The culture of the 21st century - on an increasingly ___________ scale - is oriented around the practical principles of utility, effectiveness, and impact. Things are good to the extent that they are instrumental, with instrumentality usually defined as the capacity to produce money or things. The worth of anything -an idea, an activity, an artwork, a ___________ with another person - is determined _______________.

For the first blank, we need a word that indicates the widespread or large-scale nature of modern culture. For the second blank, we need a noun that fits as an example of something whose value can be judged—ideally a human interaction. For the third blank, we need an adverb that reflects how value is assessed, and it should align with a practical or results-based approach.

Global is the best choice for the first blank, as it reflects the worldwide scale of 21st-century culture. Relationship fits the second blank because it is a type of interaction that, in this context, may be judged by its usefulness or output. Pragmatically is ideal for the third blank as it conveys that worth is assessed in realistic, result-oriented terms, matching the tone of the passage.

Hence, option D is the best choice.