are indirectly related to less unethical behavior. With the exception of pre-employment screening, this sequence corresponds closely to the pattern of adoption of organizations in the U.S. (shrink)

Maternal health is considered a key global priority by the World Health Organization, and several strategies are used to promote it. Especially in lower- and lower-middle-income countries, one widely used strategy employs financial incentives to motivate pregnant women to access available healthcare. While such interventions have been extensively empirically evaluated, their normative aspects appear to have received less attention. To address this gap, we systematically searched and reviewed normative and qualitative literature to map and analyze the ethical considerations of using (...) financial incentives to promote maternal health. Twenty-three articles (four normative and 19 qualitative) were included in the review. We grouped ethical considerations under six categories, namely the program structure, promoting institutional births, of the ethical significance of cash, justifying conditionalities for maternal health, effects on individuals’ decision-making and the experiences of vulnerable groups. While incentives could be used for beneficent goals, we show how they may emphasize global rather than local solutions, impose unfamiliar sociocultural values, unfairly expect behavior change and disempower individuals and groups. We argue that future maternal health policy, especially those targeting vulnerable groups and minorities, would benefit from taking these normative considerations into account. (shrink)

Management plays an important role in reinforcing ethics in organizations. To support this aim, managers must use incentive and goal programs in ethical ways. This study examines experimentally the potential ethical costs associated with incentive-driven and goal-induced employee behavior from a managerial perspective. In a quasi-experimental setting, 243 MBA students with significant professional work experience evaluated a hypothetical employee’s ethical behavior under incentive pay systems modeled on a business case. In the role of the employee’s manager, (...) participants evaluated the ethicality of the employee’s incentive-driven and goal-induced ethical/unethical behavior and the outcomes of behavior, with consequences that were either favorable or unfavorable to the organization. The results indicated that participants discounted the ethical considerations of incentive-driven and goal-induced behavior when consequences were favorable to the organization. Participants’ morals and outcome orientations were also significantly related to their ethical judgments and intentions to intervene. The implications of these findings for research and practice are discussed. (shrink)

Since 1983, legislators and advocates have introduced Land Access Policy Incentives in twenty of the fifty United States. These bills share a demographic goal: to fund land rental or purchase for young and beginning farmers and ranchers. States’ efforts to facilitate land access are part of a global movement to support farmers’ entry into agriculture and to resist farmers’ increasing exclusion from land. We examine the policy creation processes of nine states to describe how coalitions and government leaders are translating (...) their values around land access barriers into policy tools whose political appeal is broad. The bills often pass unanimously, and enrollments are strong: about 2,000 young and beginning US farmers and ranchers will purchase or rent farms this year through a few states’ land access policy programs. We trace the themes from interviews with 66 of the bills’ authors and advocates, and their documentation and media coverage, to demonstrate the values that bipartisan coalitions enlist to construct successful bills and the compromises that make them politically feasible. The coalitions’ values turn on the threats of rising land costs, farm expansion or consolidation, and land conversion out of agriculture. As a group, the policies serve broadacre farming operations while leaving specialty crop farms largely unserved. Two states have endeavored to include all farmers of color among their policies’ beneficiaries. Our findings demonstrate tradeoffs of states’ current Land Access Policy Incentives and suggest next steps for research and advocacy to inform policy development to support next generation farming opportunities. (shrink)

Many employers faced with rising health care costs have adopted “voluntary” wellness programs that urge employees to engage in various health-promotion activities, such as smoking cessation and weight reduction. In the proper setting, measures to promote a more healthful lifestyle are difficult to question, but there is little compelling evidence that workplace wellness programs have significant, sustained health benefits or substantially reduce health care costs other than through cost-shifting to unhealthy employees. Congressional support for workplace wellness programs (...) has persisted on a bipartisan basis for the last twenty years, and the incentives that current statutes allow employers to offer employees have become strong enough that the voluntariness of the programs has been called into question. In recent months, the battleground has shifted to the courts, where federal regulations and employer practices have been challenged. Three recent or pending cases raise questions about whether the incentives are coercing employees into the programs. (shrink)

For-profit degree granting institutions are a growing and under-researched market segment that represents an extreme level of business involvement in academe. Permitting such institutions to grant degrees is a concern because the profit motive gives an incentive to operators to misrepresent the quality and benefits of such degrees. This paper addresses the issue of how adequately government quality assurance processes are able to protect the public interest. The degree program approval processes in three countries are evaluated using the UNESCO (...) guidelines for cross-border quality provision in higher education as an internationally accepted standard of quality assurance. (shrink)

The problem of violence in schools causes considerable concern in many countries of the world and in our country as well because of the enormous psychological and physical consequences it brings to children and young people. In literature, research can be found even forty years ago, when this phenomenon was defined as aggressive, deliberate, and persistent action carried out by a group or individual against a victim who cannot be easily defended. More recently, violence is not only considered to be (...) physical, but also violence can also be experiences through social networks, which gives us an additional incentive for its further study, all in order to stand in the way of violence and reduce it as much as possible. This paper studies the theoretical and empirical knowledge about some significant factors that contribute to the occurrence of peer violence, such as: family, school environment and personality characteristics of the bully and the victim. At the end, an overview of effective violence prevention programs from different countries in the world is given. (shrink)

Background Advocates for a regulated system to facilitate kidney donation between unrelated donor-recipient pairs argue that monetary compensation encourages people to donate vital organs that save the lives of patients with end-stage organ failure. Scholars support compensating donors as a form of reciprocity. This study aims to assess the compensation system for the unrelated kidney donation program in the Islamic Republic of Iran, with a particular focus on the implications of Islam on organ donation and organ sales. Methods This study (...) reviews secondary documents for philosophical argumentation and ethical analysis of human organ donation and sale for transplantation. Results and discussion According to Islamic law, organ donation is an act of _sadaqatul jariyah,_ and individuals are permitted to donate organs with the intention of saving lives. The commercialization of humans as organ sellers and buyers is contrary to the Islamic legal maxim _eethaar_, undermining donors of ‘selfless’ or ‘altruistic’ motivations. Such an act should be considered immoral, and the practice should not be introduced into other countries for the sake of protecting human dignity, integrity, solidarity, and respect. I, therefore, argue that Iran’s unrelated kidney donation program not only disregards the position of the Islamic religion with respect to the provision or receipt of monetary benefits for human kidneys for transplantation but that it also misinterprets the Islamic legal proscription of the sale of human organs. I also argue that the implementation of Iran’s unrelated kidney donor transplantation program is unethical and immoral in that potential donors and recipients engage in a bargaining process akin to that which sellers and buyers regularly face in regulated commodity exchange markets. Conversely, I suggest that a modest fixed monetary remuneration as a gift be provided to a donor as a reward for their altruistic organ donation, which is permissible by Islamic scholars. This may remove the need to bargain for increased or decreased values of payment in exchange for the organ, as well as the transactional nature of ‘buyer and seller’, ensuring the philosophy of ‘donor and recipient’ is maintained. Conclusions Offering a fixed modest monetary incentive to organ donors would serve to increase organ supply while protecting donors’ health and reducing human suffering without legalizing the human organ trade. (shrink)

Sacred values are different from secular values in that they are often associated with violations of the cost-benefit logic of rational choice models. Previous work on sacred values has been largely limited to religious or territorial conflicts deeply embedded in historical contexts. In this work we find that the Iranian nuclear program, a relatively recent development, is treated as sacred by some Iranians, leading to a greater disapproval of deals which involve monetary incentives to end the program. Our results suggest (...) that depending on the prevalence of such values, incentive-focused negotiations may backfire. (shrink)

Since the mid-1980s, internal corporate investigations have become commonplace in the U. S., with an upsurge occurring as a result of the corporate scandals of 2001-02 involving Adelphi Communications Corporation, Enron, Merck & Company, Riggs Bank, and other companies accused of financial malfeasance. After an introduction, this article first presents the U. S. public policy framework (as implemented through the U. S. Sentencing Commission, the U. S. Department of Justice, and the Securities and Exchange Commission) encouraging the use of corporate (...) internal investigations and self-reporting of these results to federal authorities; second, evaluates this framework, identifying the public policy issues inhibiting companies from using corporate internal investigations and self-reporting significant results; third, proposes a policy incentive regime which attempts to ameliorate these outstanding issues; and fourth, offer policy recommendations and suggestions for further research on this topic, including increasing the maximum deduction in the Organizational Sentencing Guidelines Culpability Score available to a firm for development of an Effective Compliance and Ethics Program (from 3 to 5 points), and self-reporting the results of an internal investigation (from 5 to 7 points); evaluating the effectiveness of these enhancements in legal incentives over a period of 5-7 years after implementation; instituting a formal federal government effort to educate the American business community on the corporate reputation (and financial) benefits of an effective compliance program; and protecting attorney-client privilege and work product protection, through legislative action, to encourage company executives and directors to utilize independent, outside attorneys to conduct fair, comprehensive, and impartial internal investigations. (shrink)

HIV/AIDS continues to constitute a serious threat to the social and physical wellbeing of African mothers and their babies. In the hardest hit countries of sub-Saharan Africa, more than 60% of all new HIV infections are occurring in women, infants and young children. Mother-to-child transmission constitutes 90% of new HIV infections among infants and young children. Most of these infections can be prevented. However, the social stigma of HIV/AIDS insidiously continues to undermine the success of prevention programs. Ironically, some (...) attributes or characteristics of prevention of mother-to-child transmission programs may in fact serve as catalysts to the stigmatization process. This paper identifies and discusses six potential initiators: Routine HIV testing, Six months exclusive breastfeeding, Incentives, Home visits, Location of PMTCT program, and PMTCT terminology. In all these areas, there are practical strategies that may be applied to reduce the chances of being stigmatized. These strategies are introduced and discussed. (shrink)

The passing of the Patient Protection and Affordable Care Act is a triumph for the field of public health. Its inclusion of many provisions intended to prevent illness and promote health endorses the core belief of public health as expressed by Dr. Georges Benjamin, the long-time executive director of the American Public Health Association, in a Washington Post opinion piece praising ACA for “provid[ing] care as far upstream as possible… [in order to] reduce costs by identifying problems early and then (...) managing them to reduce or eliminate the need for more costly care in the future.” In this article, I consider the conflict between ACA’s adoption of public health goals seeing population health and societal interests in protecting individuals from discrimination based on their health. The article focuses on one aspect of ACA which seeks to lower the costs to employers who provide health insurance for their employees by making it easier for them to offer their employees substantial incentives for participating in and meeting the goals of employer-sponsored Wellness Programs. (shrink)

One-third of all human lives end in early death from poverty-related causes. Most of these premature deaths are avoidable through global institutional reforms that would eradicate extreme poverty. Many are also avoidable through global health-system reform that would make medical knowledge freely available as a global public good. The rules should be redesigned so that the development of any new drug is rewarded in proportion to its impact on the global disease burden (not through monopoly rents). This reform would bring (...) drug prices down worldwide close to their marginal cost of production and would powerfully stimulate pharmaceutical research into currently neglected diseases concentrated among the poor. Its feasibility shows that the existing medical-patent regime (trade-related aspects of intellectual property rights—TRIPS—as supplemented by bilateral agreements) is severely unjust—and its imposition a human-rights violation on account of the avoidable mortality and morbidity it foreseeably produces. (shrink)

This paper describes a research program that focuses on the explanation of political protest and its causes. The starting point is Mancur Olson’s theory of collective action. This theory is modified, extended and applied to explain political protest. In particular, it is argued that only a wide version of Rational Choice theory that includes ‘soft’ incentives as well as misperception is capable of providing valid explanations of protest behavior. Another part of the research program is the utilization of survey research (...) to test the predictions about protest behavior that are generated from the wide version of Rational Choice theory. The research program further aims at (a) comparing empirically Rational Choice and alternative propositions, (b) providing micro-macro explanatory models, (c) dynamic theoretical models, and (d) explaining preferences and beliefs which are usually treated as exogenous variables. The paper further reports, some results of the research program. (shrink)

A decline in public sector extension services in developing countries has led to an increasing emphasis on alternative extension approaches that are participatory, demand-driven, client-oriented, and farmer centered. One such approach is the volunteer farmer-trainer approach, a form of farmer-to-farmer extension where VFTs host demonstration plots and share information on improved agricultural practices within their community. VFTs are trained by extension staff and they in turn train other farmers. A study was conducted to understand the rationale behind the decisions of (...) smallholder farmers to volunteer their time and resources to train other farmers without pay and to continue volunteering. Data were gathered through focus group discussions and individual interviews involving 99 VFTs. Findings of the study showed that VFTs were motivated by a combination of personal and community interests that were influenced by religious beliefs, cultural norms, and social and economic incentives. Altruism, gaining knowledge and skills, and social benefits were the most frequently mentioned motivating factors for becoming VFTs.3 years after starting, the income earned from selling associated inputs and services was also a main motivating factor. There were no significant differences between motivating factors for men and women VFTs. The findings point to the fact that VFTs work effectively without being paid, but investments in human, social, and financial capital are crucial to keeping them motivated. These factors are key to ensuring the sustainability of farmer-to-farmer extension programs beyond the projects’ lifespan. (shrink)

The need to integrate ethics into professional life, from the grassroots up, has been recognized, and a comprehensive ethics program has been proposed as a model. The model includes the four dimensions of: consensus building, ethics guidelines development and review, education, and implementation. The activities of the International Society for Environmental Epidemiology (ISEE) are presented as examples and compared with the proposed model. Several innovative activities are described and incentives for ethical professional conduct are highlighted. The examples are provided for (...) emulation by other professional organizations in the hope that, thereby, greater protection of the public interest will be achieved. (shrink)

In this essay Bryan Warnick examines two recent analyses of the practice of paying students for grades, with a focus on educational justice. Philosopher Derrick Darby argues against cash-for-grades programs on the grounds that such programs leave educational inequality intact. Warnick contends that Darby's arguments are incomplete. Increasing levels of educational “adequacy” is morally desirable, Warnick argues, even if inequality remains unchanged. There is also an obligation to engage in “localized practice reforms” that benefit small groups of disadvantaged (...) students, even if such reforms do not change the structural problems that lead to inequality. At the same time, engaging in a close analysis of “cash” as an incentive does reveal specific reasons why the inequality that persists under cash-for-grades might be particularly troublesome. In contrast to Darby, Alexander Sidorkin argues that paying students for learning is not only allowed, but ethically obligatory. Schooling, for Sidorkin, is a form of labor and labor demands fair compensation. Warnick challenges the idea that schooling is a form of exploited labor by looking across a range of issues, including the nonpecuniary benefits of schooling. At the same time, it seems that schooling could become a form of exploited labor, given current trends. Overall, the justice of cash incentive programs remains an open question. The essay concludes with a discussion about how we can move forward with a philosophical analysis of cash-for-grades programs. (shrink)

This study examines the case of community resource mobilization within the context of a farmers market incentive program in Washington D.C., USA to illustrate the ways in which providing opportunities for people impacted by food inequities to develop and lead programming can help to promote food access. Through an analysis of interviews with 36 participants in the Produce Plus program, some of whom also served as paid staff and volunteers with the program, this study examines the ways that group-level (...) social interactions among program participants helped to ensure the program was accessible and accountable to the primarily Black communities that it serves. Specifically, we explore a particular set of social interactions, which we collectively term social solidarity, as a community-level form of social infrastructure that program volunteers and participants mobilized to support access to fresh, local food in their communities. We also examine the elements of the Produce Plus program that contributed to the flow of social solidarity within the program, providing insight into the ways in which the structure of food access programs can serve as a social conduit to facilitate or hinder the mobilization of community cultural resources like social solidarity. (shrink)

Public surveys conducted in many countries report widespread willingness of individuals to donate a kidney while alive to a family member or close friend, yet thousands suffer and many die each year while waiting for a kidney transplant. Advocates of financial incentive programs or “regulated markets” in kidneys present the problem of the kidney shortage as one of insufficient public motivation to donate, arguing that incentives will increase the number of donors. Others believe the solutions lie—at least in (...) part—in facilitating so-called “altruistic donation;” harnessing the willingness of relatives and friends to donate by addressing the many barriers which serve as disincentives to living donation. Strategies designed to minimize financial barriers to donation and the use of paired kidney exchange programs are increasingly enabling donation, and now, an innovative program designed to address what has been termed “chronologically incompatible donation” is being piloted at the University of California, Los Angeles, and elsewhere in the United States. In this program, a person whose kidney is not currently required for transplantation in a specific recipient may instead donate to the paired exchange program; in return, a commitment is made to the specified recipient that priority access for a living-donor transplant in a paired exchange program will be offered when or if the need arises in the future. We address here potential ethical concerns related to this form of organ “banking” from living donors, and argue that it offers significant benefits without undermining the well-established ethical principles and values currently underpinning living donation programs. (shrink)

Implementation of Solar Thermal Technology describes the successes and failures of the commercialization efforts of the U.S. solar thermal energy program, from the oil embargo of 1973 through the demise of the program in the early Reagan administration and its afterlife since then. The emphasis throughout is on lessons learned from the solar experience, with an eye toward applications to other projects as well as toward possible renewal of efforts at commercialization. Part I discusses the history of government involvement in (...) solar development and the parallel development of the market for solar products. Part II looks at the histories of specific commercialization programs for five areas. Parts III-VIII focus in turn on demonstration and construction projects, quality assurance, information dissemination programs, efforts to transfer technology to industry, incentive programs, and organizational support. Solar Heat Technologies: Fundamentals and Applications, Volume 10. (shrink)

Health information technology is becoming increasingly prevalent in medical offices and facilities. Like President George W. Bush before him, President Obama announced a plan to computerize all Americans’ medical records by 2014. Computerization is certain to transform American health care, but to ensure that its benefits outweigh its risks, the federal government must provide appropriate oversight.President Obama’s stimulus legislation, the American Recovery and Reinvestment Act of 2009, dedicated $27 billion to the promotion of health information technology. It provides payments of (...) up to $44,000 per clinician under the Medicare incentive program and $63,750 per clinician under the Medicaid program. (shrink)

Case study for Business Ethics, 5000 words. Considers the state of the payday lending market in USA and Canada as of March 2018. Suitable for undergraduate or business school use. Includes the discussion of: Storefront and online payday lending in state/province and national contexts. Applicability of the concept of exploitation to payday lending. Alternatives to payday lending ("Payday Alternative Loans" provided through credit unions, and savings incentive programs that reduce demand for payday lending). U.S. government regulation of 2017 (...) that was rescinded shortly before it was to have effects on business, specifically due to change of Presidential administration (January 2018). Class discussion questions. References. (shrink)

Whistle blowing programs have been central to numerous government, legislative, and regulatory reform efforts in recent years. To protect investors, corporate boards have instituted numerous measures to promote whistle blowing. Despite significant whistle blowing incentives, few individuals blow the whistle when presented with the opportunity. Instead, individuals often remain fallaciously silent and, in essence, become passive fraudsters themselves. Using the fraud triangle and models of moral behavior, we model and analyze fallacious silence and identify factors that may motivate an (...) individual to rationalize fallacious silence. We use a survey of graduate accounting students to test hypothesized factors that contribute to fallacious silence rationalizations in an academic setting. We find evidence that the ability to rationalize fallacious silence is related to community influences and personal traits such as awareness and moral competence. (shrink)

Background: Organ supply–demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates. Methods: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs. Ethical considerations: (...) The study was approved by the University of Malaya ethics committee. Results: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate. Conclusion: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach. (shrink)

Due to their financial incentive, clinicians who earn income from a firm that markets medical devices, pharmaceuticals, tests, etc. might inappropriately prescribe their products or services. The Cleveland Clinic’s conflict of interest (CI) policy creates rules governing clinicians who accept compensation from outside firms that market products they prescribe or use in their practice (hereafter, covered financial relationships). The CI policy is implemented by the Innovation Management and Conflict of Interest Program (IM&COI) (hereafter the Committee).

Private, voluntary compliance programs, promoted by global corporations and nongovernmental organizations alike, have produced only modest and uneven improvements in working conditions and labor rights in most global supply chains. Through a detailed study of a major global apparel company and its suppliers, this article argues that this compliance model rests on misguided theoretical and empirical assumptions concerning the power of multinational corporations in global supply chains, the role information plays in shaping the behavior of key actors in these (...) production networks, and the appropriate incentives required to change behavior and promote improvements in labor standards in these emergent centers of global production. The authors argue that it is precisely these faulty assumptions and the way they have come to shape various labor compliance initiatives throughout the world—even more than a lack of commitment, resources, or transparency by global brands and their suppliers to these programs—that explain why this compliance-focused model of private voluntary regulation has not succeeded. In contrast, this article documents that a more commitment-oriented approach to improving labor standards coexists and, in many of the same factories, complements the traditional compliance model. This commitment-oriented approach, based on joint problem solving, information exchange, and the diffusion of best practices, is often obscured by the debates over traditional compliance programs but exists in myriad factories throughout the world and has led to sustained improvements in working conditions and labor rights at these workplaces. (shrink)

When can we say that a debt crisis has been resolved fairly? An often overlooked but very important effect of financial crises and the debts that often engender them is that they can lead the crisis countries to increased dependence on international institutions and the policy conditionality they require in return for their continued support, limiting their capabilities and those of their citizens to exercise meaningful control over their policies and institutions. These outcomes have been viewed by many not merely (...) as extremely unfortunate and regrettable, but also as deeply unfair. And indeed, increasingly potent popular movements have pressured governments, financial institutions, and the financial community to seek what they take to be fairer solutions to debt crises. The merits of these programs and proposals for dealing more fairly with sovereign debt remain hotly disputed. In this essay, we try to take a step back from the political fray and examine some more fundamental considerations that seem relevant to assessing the fairness of current arrangements governing economic exchanges related to debt contracts and alternatives that have been proposed to them.Our discussion is organized into seven sections. First, we characterize briefly the concept of fairness and its role in social evaluation. Second, we clarify what sovereign debt is, and, third, the ethical statuses that particular sovereign debts can have. Fourth, we identify and describe the main features of current practices related to sovereign debt. Fifth, we describe an "ideal picture" of creditor/debtor relations. We argue that in such a scenario a broad range of ethical considerations can plausibly be invoked in support of practices that closely resemble those presently governing sovereign debt. Sixth, we draw attention to the many ways in which in reality the relations between sovereign debtors and their creditors differ markedly from the relationships between the creditor and debtor in the ideal picture. Because of this, many of the ethical considerations that would support present practices were relations between sovereign debtors and their creditors to resemble more closely those depicted in the ideal picture fail to do so under present circumstances. We conclude, moreover, that the remaining ethical considerations that might be advanced in support of the present system are at best quite inconclusive. Finally, we describe briefly specific reform proposals to current practices. While we will not attempt to show that these proposals would necessarily make the rules governing economic exchanges relevant to sovereign debt more fair, we conclude, in light of our earlier analysis, that they must be given much more serious consideration than they have so far received in policy circles. Indeed, there are strong prima facie reasons to believe that some combination of these proposed policies might prevent or mitigate some of the most ethically regrettable outcomes of present practices and norms by changing the incentives of sovereign borrowers and those who lend to them. (shrink)

Abstract If voters do not understand the programs of rival candidates or their likely consequences, they cannot rationally exercise control over government. An ignorant electorate cannot achieve true democratic control over public policy. The immense size and scope of modern government makes it virtually impossible for voters to acquire sufficient knowledge to exercise such control. The problem is exacerbated by voters? strong incentive to be ?rationally ignorant? of politics. This danger to democracy cannot readily be circumvented through ?shortcut? (...) methods of economizing on voter knowledge costs. A truly democratic government must, therefore, be strictly limited in scope. (shrink)

Pangle believes liberal democracy is in grave danger of losing its way in the tricky Cold War "endgame." This philosophical discourse rethinks the foundations of democratic society through a dialogue with Locke, Kant, Jefferson, Montesquieu, Hume, Plato, and other seminal figures. Diagnosing the "disintegration all around us" from the classical republican perspective of Aristotle and Socrates, Pangle presents prescriptions involving workplace democracy and greater citizen participation in government; he espouses policies encouraging the aged to remain employed; urges tough-minded incentives for (...) hard work as part of welfare programs; and advocates civic education as the heart of American public schooling. The last chapter defines the goals of higher education in terms of a Socratic dialogue with great books. ISBN 0-8018-4262-X: $25.95. (shrink)

_In _Evidence, Politics, and Education Policy_, political scientists Lorraine M. McDonnell and M. Stephen Weatherford provide an original analysis of evidence use in education policymaking to help scholars and advocates shape policy more effectively._ The book shows how multiple types of evidence are combined as elected officials and their staffs work with researchers, advocates, policy entrepreneurs, and intermediary organizations to develop, create, and implement education policies. _Evidence, Politics, and Education Policy_ offers an in-depth understanding of the political environment in which (...) evidence is solicited and used. Two key case studies inform the book’s findings. The primary case—a major, multimethod study—examines the development and early implementation of the Common Core State Standards at the national level and in four states: California, Indiana, Massachusetts, and Tennessee. A comparative case analyzes the evidence used in Congressional hearings over the twenty-year history of the Children’s Health Insurance Program. Together, the two cases illustrate the conditions under which different types of evidence are used and, in particular, how federalism, the complexity of the policy problem, and the policy’s maturity shape evidence use. McDonnell and Weatherford focus on three leverage points for strengthening the use of research evidence in education policy: integrating research findings with value-based policy ideas; designing policies with incentives for research use built into their rules and organizational structures; and training policy analysts to promote the use of research in policymaking venues. (shrink)

We introduce the rejection game, designed to formalize the interaction between interlocutors in a Stalnakerian conversation: a speaker who asserts something and a listener who may accept or reject. The rejection game is similar to other signalling games known to the literature in economics and biology. We point out similarities and differences, and propose an application in linguistics. We uncover basic conditions under which the Gricean maxim of quality emerges from incentives among the players, providing evidence for a functionalist understanding (...) of the Gricean program. (shrink)

Science and technology (S&T) policy studies has explored the relationship between the structure of scientific research and the attainment of desired outcomes. Due to the difficulty of measuring them directly, S&T policy scholars have traditionally equated “outcomes” with several proxies for evaluation, including economic impact, and academic output such as papers published and citations received. More recently, scholars have evaluated science policies through the lens of Public Value Mapping, which assesses scientific programs against societal values. Missing from these approaches (...) is an examination of the social activities within the scientific enterprise that affect research outputs and outcomes. We contend that activities that significantly affect research trajectories take place at the levels of individual researchers and their communities, and that S&T policy scholars must take heed of this activity in their work in order to better inform policy. Based on primary research of two scientific communities—ecologists and sustainability scientists—we demonstrate that research agendas are actively shaped by parochial epistemic and normative concerns of the scientists and their disciplines. S&T policy scholarship that explores how scientists balance these concerns, alongside more formal science policies and incentive structures, will enhance understanding of why certain science policies fail or succeed and how to more effectively link science to beneficial social outcomes. (shrink)

Much of the theoretical work on strategic voting makes strong assumptions about what voters know about the voting situation. A strategizing voter is typically assumed to know how other voters will vote and to know the rules of the voting method. A growing body of literature explores strategic voting when there is uncertainty about how others will vote. In this paper, we study strategic voting when there is uncertainty about the voting method. We introduce three notions of manipulability for a (...) set of voting methods: sure, safe, and expected manipulability. With the help of a computer program, we identify voting scenarios in which uncertainty about the voting method may reduce or even eliminate a voter's incentive to misrepresent her preferences. Thus, it may be in the interest of an election designer who wishes to reduce strategic voting to leave voters uncertain about which of several reasonable voting methods will be used to determine the winners of an election. (shrink)

Fundamento: El currículo de estudios, principalmente de posgrado, no puede considerarse como un plan al que hay que ajustarse de manera estricta, sino que debe ser más flexible, que dé salida a los objetivos propuestos según las situaciones del entorno. Objetivo: mostrar algunos resultados de la vinculación del residente de Higiene y Epidemiología a actividades epidemiológicas emergentes en la actualidad. Método: se realizó un estudio descriptivo transversal en el Centro Provincial de Higiene, Epidemiología y Microbiología de Camagüey durante junio de (...) 2014. Se entrevistó a un universo de 32 profesionales. Las variables utilizadas fueron: utilidad de la vinculación extracurricular a programas y tareas de control epidemiológico, desarrollo práctico de los aspectos teóricos, vencimiento con calidad del diseño curricular de la residencia y si se consideró necesario o no interrumpir el plan de estudios ante eventos epidemiológicos de emergencia. Resultados: La mayoría de los especialistas consideró que la vinculación a actividades específicas le permitió vencer con calidad el plan de estudios, mientras que el mayor porcentaje de los residentes no lo estimó así. Ningún residente entrevistado estuvo de acuerdo con la interrupción del plan de estudios ante situaciones emergentes. Conclusiones: la vinculación del residente a actividades prácticas emergentes puede servir de incentivo para la graduación de un especialista con mayor competencia profesional, sin abandonar el diseño curricular establecido. Fundament: The study curriculum, especially of post grade, cannot be considered as a plan to which one has to be adjusted in a strict way, but to be more flexible, offering a way out to the proposed objectives according to the situations of the environment. Objective: to offer some results of the linking of the medical resident of Hygiene and Epidemiology to emergent epidemiological activities at the present time. Method: A cross-sectional descriptive study at the Provincial Center of Hygiene, Epidemiology and Microbiology during June 2014 was carried out. A universe of 32 professionals was interviewed. The variables used were: usefulness of the extracurricular linking to programs and tasks of epidemiological control, practical development of theoretical aspects, quality achievement of the curricular design of the medical residency, and if it was necessary or not to interrupt the study plan in emergent epidemiological events. Results: Most of the specialists considered the linking to emergent epidemiological activities allowed to finish with quality its study plan, while that the biggest percentage of the residents did not estimate it in the same way. None of the interviewed resident agreed with the interruption of the study plan in front of emergent situations. Conclusions: the linking of the medical resident to practical emergent activities can serve as incentive for the graduation of the specialists with better professional competence without abandoning the established curricular design. (shrink)

Accounting professionals play an important role in the generation and auditing of financial statements and, given their understanding of business processes, may be relied upon in the development of organizations’ ethical infrastructures (i.e., the formal aspects of an organization’s ethical environment that are explicitly under the control of the organization). Thus, understanding and improving the work environments of accounting professionals is crucial to improving organizational ethical culture and reducing fraud. In this study, we extend prior research that documents the prevalence (...) of ethical infrastructure programs by assessing how accounting professionals, a key employee group, perceive their organizations’ ethical infrastructures. In addition, we examine whether perceptions of the effectiveness of the ethical infrastructure and professional autonomy influence accountants’ ethical judgments. Based on the responses of 378 CPAs in the United States, we find the perceived state of the ethical infrastructure across accounting work environments—both public accounting firms and other organization types—is relatively strong. However, of the five ethical infrastructure components we examine (i.e., ethics code, ethics training, ethics-based punishments and incentives, ethics reporting system, and ethics review system), only 35% of respondents indicate that their organizations have more than three of these components. Importantly, we find that perceived ethical infrastructure effectiveness and professional autonomy influence both perceptions of the ethical culture and the ethical judgments of accounting professionals. We also contribute to practice by highlighting opportunities for improvement in ethics training formats, ethics-based incentives, and ethics review systems. (shrink)

The United Nations Global Compact has generated a lively debate among academics, activists, and policy practitioners. Given the scope and ambition of this program, and the prestige of the United Nations associated with it, its supporters believe it will fundamentally reshape how businesses practice corporate social responsibility. Its critics view it as a flawed program because it does not impose verifiable obligations and does not compel its participants to adhere to their program obligations. We present an approach to study CSR (...) programs grounded in rational-choice institutionalist theory, building on previous work viewing CSR programs as clubs which can produce reputational benefits for members as well as positive societal externalities, provided that they incorporate institutional mechanisms to prevent member shirking. This perspective puts the focus squarely on the institutional rules of the UNGC and their impacts on member behavior. While we conclude that the UNGC has not yet demonstrated a capacity to generate across-the-board improvements in CSR performance beyond what member firms would have done otherwise, we are hopeful that its sponsors and leaders can undertake worthwhile changes in program design to align member incentives with program objectives. (shrink)

The United States Environmental Protection Agency has begun to encourage innovative market-based approaches to address nonpoint source water pollution. These water quality trading programs have the potential to achieve environmental standards at a lower overall cost. Two fundamental questions must be answered before these benefits can be realized: How will trades between point and nonpoint sources be monitored and enforced? and, How will nonpoint sources be included within a trading market? ;Point-nonpoint source trading can be accommodated through either a (...) technology-based or performance-based approach. The technology-based approach accommodates trading through the use of a proxy for unobservable, individual nonpoint source emission reductions. While trading ratios can effectively deal with the uncertainty associated with using a proxy for actual abatement, they are inefficient and ineffective for dealing with problems of hidden action. The alternative use of performance-based trading approaches requires the use of team contracts that provide individual incentives linked to the performance of the entire group. Such contracts must be designed to overcome both adverse selection and moral hazard problems. Performance-based approaches promise efficiency gains in terms of reducing the problems of asymmetric information, and by introducing flexibility into the choice of nonpoint source abatement technologies and practices. ;Nonpoint sources are exempted from direct regulation under the polluter-pays-principle. As a result, their participation in trading markets is voluntary, thus preventing a baseline cap on pre-trade emissions. To determine whether this arrangement should be changed, we must ask if there something that morally prohibits the direct regulation of nonpoint sources of pollution. While a morally relevant distinction can be made between point and nonpoint sources of emission based on differences in the ability to observe individual emission levels, this relevance is limited to the case of performance-based policy instruments. The moral legitimacy of applying the polluter-pays-principle to nonpoint sources of pollution must be made on a case by case basis, as it is dependent upon existing social, economic, and other practical factors. However, it can be stated that there is no general moral barrier to prohibit the application of the polluter-pays-principle to nonpoint sources of pollution. (shrink)