This article considers some different views of fairness and whether they conflict with the use of a version of Cost Effectiveness Analysis (CEA) that calls for maximizing health benefits per dollar spent. Among the concerns addressed are whether this version of CEA ignores the concerns of the worst off and inappropriately aggregates small benefits to many people. I critically examine the views of Daniel Hausman and Peter Singer who defend this version of CEA and Eric Nord among (...) others who criticize it. I come to focus in particular on the use of CEA in allocating scarce resources to the disabled. (shrink)

-/- This chapter evaluates the ethical issues that using cost-effectiveness considerations to set animal health priorities might present, and its conclusions are cautiously optimistic. While using cost-effectiveness calculations in animal health is not without ethical pitfalls, these calculations offer a pathway toward more rigorous priority-setting efforts that allow money spent on animal well-being to do more good. Although assessing quality of life for animals may be more challenging than in humans, implementing prioritization based on cost- (...) class='Hi'>effectiveness is less ethically fraught. (shrink)

The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA’s provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither (...) uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the health care system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry. (shrink)

This project considers whether and how research ethics can contribute to the provision of cost-effective medical interventions. Clinical research ethics represents an underexplored context for the promotion of cost-effectiveness. In particular, although scholars have recently argued that research on less-expensive, less-effective interventions can be ethical, there has been little or no discussion of whether ethical considerations justify curtailing research on more expensive, more effective interventions. Yet considering cost-effectiveness at the research stage can help ensure that (...) scarce resources such as tissue samples or limited subject popula- tions are employed where they do the most good; can support parallel efforts by providers and insurers to promote cost-effectiveness; and can ensure that research has social value and benefits subjects. I discuss and rebut potential objections to the consideration of cost-effectiveness in research, including the difficulty of predicting effectiveness and cost at the research stage, concerns about limitations in cost-effectiveness analysis, and worries about overly limiting researchers’ freedom. I then consider the advantages and disadvantages of having certain participants in the research enterprise, including IRBs, advisory committees, sponsors, investigators, and subjects, consider cost-effectiveness. The project concludes by qualifiedly endorsing the consideration of cost-effectiveness at the research stage. While incorporating cost-effectiveness considerations into the ethical evaluation of human subjects research will not on its own ensure that the health care system realizes cost-effectiveness goals, doing so nonetheless represents an important part of a broader effort to control rising medical costs. (shrink)

Background: Food fortification refers to the process of adding nutrients to foods during their production. It is a cost-effective strategy with well-documented health, economic, and social benefits. Food fortification practices in school meal programs need guidance and legal support from various national policies. Aim: This study aims to analyze how various national policies—such as those related to school feeding, nutrition, health, food safety, agriculture, and the private sector—associate with the implementation of in-school food fortification among countries with school meals (...) programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: Findings showed that food safety policy and agriculture policy were positively and significantly associated with the in-school food fortification practices, while school feeding policy and private sector policy had ambiguous relationships with these practices. Nutrition policy and health policy had a significant negative association with food fortification practices among countries implementing school meal programs. Conclusions: Findings underscore the strong position of food safety policy and agriculture policy in guiding food fortification practices in school meal programs. There is a need to re-assess the implemented nutrition policy and health policy due to their significant negative associations with these practices. Enhancing and strengthening the school feeding policy and private sector policy may increase their potencies in giving positive impacts on in-school food fortification practices. (shrink)

Civil disobedience, despite its illegal nature, can sometimes be justified vis-à-vis the duty to obey the law, and, arguably, is thereby not liable to legal punishment. However, adhering to the demands of justice and refraining from punishing justified civil disobedience may lead to a highly problematic theoretical consequence: the debilitation of civil disobedience. This is because, according to the novel analysis I propose, civil disobedience primarily functions as a costly social signal. It is effective by being reliable, reliable by (...) being costly, and costly primarily by being punished. My analysis will highlight a distinctive feature of civil disobedience: civil disobedients leverage the punitive injustice they suffer to amplify their communicative force. This will lead to two paradoxical implications. First, the instability of the moral status of both civil disobedience and its punishment to the extent where the state may be left with no permissible course of action with regard to punishing civil disobedience. Second, by refraining from punishing justified civil disobedience, the state may render uncivil disobedience—illegal political activities that fall short of the standards of civil disobedience—potentially permissible. (shrink)

Norman Daniels’s theory of ‘accountability for reasonableness’ is an influential conception of fairness in healthcare resource allocation. Although it is widely thought that this theory provides a consistent extension of John Rawls’s general conception of justice, this paper shows that accountability for reasonableness has important points of contact with both utilitarianism and intuitionism, the main targets of Rawls’s argument. My aim is to demonstrate that its overlap with utilitarianism and intuitionism leaves accountability for reasonableness open to damaging critiques. The important (...) role that utilitarian-like cost-effectiveness calculations are allowed to play in resource allocation processes disregards the separateness of persons and is seriously unfair towards individuals whose interests are sacrificed for the sake of groups. Furthermore, the function played by intuitions in settling frequent value conflicts opens the door for sheer custom and vested interests to steer decision-making. (shrink)

Suppose you want to do as much good as possible. What should you do? According to members of the effective altruism movement—which has produced much of the thinking on this issue and counts several moral philosophers as its key protagonists—we should prioritise among the world’s problems by assessing their scale, solvability, and neglectedness. Once we’ve done this, the three top priorities, not necessarily in this order, are (1) aiding the world’s poorest people by providing life-saving medical treatments or alleviating poverty (...) itself, (2) preventing global catastrophic risks, such as those posed by nuclear war or rogue artificial intelligence, and (3) ending factory farming. These claims are both plausible and striking. If correct, they should prompt a stark revision of how we approach our altruistic activities. However, the project of determining how to do the most good—as opposed to say, whether we should do the most good—has only recently, within the last ten years, become the subject of serious academic attention. Many key claims have not yet been carefully scrutinised. This is a cause for concern: are effective altruists doing good badly? In this thesis, I critique and develop some of the latest claims about how individuals can do the most good. I do this in three areas: the value of saving lives (preventing premature deaths), how best to improve lives (making people happier during their lives), and cause prioritisation methodology (frameworks for determining which problems are the highest priorities). In each case, I raise novel theoretical considerations that, when incorporated, change the analysis. Roughly speaking, my main conclusions are (1) saving lives is not as straightforwardly good we tend to suppose, may not be good at all, and is not clearly a priority; (2) happiness can be measured through self-reports and, based on the self-reported evidence, treating mental health stands out as an overlooked problem that may be an even more cost-effective way to improve lives than alleviating poverty; (3) the cause prioritisation methodology proposed by effective altruists needs to be moderately reconceptualised and, when it is, it turns out it is not as illuminating a tool as we might have thought and hoped. (shrink)

Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of a systematic (...) literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. -/- Results: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. -/- Conclusions: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access. (shrink)

In this book some options concerning the greenhouse effect are assessed from a welfarist point of view: business as usual, stabilization of greenhouse gas emissions and reduction by 25% and by 60%. Up to today only economic analyses of such options are available, which monetize welfare losses. Because this is found to be wanting from a moral point of view, the present study welfarizes (among others) monetary losses on the basis of a hedonistic utilitarianism and other, justice incorporating, welfare ethics. (...) For these welfarist evaluations information about the social consequences of the four options are collected from the literature and eventually corrected; then the consequences for individual well-being are assessed based on psychological research about well-being dependent on the social situation of the individual; finally the aggregation formulas of the respective welfare ethics are applied to these data. Assessments by other types of ethics, e.g. Kantian ethic, are included. The strongest abatement option is found to be optimum with great unanimity. - In addition a cost-welfare analysis of greenhouse gas abatement is undertaken revealing efficient cost-welfare ratios for these measures and the most efficient ratio for the strongest option. - A final, more theoretical part discusses the moral obligations following from such evaluations. The notion of 'moral obligation' is explained in a way that, apart from moral goodness of the required act, reinforcement by formal or informal sanctions is another necessary condition for moral obligations. This leads to a conception of a historical morality according to which the demands of morality rise in the long run. Applying this conception to the greenhouse effect implies that presently we have the moral duty to raise the standards of greenhouse gas abatement as much as is politically feasible. (shrink)

The central thesis of this essay is that basic income experiments are justified if their expected benefits in terms of justice exceed their expected costs in terms of justice. The benefits are a function of basic income’s effect on the level of justice attained in the context in which it is implemented, and the experiment’s impact on future policy-making. The costs comprise the sacrifices made as a result of the experiment’s interventional character, as well as the study’s opportunity costs. In (...) light of the proposed standard of justification for basic income experiments, the factors that play a role in it, and the way these interact with one another, this essay provides some practical recommendations for researchers hoping to conduct such an experiment. (shrink)

One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and (...) argues that all are problematic. Instead, we argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or (...) injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

Building information modeling can help in predicting the energy efficiency in future based on dynamic patterns obtained by visualization of data. The aim of this study was to investigate the effective parameters of energy consumption using BIM technology which can evaluate the buildings energy performance. First, three forms of general states in the building were modeled to evaluate the proposed designs in Autodesk Revit Software. Then, the main building form for energy modeling and analysis was selected. Autodesk Revit 2020 (...) software was also used to obtain the results of climate data analysis and building energy consumption index. Finally, the most optimal mode was selected by examining different energy consumption modes. The results showed that the use of building information modeling technology in adjusting the parameters affecting energy consumption can save energy cost up to 58.23% in block D. Energy cost savings for block C and the western lobby were obtained as 51.03% and 43.05%, respectively. Based on energy use intensity, energy cost savings for blocks C, D, and the western lobby were estimated as 16.67%, 16.30%, and 11%, respectively. The results of parametric studies on alternative schemes of energy use intensity optimization showed that 16.30% savings could be achieved by the base building model in a 30-year time horizon. Therefore, it was concluded that optimization of energy consumption would reduce the environmental pollutants emission and contribute to preservation and sustainability of the environment. (shrink)

Although policymakers and investigators still struggle to quantify and compare the effects of various Covid-related interventions, we are steadily amassing data that could help inform choices. The pandemic’s medical, social, and economic harms have been immense, and they warrant a continuous policy response. All decision makers use some type of mental model to weigh the pros and cons of various policy options. Rigorous economic evaluation formalizes this process. Value judgments will still be required, but economic evaluation can make the decision-making (...) process more systematic, comprehensive, and transparent. (shrink)

In carrying out cost-benefit or cost-effective analysis, a discount rate should be applied to some kinds of future benefits and costs. It is controversial, though, whether future health is in this class. I argue that one of the standard arguments for discounting (from diminishing marginal returns) is inapplicable to the case of health, while another (favouring a pure rate of time preference) is unsound in any case. However, there are two other reasons that might support a positive (...) discount rate for future health: one relating to uncertainty, and the other relating to the instrumental benefits of improved health. While the latter considerations could be modelled via a discount rate, they could alternatively be modelled more explicitly, in other ways; I briefly discuss which modelling method is preferable. Finally, I argue against the common claims that failing to discount future health would lead to paradox, and/or to inconsistency with the way future cash flows are treated. (shrink)

David Tomasi presents new, groundbreaking research on the science and application of Mind-Body Medicine strategies to improve clinical outcomes in inpatient psychiatry settings. Much more than a list of therapeutic recommendations, this book is a thorough description of how Mind-Body Medicine can be successfully applied, from a therapeutic as well as from an organizational, cost-effective analysis viewpoint, to the full spectrum of psychiatric treatments. Furthermore, this study examines the role of multidisciplinary and interdisciplinary treatment teams, with a special (...) focus on the profession and the role of psychotherapists and group therapists, thereby providing solid scientific evidence of the benefits of patient-provider therapeutic alliances. In this sense, this book serves as a guide for professionals and institutions both in the private and the public sphere, to learn effective treatment and management strategies. About the Author Psychotherapist, Researcher, and Philosopher Dr. David Låg Tomasi is the author of Medical Philosophy (ibidem, 2016) and the co-author of Positive Patient Response to a Structured Exercise Program Delivered in Inpatient Psychiatry (Global Advances in Health and Medicine, 2019), the most-read research item from the University of Vermont (Researchgate, 2019). A member of several national and international Academies of Sciences, Dr. Tomasi works in the Inpatient Psychiatry Unit at the UVM Medical Center, and teaches at the University of Vermont and the Community College of Vermont. ---- Ibidem / Columbia University Press. (shrink)

Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...) overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely non-health and indirect benefits. (shrink)

The starting point in the development of probabilistic analyses of token causation has usually been the naïve intuition that, in some relevant sense, a cause raises the probability of its effect. But there are well-known examples both of non-probability-raising causation and of probability-raising non-causation. Sophisticated extant probabilistic analyses treat many such cases correctly, but only at the cost of excluding the possibilities of direct non-probability-raising causation, failures of causal transitivity, action-at-a-distance, prevention, and causation by absence and omission. I show (...) that an examination of the structure of these problem cases suggests a different treatment, one which avoids the costs of extant probabilistic analyses. (shrink)

Academia is a competitive environment. Early Career Researchers (ECRs) are limited in experience and resources and especially need achievements to secure and expand their careers. To help with these issues, this book offers a new approach for conducting research using the combination of mindsponge innovative thinking and Bayesian analytics. This is not just another analytics book. 1. A new perspective on psychological processes: Mindsponge is a novel approach for examining the human mind’s information processing mechanism. This conceptual framework is used (...) to construct models in studies. The framework is highly flexible and widely applicable for many different types of information processes. The mindsponge approach can help researchers discover interesting ideas or even formulate their very own theories when investigating psychosocial phenomena. This approach brings a fresh wind to the current landscape of social sciences and humanities (SSH). 2. Easy-to-follow analysis protocol: The Bayesian Mindsponge Framework (BMF analytics) is useful in terms of computing and visualizing power but also easy to learn and apply. Contrary to being intimidating, the Bayesian analytics section of this book is presented in a reader-friendly manner with a detailed yet clear step-by-step procedure. Examples are from published BMF articles, allowing readers to immediately practice the method and quickly create their own applications. With educational purposes in mind, the book is very suitable for ECRs who are looking to innovate their research methods. 3. Advocating for low-cost, high-quality research: Doing science can be very costly. Mindsponge innovative thinking and BMF analytics help produce impactful studies using openly available data on online repositories. This is based on the authors’ previous works and experiences. The book presents examples of employing the open R package bayesvl on secondary data from different sources. With less financial constraints, researchers can have more freedom of thought to pursue their curiosity and creativity. ECRs in low- and middle-income countries may find this aspect crucial in their careers. 4. Support and collaboration: The authors share their insights from experiences in the academic publishing system to help readers get through the processes of manuscript writing and peer-reviewing more easily. The authors are also ready to support other researchers with further inquiries and collaboration opportunities at the following website, mindsponge(dot)info. This book is for: a) ECRs whose only abundant resources are their innovation capacity and strength of will; b) Researchers in SSH who want to explore a novel approach to thinking and study conducting; c) Low- and middle-income countries’ researchers looking for a cost-effective research protocol; and, d) Innovative thinkers who want to turn their interesting thoughts into good publications. (shrink)

Recently, a number of philosophers have argued that we can and should “consequentialize” non-consequentialist moral theories, putting them into a consequentialist framework. I argue that these philosophers, usually treated as a group, in fact offer three separate arguments, two of which are incompatible. I show that none represent significant threats to a committed non-consequentialist, and that the literature has suffered due to a failure to distinguish these arguments. I conclude by showing that the failure of the consequentializers’ arguments has implications (...) for disciplines, such as economics, logic, decision theory, and linguistics, which sometimes use a consequentialist structure to represent non-consequentialist ethical theories. (shrink)

Davis called for “extreme caution” in the use of non-invasive brain stimulation to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child’s future options. The distinction between treatment and enhancement has some normative force here. (...) As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests diminish, and the need to protect the child’s autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are themselves justified on a best interests standard. (shrink)

The rule of rescue holds that special weight should be given to protecting the lives of assignable individuals in need, implying that less weight is given to considerations of cost-effectiveness. This is sometimes invoked as an argument for funding or reimbursing life-saving treatment in public healthcare even if the costs of such treatment are extreme. At first sight one might assume that an individualist approach to ethics—such as Scanlon’s contractualism—would offer a promising route to justification of the rule (...) of rescue. In this chapter I argue that contractualism cannot endorse the rule of rescue, whereas a collectivist approach that appeals to group solidarity would offer support for rescue cases. The argument, however, has its limitations, and though solidarity is of central concern in shaping public healthcare, there are good reasons for not endorsing the rule of rescue as a moral basis for allocating scarce resources in clinical care. (shrink)

Cheating is a major problem in society, especially in the educational system. From the viewpoint of subjective cost-benefit analysis, concerns about reputation damage as well as considerations of cultural values against unethical behavior can help increase the perceived costs of cheating. To explore deeper into the psychological processes in such assessments, we employ Bayesian Mindsponge Framework (BMF) analytics – an information-processingbased method. Conducting Bayesian analysis on 493 university students from Germany, Vietnam, China, Taiwan, and Japan, we found (...) that reputation concern is negatively associated with cheating behavior. If a student embraces Confucian values, the above negating effect is stronger. Our findings support the notion that mentally simulated negative consequences of cheating reduce the probability of carrying out such behavior. As the educational system is changing rapidly due to technological advancement, a better understanding of the influences of sociocultural factors can be helpful in cheating prevention efforts. (shrink)

In the modern digital era, cloud storage has become an indispensable service due to its scalability, accessibility, and cost-effectiveness. However, with the vast amount of sensitive information stored on cloud platforms, ensuring data security and privacy remains a critical challenge. Traditional encryption techniques, while secure, often hinder efficient data retrieval, especially when using keyword searches. To address this, attribute-based keyword search (ABKS) offers a promising solution by allowing secure, fine-grained access control and efficient keyword searches over encrypted data. (...) This paper delves into the integration of optimization techniques within ABKS to enhance search efficiency and data security in cloud storage environments. We explore various optimization strategies, such as index compression, query processing enhancement, and encryption optimization, which aim to reduce computational overhead while maintaining robust security measures. Through a comprehensive analysis, the paper illustrates how these techniques can significantly improve the performance of cloud storage systems, ensuring both security and usability. Experimental results demonstrate that optimized ABKS not only accelerates search queries but also reduces storage costs, making it a viable solution for modern cloud storage challenges. Future research directions include exploring advanced machine learning algorithms for predictive search optimizations and further improving the resilience of ABKS against emerging security threats. (shrink)

Driven by technological innovations, newborn screening (NBS) panels have been expanded and the development of genomic NBS pilot programs is rapidly progressing. Decisions on disease selection for NBS are still based on the Wilson and Jungner (WJ) criteria published in 1968. Despite this uniform reference, interpretation of the WJ criteria and actual disease selection for NBS programs are highly variable. A systematic literature search [PubMED search “Wilson” AND “Jungner”; last search 16.07.22] was performed to evaluate the applicability of the WJ (...) criteria for current and future NBS programs and the need for adaptation. By at least two reviewers, 105 publications (systematic literature search, N = 77; manual search, N = 28) were screened for relevant content and, finally, 38 publications were evaluated. Limited by the study design of qualitative text analysis, no statistical evaluation was performed, but a structured collection of reported aspects of criticism and proposed improvements was instead collated. This revealed a set of general limitations of the WJ criteria, such as imprecise terminology, lack of measurability and objectivity, missing pediatric focus, and absent guidance on program management. Furthermore, it unraveled specific aspects of criticism on clinical, diagnostic, therapeutic, and economical aspects. A major obstacle was found to be the incompletely understood natural history and phenotypic diversity of rare diseases prior to NBS implementation, resulting in uncertainty about case definition, risk stratification, and indications for treatment. This gap could be closed through the systematic collection and evaluation of real-world evidence on the quality, safety, and (cost-)effectiveness of NBS, as well as the long-term benefits experienced by screened individuals. An integrated NBS public health program that is designed to continuously learn would fulfil these requirements, and a multi-dimensional framework for future NBS programs integrating medical, ethical, legal, and societal perspectives is overdue. (shrink)

Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s (...) severity criteria in Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

According to the United Nations Environment Programme (UNEP), buildings are the largest worldwide consumers of energy. Most of the energy used by any building is consumed during the usage (or operational) stage of the building’s life-cycle. Achieving sustainable development at the national level will require minimizing the effects of buildings on the environment with the low energy consumed by buildings. The energy performance of a given building is predicted and assessed by conducting an energy simulation. Using BIM in EPAs greatly (...) reduces time and costs. The purpose of this study was to optimize energy consumption in buildings, using Building Information Modeling Technology (BIM), which can assess energy performance in the building. In this research, the general form of the building was modeled in the Autodesk Revit Software. After reviewing the proposed designs, the main form of the building was selected for modeling. Then, according to the type of materials consumed, the equipment and location of the project, the calculation of the energy consumption of the building was carried out using relevant tools in this scope. Finally, the best possible mode was chosen by examining different energy consumption modes. The results of energy simulation showed that 61.48% of the difference between the best mode of energy consumption optimization and the current state of the building, as well as 79.35%, is compared to the initial state. Finally, parametric studies of alternative cost optimization schemes showed that saving 58.23% of the building's current status for a 30-year horizon. (shrink)

Future superintelligent AI will be able to reconstruct a model of the personality of a person who lived in the past based on informational traces. This could be regarded as some form of immortality if this AI also solves the problem of personal identity in a copy-friendly way. A person who is currently alive could invest now in passive self-recording and active self-description to facilitate such reconstruction. In this article, we analyze informational-theoretical relationships between the human mind, its traces, and (...) its future model; based on this analysis, we suggest the instruments to most cost-effectively collect quality data about a person for future resurrection. These guidelines form a “digital immortality protocol”. Digital immortality is plan C for achieving immortality, after plan A, life extension, and plan B, cryonics. (shrink)

This study addresses the issue of maintaining nutritional quality amidst financial hardship faced by families in Plateau State, Nigeria. Surveys research designed was used for the study. The study covers 3 local government areas in Plateau State, ensuring diverse representation. The sample size of 400 families residing in Plateau State was used. Questionnaire was used to collect data for the study which capture the demographic information, dietary habits, household budget allocation for food, and perceptions of nutritional value. Mean and standard (...) deviation was used to present result for the findings. The findings of the study revealed that that there should be cost-effective meal planning strategies in promoting healthy eating habits. Also, socioeconomic factors impact cost-effective meal planning in promoting healthy eating habits. Based on the findings, stakeholders, policymakers, and community organizations should implement interventions that support cost-effective meal planning, enhance nutritional literacy, and alleviate financial burdens on families in Plateau State. This study may empower families to make informed dietary choices and achieve better health outcomes despite economic constraints. (shrink)

When probability discounting (or probability weighting), one multiplies the value of an outcome by one's subjective probability that the outcome will obtain in decision-making. The broader import of defending probability discounting is to help justify cost-benefit analyses in contexts such as climate change. This chapter defends probability discounting under risk both negatively, from arguments by Simon Caney (2008, 2009), and with a new positive argument. First, in responding to Caney, I argue that small costs and benefits need to be (...) evaluated, and that viewing practices at the social level is too coarse-grained. Second, I argue for probability discounting using a distinction between causal responsibility and moral responsibility. Moral responsibility can be cashed out in terms of blameworthiness and praiseworthiness, while causal responsibility obtains in full for any effect which is part of a causal chain linked to one's act. With this distinction in hand, unlike causal responsibility, moral responsibility can be seen as coming in degrees. My argument is, given that we can limit our deliberation and consideration to that which we are morally responsible for and that our moral responsibility for outcomes is limited by our subjective probabilities, our subjective probabilities can ground probability discounting. (shrink)

With an increased emphasis on upstream activity and Defence Engagement, it has become increasingly more important for the UK Ministry of Defence (MOD) and government to understand the relationship between conflict and regional instability. As part of this process, the Historical and Operational Data Analysis Team (HODA) in Defence Science and Technology Laboratory (Dstl) was tasked to look at factors that influenced the regional spread of internal conflicts to help aid the decision making of government. Conflict contagion is the (...) process by which a conflict in one state (State A) influences the outbreak of conflict in another state (State B). The aim of looking at these factors was to produce a tool to assist in the cost/benefit analysis of intervening in future conflicts. The task was carried out by quantitatively studying a selection of contagion and non-contagion case studies over a set of 14 numerical variables that covered structural, political, socioeconomic and cultural factors of both States A and B. All case studies took place after the end of the Cold War. The dataset used contained both binary and continuous data. A range of statistical techniques were used including correlation, regression and principal component analyses along with graphical analytical methods. Unfortunately creating a tool to predict contagion has proven difficult and so the scope of the study was changed-as no statistically relevant link was found. However, it was shown that some links do exists between the variables and the existence of contagion, and it also appears it is a combination of variables which has an effect on the likelihood of contagion. Conflict contagion is a rare event and was only recorded in less than 1% of cases present in the dataset. Of the variables analysed, the most significant factor was the number of refugees present in State B who originated in State A for the year before the case study. It is recommended that further work be conducted. It is possible that a more detailed investigation, using a broader range of techniques and/or a wider selection of variables might be successful in assessing the likelihood of conflict contagion. (shrink)

Recently theorists have demonstrated a growing interest in the ethical aspects of resource allocation in international non-governmental humanitarian, development and human rights organizations (INGOs). This article provides an analysis of Thomas Pogge's proposal for how international human rights organizations ought to choose which projects to fund. Pogge's allocation principle states that an INGO should govern its decision making about candidate projects by such rules and procedures as are expected to maximize its long-run cost-effectiveness, defined as the expected (...) aggregate moral value of the projects it undertakes divided by the expected aggregate cost of these projects? I critique Pogge's argument on two fronts: (1) I demonstrate that his view is problematic on his own terms, even if we accept the cost-effectiveness framework he employs. (2) I take issue with his overall approach because it generates results which can undermine the integrity of INGOs. Further, his approach mis-characterizes the nature of INGOs, and this mistake is at the root of his problematic view of INGO priority-setting. Ultimately, I argue for a conception of INGOs in which they are understood as ?organizations of principle?, in the sense that they are independent moral agents and so should be permitted a fairly wide sphere of autonomy within reasonable moral constraints. (shrink)

The policy makers or lawyers may face the need of legal research for reasons. The congressmen may plan to make new laws to address the challenges of their constituent or to the interest of nation. The lawyers may need to serve their clients who like to know the legal issues involved, the strategies to deal with their loss and recovery, and prospect for winning the case if the dispute has gotten worse. The lawyers may practice in a solo business or (...) might work as an associate lawyer in the law firms. A senior lawyer or partner in some cases may like to exploit the junior work force about the problems or grievances from the potential clients. Since he needs to focus their attention on other matters, such as the business expansion of his law firm or more lucrative cases in need of career hands, he may tap the junior lawyer for the legal research, who could assist with the basis of his final legal opinion. The memorandum, opinion letter and brief would be such forms of professional communication for the lawyers and legal researchers. The congressman also can be supplemented with the aid of staffs in terms of his legal expertise and grasp of the issues standing for carrying their responsibility more effectively. For the lawyers and legal researchers, the structure of state and federal legal system is the kind of important variants to orient their work direction and basic frame for the most efficient and adequate scope of search and analysis. The paradigm change also is revolutionary to impact the general base of people. Decades ago, the research or researcher only related with the class of professionals, such as professors, lawyers, career officers and cadres of enterprises. They would enjoy insulation and exploit their research work as an entrance barrier from lay people. Their large shelves at home study or in the room or corner of office thrust an impression that he or she is learned and knowledgeable. This impliedly communicates his or her prestige of social or professional success. The books and articles seem to symbolize a kind of monopoly which bears to exclude unclassified or non-professional workers. The change is remarkable that every citizen could benefit from the on-line sources of information, which, of course, is generally true of professional knowledge. Now professors fear of plagiarism that students often are the kind of suspect. The legal research would turn on the help of digitization which revolutionizes to incur a new mode of research operation. About the query, the citizens and people can readily verify its truth or falsity with one clique within the personal computer. An enormous amount of information is currently flowing on the internet and on-line sources of reference, which shapes an informative and knowledgeable society. As the medical doctors warned decades ago, the precept is any most effective, “forbear from your intelligence or knowledge work for your health.” Many of them now spend long hours a day to satisfy their curiosity and intelligent search. He or she may be well awarded an academic degree if to recognize their hard work on his PC. Nevertheless, this information age does not always bring a positive progress, which arouses the kind of issues, say, right of privacy, on-line fraud. In some cases, this transformation may lead to an inferior attitude of researcher. My today’s experience is one of exotic case. I have received an e-mail from Google CEO stating that I have been selected as one of twelve winners from the pool of Google users. The award money is enormous which stalls me for some time. The authenticity and reliability have hit my head, and I utilized a verification service website managed by the team of lawyers. It costs five dollars and remaining 24 dollars would be processed upon the progress of interaction. I am waiting for an answer from the team. Then the research nowadays is not limited to the basic context of our subsistence, but influences in any depth into the professional lives. (shrink)

Control measures, such as “lockdowns”, have been widely used to suppress the COVID-19 pandemic. Under some conditions, they prevent illness and save lives. But they also exact an economic toll. How should we balance the impact of such policies on individual lives and livelihoods (and other dimensions of concern) to determine which is best? A widely used method of policy evaluation, benefit–cost analysis (BCA), answers these questions by converting all the effects of a policy into monetary equivalents and (...) then summing them up. A different method, social welfare analysis, proceeds by determining the effects of a policy on individual wellbeing and then applying an aggregation formula to them to evaluate the overall effects of a policy. In this chapter, we survey these methods and argue that social welfare analysis has important advantages. One crucial advantage is that it enables ethical considerations relating to the impact of policies on individual wellbeing and its distribution to be incorporated into policy assessments in a transparent way. We illustrate this with a simple numerical model for evaluating pandemic policies that vary in terms of the stringency of the controls that they impose on individual behaviour, showing how the evaluation depends on the ethical significance accorded to their impact on the wellbeing of different age and income groups. (shrink)

According to evidentialist views, credence in a proposition p should be proportional to the degree of evidential support that one has in favor of p. However, empirical evidence suggests that our credences are systematically sensitive to practical factors. In this article, I provide a cost–benefit analysis of credences' practical sensitivity. The upshot of this analysis is that credences sensitive to practical factors fare better than practically insensitive ones along several dimensions. All things considered, our credences should be (...) sensitive to practical factors. (shrink)

The assumption that procuring more organs will save more lives has inspired increasingly forceful calls to increase organ procurement. This project, in contrast, directly questions the premise that more organ transplantation means more lives saved. Its argument begins with the fact that resources are limited and medical procedures have opportunity costs. Because many other lifesaving interventions are more cost‐effective than transplantation and compete with transplantation for a limited budget, spending on organ transplantation consumes resources that could have been used (...) to save a greater number of other lives. This argument has not yet been advanced in debates over expanded procurement and could buttress existing concerns about expanded procurement. To support this argument, I review existing empirical data on the cost‐effectiveness of transplantation and compare them to data on interventions for other illnesses. These data should motivate utilitarians and others whose primary goal is maximizing population‐wide health benefits to doubt the merits of expanding organ procurement. I then consider two major objections: one makes the case that transplant candidates have a special claim to medical resources, and the other challenges the use of cost‐effectiveness to set priorities. I argue that there is no reason to conclude that transplant candidates’ medical interests should receive special priority, and that giving some consideration to cost‐effectiveness in priority setting requires neither sweeping changes to overall health priorities nor the adoption of any specific, controversial metric for assessing cost‐effectiveness. Before searching for more organs, we should first ensure the provision of cost‐effective care. (shrink)

Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.

The purpose of this investigation is to develop a new methodological basis for studying the market opportunities of the multinational corporation (MNC) on the basis of the synthesis of modern scientific methods for further forecasting their change. The results showed the degree of dependence of the effectiveness of business management on the trends in the field development and competitor’s actions, market access opportunities, the use of MNC opportunities, their strategic positions, and the totality of internal factors that determine the (...) profitability of activities. The practical value of the obtained results is to identify areas for increasing the efficiency of MNC business management and forecasting the dynamics of sales volumes of their products on the market. (shrink)

Cheating is widely considered a condemnable behavior in society and a big problem in the educational system. In this study, we employ the information-processing-based Bayesian Mindsponge Framework to explore deeper the subjective cost-benefit evaluation involving the perceived value of cheating. Conducting Bayesian analysis on 493 university students from Germany, Vietnam, China, Taiwan, and Japan, we found that students who have more positive attitudes toward cheating are more likely to cheat. However, a higher capability of cognitive reflection acts as (...) a moderator that negates the above effect. Re-evaluation of prior thoughts allows for more accurate assessments of the associated risks and possible costs, which help reduce the probability of carrying out cheating behavior. As rapid technological advancement may introduce new and efficient cheating methods, a better understanding of the psychology of cheating in students can help schools prepare better countermeasures. (shrink)

Artykuł podejmuje problematykȩ zwolnień pracowników przedsiȩbiorstw, która zyskuje na znaczeniu wraz z utrzymywaniem siȩ globalnego kryzysu gospodarczego na pocz¸a}tku XXI wieku. Kryzys prowadzi do dynamicznych zmian w otoczeniu organizacji i w wielu przypadkach wymusza decyzje o podjȩciu działań restrukturyzacyjnych. Restrukturyzacja przedsiȩbiorstw może obejmować zarówno ograniczenie kosztów prowadzenia działalności, modernizacjȩ procesów produkcji i świadczenia usług, zmianȩ rynków i partnerów biznesowych, jak również racjonalizacjȩ zatrudnienia. Zmiany w strukturze zatrudnienia mog¸a} prowadzić do kształtowania nowych, bardziej elastycznych relacji z pracownikami. W tym kontekście outplacement (...) jako koncepcja odpowiedzialnego zarz¸a}dzania zwolnieniami pracowników umożliwia zarówno złagodzenie negatywnych skutków utraty pracy i skrócenie okresu bezrobocia, jak też ochronȩ kompetencji istotnych przedsiȩbiorstwa. Opracowanie w oparciu o krytyczn¸a} analizȩ literatury przedmiotu przybliża: przesłanki do outplacementu jakimi s¸a negatywne efekty redukcji zatrudnienia w organizacji, stereotypowe i racjonalne kryteria zwolnień pracowników oraz koncepcjȩ kompetencji kluczowych i ich ochrony. ** Article undertakes issue of enterprises layoffs, which is becoming increasingly important along with persistence of the global economic crisis at the beginning of the 21st century. Crisis leads to dynamic changes in the organization environment and in many cases forces the decision to take restructuring actions. Restructuring of firms may include both reduction of operating costs, modernization of production and services processes, changing markets and business partners, as well as the rationalization of employment. Changes in the structure of employment can lead to the development of new, more flexible relationship with employees. In this context, the outplacement as a concept of responsible management of the redundancies can both address the possible negative effects of job losses and reduction of unemployment, as well as the protection essential company competences. Article on the basis of the literature critical analysis brings: evidence for outplacement which are the negative effects of downsizing in the organization, stereotyped and rational criteria for redundancies as well as the concept of key competencies and their protection. (shrink)

Consumer behavior analytics has become a pivotal aspect for businesses to understand and predict customer preferences and actions. The advent of machine learning (ML) algorithms has revolutionized this field by providing sophisticated tools for data analysis, enabling businesses to make data-driven decisions. However, the effectiveness of these ML algorithms significantly hinges on the optimization techniques employed, which can enhance model accuracy and efficiency. This paper explores the application of various optimization techniques in consumer behaviour analytics using machine learning (...) algorithms. By focusing on the optimization of key parameters, the study aims to improve the predictive power of models and reduce computational costs. (shrink)

In this extended book review, I summarize Adler's views and critically analyze his key arguments on the measurement of well-being and the foundations of prioritarianism.

Many global catastrophic and existential risks (X-risks) threaten the existence of humankind. There are also many ideas for their prevention, but the meta-problem is that these ideas are not structured. This lack of structure means it is not easy to choose the right plan(s) or to implement them in the correct order. I suggest using a “Plan A, Plan B” model, which has shown its effectiveness in planning actions in unpredictable environments. In this approach, Plan B is a backup (...) option, implemented if Plan A fails. In the case of global risks, Plan A is intended to prevent a catastrophe and Plan B to survive it, if it is not avoided. Each plan has similar stages: analysis, planning, funding, low-level realization and high-level realization. Two variables—plans and stages—provide an effective basis for classification of all possible X-risks prevention methods in the form of a two-dimensional map, allowing the choice of optimal paths for human survival. I have created a framework for estimating the utility of various prevention methods based on their probability of success, the chances that they will be realized in time, their opportunity cost, and their risk. I also distinguish between top-down and bottom-up approaches. (shrink)

This paper identifies a new source of differences in religiosity: the type of future tense marking in language. We argue that the rewards and punishments that incentivize religious behaviour are more effective for speakers of languages without inflectional future tense. Consistent with this prediction, we show that speakers of languages without inflectional future tense are more likely to be religious and to take up the short-term costs associated with religiosity. What is likely to drive this behaviour, according to our results, (...) is the relatively greater appeal of the religious rewards to these individuals. Our analysis is based on within-country regressions comparing individuals with identical observable characteristics who speak a different language. (shrink)

"Procedural Justice" offers a theory of procedural fairness for civil dispute resolution. The core idea behind the theory is the procedural legitimacy thesis: participation rights are essential for the legitimacy of adjudicatory procedures. The theory yields two principles of procedural justice: the accuracy principle and the participation principle. The two principles require a system of procedure to aim at accuracy and to afford reasonable rights of participation qualified by a practicability constraint. The Article begins in Part I, Introduction, with two (...) observations. First, the function of procedure is to particularize general substantive norms so that they can guide action. Second, the hard problem of procedural justice corresponds to the following question: How can we regard ourselves as obligated by legitimate authority to comply with a judgment that we believe (or even know) to be in error with respect to the substantive merits? The theory of procedural justice is developed in several stages, beginning with some preliminary questions and problems. The first question - what is procedure? - is the most difficult and requires an extensive answer: Part II, Substance and Procedure, defines the subject of the inquiry by offering a new theory of the distinction between substance and procedure that acknowledges the entanglement of the action-guiding roles of substantive and procedural rules while preserving the distinction between two ideal types of rules. The key to the development of this account of the nature of procedure is a thought experiment, in which we imagine a world with the maximum possible acoustic separation between substance and procedure. Part III, The Foundations of Procedural Justice, lays out the premises of general jurisprudence that ground the theory and answers a series of objections to the notion that the search for a theory of procedural justice is a worthwhile enterprise. Sections II and III set the stage for the more difficult work of constructing a theory of procedural legitimacy. Part IV, Views of Procedural Justice, investigates the theories of procedural fairness found explicitly or implicitly in case law and commentary. After a preliminary inquiry that distinguishes procedural justice from other forms of justice, Part IV focuses on three models or theories. The first, the accuracy model, assumes that the aim of civil dispute resolution is correct application of the law to the facts. The second, the balancing model, assumes that the aim of civil procedure is to strike a fair balance between the costs and benefits of adjudication. The third, the participation model, assumes that the very idea of a correct outcome must be understood as a function of process that guarantees fair and equal participation. Part IV demonstrates that none of these models provides the basis for a fully adequate theory of procedural justice. In Part V, The Value of Participation, the lessons learned from analysis and critique of the three models are then applied to the question whether a right of participation can be justified for reasons that are not reducible to either its effect on the accuracy or its effect on the cost of adjudication. The most important result of Part V is the Participatory Legitimacy Thesis: it is (usually) a condition for the fairness of a procedure that those who are to be finally bound shall have a reasonable opportunity to participate in the proceedings. The central normative thrust of Procedural Justice is developed in Part VI, Principles of Procedural Justice. The first principle, the Participation Principle, stipulates a minimum (and minimal) right of participation, in the form of notice and an opportunity to be heard, that must be satisfied (if feasible) in order for a procedure to be considered fair. The second principle, the Accuracy Principle, specifies the achievement of legally correct outcomes as the criterion for measuring procedural fairness, subject to four provisos, each of which sets out circumstances under which a departure from the goal of accuracy is justified by procedural fairness itself. In Part VII, The Problem of Aggregation, the Participation Principle and the Accuracy Principle are applied to the central problem of contemporary civil procedure - the aggregation of claims in mass litigation. Part VIII offers some concluding observations about the point and significance of Procedural Justice. (shrink)

By using the general investigation framework offered by the cognitive science of religion (CSR), I analyse religion as a necessary condition for the evolutionary path of knowledge. The main argument is the "paradox of the birth of knowledge": in order to get to the meaning of the part, a sense context is needed; but a sense of the whole presupposes the sense (meaning) of the parts. Religion proposes solutions to escape this paradox, based on the imagination of sense (meaning) contexts, (...) respectively closures of these contexts through meta-senses. What is important is the practical effectiveness of solutions proposed by religion, taking into account the costs of faith and the costs of the absence of religious belief. The hypothesis has the following consequences: religion is a necessary condition for the initial evolution of knowledge and the emergence of religion is determined by the evolution of knowledge. The continuation of the solving of paradox is a Bayesian one, using explorations: a sense of the whole allows cognitive arrangements of the parties, which in turn open the possibility of a rearrangement of the whole. The contribution of religion to the emergence of sense (meaning) could be governed by the rule: any map of the world is more useful than no map; any meaning (of life) is better than no meaning. The human mind fills the perceptual and cognitive gaps, some (religious) filling solutions being true vault keys of the entire cognitive construction called the world. Knowledge is conditioned by the existence of an organized context, as the cosmos created by religion by means of explanatory meta-theories supports knowledge by closing the cognitive context and using meaning networks. The proposed analysis is consistent with a redefinition of rationality from the perspective of evolution: the importance and relevance of knowledge is determined by its practical outcome - survival. In the context of useful fictions, it does not matter what God actually does, but what we have done by believing in God. Existence has provided a pragmatic verification of the cognitive solutions that underlie the survival strategies promoted by religions. (shrink)

A small but growing number of studies have aimed to understand, assess and reduce existential risks, or risks that threaten the continued existence of mankind. However, most attention has been focused on known and tangible risks. This paper proposes a heuristic for reducing the risk of black swan extinction events. These events are, as the name suggests, stochastic and unforeseen when they happen. Decision theory based on a fixed model of possible outcomes cannot properly deal with this kind of event. (...) Neither can probabilistic risk analysis. This paper will argue that the approach that is referred to as engineering safety could be applied to reducing the risk from black swan extinction events. It will also propose a conceptual sketch of how such a strategy may be implemented: isolated, self-sufficient, and continuously manned underground refuges. Some characteristics of such refuges are also described, in particular the psychosocial aspects. Furthermore, it is argued that this implementation of the engineering safety strategy safety barriers would be effective and plausible and could reduce the risk of an extinction event in a wide range of possible scenarios. Considering the staggering opportunity cost of an existential catastrophe, such strategies ought to be explored more vigorously. (shrink)

Most mental disorders affect only a small segment of the population. On the reasonable assumption that minds or brains are prone to occasional malfunction, these disorders do not seem to pose distinctive explanatory problems. Depression, however, because it is so prevalent and costly, poses a conundrum that some try to explain by characterizing it as an adaptation—a trait that exists because it performed fitness-enhancing functions in ancestral populations. Heretofore, proposed evolutionary explanations of depression did not focus on thought processes; instead, (...) they emphasized that it facilitates navigation of adverse social circumstances or promotes immune response to infectious agents. According to a new hypothesis, the “analytical rumination hypothesis” (ARH), however, depression’s crucial adaptive trait is rumination—negative, intrusive thought. ARH holds that, (i) social dilemmas trigger depressed mood; (ii) depressed mood induces changes in body systems that facilitate ruminative analysis aimed at solving dilemmas; and, (iii) depressive rumination is a fitness-enhancing trait that was selected for in evolutionary time. Jointly, (i)~(iii) imply that we should not think of rumination as a disorder; instead, it is a trade-off, an eminently rational one. In the same way that fever solves a problem—coordination of the immune system in response to infection—so too does depressive rumination solve a problem, a social dilemma, albeit at the cost of inducing anhedonia and other maladies. But they argue that the cost is worthwhile, something that should be endured “until the problem is solved.” First, we argue that there are two distinct types of rumination, brooding and pondering; the former is associated with a disposition for depression, not the latter. But only the latter has the problem-solving capabilities that ARH requires. Second, recent brain imaging studies of depression reveal resting state hypoactivity in lateral regions and hyperactivity in paralimbic regions; this asymmetric pattern correlates with heightened levels of brooding, self-focused rumination. In other words, on the personal level, patients are trapped within self, isolated from the external world and suffused with negative affect; on the subpersonal level, this pattern is reflected by an asymmetric pattern of lateral vs. paralimbic resting state activity. Third, we proceed to conjecture that rational responses (e.g., pondering) to social dilemmas are those that strike a balance between internal and external considerations in the process of belief formation. Fourth, because the asymmetric resting state activity blocks those who suffer with depression from accessing and processing potentially positive stimuli from the external world, the capacity for rational, analytic response—hence, problem-solving—is constrained. Fifth, it follows that, although there might be conditions for which suffering should be endured rather than pharmacologically alleviated, depression is not one of those. Indeed, in view of the effects of the asymmetric resting state pattern, it is unlikely that depressive rumination would have been useful even for ancestral populations. (shrink)