Moral externalisation fails to scale.

We argue that Stanford's picture of the evolution of externalised norms is plausible mostly because of the idealisations implicit in his defence of it. Once we take into account plausible amounts of normative disagreement, plausible amounts of error and misunderstanding, and the knock-on consequences of shunning, it is plausible that Stanford under-counts the costs of externalisation.

Preferences, predictions and patient enablement: a preliminary study.

Background: The widely used patient enablement instrument (PEI) is sometimes contrasted against measures of patient satisfaction as being a more objective measure of consultation quality, in that it is less likely to be positively influenced by fulfilling pre-existing expectations for specific consultation outcomes (such as prescriptions or referrals). However the relationship between expectation and enablement is underexplored, as is the relationship between 'expectation' understood as a patient preference for outcome, and patient prediction of outcome. The aims of the study are to 1) assess the feasibility of measuring the relationship between expectation fulfilment and patient enablement, and 2) measure the difference (if any) between expectation understood as preference, and expectation understood as prediction.