Some criteria for making decisions concerning the distribution of scarce medical resources

In this paper I proceed on the assumption that moral philosophers can and should contribute to the resolution of perplexing moral problems. The ones considered here relate to decisions concerning the distribution of scarce medical resources as between those in need of treatment. I draw on considerations of egalitarianism and concern for the maximization of the use of scarce resources in the task of satisfying basic human needs (such as for good health). I propose certain principles and offer some supporting suggestions as guidelines or rules for medical decisions with a view to providing a helpful decision procedure for the various persons (doctors, community panels and so on) whose task it is to make the life-or-death decisions involved in allocating certain scarce medical resources.     

Resource management schemes

Every large management organization undergoes the cyclic progress of planning, programming, budgeting, and rating of work tasks of projects to be accomplished by priority in the light of resource constraints controlling personnel strenghts and operating funds by fiscal periods. This is true, especially of governmental departments that are commodity oriented. There must be some ultimate goal of fine grain visibility that management can attempt to achieve or at least approach in order for the functional directors within the organization structure to relate and report most readily to provide required data for proficient resource management. Two essential requirements are visibility and integrated reporting as herein prescribed. Following the ascertainment of resource requirements in the light of projected work effort, some logical procedure should be employed in the rationale of resource adjustments. The Tolerance Box technique is herein described.     

Repeat abortion

A reanalysis of the repeat abortion experience of New York City residents during July 1, 1970 to June 30, 1972 is undertaken on the basis of a probability model that generates repeat abortion ratios as a function of assumptions about fecundity, contraceptive efficiency, and exposure lengths. Tested are three hypotheses put forward by Daily et al. in a 1973 analysis: (i) the low repeat abortion ratio of .0245 is attributable in part to underreporting of registered induced abortions as repeat ones; (ii) a major part of the rise in repeat abortion ratios, from virtually zero to six percent over four consecutive six-month intervals, is explainable in terms of the rising volume of exposure time to risk of repeat abortion relative to the stream of initial abortions; and (iii) the higher abortion ratios of women in their twenties compared to those of older or younger women is ascribable to “differences in fecundity and intercourse frequency.” Support is found for the first two hypotheses, and a mixed outcome for the third.     

An Information Theoretic Framework for Exploratory Multivariate Market Segmentation Research*

State-of-the-art market segmentation often involves simultaneous consideration of multiple and overlapping variables. These variables are studied to assess their relationships, select a subset of variables which best represent the subgroups (segments) within a market, and determine the likelihood of membership of a given individual in a particular segment. Such information, obtained in the exploratory phase of a multivariate market segmentation study, leads to the construction of more parsimonious models. These models have less stringent data requirements while facilitating substantive evaluation to aid marketing managers in formulating more effective targeting and positioning strategies within different market segments. This paper utilizes the information-theoretic (IT) approach to address several issues in multivariate market segmentation studies. A marketing data set analyzed previously is employed to examine the suitability and usefulness of the proposed approach [12]. Some useful extensions of the IT framework and its applications are also discussed.     

PROFITABILITY IN BUYING PUTS AND CALLS

It is a rather widely held view that a large majority of purchases of put and call options are unprofitable, and that the profit to be made is in writing the options. A number of authors have suggested that selling options can be a profitable adjunct to institutional portfolio management. The results of an analysis of variance factorial design of a random selection of options in various market trends, shows that only a slim majority of the options purchased would have been unprofitable. In addition, if one is able to forecast the market trend, a random selection of the proper type of options would yield a high return.     

INTERVENTIONS INTO GROUP PROCESS: AN APPROACH TO IMPROVING THE EFFECTIVENESS OF GROUPS*

Some new directions for research on group effectiveness are proposed. These include: (a) explicit recognition of group interaction process as the moderator of input-output relationships in groups; (b) research which focuses on the functions of group interaction in influencing group performance; and (c) use of experimental interventions which create new, non-typical patterns of interpersonal behavior in groups as an approach to studying group effectiveness. The results of two studies based on these proposals are summarized. One study examines the effectiveness of implicit vs. explicit discussion of group task “strategies”; the other addresses the effects of implicit (“traditional”) vs. explicit (“adaptive”) approaches to the maintenance of internal social relationships in work groups. Implications of the research are drawn both for future research on group effectiveness, and for the design of interventions aimed at improving the performance of on-going groups in organizations.