An exploratory analysis of composite choices: Weighing rationality versus irrationality

Humans are engineered neurologically to make rational and irrational choices. This paper introduces a new paradigm for decision making – a composite choice model – in which economic agents are constantly weighing rationality versus irrationality when encountering options. In an exploratory, deterministic, two-period model, an assumption of a two-way cross-embedment (i.e., a two-way interaction between the rational and irrational components) results in a paradoxical phenomenon, an outcome of either tending toward bliss or abyss at the end of the first period. This implies, for instance, a psychological struggle between two selves within the mind. The paradigm proposed is compared to the dual-process theories recently developed by the cognitive sciences. Future research will explore implications for public policy design and implementation.     

Returning Patients to the Community: disability, medicine and economic rationality before the Industrial Revolution

This paper offers an interpretation of physical impairment in eighteenth-century Britain which challenges the view that disability was largely a product of industrial capitalism. After reviewing the historical models of Finkelstein, Stone and Oliver, in which this position is put forward, attention turns to a case study of the General Infirmary at Bath, founded in 1739 to grant 'poor cripples and other indigent strangers' access to the spa waters. Dedicated to the prevailing moral economy of mercantilism, the Bath Infirmary sought to return its patients to the community in a state of physical and moral fitness. The economic implications of this objective are discussed in relation to the work imperative, the therapeutic performance of the institution and the age/sex characteristics of its clientele. The political implications are discussed in relation to the practice of medicine and the pursuit of an orderly society. It is concluded that medical charity points to incompatibilities between impairment and economic rationality in advance of the Industrial Revolution.     

Independence, Dependence, Interdependence: some reflections on the subject and personal autonomy

A sociology of disablement needs to redefine the meaning of independence. In Western industrial societies, independence is associated with being able to do things for oneself, to be self-supporting and self-reliant. The paper attempts to show that some of our understanding of independence is influenced by views of the subject and personal autonomy stemming from the Enlightenment philosophy. The main target of the paper is to show that the modernist view of the subject is inadequate. What is missing is the notion of interdependence. The paper suggests an understanding of the subject that recognises the human condition as one of interdependence. It is argued that a reformulation of the subject as both embedded and embodied, bears better to a sociology of disablement.     

Postmodernism, rationality and the evaluation of health care

This paper examines the logic of evaluation of health care services, calling into question the possibility of assessing the extent to which medicine and health care systems are ‘rational’ or ‘irrational’ The paper analyses and rejects claims to rationality made in discourses on evaluation and in particular economic evaluation, by recourse to Weber's distinction between formal and substantive rationalities. The rationality claimed by evaluation is a value-laden and therefore substantive rationality. Similarly, the claims of the rational actor model are seen to over-simplify the ways actors interact in the market. This leads to a postmodernist perspective rejecting the idea of a single rationality, which if it can only be grasped enables the achievement of Truth, and substituting the position of contingent and fragmentary discourse, brought into being to serve the interests of particular groups in determining knowledge and power. With regard to the evaluation of health services, whereas the modernist assumes that the Enlightenment metanarrative of rationality has imbued the provision and delivery of health care, and that the evaluation by another discipline within this metanarrative, for instance health economics, can fine-tune this rational system for efficacy and efficiency, and suggest changes, the postmodern position recognises that both are distinct discursive perspectives, constituted for local reasons. This position is then applied to a case study of the management of surgical services based on ethnographic work conducted by the author. Deconstruction of the ethnography derives an understanding of the disruption of surgery as being a consequence of the arrangements for clinical advice in the committee structure of management.     

Older lesbian sexuality: identity, sexual behavior, and the impact of aging

In response to the very limited and mostly outdated literature on older lesbian sexuality, this exploratory study examined older lesbian sexual identity, romantic relationships, the impact of aging, and experiences of discrimination within these contexts. Utilizing an online survey that recruited via numerous online lesbian communities and snowball sampling, 456 lesbians over the age of 50 responded to closed, Likert scale, and open-ended questions that provided a preliminary understanding of older lesbian sexuality. The results indicated that older lesbians have experienced fluidity in past romantic and sexual relationships, as well as in erotic fantasies, despite strong identification with being lesbian. The findings also indicate a decreased focus on sexuality in the context of relationships, with more focus on stability and continuity. Future research is needed that provides greater specificity and detail about older lesbian conceptions of sexual behavior and sexual identity labels, as well as specific sexual behaviors.     

Ethnographic boundaries: Culture,class, and sexuality in Tokyo

For those engaged in participant-observation, the first few months in the field are usually extremely difficult. By taking a reflexive turn, however, the events recorded during entrée are invaluable for revealing the social and cultural dimensions of the new life a researcher creates for him or herself. The following is an account of one researcher's attempt to enter a community in contemporary Tokyo. This account reveals the boundaries of culture, class and sexuality between the researcher and the community. The complex set of highly personal ramifications resulting from crossing those boundaries are also discussed.Many people have read various versions of this paper, but I would especially like to thank the following for taking the time to provide me with thought provoking comments: Beverly Eliasoph, Steven Brint, Deborah Davis-Friedmann, Ezra Vogel, Robert J. Smith, Shulamit Reinharz, and Lee Rainwater. I am especially indebted to Dorinne Kondo, whose insights and warm support proved to be invaluable. Of course, all of the usual disclaimers apply.     

Disability,poverty and development: critical reflections on the majority world debate

Beyond rough estimates, little is known about disability in the majority world and complexities related to context and poverty are too often unacknowledged in the quest to simplify, generalise and export disability discourse, models and strategies. Disability remains peripheral to the larger development agenda and the disability studies debate maintains an almost exclusive focus on western settings, loaded with associated historical, social and cultural assumptions. In the light of this, this paper seeks to elucidate and engage with complex issues surrounding the disability and majority world debate, critique and challenge the exportation of western focused disability models and discourse and engage with possible avenues for bridging the gap between disability and development.     

Two sources of human irrationality: Cognitive dissonance and brain dysfunction

Akerof and Dickens explored the relevance of cognitive dissonance theory for economics, and the theory is shown here to predict occasional irrational thinking. Secondly, it is proposed that the focus of neuroeconomics on brain dysfunction and the role of neurotranmitters on cognition suggests two ways in which the functioning of the brain can impair rational decision-making.     

Narratives of identity: Denying empathy in conservative discourses on race,class, and sexuality

Issues of identity are crucial in current political debate. This article analyses narratives of identity using three very different examples, namely colonial-settler Australia, lesbian romance genres, and the role of class in contemporary American and British politics. It explores both privileged and marginalized identity narratives and the tensions between them. For example, lesbian romance narratives are contrasted with religious right arguments against same-sex marriage. Some argue that the complex intersections, compatibilities, and differences between conflicting narratives of identity reveal a great deal about how specific concepts of identity are formed. The narratives examined do not produce explicit binary constructions of dominant and subordinate identity categories. Rather, being able to imagine (or not imagine) other narratives plays an important part in the process of constructing identities within these discourses. Narratives that foreclose empathy facilitate the denial that discrimination or subordination is taking place. Similarly, privileged narratives of identity facilitate subjects ability to think well of themselves and their treatment of others.