Overpowered: American domination, democracy and the ethics of energy consumption

The United States has used its overwhelming political and economic power to secure for itself a disproportionate share of the world’s non-renewable energy resources, most of which are located outside of our borders. We therefore produce a disproportionate amount of pollution, some of which affects people and ecosystems outside of our own borders

Exploitation and Joint Action

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Illness Mapping: A time and cost effective method to estimate healthcare data needed to establish community-based health insurance

Background: Most healthcare spending in developing countries is private out-of-pocket. One explanation for low penetration of health insurance is that poorer individuals doubt their ability to enforce insurance contracts. Community-based health insurance schemes (CBHI) are a solution, but launching CBHI requires obtaining accurate local data on morbidity, healthcare utilization and other details to inform package design and pricing. We developed the "Illness Mapping" method (IM) for data collection (faster and cheaper than household surveys). Methods. IM is a modification of two non-interactive consensus group methods (Delphi and Nominal Group Technique) to operate as interactive methods. We elicited estimates from "Experts" in the target community on morbidity and healthcare utilization. Interaction between facilitator and experts became essential to bridge literacy constraints and to reach consensus.The study was conducted in Gaya District, Bihar (India) during April-June 2010. The intervention included the IM and a household survey (HHS). IM included 18 women's and 17 men's groups. The HHS was conducted in 50 villages with1,000 randomly selected households (6,656 individuals). Results: We found good agreement between the two methods on overall prevalence of illness (IM: 25.9% ±3.6; HHS: 31.4%) and on prevalence of acute (IM: 76.9%; HHS: 69.2%) and chronic illnesses (IM: 20.1%; HHS: 16.6%). We also found good agreement on incidence of deliveries (IM: 3.9% ±0.4; HHS: 3.9%), and on hospital deliveries (IM: 61.0%. ± 5.4; HHS: 51.4%). For hospitalizations, we obtained a lower estimate from the IM (1.1%) than from the HHS (2.6%). The IM required less time and less person-power than a household survey, which translate into reduced costs. Conclusions: We have shown that our Illness Mapping method can be carried out at lower financial and human cost for sourcing essential local data, at acceptably accurate levels. In view of the good fit of results obtained, we assume that the method could work elsewhere as well

Hardship financing of healthcare among rural poor in Orissa, India

<p>Abstract</p> <p>Background</p> <p>This study examines health-related "hardship financing" in order to get better insights on how poor households finance their out-of-pocket healthcare costs. We define hardship financing as having to borrow money with interest or to sell assets to pay out-of-pocket healthcare costs.</p> <p>Methods</p> <p>Using survey data of 5,383 low-income households in Orissa, one of the poorest states of India, we investigate factors influencing the risk of hardship financing with the use of a logistic regression.</p> <p>Results</p> <p>Overall, about 25% of the households (that had any healthcare cost) reported hardship financing during the year preceding the survey. Among households that experienced a hospitalization, this percentage was nearly 40%, but even among households with outpatient or maternity-related care around 25% experienced hardship financing.</p> <p>Hardship financing is explained not merely by the wealth of the household (measured by assets) or how much is spent out-of-pocket on healthcare costs, but also by when the payment occurs, its frequency and its duration (e.g. more severe in cases of chronic illnesses). The location where a household resides remains a major predictor of the likelihood to have hardship financing despite all other household features included in the model.</p> <p>Conclusions</p> <p>Rural poor households are subjected to considerable and protracted financial hardship due to the indirect and longer-term deleterious effects of how they cope with out-of-pocket healthcare costs. The social network that households can access influences exposure to hardship financing. Our findings point to the need to develop a policy solution that would limit that exposure both in quantum and in time. We therefore conclude that policy interventions aiming to ensure health-related financial protection would have to demonstrate that they have reduced the frequency and the volume of hardship financing.</p

Sexual Exploitation and the Social Contract

Nearly everyone agrees that sexual exploitation occurs and that, when it does, it is morally wrong. However, there is substantial disagreement over what constitutes sexual exploitation and why it is wrong. Is sex between freely consenting adults ever exploitative? Is prostitution always exploitative? What features of sexually exploitative interactions lead us to regard them as morally wrong? And if sexual exploitation is morally wrong, what should be done about it?These are not new questions for the social philosopher. However, recent criticisms of social contract theory may lead us to wonder whether contractarianism (of any variety) has the resources to criticize important cases of sexual exploitation—particularly prostitution. Some liberals have defended prostitution “in principle,” arguing that when prostitution is truly consensual, there is nothing wrong with it. This is called “sound prostitution.” Indeed, in cases where the parties to a sexual exchange are both competent adults, liberals and libertarians have a difficult time criticizing it, since to do so runs the risk of imposing a local and historically specific sexual ideal on members of society who explicitly reject it or else suggests that the prostitutes and their clients are not really competent agents.</jats:p

Autism and the Extreme Male Brain

ABSTRACT: Simon Baron-Cohen has argued that autism and related developmental disorders (sometimes called “autism spectrum conditions” or “autism spectrum disorders”) can be usefully thought of as the condition of possessing an “extreme male brain.” The impetus for regarding autism spectrum disorders (ASD) this way has been the accepted science regarding the etiology of autism, as developed over that past several decades. Three important features of this etiology ground the Extreme Male Brain theory. First, ASD is disproportionately male (approximately 10:1 in the case of Asperger’s Syndrome or high-functioning autism (HFA) and approximately 4:1 in the case of autistic disorder). Second, ASD is not psychogenic but biological in origin, and hence is not the product of sexist conditioning or childrearing practices, although these may affect the development of the disorder. Third, ASD is regarded as a spectrum developmental disorder, unlike other disorders such as Down Syndrome that are diagnosed by a (nearly) binary criterion. Down Syndrome, for example, is diagnosed by the presence in all or most cells within a given individual of an extra copy of Chromosome 21. Autism, on the other hand, is diagnosed by the presence of a set of symptoms that vary in their intensity and in their milder forms seem to conform to purported sex differences in cognitive, emotional, and social functioning. In this paper, I do not challenge accepted science regarding the etiology of autism, and I do not challenge the idea of ASD as a disorder. Nor do I wish to offer an alternative account of what autism is. Instead, I focus on the usefulness of thinking of a disorder as an extreme version of ordinary sex differences. Does it follow from the fact that a disorder is more often found in men that we should think of it as an extreme form of maleness? If not, what other conditions must be met in order to warrant this way of thinking about ASD? What does it mean to say that ASD is a form of “extreme male brain”? Feminists are rightly skeptical of theories that make claims about male and female brains, so how should we respond to the clear evidence that the differences between typical and ASD individuals are not caused by childrearing practices? I explain what I take to be Baron-Cohen’s central argument that autism should be seen as the extreme male brain, and critique that argument. I conclude that there is no good argument that autistic symptoms should be regarded as an extreme form of male mental traits, and that Baron-Cohen’s claim does not help us to understand autism, women, or men. His claim is a speculative thesis that is readily mobilized for sexist practices. As such it requires a higher threshold for evidentiary support and rigorous argumentation—support and argumentation that does not exist. KEYWORDS: autism, brain, gender, neuroscience, feminism, mal