Disclosure Issues in Neuroscience Research

Issues of disclosure arise in neuroscientific research during the informed consent process, whenever incidental findings are identified, and when study results are generated. The possibility of disclosure of incidental findings and/or research results may raise informational expectations on the part of subjects and may alter a study's risk:benefit ratio. We recommend that the informed consent process address this potential consequence of research participation, and specify the conditions under which particular types of information will be offered, the conditions under which information may not be disclosed, and any provisions for helping subjects make sense of the information to be disclosed.     

Disclosure issues in neuroscience research

Issues of disclosure arise in neuroscientific research during the informed consent process, whenever incidental findings are identified, and when study results are generated. The possibility of disclosure of incidental findings and/or research results may raise informational expectations on the part of subjects and may alter a study's risk:benefit ratio. We recommend that the informed consent process address this potential consequence of research participation, and specify the conditions under which particular types of information will be offered, the conditions under which information may not be disclosed, and any provisions for helping subjects make sense of the information to be disclosed.     

How Much Internalization of Nuclear Risk Through Liability Insurance?

An important source of conflict surrounding nuclear energy is that with a very small probability, a large-scale nuclear accident may occur. One way to internalize the associated financial risks is through mandating nuclear operators to have liability insurance. This paper presents estimates of consumers' willingness to pay for increased financial security provided by an extension of coverage, based on the 'stated choice' approach. A Swiss citizen with median characteristics may be willing to pay 0.14 US cents per kwh to increase coverage beyond the current CHF 0.7 billion (bn.) (US$ 0.47 bn.). Marginal willingness to pay declines with higher coverage but exceeds marginal cost at least up to CHF 4 bn.(US$ 2.7 bn.). An extension of nuclear liability insurance coverage therefore may be efficiency-enhancing.     

Incidental findings: a common law approach

Federal regulations governing human subjects research do not address key questions raised by incidental neuroimaging findings, including the scope of a researcher's disclosure with respect to the possibility of incidental findings and the question whether a researcher has an affirmative legal cuty to seek, detect, and report incidental findings. The scope of researcher duties may, however, be mapped with reference to common law doctrine, including fiduciary, tort, contract, and bailment theories of liability.     

Incidental Findings: A Common Law Approach

Federal regulations governing human subjects research do not address key questions raised by incidental neuroimaging findings, including the scope of a researcher's disclosure with respect to the possibility of incidental findings and the question whether a researcher has an affirmative legal cuty to seek, detect, and report incidental findings. The scope of researcher duties may, however, be mapped with reference to common law doctrine, including fiduciary, tort, contract, and bailment theories of liability.     

Lloyd's Financial Distress and Contagion within the US Property and Liability Insurance Industry

The intra-industry effect of Lloyd's financial distress on publicly traded US insurance companies is examined. Given Lloyd's prominence in the international insurance industry, large losses raised questions about the industry's capacity for certain types of risks and the financial solvency of other insurers. The market value of US property-liability insurers fell significantly at the announcement. This decline is related to the firm's revenues from insurance and reinsurance exposure. Results support contagion between Lloyd's distress and the US insurance industry. The study raises concerns about the potential for a systematic disruption of the supply of reinsurance in the international marketplace.     

Insurance demand and social comparison: An experimental analysis

This paper analyzes whether social comparison can explain the low take-up of disaster insurance usually reported in field studies. We argue that risks in the case of disasters are highly correlated between subjects whereas risks for which high insurance take-up can be observed (e.g. extended warranties or cell phone insurance) are typically idiosyncratic. We set up a simple model with social reference points and show that in the presence of inequality aversion social comparison makes insurance indeed less attractive if risks are correlated. In addition we conducted a simple experiment which confirms these theoretical results. The average willingness to pay for insurance is significantly higher for idiosyncratic than for correlated risks.     

Guaranteed renewability uniquely prevents adverse selection in individual health insurance

New models of multi-period insurance show that health insurance buyers can be protected against changes in premiums from health shocks associated with chronic conditions by the addition of “guaranteed renewability” provisions. These models assume that a buyer’s risk level in every time period is observed by all insurers. They also require a premium sequence that is “front-loaded,” which may be costly to buyers if capital markets are imperfect. We relax the common knowledge feature of the model by assuming that a person’s risk in any time period is known only by that individual and the current insurer. One might suspect that a premium sequence with higher later period premiums would be incentive compatible because low risks will have less desirable offerings from alternative insurers. However, we show that generally, only the original premium schedule is incentive compatible, and attempts to alter front-loading will not be an equilibrium.     

Does insurance fraud in automobile theft insurance fluctuate with the business cycle?

Financial institutions face various cyclical risks, but very few studies have analyzed the cyclicality of operational risk. External fraud is an important operational risk faced by insurers. In this research, we analyze the empirical relationship between insurance fraud and the business cycle and we concentrate our study on two insurance contracts that may create an incentive to defraud. We find that residual insurance fraud exists both in the contract with replacement cost endorsement and the contract with no-deductible endorsement in the Taiwan automobile theft insurance market. These results are consistent with previous literature on the relationship between fraud activity and non-optimal insurance contracting. We also show that the severity of insurance fraud is countercyclical. Fraud is stimulated during periods of recession and mitigated during periods of expansion. Although this last result seems intuitive, our contribution is the first to measure its significance.     

Social exclusion and neighborhood support: a case study of empty-nest elderly in urban shanghai

The phenomenon of empty-nest elderly (ENE) has become a significant social issue in China. In this research on ENEs in urban Shanghai, a coastal city in China, case studies were undertaken through in-depth semistructured interviews to examine the social exclusion risks ENEs may face and the influence of neighborhood support on such risks. The results show 5 aspects of social exclusion ENEs are experiencing. Moreover, the neighborhood has the potential for providing different forms of support to reduce social exclusion risks. The research and service implications of our findings for promoting the holistic well-being of ENEs in China are discussed.     

The economics of adding and subdividing independent risks: Some comparative statics results

In this paper we address the problem of determining whether adding independent risks or subdividing them is a good substitute for insurance. Despite the fact that accepting more i.i.d. risks increases total risk, it is shown that some risk-averse decision makers can rationally reduce their demand for insurance by doing so. Similarly, a better diversified portfolio of i.i.d. risky assets can rationally be more insured, even if diversification is a risk-reduction scheme. We derive conditions sufficient to obtain unambiguous comparative statics results. Assuming that absolute risk aversion is decreasing and that the fourth derivative of the utility function is positive, we show that diversification is an exceptionally good substitute for insurance. Under the same conditions, adding independent risks to wealth reduces the demand for insurance on each unit.     

Labour market mobility and workers' skills in a comparative perspective: exploring the role of unemployment insurance benefits

This article argues that there might be important efficiency gains for countries to provide generous unemployment insurance benefits. Firstly, generous unemployment benefits might reduce the risks, real or perceived, associated with labour market transitions such as changing employer and/or career. Secondly, such benefits might increase workers' skills levels, both by functioning as a form of insurance for workers' investments in skills that are not easily transferable between employers and by facilitating the accumulation of skills that are developed through experience with different employers. These arguments are supported by empirical data, covering 14 countries, from the Eurobarometer survey.     

Disclosure of Unknown Harms in Magnetic Resonance Imaging Research

Unknown harms are by their nature difficult to communicate. While magnetic resonance imaging (MRI) has known risks (e.g., metal projectiles, dislodgement of medical implants), this imaging modality also has potential unknown long-term negative health effects associated with its static magnetic fields. We carried out a research ethics board (REB) file review of previously approved MRI research studies and found that unknown risks were either left undisclosed or were inadequately disclosed to research participants and REBs. This article outlines issues raised by our REB file review and suggests steps that should be taken in order to satisfactorily communicate information about potential unknown harms of MRI.     

Buying Insurance for Disaster-Type Risks: Experimental Evidence

This paper presents a series of experiments that confront subjects with low probability, high loss situations. A rich parameter set is examined and we find subjects respond to low probability, high loss risks in predictable ways. As loss events become more likely, or loss amounts get larger, or the cost of insurance falls, subjects are more likely to buy indemnifying insurance, even for the class of low probability risks that usually presents problems for standard expected utility theory. A novel application of Cameron's method to estimate willingness to pay from dichotomous choice responses allows us to estimate willingness to pay for insurance. We do not observe the bimodal distribution of bids found in other studies of similar risk situations.     

The catastrophic effects of natural disasters on insurance markets

Natural disasters often have catastrophic risks on insurance companies as well as on the insured. Using a very large dataset on homeowners’ insurance coverage by state, by firm, and by year for the 1984 to 2004 period, this paper documents the positive effect on losses and loss ratios of both unexpected catastrophes as well as large events that the authors term “blockbuster catastrophes.” Insurers adapt to these catastrophic risks by raising insurance rates, leading to lower loss ratios after the catastrophic event. There is a widespread event of unexpected catastrophes and blockbuster catastrophes that reduces total premiums earned in the state, reduces the total number writing insurance coverage in the state, and leads to the exit of firms from the state. Firms with low levels of homeowners’ premiums are most adversely affected by the catastrophes.     

The Diversification Theorem Restated: Risk-pooling Without Assignment of Probabilities

Bayesian decision theory assumes that agents making choices assign subjective probabilities to outcomes, even in cases where information on probabilities is obviously absent. Here we show that agents that presume that they are equal risks can share risks mutually beneficially, even if the probabilities of losses are unpredictable or genuinely uncertain. We show also that different risk aversions among pool members do not exclude mutually beneficial loss sharing at uncertainty. Sharing when individuals’ losses differ in probabilities or in amount may still make individuals better off. Our findings are related to the theory of the insurance firm, to the management of development risks, and to the theory of justice.JEL Classification: D8, G22, L10, L30     

Inequality in Social Insurance Participation and Generosity: Do Firm Characteristics Matter?

Income inequality in China has been much documented and debated. However, one important aspect of income inequality – social insurance inequality – has been largely understudied. We use a large national panel of firm data to examine the possible influence of various firm characteristics on the inequalities in social insurance participation and generosity in the period 2004–07. Our findings reveal substantial ownership sector and regional gaps in social insurance provision by firms, with the private domestic sector and those in the central region lagging behind. Unionized firms, larger firms, and firms with greater market shares also tend to provide better social insurance to their employees. While being an exporting firm is linked with greater social insurance participation and generosity, being a purely exporting firm, however, is associated with reduced social insurance generosity. Lastly, highly educated workers receive substantially better social insurance coverage than their less educated peers. These social insurance inequalities are highly relevant as China pushes forward with establishing a unified social insurance system across urban‐rural boundaries, ownership sectors and industries.     

The Role of Intuition in Risk/Benefit Decision-Making in Human Subjects Research

One of the key principles of ethical research involving human subjects is that the risks of research to should be acceptable in relation to expected benefits. Institutional review board (IRB) members often rely on intuition to make risk/benefit decisions concerning proposed human studies. Some have objected to using intuition to make these decisions because intuition is unreliable and biased and lacks transparency. In this article, I examine the role of intuition in IRB risk/benefit decision-making and argue that there are practical and philosophical limits to our ability to reduce our reliance on intuition in this process. The fact that IRB risk/benefit decision-making involves intuition need not imply that it is hopelessly subjective or biased, however, since there are strategies that IRBs can employ to improve their decisions, such as using empirical data to estimate the probability of potential harms and benefits, developing classification systems to guide the evaluation of harms and benefits, and engaging in moral reasoning concerning the acceptability of risks.     

Catastrophic responses to catastrophic risks

Socializing risks from catastrophic losses is difficult even in an ideal political environment, owing to different estimates of low probability risks, solvency constraints, dangers of moral hazard, and high loss correlation. However, these intrinsic contracting problems do not justify invalidating ordinary insurance contracts or forcing insurers to cover catastrophic losses. Yet, political pressures forcing insurance subsidies now induce inefficient decisions in siting and construction, with high expected social losses. Ordinary contract solutions are always imperfect, but superior to the regulatory maze. Unfortunately, patterns of legislation and court decisions are running in the wrong direction.     

Safety First: Recognizing and Managing the Risks to Child Participants in Magnetic Resonance Imaging Research

Specialized and up-to-date knowledge is required to identify and manage the risks associated with advanced biomedical research. Additional complexities need to be considered when the research involves infants or young children. In this article, we focus on recent information about the physical risks of pediatric magnetic resonance imaging research and highlight information gaps. With an eye to assisting institutional review boards and researchers, we consider strategies for the management of these risks and formulate key questions aimed at exposing hidden hazards. Institutional review boards should ask these questions, and researchers should bear them in mind as they develop research protocols.