How Uber and other digital platforms could trick us using behavioral science – unless we act fast

The Conversation  online

2019-05-10

Uber’s business model is incredibly simple: It’s a platform that facilitates exchanges between people. And Uber’s been incredibly successful at it, almost eliminating the transaction costs of doing business in everything from shuttling people around town to delivering food.

view more

Summer Bummer: A Young Camper's $142,938 Snakebite

NPR  online

2019-04-29

"It was a major comfort for me to realize, OK, we're getting the best care possible," said Perry, who is a health care ethics professor at the business school at Indiana University, Bloomington. Less than 24 hours after the bite, Oakley left the hospital with her grateful parents.

view more

For-profit hospice industry raises worries

PNHP  online

2011-05-19

Dr. Robert Stone, an emergency medicine physician in Bloomington, Ind., and Joshua Perry of Indiana University say end-of-life hospice care was once the province of charitable organizations, but 52 percent of hospices are now part of the for-profit sector.

view more

Newt's bad prescription

Salon  online

2011-10-17

Asked at last week's Republican presidential candidates' debate about the massive amounts of Medicare money spent on patients in the last two years of life, the former House speaker chose to focus his remarks on prostate cancer, a matter of no small concern to the 44 million men in America who are age 50 and older – a key voting demographic.

view more

Stupid Money: Can you ever be ethical with money in this godforsaken globalized world?

MEL Magazine  online

Bearing in mind the unsavory aspects of industrialization and globalization, it can seem like every transaction you make inevitably negatively affects someone or something, somewhere. So how can one spend their money in an ethical way these days? Alongside two business ethics professors — Robert Prentice at the University of Texas’ McCombs School of Business, and Josh Perry at Indiana University’s Kelley School of Business — we’re going to look for some rays of light.

view more

Indiana University Office of the Vice Provost for Research Grant

University of Indiana 

Recipient, IU Office of the Vice Provost for Research Grant, funding a research seminar entitled “Turning Pro: The University, the Workplace, and the Changing Role of Professionalism”

view more

Cal Turner Program for Moral Leadership in the Professions at Vanderbilt University Faculty Research Grant

Vanderbilt University 

Recipient, Cal Turner Program for Moral Leadership in the Professions at Vanderbilt University Faculty Research Grant, funding research on how healthcare lawyers resolve ethical dilemmas (2005 - 2008)

view more

Vanderbilt University Center for Ethics Research Grant

Vanderbilt University 

Recipient, Vanderbilt University Center for Ethics Research Grant, funding research on the common ethical dilemmas encountered by lawyers and physicians (2007 - 2008)

For Patients and Profits: Ethical Astuteness and the Business of Dialysis

2016 The view of ethical astuteness introduced and outlined in this paper aims to add value for a firm in the healthcare business – with a particular application to a for-profit organization providing dialysis services – by addressing two chief concerns: A.) The competing priorities between the patient’s interest in the healthcare encounter and the investor’s interest in generating a return on profits; and B.) The vulnerabilities of a financially-conflicted, for-profit healthcare provider to an allegation of medical malpractice.

view more

The People's NIH? Ethical and Legal Concerns in Crowdfunded Biomedical Research

2015 Over the last decade, online crowdfunding has become a mainstream source of capital formation for a range of artistic and entrepreneurial endeavors. Low-barrier websites such as Kickstarter and IndieGoGo that fund production of a movie or recording of an album, in addition to charity conduits such as Kiva that facilitate the dissemination of microloans in the developing world, are trusted fundraising mechanisms that offer alternatives to traditional financing through banks and venture capitalists. Moreover, these models predicated on the solicitation of relatively modest amounts of money create a more egalitarian investment environment wherein donors can join the effort—and often receive some token reward— in exchange for a sense of personal engagement and affiliation with the underlying project being financed. Crowdvesting is a kind of crowdfunding designed to raise capital a la traditional stock offerings and the sale of ` securities. Unlike charitable donations, such investment opportunities trigger analysis under existing securities laws and regulations, some of which date to post-Great Depression concerns, i.e., the 1933 and 1934 Securities Acts and others flowing from the more recent Great Recession milieu, i.e, the JOBS Act of 2012 and related state analogues. Given the decreasing availability of federal research funding, biomedical researchers have begun to explore the potential for crowdfunding models of financing. This paper explores the ethical and legal issues triggered by the specific case of the physician-researcher, active both in the clinic and at the bench, who seeks to raise funding via crowdfunding channels. Should physician-researchers solicit research funding from their patients? What are the implications for the patient’s sense of trust and the patient’s relationship with the physician? And what about those donating who are not patients or related stakeholders, but rather interested and sympathetic donors who wish to help the cause? This paper maps the landscape of these questions and concerns, and lays the groundwork for future empirical and theoretical explorations, as well as policy and practice guidelines.

view more

Efficient, Compassionate, and Fractured: Contemporary Care in the ICU

2014 Alasdair MacIntyre described the late modern West as driven by two moral values: efficiency and effectiveness. Regardless of whether you accept MacIntyre's overarching story, it seems clear that efficiency and effectiveness have achieved a zenith in institutional health care structures, such that these two aspects of care become the final arbiters of what counts as “good” care. At the very least, they are dominant in many clinical contexts and act as the interpretative lens for the judgments of successful health care managers. The drive of efficiency can also be seen in “lean” management methods (originally imported from the automotive manufacturing industry) increasingly deployed in the intensive care unit. This drive gives us pause. The high stress of the ICU is exacerbated by the enormous complexity of technological interventions designed to maintain physiological functioning as the body heals, as well as the ever-present concerns related to cost, effectiveness, and efficiency. The ICU, therefore, provides an illustrative view of the challenges facing clinicians, as well as resource managers, in terms of delivering care. In short, the goal of technocratic efficiency often ends up at odds with humane purposes. To better understand these contemporary health care dynamics, we conducted a limited series of focus group discussions and interviews with residents experienced in the challenges of delivering care in the ICU environment. In what follows, we highlight some narrative observations drawn from these focus groups. We found a recurrent and disconcerting refrain among our informants that has not been adequately described or addressed in the literature: technocratic management techniques have crept into and bifurcated clinical care strategies in the ICU. Specifically, we highlight the influence of concerns around efficiency and effectiveness and the ways in which these foci have contributed to a bifurcation in care in the ICU along two trajectories: either compassionate care or curative care.

view more

Trust and Transparency: Patient Perceptions of Physicians' Financial Relationships with Pharmaceutical Companies

2014 Financial relationships and business transactions between physicians and the health care industry are common. These relationships take a variety of forms, including payments to physicians in exchange for consulting services, reimbursement of physician travel expenses when attending medical device and pharmaceutical educational conferences, physician ownership in life science company stocks, and the provision of free drug samples.

view more

Direct-to-Consumer Drug Advertisements and the Informed Patient: A Legal, Ethical, and Content Analysis

2013 The ultimate goal of most advertising is to increase product sales. However, much advertising does not exert an immediate impact on consumer purchase behavior, but rather elicits intermediate consumer responses, such as increased brand awareness, interest, and information seeking.

view more

In the business of dying: questioning the commercialization of hospice.

2011 This article critically questions the commercialization of hospice care and the ethical concerns associated with the industry's movement toward "market-driven medicine" at the end of life. For example, the article examines issues raised by an influx of for-profit hospice providers whose business model appears at its core to have an ethical conflict of interest between shareholders doing well and terminal patients dying well. Yet, empirical data analyzing the experience of patients across the hospice industry are limited, and general claims that end-of-life patient care is inferior among for-profit providers or even that their business practices are somehow unseemly when compared to nonprofit providers cannot be substantiated. In fact, non-profit providers are not immune to potentially conflicting concerns regarding financial viability (i.e., "no margin, no mission"). Given the limitations of existing empirical data and contrasting ideological commitments of for-profit versus non-profit providers, the questions raised by this article highlight important areas for reflection and further study. Policymakers and regulators are cautioned to keep ethical concerns in the fore as an increasingly commercialized hospice industry continues to emerge as a dominant component of the U.S. health care system. Both practitioners and researchers are encouraged to expand their efforts to better understand how business practices and commercial interests may compromise the death process of the patient and patient's family--a process premised upon a philosophy and ethical tradition that earlier generations of hospice providers and proponents established as a trusted, end-of-life alternative.

view more