The equitable allocation of resources has long been a central concern for humanity, prompting extensive research into various motivations that drive the pursuit of distributive justice. In contrast to one of the most fundamental motives, inequality aversion, a conflicting motive has been proposed: rank-reversal aversion. However, it remains unclear whether this rank-reversal aversion persists in the presence of self-rank. Here we provide evidence of rank-reversal aversion in the first-party context and explore diverse moral strategies for distribution. In a modified version of the redistribution game involving 55 online-recruited participants, we observed rank-reversal aversion only when one\'s rank was maintained. When participants\' self-rank was altered, they tended to base their behavior on their new ranks. This behavioral tendency varied among individuals, revealing three distinct moral strategies, all incorporating considerations of rank-reversal. Our findings suggest that rank-reversal aversion can indeed influence one\'s distribution behavior, although the extent of its impact may vary among individuals, especially when self-rank is a factor. These insights can be extended to political and economic domains, contributing to a deeper understanding of the underlying mechanisms of distributive justice.

UNASSIGNED: The COVID-19 pandemic has brought severe health consequences among older adults and posed ethical challenges. The aim of this study was to explore the impacts of COVID-19 on the health and medical care of older adults in Ethiopia and associated ethical implications, regardless of older adults\' COVID-19 infection status.
UNASSIGNED: In this qualitative study, we followed an inductive exploratory approach based on reflexive thematic analysis. We conducted semistructured interviews between March 2021 and November 2021 with 20 older adults and 26 health professionals who were selected from healthcare facilities and communities in Ethiopia using purposive and snowball sampling techniques. We audio-recorded, transcribed, translated, and inductively analyzed the interviews using thematic analysis.
UNASSIGNED: Participants reported that the pandemic compromised the accessibility and quality of both COVID and non-COVID healthcare services for older adults, which negatively impacted older adults\' health conditions and medical care. Moreover, participants elaborated on the health conditions and care of older patients with COVID-19 and highlighted that older COVID-19 patients often have severe health conditions, do not get adequate COVID-19 care, and may receive lower priority for admission to intensive care units compared to younger patients when resources are limited.
UNASSIGNED: Results of this study showed that practices of COVID-19 care and measures may have led to adverse consequences such as limited availability and access to aged care in Ethiopia, which could have further health consequences on older patients. Our results contribute to a better understanding of ethical issues such as distributive justice and prioritization arising in the healthcare of older patients in times of global pandemic. It is imperative for local and international health policymakers and ethicists to further analyze and address the challenges that compromise the accessibility and continuity of quality care for older persons during a public healthcare crisis.

According to the sufficiency theory of justice in health, justice requires that people have equal access to adequate health. In this article, I lay out the structure of this view and I assess its distributive implications for setting priority (i) between health needs across persons and (ii) between health care spending and other societal goods. I argue, first, that according to the sufficiency theory, deficiency in health cannot be completely offset by providing other societal goods. And, second, that it can prevent the medicalization of societies by stressing that improvements beyond the level of adequate health have relatively little weight, if any, from the standpoint of justice.

COVID-19 presents a variety of ethical challenges in a set of arenas, arenas not always considered in past pandemics. These challenges include issues related to autonomy, distributive ethics, and the establishment of policies of equity and justice. Methods are a literature review based on regular editing of an online textbook during the COVID-19 outbreak and a literature review using key ethical terms. Patients are confronted with new issues related to autonomy. Providers need to expand their concepts of ethical issues to include decisions based on proportionality and public health ethics. The public health sector needs to assess the beneficence of alternative modes of disease control. The research community needs to redefine the concept of informed consent in emergent conditions. All elements of the medical spectrum-physicians, scientists, and the community-at-large including the pharmaceutical industry-need to consider the multifaceted methods for preventing future pandemics. This will require giving particular emphasis to public health funding and ending the documented discrimination that exists in the provision of proven therapies. The developing world is especially at risk for most of the ethical issues, especially those related to equity and justice. The ethical issues associated with the COVID-19 outbreak are not unique but provide a diverse set of issues that apply to patients, providers, social groups, and investigators. The further study of such issues can help with preventing future outbreaks.

Residential aged care facilities (RACF) are sites of high antibiotic use in Australia. Misuse of antimicrobial drugs in RACF contributes to antimicrobial resistance (AMR) burdens that accrue to individuals and the wider public, now and in the future. Antimicrobial stewardship (AMS) practices in RACF, e.g. requiring conformation of infection, are designed to minimise inappropriate use of antibiotics. We conducted dialogue groups with 46 participants with a parent receiving aged care to better understand families\' perspectives on antibiotics and care in RACF. Participants grappled with value trade offs in thinking about their own parents\' care, juggling imagined population and future harms with known short term comfort of individuals and prioritising the latter. Distributive justice in AMR relies on collective moral responsibility and action for the benefit of future generations and unknown others. In RACF, AMS requires value trade-offs and compromise on antimicrobial use in an environment that is heavily reliant on antimicrobial drugs to perform caring functions. In the context of aged care, AMS is a technical solution to a deeply relational and socio-structural problem and there is a risk that carers (workers, families) are morally burdened by system failures that are not addressed in AMS solutions.

Taking inequality as a key challenge of our time, this article aims to highlight consumer markets, and their underpinning legal ground rules, as important contributors to inequitable wealth distributions. It illustrates how product design, as manifested in contractual terms, can allow firms to evade competition and divert resources upwards along society\'s wealth distribution curve. It then highlights the contestable legality of certain pricing practices, such as \'contingent charges\', and the challenge they pose to fundamental principles of contract law. An in-depth view of the 2015 case of Beavis v ParkingEye argues that the UK Supreme Court has validated contingent pricing models in a manner unsupported by traditional contractual reasoning and unjustified by contemporary market failure analysis. The article asks contract law to confront the reality that it shapes market distributions in economically and politically significant ways, and appeals for greater scrutiny of the contribution of contract law adjudication to inequality.

Societies are confronted with the dilemma that need satisfaction requires transparent individual needs. We study the effect of information about others\' needs on the distribution of a joint endowment in a three-player network exchange game in a laboratory experiment. Need levels are exogenously given and either transparent (known to all three network members) or opaque (only known to the players themselves). The three players negotiate in dyads until two players agree on a distribution. We expect that the transparency of need thresholds raises need satisfaction but lowers equality. The results suggest that the members of the dyad who agree on the distribution can satisfy their own need thresholds even when information about thresholds is opaque. The effect of transparency on the remaining network member is antithetical: while transparency increases the rate of need satisfaction, it decreases the average share of allocations when needs are low. In the opaque condition, allocated shares are larger, but need satisfaction is lower. This reveals the ambivalent distributive effects of transparent need thresholds: Transparency helps those with the highest need thresholds, but it can hurt those with lower need thresholds, and it barely affects the ones with the most influence on the decision.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s11211-024-00434-0.

When considering the introduction of a new intervention in a budget constrained healthcare system, priority setting based on fair principles is fundamental. In many jurisdictions, a multi-criteria approach with several different considerations is employed, including severity and cost-effectiveness. Such multi-criteria approaches raise questions about how to balance different considerations against each other, and how to understand the logical or normative relations between them. For example, some jurisdictions make explicit reference to a large patient benefit as such a consideration. However, since patient benefit is part of a cost-effectiveness assessment it is not clear how to balance considerations of greater patient benefit against considerations of severity and cost-effectiveness. The aim of this paper is to explore the role of a large patient benefit as an independent criterion for priority setting in a healthcare system also considering severity and cost-effectiveness. By taking the opportunity cost of new interventions (i.e., the health forgone in patients already receiving treatment) into account, we argue that patient benefit has a complex relationship to priority setting. More specifically, it cannot be reasonably concluded that large patient benefits should be given priority if severity, cost-effectiveness, and opportunity costs are held constant. Since we cannot find general support for taking patient benefit into account as an independent criterion from any of the most discussed theories about distributive justice: utilitarianism, prioritarianism, telic egalitarianism and sufficientarianism, it is reasonable to avoid doing so. Hence, given the complexity of the role of patient benefit, we conclude that in priority practice, a large patient benefit should not be considered as an independent criterion, on top of considerations of severity and cost-effectiveness.

OBJECTIVE: Justice Capital provides a theoretical framework for explaining individual differences in the belief in a just world (BJW). However, this framework has yet to receive empirical validation.
METHODS: Using Round 9 of the European Social Survey, a large (n = 43,209) multi-country (N = 29) sample, I conduct multilevel latent profile analysis and multilevel multinomial logistic regression to determine the latent profiles that emerge at a population level and map the demographic and experiential covariates of these profiles.
RESULTS: Incorporating measures of general BJW, distributive and procedural justice, and the belief in equality of opportunity, I find three latent profiles: meritocrats, moderates, and egalitarians. Compared with egalitarians, meritocrats (strong just world believers) are more likely to be male; younger; have a higher income; have attained more years of education; to be politically conservative; and have no recent experience of discrimination or crime. Meritocrats were overrepresented in countries with a higher Human Development Index.
CONCLUSIONS: This study demonstrates the feasibility of Justice Capital for understanding individual variation in general BJW and related justice beliefs; discussion centers on anomalous findings and extension of this theoretical framework.

BACKGROUND: Codes of ethics provide guidance to address ethical challenges encountered in clinical practice. The harmonization of global, regional, and national codes of ethics is important to avoid gaps and discrepancies.
METHODS: We compare the European Psychiatric Association (EPA) and the World Psychiatric Association (WPA) Codes of Ethics, addressing main key points, similarities, and divergences.
RESULTS: The WPA and EPA codes are inspired by similar fundamental values but do show a few differences. The two codes have a different structure. The WPA code includes 4 sections and lists 5 overarching principles as the basis of psychiatrists\' clinical practice; the EPA code is articulated in 8 sections, lists 4 ethical principles, and several fundamental values. The EPA code does not include a section on psychiatrists\' education and does not contain specific references to domestic violence and death penalty. Differences can be found in how the two codes address the principle of equity: the EPA code explicitly refers to the principle of universal health care, while the WPA code mentions the principle of equity as reflected in the promotion of distributive justice.
CONCLUSIONS: We recommend that both WPA and EPA periodically update their ethical codes to minimize differences, eliminate gaps, and help member societies to develop or revise national codes in line with the principles of the associations they belong to.Minimizing differences between national and international codes and fostering a continuous dialogue on ethical issues will provide guidance for psychiatrists and will raise awareness of the importance of ethics in our profession.