Improving compliance with medical fitness to drive reviews: The role of behaviourally-optimised letters

To manage the increased crash risk posed by drivers with medical conditions and impairments, many licensing authorities ask high-risk drivers to undergo medical fitness to drive assessments. Maximising drivers’ compliance and satisfaction with these assessments is an ongoing challenge for these authorities. This study tested whether drivers’ compliance and satisfaction with a licensing authority’s request to provide a medical report could be improved by incorporating two applied behaviour change principles – simplified messaging and procedural fairness – into the authority’s request letter. Drivers undergoing medical review (N = 876) were assigned to receive either a standard request letter currently used by the authority, or a revised letter that incorporated simplified messaging and procedural fairness amendments. Drivers who received the revised letter were significantly more likely to submit a medical report by the due date. Additionally, of the drivers who submitted the report, those who received the revised letter submitted the report an average of four days faster than those who received the standard letter. These findings demonstrate that optimising letters using behavioural principles can improve compliance with licensing authorities’ requests, resulting in substantial time and cost savings for licensing authorities, possible road safety benefits, and potential reductions in the number of licences suspended for failure to provide a report.     

Ethical Dilemmas in Protecting Susceptible Subpopulations From Environmental Health Risks: Liberty,Utility, Fairness,and Accountability for Reasonableness

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations.     

Exploring Associations Among African American Youths' Perceptions of Racial Fairness and School Engagement: Does Gender Matter?

In addition to experiencing race as a unique social milieu within school, gender may also provide an important context for African American students. The authors explored gender differences in associations between African American youths' perceptions of racial fairness and school engagement (behavioral, emotional, and cognitive). One hundred thirty-nine (72 girls, 67 boys) African American high schoolers were recruited from the southeastern region of the United States. Gender differences were found for neither perceptions of racial fairness nor emotional and cognitive engagement. Girls reported higher behavior engagement relative to boys. Also, racial fairness was positively associated with emotional engagement among girls. For boys, racial fairness related positively to the three engagement dimensions. Implications and resources relevant for school psychology practice are discussed.     

How Politicians’ Reelection Efforts Can Reduce Public Trust,Electoral Support,and Policy Approval

Politicians’ desire for reelection motivates them to be responsive to voters’ policy preferences. In the traditional view, voters choose between candidates based on their delivery of favorable outcomes such as ideologically appealing policies or a prospering economy. However, research in psychology shows that, in addition to outcomes, people care about procedural fairness and, particularly, impartial decision‐makers who make decisions without personal motives and interests. This, I argue, confronts politicians with a delicate task: politicians must present voters with favorable policy outcomes but without appearing as if they pursue these policies based on a personal, vote‐maximizing motive for reelection. In four survey experiments, I find support for this argument. Participants were significantly less inclined to trust and vote for politicians and support their policies when political decisions were described as motivated by reelection considerations than when no such motive was present. The findings advance our understanding of how citizens view political representation and have important implications for research on public opinion, legislative behavior, and democratic theory.     

Multiple reference points in satisfaction and fairness assessment

Most studies of reference point effects have used a single referent, such as a price, a salary, or a target. There is considerable evidence that the judged fairness of, or satisfaction with, an outcome is significantly influenced by discrepancies from such single referents. In many settings, however, more than one reference point may be available, so the subject may be confronted simultaneously with some referents above, some at, and some below the focal outcome. Little is known about the simultaneous impact of such multiple reference points. We examine here the effects of two referents on ratings of salary satisfaction and fairness. Subjects were presented with a series of scenarios that described a salary offer made to a hypothetical MBA graduate and provided information about the salary offers made to either one or two other similar graduates. For each scenario, subjects judged how fair the focal graduate would feel the offer to be, and how satisfied he or she would be with it. Satisfaction ratings displayed asymmetric effects of comparisons: the pain associated with receiving a salary lower than another MBA is greater than the pleasure associated with a salary higher than the other student by the same amount. Fairness ratings showed a different pattern of asymmetric effects of discrepancies from the reference salaries: the focal graduate's salary was judged somewhat less fair when others received lower offers, and much less fair when others received higher offers. The asymmetric effects occurred for both reference points, suggesting that the focal salary was compared separately to each of the referents rather than to a single reference point formed by prior integration of the referents. Copyright © 2000 John Wiley & Sons, Ltd.     

论病人的“选医权”

选医权是病人的一项基本权力,它能消除医患间事实上的不平等,具有公平的法律价值,能够保证起点公平、过程公平和结果公平。在实施选医权的过程中,病人要正确行使权力,不能滥用权力,履行自己应尽的义务;医院和医生必须为保证病人选医权履行相应的义务。     

我国社会医疗保险模式兼容性问题研究

通过对我国目前多种社会医疗保险模式共存的背景及其负面影响分析,阐述了社会医疗保险模式兼容性之理论、政策与现实基础,从推动社会成员公平地享受社会医疗保障角度,提出了和谐社会建设层面提高社会医疗保险模式兼容性的建议和措施。     

How fair treatment affects saliva cortisol release in stressed low and high type-A behavior individuals

The effects of fair treatment on saliva cortisol release of low and high Type-A behavior participants in high or low stress conditions are studied. Based on the Injustice Stress Theory (Vermunt & Steensma, 2001), predictions were made about fair treatment as a stress reducing factor. The results support the expected effect of fair treatment in that high type-A behavior participants in the low stress conditions had lower saliva cortisol levels after fair treatment while this effect was absent in the neutral condition, while low type-A behavior participants showed lower saliva cortisol release in the high stress conditions after fair treatment while this effect was absent in the neutral condition. Moreover, saliva cortisol scores are correlated positively with negative affect scores and negatively with positive affect scores. The discussion focuses on theoretical implications and suggestions for future research.     

On Being Responsible and Holding Responsible

A number of philosophers have recently argued that we should interpret the debate over moral responsibility as a debate over the conditions under which it would be “fair” to blame a person for her attitudes or conduct. What is distinctive about these accounts is that they begin with the stance of the moral judge, rather than that of the agent who is judged, and make attributions of responsibility dependent upon whether it would be fair or appropriate for a moral judge to react to the agent in various (negative) ways. This is problematic, I argue, because our intuitions about whether and when it would be fair to react negatively to another are sensitive to a host of considerations that appear to have little or nothing to do with an agent’s responsibility or culpability for her attitudes or behavior. If this is correct, then theories which make attributions of responsibility dependent upon the appropriateness of our reactions as moral judges will turn out to be fundamentally misguided. I am grateful to Barbara Herman, T. M. Scanlon, and two anonymous reviewers for The Journal of Ethics for their helpful comments on earlier drafts of this paper. I am also grateful to Pamela Hieronymi and the members of her Fall 2201 graduate seminar on moral responsibility at UCLA, and to the audience members at Simon Fraser University, for their valuable feedback on earlier versions of this material. My biggest debt of gratitude goes to Jean Roberts, for stimulating discussion and insightful commentary on multiple drafts of this paper.     

Exploring how people respond to conflicts between self‐interest and fairness: Influence of threats to the self on affective reactions to advantageous inequity

Two studies examined how people deal with conflicts between their self‐interest concerns and their striving for fairness. Specifically, the affective reactions to outcome arrangements in which people receive better outcomes than comparable other persons, were studied. These arrangements of advantageous inequity constitute situations in which fairness and self‐interest concerns are in conflict. Building on the social psychology of the self, it was predicted, and found, in both field and lab experiments that when people experience a self‐threat, they react more positively to arrangements of advantageous inequity than when not experiencing this threat. This supports the view that people's need for positive information about their selves is an important factor in the underlying psychological processes of the way that people deal with conflicts between their fairness and self‐interest concerns.