Need, allocation and justice — on priorities in the social services

Cuts in public spending and financial constraints faced by Swedish municipalities have led to an increased interest in issues concerning priorities. This interest reflects a practical need to meet current rationing with accurate allocative decisions, where the interests of different areas and categories of users are dealt with in a well-considered way. In social work, these needs today are obvious. The article raises issues concerning priorities with relevance for social work in the Swedish social services. The purpose is to develop a conceptual and theoretical framework regarding how priorities on different levels of decision-making are made, where the main focus is on different principles as grounds for and forms of prioritizing. Central are the following questions: What actors can be identified in the process of shaping priorities in social work? What are the principles behind allocative decisions made on different levels of the municipal organization? Which categories of potential and actual users gain advantages or suffer disadvantages from different allocative principles? A theoretical division into first- and second-order decisions and of allocations from notions of efficiency, justice and self-interest offer the main structure for the article. First-order decisions are political decision-making concerning the total amount of resources distributed to various sectors or programs. Second-order decisions deal with the issue of how to allocate given resources among claimants or possible users. Efficiency is discussed from the aspects of productivity, marginal utility and longterm effects. Material principles of justice dealt with are the principles of need, increment, contribution and merit. Self-interest is discussed in terms of self-serving bias, group-oriented interests and professional gain.     

Marital Relationships in Old Age

The data of a sociological survey conducted in the city of Saratov in 2009 reveal a narrow perception of the everyday lives of an elderly married couple on the part of those who are in regular contact with them (relatives, neighbors, and friends). They are most often described in terms of a declining trajectory of health and material security, or performance of generic activities (gardening, tending grandchildren), and only rarely in terms of the emotional relationship between the married partners.     

Euthanasia: an introduction

It has been argued that euthanasia is one of the most pressing social concerns of our times. A review of current scientific and legal materials, however, indicates that this issue is a complex and contentious one that crosses numerous perspectives and theoretical orientations. In order to provide background for the other articles in this collection, we present a brief history of attitudes toward euthanasia. In addition, various terms that are associated with the concept of euthanasia are defined. Finally, this paper provides a framework for the articles that follow by suggesting that three central issues must be addressed in order to resolve the controversies surrounding euthanasia. These are (1) the establishment of standardized criteria of euthanasia eligibility, (2) the investigation of public attitudes regarding acceptable means for engaging in euthanasia, and (3) the evaluation of the roles of professionals who are directly involved in euthanasia decisions. We hope that the following articles will provide insight into these issues.     

Asymmetric Choquet random walks and ambiguity aversion or seeking

Asymmetric Choquet random walks are defined, in the form of dynamically consistent random walks allowing for asymmetric conditional capacities. By revisiting Kast and Lapied (Dynamically consistent Choquet random walk and real investments. Document de Travail n. 2010-33, GREQAM, HAL id: halhs-00533826, 2010b) and Kast et al. (Econ Model, 38:495–503, 2014) we show that some findings regarding the effects of ambiguity aversion are preserved in the more general framework, which is of interest in several applications to policy making, risk management, corporate decisions, real option valuation of investment/ disinvestment projects, etc. The effect of ambiguity on the higher moments is investigated, as well, as they have an interpretation in terms of the psychological attitude of a decision-maker towards ambiguity. Finally, some financial applications are provided as an illustration.     

Developing a compliance‐based approach to address error,evasion and fraud in social security systems

To support the improved administration of social security programmes, this article presents a preliminary compliance risk management (CRM) model for social security institutions to use as a tool to help address the operational challenges of error, evasion and fraud. Within the model, error, evasion and fraud are collectively referred to as issues of non‐compliance. The model's framework addresses non‐compliance in an integrated manner with regard to the main functions of contribution collection and benefit administration. The model aims to facilitate tackling these important issues by better permitting the identified challenges to be prioritized and, thereafter, addressed based on the assessed severity of their impacts and the cost‐effectiveness of the selected responses. Three generic types of intervention are recommended to tackle non‐compliance worldwide: prevention, detection and deterrence. The article's objective is to contribute to ongoing work to develop an encompassing CRM framework for all social security systems.     

The effect of fast and slow decisions on risk taking

We experimentally compare fast and slow decisions in a series of experiments on financial risk taking in three countries involving over 1700 subjects. To manipulate fast and slow decisions, subjects were randomly allocated to responding within 7 seconds (time pressure) or waiting for at least 7 or 20 seconds (time delay) before responding. To control for different effects of time pressure and time delay on measurement noise, we estimate separate parameters for noise and risk preferences within a random utility framework. We find that time pressure increases risk aversion for gains and risk taking for losses compared to time delay, implying that time pressure increases the reflection effect of Prospect Theory. The results for gains are weaker and less robust than the results for losses. We find no significant difference between time pressure and time delay for loss aversion (tested in only one of the experiments). Time delay also leads to less measurement noise than time pressure and unconstrained decisions, and appears to be an effective way of decreasing noise in experiments.     

A theory of instrumental and existential rational decisions: Smith,Weber, Mauss,Tönnies after Martin Buber

This paper proffers a dialogical theory of decision-making: decision-makers (DMs) are engaged in two modes of rational decisions, instrumental and existential. Instrumental rational decisions take place when the DM views the self externally to the objects, whether goods or animate beings. Existential rational decisions take place when the DM views the self in union with such objects. While the dialogical theory differs from Max Weber’s distinction between two kinds of rationality, it follows Martin Buber’s philosophical anthropology. The paper expounds the ramifications of the dialogical theory in understanding structures of exchange considering assessments of diverse thinkers.

     

Examination of the Child Protective Services Decision-Making Context with Implications for Decision Support System Design

Abstract

The general perception of Child Protective Services (CPS) decision making is that it is inconsistent and prone to error. As a result, risk assessment instruments were developed to enable investigators to make better decisions. The present study uses a qualitative approach with an explicit theoretical framework pertinent to management information systems and decision support system design to examine the context in which investigators operate and make decisions. The resulting information can be used to determine design requirements that would improve the experience of using a risk assessment instrument that serves as a decision support system (DSS) for CPS investigators.     

Research as a Social Process

The activity of social research has been much discussed in recent years. It is examined here as a social process, with special attention to the participation of different groups of people. Four modes of doing research are identified. The framework accommodates and shows close relationships between established modes of research which generally have been seen to be substantially different. At the same time it includes modes which are more participatory in character and which have important implications for undertaking research, the development of theory, and the functioning of social groups, including society.     

A procedural model of voting

The formal framework of social choice theory is generalized through the introduction of separate representations of preferences and choices. This makes it possible to treat voting as a procedure in which decisions are actually made by interacting participants, rather than as a mere mechanism for aggregation. The extended framework also allows for non-consequentialist preferences that take procedural factors into account. Concepts such as decisiveness, anonymity, neutrality, and stability are redefined for use in the new context. The formal results obtained confirm the universality of strategic voting.     

When risky decisions generate externalities

Many risky decisions generate either positive externalities (e.g., opening a small business, engaging in research and development, vaccinating) or negative externalities (e.g., smoking, reckless driving, unprotected sex). I develop a new experimental framework for evaluating risk tolerance when risky decisions that generate externalities by modifying the allocation task of Gneezy and Potters (1997). In the ‘risk with externalities’ framework, for each unit increase in a risky allocation, an external cost or benefit is imposed upon a group member. I further vary the magnitude of the external effect to investigate the sensitivity of risk taking to the marginal external effect. Results indicate that risky decisions are driven by a combination of social and non-social factors. When individuals both impose and receive externalities, the preferred level of risk taking is lower if the externality is negative, regardless of the magnitude of the marginal external effect. Risk taking is then further affected by the magnitude of the marginal external effect. For individuals who only impose externalities, behavior is consistent with a disutility from imposing harm (but not a sensitivity to the magnitude of the external effect). For those who only receive externalities, individuals increase (decrease) their risky allocation when they are in a decision environment where they receive external benefits (costs). Additional treatments suggest that results are consistent with decreasing relative risk aversion plus an additional disutility from either imposing or receiving harmful externalities.

     

Robust Control in Water Management

Since surface water flows are often stochastic, there is a role for water reservoirs in protecting users against uncertainty. We assume uncertainty regarding the probability distribution for the stochastic variable. Thus the decision allows for a range of approximate models that could be true, and the problem can be solved using robust optimal control. This paper analyses the implications of a robust framework on resource management decisions, using the case of water as an illustration. Robust choices are compared with those of a benchmark stochastic model and the emergence of precautionary behaviour is discussed.     

Psychological issues in euthanasia, suicide, and assisted suicide

This paper reviews various life-ending techniques such as euthanasia, suicide, and assisted suicide in order to better address the psychological issues related to these actions. Specific attention is paid to investigating when a death is deemed to be appropriate and the role that the level of appropriateness should play in the decisions of individuals to terminate a life. In addition, a number of additional psychological concepts such as locus of control and subjective norms are examined in terms of their importance for decisions regarding euthanasia and suicide.     

Health Policy and the Politics of Evidence

National decisions on the drugs, treatments and medical devices that should be funded through public expenditure are a fundamental element of health policy. But despite a political emphasis upon evidence‐based policy, the results of rigorous clinical trials and statistical modelling techniques rarely speak for themselves. So, does the pre‐eminence traditionally accorded to quantitative data in the medical field underpin policy decisions on a consistent basis? Or are more subtle, less transparent characteristics of context and interaction evident in the shaping of attendant decisions? This article considers these questions by drawing on a study of decision‐making in the National Institute for Health and Clinical Excellence (NICE)—an organization established by the British government in 1999 to decide whether selected health technologies should be made available throughout the National Health Service in England and Wales. In broad terms, the findings point to the primacy of arguments based on quantitatively oriented, experimentally derived data but also to a discursive hegemony of clinicians and health economists in mediating, including or debarring more qualitative, experientially based evidence. A more complex, dynamic understanding of policy governance in the field of health technology appraisal—founded on a discursive appropriation of the idea of the “common good”—goes some way to explaining the persistence of this hegemony despite an avowedly inclusive, plural approach to decision‐making.     

A Survey of Approved Social Work in England and Wales

Correspondence to Prof. P. Huxley, Department of Psychiatry, University of Manchester, Mathematics Tower, Oxford Road, Manchester M13 9PL. Summary A survey of approved social workers (ASWs) was undertaken withlocal authorities in England and Wales, to review the provisionand organization of ASW services, and the contribution theymake towards the establishment and maintenance of a comprehensivemental health service. The findings show some variation in provisionwhich is in itself indicative of a variety of factors operatingto produce local and regional patterns of provision. Some ofthese are related directly to policy decisions, others to demographicand geographic variables, while still more are related to teamstructure, workload demands, and generic/specialist issues.The future pattern of mental health social work following theimplementation of the NHS and Community Care Act is consideredin the light of the findings from the survey.     

Multiple-Stage Decision-Making: The Effect of Planning Horizon Length on Dynamic Consistency

Many decisions involve multiple stages of choices and events, and these decisions can be represented graphically as decision trees. Optimal decision strategies for decision trees are commonly determined by a backward induction analysis that demands adherence to three fundamental consistency principles: dynamic, consequential, and strategic. Previous research (Busemeyer et al. 2000, J. Exp. Psychol. Gen. 129, 530) found that decision-makers tend to exhibit violations of dynamic and strategic consistency at rates significantly higher than choice inconsistency across various levels of potential reward. The current research extends these findings under new conditions; specifically, it explores the extent to which these principles are violated as a function of the planning horizon length of the decision tree. Results from two experiments suggest that dynamic inconsistency increases as tree length increases; these results are explained within a dynamic approach–avoidance framework. This revised version was published online in June 2006 with corrections to the Cover Date.     

The future of inter‐country adoption: A paradigm shift for this century

Fronek P, Cuthbert D. The future of inter‐country adoption: a paradigm shift for this century The only existing international framework for inter‐country adoption (ICA) is a legal one. Current legal and welfare approaches have limitations in that ICA tends to be conceptualised in individualistic terms, while strategies that prevent ICA by strengthening communities and addressing structural inequalities in the first instance are neglected and divorced from ICA practice. A vision and an overarching framework based on a socioecological approach that informs other arenas, such as health promotion, are proposed. The article concludes that the development of collaborative, intersectoral approaches, the reorientation of public and private resources and international leadership from academics, legislators, policy makers, practitioners and communities are necessary for a paradigm shift for this century.     

Fit for Work? The Influence of Sick Pay and Job Flexibility on Sickness Absence and Implications for Presenteeism

Recent developments in UK policy on health and employment have sought to change perceptions about what constitutes ‘fitness for work’. With the aim of reducing the incidence and duration of sickness absence, a range of initiatives, including the introduction of the ‘fit note’, are challenging the belief that it is necessary to be 100 per cent well in order to be at work. However, this article suggests that contextual factors independent of health may also influence people's decisions about whether or not to attend work at times of reduced wellness. Drawing upon data from a qualitative study of mental health and employment, this article illustrates how the terms and conditions of a person's employment may influence sickness absence decisions in a number of ways. It is argued that sick pay provisions, size of employer and nature of work may influence both decisions to take time off and decisions about when to return to work. The degree of flexibility to manage one's workload around times of poorer health may also have a bearing on whether people feel able to carry on with their work without recourse to sickness absence. Therefore, it may be important for policy interventions to consider not only health circumstances but also structural/contextual influences on conceptualizations of being ‘fit for work’. The implications of such contextually‐influenced decision‐making for ‘presenteeism’ are also considered. It is suggested that current conceptualizations of presenteeism are somewhat ambiguous; employees coming to work despite ill health is simultaneously presented as a problem and an aspiration.     

Data audit: Its place in auditing

The terms “audit”; and “data audit”; have previously appeared in the science literature (see for example, Glide, 1975, p. 207, 1976, pp. 187–190; Noel, 1979, p. 73). Attempts have been made in that literature to discuss the nature of these terms. However, we are not aware of any discussions that have evaluated the nature of “data auditing”; in terms of the existing auditing literature. In this paper we briefly review the history of traditional auditing; briefly review the various types of auditing and auditors that exist in the United States; consider the generic nature of auditing; consider definitions of data audits that appear in existing science literature; consider the nature of data auditing; and consider where data auditing can be placed within auditing.