Navigating a Collision Course: Clinical Ethics vs. Business Ethics

The purpose of this paper is to present a teaching tool that can be used in a variety of courses to examine ethical issues that have emerged in the turbulent health services environment of the United States. More specifically, we describe a structured discussion on the collision between traditional medicine and business practice. We examine six ethical dilemmas and frame them according to the major stakeholders in each situation. We describe these dilemmas in the form of double binds, unattainable situations, conflicts of interest, and countervailing incentives existing between the stakeholders. We analyze the roles that various players have in maintaining the integrity and ethical foundations of health care in the United States. Finally, in light of the increasing industrialization of medicine, we use evidence from the business ethics literature to provide an additional perspective on these relevant health care issues.     

What's So Special About a Special Ethics for Business?

In business ethics literature, debate over a special ethics generally has framed examination of the rules governing business. By constructing a dilemma faced by proponents of a special ethics, I argue that this framing is misguided. Proponents must adopt either an insular or a derivative conception. The former, the view that business is insulated from moral rules, is problematic because arguments used to support it force proponents to accept the idea that each aspect of life is insulated from moral rules. This idea, however, renders philosophically insignificant the claim that business has a special ethics. Proponents no longer make a claim about business, but, rather, a relativistic claim about ethics in general. The derivative conception is the view that business is a set of circumstances that bear on the application of moral rules. This, however, is true of each aspect of life, and is simply an application of the principle 'ought implies can'. The result is that there is nothing special about this sense of a special ethics. Despite lacking specialness, however, the derivative conception provides proper framing for examination of the rules governing business. It subjects business to moral rules, but, also, accounts for the challenging circumstances businesspersons face.     

THE DISPERSION OF BIDS ON INDIVIDUAL NEW MUNICIPAL ISSUES

This paper examines the determinants of the dispersion of interest rates bid on competitively sold, new municipal issues. Theory suggests that the dispersion of prices (interest rates) on a new municipal issue depends on the expected costs and benefits of underwriter search on that issue. The greater the expected costs and the lower the expected benefits, the smaller will be underwriter search and the greater will be municipal interest rate dispersion. For empirical testing, the expected costs and benefits of underwriter search are measured by characteristics of the bond issue, the bond issuer, and the market conditions. The empirical tests suggest that the theory holds.     

Consequences of Price Discrimination in Health Care

Atlantic Economic Journal -     

Lifestyle changes and the lifestyle selection process

This paper presents an analysis of barriers to the uptake of eco-friendly ways of life that is based upon an evolutionary complex systems approach to the workings of the mind and the choices that people make. It questions the effectiveness of price-based policies for promoting change and emphasizes the role of non-price factors and complementarities in choice. Inducing behaviour change may therefore require ensuring consumers’ lifestyle prerequisites are met. In the light of Hayek’s (1952) book The sensory order (Chicago: University of Chicago Press), the paper examines the systematic processes by which cognitions are formed and minds evolve, and potential for inducing changes via policy measures that aim to derail stereotypical lines of thinking. Though the paper’s theoretical perspective differs from the behavioural economics that underpins the ‘Nudge’ approach to policy, the paper’s analysis is intended to be complementary with the ‘Nudge’ approach.     

Rules of origin and gains from trade

Free trade areas (FTAs) involve unharmonized tariffs and rules of origin that have prevented proving the formal general equilibrium existence of a welfare-enhancing FTA. This paper identifies the most restrictive limit that rules of origin can enforce and still continue to guarantee gains from trade for FTA formation. We note that many commonly used rules of origin exceed this condition in practice. We apply the identified welfare-supporting rules of origin and prove the existence of a FTA general equilibrium involving only within-FTA transfers that is at least as satisfactory for every consumer as an arbitrary original world trade allocation. The analysis also helps to explain why hub-and-spoke extensions of FTAs cannot be expected to guarantee gains from trade for all participants in general.     

Procedural protectionism: The American trade bill and the new interventionist mode

Zusammenfassung Administrativer Protektionismus: Das amerikanische Handelsgesetz und die neue Art des Interventionismus. - Der Verfasser beschreibt die ?nderungen des US-Handelsrechts, die durch das “Omnibus Trade and Competitiveness Act” von {dy1988} eingeführt wurden. Er sagt voraus, da\ das neue Au\enhandelsgesetz zu einer Zunahme der Handelsbeschr?nkungen fuhren wird, weil es den einheimischen Firmen leichter gemacht wird, Au\enhandelsprotektion zu erlangen, sei es mit Hilfe der Ausweichklausel, der Antidumpingvorschriften, der Ausgleichsz?lle und Ma\nahmen gegen unfaire Handelspraktiken. Der Verfasser stellt fest, da\ die Zunahme des administrativen Protektionismus dieser Art den Rückgang des offenen Protektionismus (in Form von Z?llen und Quoten) wieder aufhebt. Die Tendenz zu mehr Protektionismus. und die Wirkungen früherer Verfahrens?nderungen zeigen sich darin, da\ die amerikanischen Trade Remedy Laws im Laufe der letzten Dutzend Jahre verst?rkt in Anspruch genommen wurden.

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Resumen Proteccionismo procesal: la Ley de Comercio de los EE.UU. y el nuevo intervencionismo. - El autor describe los cambios en las leyes comerciales de los EE.UU. después de la sanción de la “Omnibus Trade and Competitiveness Act” de 1988. Predice que la nueva ley aumentará las barreras al comercio al facilitate a las empresas locales la obtención de protección bajo las cláusulas de escape y las disposiciones relativas al antidumping, a las tasas compensatorias y a prácticas comerciales injustas. El autor subraya que un aumento de la protection procesal de este tipo deja sin efecto la reducción de la protección abierta en calidad de aranceles y contingentes. La tendencia hacia un mayor proteccionismo y los efectos de cambios procesales ocurridos en el pasado se evidencian en el creciente recurso a las leyes comerciales estadounidenses en los últimos doce a?os.

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Résumé Protectionisme par procédure: la loi commerciale des Etat-Unis et le mode du nouvel interventionisme. - L’auteur décrit les changements dans le droit commercial des Etats-Unis qui ont été introduits par ?The Omnibus Trade and Competitiveness Act? de l’année 1988. Il prédit que cette nouvelle loi augmentera les barrières commerciales en rendant plus facile aux entreprises américaines d’obtenir la protection par la clause de résiliation et les dispositions concernant l’antidumping, les tarifs douaniers compensateurs et les pratiques commerciales déloyales. L’auteur observe que l’augmentation de protection par procédure compense le déclin de la protection évidente en forme des tarifs et des quotas. La tendance vers un protectionisme plus répandu et les conséquences des changements de la procédure au passé se sont manifestées dans l’usage croissant des lois de remède commerciales américaines pendants la dernière douzaine d’années.

     

Foreign capital,dependence, destabilisation and feasibility of transition to socialism

The paper analyses the argument that external capital inflow could create dependence and thus sabotage the possibility of a successful transition to socialism. The formal model deployed is of the Harrod-Domar variety and simulation run are undertaken for five underdeveloped countries, using savings functions estimated by Weisskopf. The conclusions lend some support to radical concerns about the adverse effects of foreign aid on recipient countries.