Informed desire and the ambitions of libertarian paternalism

Sunstein and Thaler’s ‘libertarian paternalism’ (LP) is inspired by the findings of behavioural economics. Its ambitious policy agenda promotes interference which does not block free choice when agents fall short of fully informed and rational choice. Their implicit version of the informed desire view of welfare either provides no, or potentially erroneous, guidance to planners. LP thus faces significant implementation problems. To address these LP might adopt a weaker version of the information requirement on desires or an alternative view of welfare. Nonetheless, informational and bounded rationality considerations suggest that LP should be rethought and its level of ambition reduced.     

Informed Consent as Process: Problematizing Informed Consent in Organizational Ethnographies

This article examines the implications of informed consent in organizational ethnographies, where the research site is a bounded and formal institution that has its own sets of rules which govern action and membership. While there is considerable scholarship on the issue of ethics in ethnography in general, very little has been written about informed consent in organizational ethnographies where researchers often simultaneously observe managers, “studying” up according to Nadar, and employees referred to as “studying down”. Organizational researchers tend to discuss ethics in terms of obtaining informed consent for individual interviews or in terms of access to an organization as a research site. This essay examines ethical dilemmas experienced in fieldwork studying participatory work arrangements in a Mexican garment firm. By discussing practical issues of gaining access, problems of maintaining access and consent, and concerns of how gatekeeper consent affects subordinates, I problematize the practice of obtaining informed consent in organizations. I argue that thinking of informed consent as an on-going process that requires an active reflexivity on the part of the ethnographer will help researchers to navigate the ever-shifting web of power dynamics present in organizations.     

Do participation rates change when active consent procedures replace passive consent

Researchers face considerable ambiguity and controversy regarding the issue of informed consent. Decisions about consent procedures can affect study participation rates and prevalence estimates among specific populations. Changing from passive to active parental consent procedures was examined in a case study with an anonymous survey of sixth- through eighth-grade students' substance use. Four types of procedures for obtaining parental consent were examined. Results suggest that certain types of consent procedures can yield high levels of participation. This study also demonstrates that low participation rates with some active consent procedures can cause biases in sample characteristics and outcome data.     

The Content of Survey Introductions and the Provision of Informed Consent

Information disclosed to potential respondents in survey introductionswas examined in a sample of 78 introductions obtained by mailfrom AAPOR members. The following information was disclosed:research organization, in 86 percent of the introductions; interviewer,82 percent; research topic, 81 percent; sponsor, 45 percent;confidentiality, 42 percent; survey purpose, 26 percent; futuredata use, 24 percent; anonymity, 24 percent; sampling technique,21 percent; survey length, 13 percent; statement that participationwas voluntary, 10 percent; sample size, 4 percent; and consentsignature requirement, 4 percent. Mail surveys (and to a lesserextent those by academic institutions and on sensitive topics)provided more introductory information. For ethical reasons,such as providing informed consent, as well as methodologicalreasons, professional norms about providing information in surveyintroductions need to be examined.     

Counseling minors without parental consent

Counseling services provided to minors without parental knowledge or consent are based on uncertain and often conflicting policies and procedures. This article examines these services from legal and psychological perspectives, explores current agency policies and practices, and makes recommendations with regard to the counseling needs and rights of minors.     

Enabling Informed Consumer Choice in the Long-Term Care Insurance Market

ABSTRACT

Provisions in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) may increase private long-term care insurance sales without imposing substantially more stringent consumer-protection features. The ability of consumers to make informed choices when purchasing this complex product is examined in light of these changes. Data were collected through detailed examinations of policies and interviews with industry experts, insurance companies, agents, consumer groups, and regulators. Because of the complexity of this product, the goals of expanding consumer choice and ensuring that consumers are able to make informed decisions often work against each other. Mechanisms are discussed through which the government can facilitate informed choice and improve consumer protection. The authors contend that, because the government is providing tax incentives that encourage consumers to purchase the product, it has the responsibility to ensure that consumers understand the long-term care insurance they purchase.     

Differential attrition rates and active parental consent.

Active parental consent in survey research poses ethical and practical concerns. One common argument against the requirement of active consent procedures is its effect on participation rates. There is additional concern that higher risk groups may be underrepresented in the final sample. Empirical support of differential attrition, however, is lacking. In the current multisite longitudinal study, passive consent procedures were approved for the collection of pretest data. For subsequent years of data collection, active parental consent procedures were required. In this article, we use the pretest data to examine demographic, attitudinal, and behavioral differences between those students for whom active consent was provided and those for whom active consent was either denied or for whom no response was received. The results indicate that active consent procedures produce deleterious effects on participation rates and lead to an underrepresentation of at-risk youth in the sample.     

Informed Consent in the Twenty‐First Century: What It Is,What It Isn't,and Future Challenges in Informed Consent and Shared Decision Making

Consent evolved from judge‐made law in Great Britain in 1767. The term informed consent entered the judicial lexicon in 1957. The first court case to articulate a reasonable person standard adopted by the high courts in Canada and Australia was heard in the U.S. in 1972. Today, informed consent continues to develop in four areas: (i) the court‐based doctrines of consent and informed consent in clinical care in judge‐made law; (ii) federal regulations related to research on human study participants; (iii) shared decision making adopted by care organizations and medical societies in the US, Canada, and Europe; and (iv) areas including decision analysis, discourse analysis, ethics, linguistic analysis, patient–physician communication, risk and evidence communication, and social theory. In this paper, we will focus on consent and informed consent in the first part of the twenty‐first century. We will examine a range of information and decision making frameworks from the oldest court‐established frameworks of consent and informed consent to recent conceptions of information and decision making in evidence‐based decision making and shared decision making in the patient–physician relationship. This paper is divided into three parts: I. What informed consent is, II. What informed consent isn't, and III. Future challenges in informed consent and shared decision making.     

Informed Consent: Provider Responsibilities in Psychotherapy

Abstract

When a psychotherapist and patient meet for the first time, there may be a multiplicity of assumptions on both sides about expectations and goals. This paper describes that crucial relationship and the work that must take place in order that a patient gives a relatively informed consent about the therapeutic process. Due to the many variables and unknowns, there is no such thing as an absolute informed consent in psychotherapy. A relatively informed patient, however, is one who is better prepared to enter into a therapeutic alliance. These important concepts are illustrated with case examples.     

A Genetically Informed Study of the Intergenerational Transmission of Marital Instability

Environmental or genetic influences, or both could account for the increased risk of divorce among the offspring of separated parents. Previous studies have used covariates to statistically control for confounds, but the present research is the first genetically informed study of the topic. The investigation used the Children of Twins Design with twins, their spouses, and their young adult offspring (n = 2,310) from the Australian Twin Registry to test whether selection on the basis of genetic or shared environment factors accounted for part of the intergenerational association. The analyses also controlled for measured characteristics of both parents. The results suggest that both environmentally mediated and genetic risk account for the intergenerational transmission, supporting the roles of both selection and causation.     

Individual powers and social consent: an axiomatic approach

We introduce a notion of conditionally decisive powers the exercise of which depends on social consent. Decisive powers, or the so-called libertarian rights, are examples and much weaker forms of powers are covered by our notion. We provide an axiomatic characterization of existence of a system of powers and its uniqueness as well as characterizations of various families of rules represented by systems of powers. Critical axioms are monotonicity, independence and symmetric linkage (person i and i’s issues should be treated symmetrically to person j and j’s issues for at least one linkage between issues and persons).     

Outsiders in the union: organizing,consent, and union recognition campaigns

Although outsiders have played an important role in social protest in the U.S., outsiders’ role in the U.S. labor movement has been the focus of spirited debate. Debate about outsider organizers, in particular, reached a fevered pitch in the late 1990s, and continues today. This paper scrutinizes two of the core assumptions of this debate: that insider and outsider organizers operate differently on union recognition campaigns, and that workers respond to them differently in these settings. We analyzed 153 in-depth interviews with workers and organizers conducted at the height of the debate, in order to answer two questions: What is the role of outsider organizers during private sector union recognition campaigns, and how do outsider organizers secure workers’ consent in these settings? All of the organizers in our data-set were graduates of the AFL-CIO’s Organizing Institute, and 64 of them were outsiders. The outsider organizers in our data-set confronted barriers that insider organizers did not, including workers’ concerns about their youth, inexperience and lack of professionalism, and their own inability to relate to workers. While many critics of outsider organizers claim that these barriers are insurmountable, we found the opposite to be true. The vast majority of outsider organizers in our data-set successfully secured workers’ consent by demonstrating commitment, building relationships, and being honest and forthright. After proposing changes in organizer training and leadership development in response to these findings, we conclude with a brief discussion of the enduring debate about outsiders’ role in social protest in the U.S.