"ACT Administrative Appeals Tribunal Decisions." Ethos: Official Publication of the Law Society of the Australian Capital Territory, (200), pp. 42.

Ethical thought experiments such as the trolley dilemma have been investigated extensively in the past, showing that humans act in utilitarian ways, trying to cause as little overall damage as possible. These trolley dilemmas have gained renewed attention over the past few years, especially due to the necessity of implementing moral decisions in autonomous driving vehicles. We conducted a set of experiments in which participants experienced modified trolley dilemmas as drivers in virtual reality environments. Participants had to make (...) class='Hi'>decisions between driving in one of two lanes where different obstacles came into view. Eventually, the participants had to decide which of the objects they would crash into. Obstacles included a variety of human-like avatars of different ages and group sizes. Furthermore, the influence of sidewalks as potential safe harbors and a condition implicating self-sacrifice were tested. Results showed that participants, in general, decided in a utilitarian manner, sparing the highest number of avatars possible with a limited influence by the other variables. Derived from these findings, which are in line with the utilitarian approach in moral decision making, it will be argued for an obligatory ethics setting implemented in ADVs. (shrink)

Mele develops a view of paradigmatically free actions--including decisions--as indeterministically caused by their proximal causes. He mounts a masterful defense of this thesis that includes solutions to problems about luck and control widely discussed in the literature on free will and moral responsibility.

OBJECTIVES: Life-sustaining treatment at the end of life gives rise to many ethical problems in Japan. Recent surveys of Japanese physicians suggested that they tend to treat terminally ill patients aggressively. We studied why Japanese physicians were reluctant to withhold or withdraw life-support from terminally ill patients and what affected their decisions. DESIGN AND PARTICIPANTS: A qualitative study design was employed, using a focus group interview with seven physicians, to gain an in-depth understanding of attitudes and rationales in Japan (...) regarding medical care at the end of life. RESULTS: Analysis revealed that physicians and patients' family members usually make decisions about life-sustaining treatment, while the patients' wishes are unavailable or not taken into account. Both physicians and family members tend to consider withholding or withdrawing life-sustaining treatment as abandonment or even killing. The strongest reason to start cardiopulmonary resuscitation- and to continue it until patients' family members arrive-seems to be the family members' desire to be at the bedside at the time of death. All physicians participating in our study regarded advance directives that provide information as to patients' wishes about life-sustaining treatment desirable. All expressed concern, however, that it would be difficult to forego or discontinue life-support based on a patient's advance directive, particularly when the patient's family opposed the directive. CONCLUSION: Our group interview suggested several possible barriers to death with dignity and the appropriate use of advance directives in Japan. Further qualitative and quantitative research in this regard is needed. (shrink)

This paper discusses the role of consent in decision making generally and its role in end of life decisions in particular. It outlines a conception of autonomy which explains and justifies the role of consent in decision making and criticises some misapplications of the idea of consent, particular the role of fictitious or “proxy” consents.Where the inevitable outcome of a decision must be that a human individual will die and where that individual is a person who can consent, then (...) that decision is ethical if and only if the individual consents. In very rare and extreme cases such a decision will be ethical in the absence of consent where it would be massively cruel not to end life in order to prevent suffering which is in no other way preventable.Where, however, the human individual is not a person, as is the case with abortion, the death of infants like Mary , or in the very rare and extreme cases of those who have ceased to be persons like Tony Bland, such decisions are governed by the ethics of ending the lives of non-persons. (shrink)

Some decisions result in cognitive consequences such as information gained and information lost. The focus of this study, however, is decisions with consequences that are partly or completely noncognitive. These decisions are typically referred to as ‘real-life decisions’. According to a common complaint, the challenges of real-life decision making cannot be met by decision theory. This complaint has at least two principal motives. One is the maximizing objection that to require agents to determine the optimal act (...) under real-world constraints is unrealistic. The other is the precision objection that the numeric requirements for applying decision theory are overly demanding for real-life decisions. Responses to both objections are aired in the History section of this chapter. The maximizing objection is addressed with reference to work by Weirich and Pollock, while the precision objection is countered via a proposal by Kyburg and another by Gärdenfors and Sahlin. However, the Current Research section urges a different response to the precision objection by introducing a comparative version of decision theory. Drawing on Chu and Halpern’s notion of generalized expected utility, this version of decision theory permits many choices to be based on merely comparative plausibilities and utilities. Finally, the Further Research section undertakes an open-ended exploration of three of the assumptions upon which this form of decision theory (and many others) is based: transitivity, independence, and plausibilistic decision rules. (shrink)

: The standard bioethics account is that respecting patient autonomy means ensuring patients make their own decisions. In fact, respecting patient autonomy often has more to do with the overall shape and meaning of patients' health care regimes, and sometimes, at least, patients will very reasonably defer to medical authority.

The standard bioethics account is that respecting patient autonomy means ensuring that patients make their own decisions, and that requires that they give informed consent. In fact, respecting autonomy often has more to do with the overall shape and meaning of their health care regimes. Ideally, patients will sometimes take control of their health care but sometimes defer to medical authority. The physician's task is, in part, to inculcate patients into the appropriate good health care regimes.

This paper sets out to explore the relation between social argumentation and inner debate by taking into account suggestions from argumentation studies and from social and discursive psychology. It develops Dascal’s (2005) claim that there are metonymical and structural relations between the two realms of debate by substantiating it with data taken from international migrants’ inner debates at moments of difficult decisions. The data are drawn from the experience of migrating mothers who have to decide whether to go back (...) or to remain in their host country (the UK). I show that others are present in migrants’ multivoiced decisions in two important senses: first, inner debates can be reconstructed as critical discussions (van Eemeren and Grootendorst 1984). Second, the locus from analogy has the special function of allowing the comparison between the migrant’s experience and someone else’s experience. (shrink)

Under the independence and competence assumptions of Condorcet’s classical jury model, the probability of a correct majority decision converges to certainty as the jury size increases, a seemingly unrealistic result. Using Bayesian networks, we argue that the model’s independence assumption requires that the state of the world (guilty or not guilty) is the latest common cause of all jurors’ votes. But often – arguably in all courtroom cases and in many expert panels – the latest such common cause is a (...) shared ‘body of evidence’ observed by the jurors. In the corresponding Bayesian network, the votes are direct descendants not of the state of the world, but of the body of evidence, which in turn is a direct descendant of the state of the world. We develop a model of jury decisions based on this Bayesian network. Our model permits the possibility of misleading evidence, even for a maximally competent observer, which cannot easily be accommodated in the classical model. We prove that (i) the probability of a correct majority verdict converges to the probability that the body of evidence is not misleading, a value typically below 1; (ii) depending on the required threshold of ‘no reasonable doubt’, it may be impossible, even in an arbitrarily large jury, to establish guilt of a defendant ‘beyond any reasonable doubt’. (shrink)

This paper sets out to explore the relation between social argumentation and inner debate by taking into account suggestions from argumentation studies and from social and discursive psychology. It develops Dascal’s claim that there are metonymical and structural relations between the two realms of debate by substantiating it with data taken from international migrants’ inner debates at moments of difficult decisions. The data are drawn from the experience of migrating mothers who have to decide whether to go back or (...) to remain in their host country. I show that others are present in migrants’ multivoiced decisions in two important senses: first, inner debates can be reconstructed as critical discussions. Second, the locus from analogy has the special function of allowing the comparison between the migrant’s experience and someone else’s experience. (shrink)

Firms use algorithms to make important business decisions. To date, the algorithmic accountability literature has elided a fundamentally empirical question important to business ethics and management: Under what circumstances, if any, are algorithmic decision-making systems considered legitimate? The present study begins to answer this question. Using factorial vignette survey methodology, we explore the impact of decision importance, governance, outcomes, and data inputs on perceptions of the legitimacy of algorithmic decisions made by firms. We find that many of the (...) procedural governance mechanisms in practice today, such as notices and impact statements, do not lead to algorithmic decisions being perceived as more legitimate in general, and, consistent with legitimacy theory, that algorithmic decisions with good outcomes are perceived as more legitimate than bad outcomes. Yet, robust governance, such as offering an appeal process, can create a legitimacy dividend for decisions with bad outcomes. However, when arbitrary or morally dubious factors are used to make decisions, most legitimacy dividends are erased. In other words, companies cannot overcome the legitimacy penalty of using arbitrary or morally dubious factors, such as race or the day of the week, with a good outcome or an appeal process for individuals. These findings add new perspectives to both the literature on legitimacy and policy discussions on algorithmic decision-making in firms. (shrink)

[Abstract and PDF at the Pittsburgh PhilSci Archive] A slightly shorter version of this paper is to appear in a volume edited by Jonathan Barrett, Adrian Kent, David Wallace and Simon Saunders, containing papers presented at the Everett@50 conference in Oxford in July 2007, and the Many Worlds@50 meeting at the Perimeter Institute in September 2007. The paper is based on my talk at the latter meeting (audio, video and slides of which are accessible here).

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, (...) how decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

Discerning the motives that lead businesspeople to make ethical decisions in economic contexts is important, for it aids the moral evaluation of such decisions. But conventional economic theory has for too long assumed an egoist model of motivation, to which many contrast an altruist view of ethical choices. The result is to see business decision making as implying dilemmas. On the other hand, we argue, if one assumes multiple motives, economic and ethical, in ordinary business decisions, a (...) more fruitful model of ethical motivation in such decisions emerges. In this paper multiple motives are assumed to be the norm in a world of large organizations, complex decisions and stakeholder management. An example of a technology acquisition decision, with environmental overtones is presented in illustration of this approach. A method for discerning motives, primarily in terms of behavioural efficacy is presented. On this basis a two step approach to morally evaluating mixed motives in business decisions is proposed. First, the fit of motives with substantive ethical values should be ascertained, and then the efficacy of moral motives in yielding ethical behaviour and outcomes should be determined. This approach, we conclude, offers a much more concrete model of the actual role of moral motives in business decision making. It also signals the importance of moral learning in organizations. (shrink)

With disagreement, doubts, or ambiguous grounds in end–of-life decisions, doctors are advised to involve a clinical ethics committee. However, little has been published on doctors’ experiences with discussing an end-of-life decision in a CEC. As part of the quality assurance of this work, we wanted to find out if clinicians have benefited from discussing end-of-life decisions in CECs and why. We will disseminate some Norwegian doctors’ experiences when discussing end-of-life decisions in CECs, based on semi-structured interviews with (...) fifteen Norwegian physicians who had brought an end-of-life decision case to a CEC. Almost half of the cases involved conflicts with the patients’ relatives. In a majority of the cases, there was uncertainty about what would be the ethically preferable solution. Reasons for referring the case to the CEC were to get broader illumination of the case, to get perspective from people outside the team, to get advice, or to get moral backing on a decision already made. A great majority of the clinicians reported an overall positive experience with the CECs’ discussions. In cases where there was conflict, the clinicians reported less satisfaction with the CECs’ discussions. The study shows that most doctors who have used a CEC in an end-of-life decision find it useful to have ethical and/or legal aspects illuminated, and to have the dilemma scrutinized from a new perspective. A systematic discussion seems to be significant to the clinicians. (shrink)

Algorithms increasingly make managerial decisions that people used to make. Perceptions of algorithms, regardless of the algorithms' actual performance, can significantly influence their adoption, yet we do not fully understand how people perceive decisions made by algorithms as compared with decisions made by humans. To explore perceptions of algorithmic management, we conducted an online experiment using four managerial decisions that required either mechanical or human skills. We manipulated the decision-maker, and measured perceived fairness, trust, and emotional (...) response. With the mechanical tasks, algorithmic and human-made decisions were perceived as equally fair and trustworthy and evoked similar emotions; however, human managers' fairness and trustworthiness were attributed to the manager's authority, whereas algorithms' fairness and trustworthiness were attributed to their perceived efficiency and objectivity. Human decisions evoked some positive emotion due to the possibility of social recognition, whereas algorithmic decisions generated a more mixed response – algorithms were seen as helpful tools but also possible tracking mechanisms. With the human tasks, algorithmic decisions were perceived as less fair and trustworthy and evoked more negative emotion than human decisions. Algorithms' perceived lack of intuition and subjective judgment capabilities contributed to the lower fairness and trustworthiness judgments. Positive emotion from human decisions was attributed to social recognition, while negative emotion from algorithmic decisions was attributed to the dehumanizing experience of being evaluated by machines. This work reveals people's lay concepts of algorithmic versus human decisions in a management context and suggests that task characteristics matter in understanding people's experiences with algorithmic technologies. (shrink)

This study investigates the performance of psychopathic individuals on tasks believed to be sensitive to dorsolateral prefrontal and orbitofrontal cortex (OFC) functioning. Psychopathic and non-psychopathic individuals, as defined by the Hare psychopathy checklist revised (PCL-R) [Hare, The Hare psychopathy checklist revised, Toronto, Ontario: Multi-Health Systems, 1991] completed a gambling task [Cognition 50 (1994) 7] and the intradimensional/extradimensional (ID/ED) shift task [Nature 380 (1996) 69]. On the gambling task, psychopathic participants showed a global tendency to choose disadvantageously. Specifically, they showed an (...) impaired ability to show learning over the course of the task. On the ID/ED task, the performance of psychopathic individuals was not significantly different from incarcerated controls on attentional set-shifting, but significant impairments were found on response reversal. These results are interpreted with reference to an OFC and amygdala dysfunction explanation of psychopathy. (shrink)

How can we make rational decisions that involve transformative experiences, that is, experiences that can radically change our core preferences? L. A. Paul (2014) has argued that many decisions involving transformative experiences cannot be rational. However, Paul acknowledges that some traumatic events can be transformative experiences, but are nevertheless not an obstacle to rational decision-making. For instance, being attacked by hungry sharks would be a transformative experience, and yet, deciding not to swim with hungry sharks is rational. Paul (...) has tried to explain why decisions involving ‘sharky’ outcomes are an exception to the rule. However, her putative explanation has been criticized by Campbell and Mosquera (2020). In this paper, I offer a different solution to this problem. Roughly, I argue that transformative experiences give rise a problem for rational decision-making only if the decision can lead to satisfying some of our (new) core preferences, but can also frustrate other (new) core preferences. I also argue that agents can partially project what traumatic transformative experiences are like. (shrink)

Students face many important decisions: What college or university should I attend? What should I study? What kind of job should I try to get? Which people should I hang out with? Should I continue or break off a relationship? Should I get married? Should I have a baby? What kind of medical treatment should I use? A theory of practical reasoning should have something to say about how students and other people can improve their decision making.

Given the potential dangers of unethical decisions in the workplace, it has become increasingly important for managers to hire, and promote into leadership positions, those who are morally inclined. Behavioral ethics research has contributed to this effort by examining an array of individual difference variables that play a role in morality. However, past research has focused mostly on direct causal effects and not so much on the processes through which different factors, especially those that are morality based, decrease unethical (...) choices. The purpose of the current research is to examine the process, which includes both subconscious and conscious decision pathways, through which moral attentiveness curbs unethical decision making at the individual level. The findings of a study employing about 200 participants and a cheating task reveal that both accurate ethical prototypes and moral awareness of the situation decreased unethical decisions, and moral attentiveness was found to be positively related to both of these constructs. In addition, having accurate ethical prototypes was found to be a partial mediator between perceptual moral attentiveness and less cheating, while moral awareness was found to be a partial mediator between reflective moral attentiveness and less cheating. The theoretical and practical implications of these findings are discussed. (shrink)

Objectives: The objective of this study is to estimate the proportion of different types of end‐of‐life decisions (ELDs) of physicians in the city of Hasselt (Flanders, Belgium). The question is addressed to what degree these ELD meet legal constraints and the ethical requirements for prudent practice. Methodology: All physicians of the city of Hasselt who signed at least one death certificate in 1996 (N=166) received an anonymous self‐administered mail questionnaire per death case (max. 5/doctor) Results: the response rate was (...) 55% (N=269). In 37.3% of all cases at least one ELD was made (16.5% non‐treatment decisions; 16% potential life‐shortening by intensifying the treatment of pain and symptoms; 4.8% administration, supply or prescription of lethal drugs). In 59.5% of the cases were an ELD was made that decision was legally questionable. Patient characteristics were clearly related to the type of ELD. There was no influence of physician characteristics, except for commitment to life‐stance. In 71.3% of the cases the ELD was in no way discussed with the patient. 8.1% of the ELD‐cases were in response to a direct request from the patient Conclusions: The incidences of ELDs in Hasselt are consistent with earlier findings. The study shows that religious commitment influences the behaviour of physicians at the end of their patients' life. The patient's and her family's entitlements to participation in the decision making process were rather poorly respected. (shrink)

Although ethical decision‐making theory has evolved over the years, within the field of management, research still revolves around James Rest’s (1986) four‐step framework, dominated by a positivist epistemology and a quantitative methodology. Given that currently there is a call for a theoretical, epistemological, and methodological renovation for the enlargement and enrichment of knowledge about how decisions are morally made in organizations, this paper has a double aim. First, by showing the models’ main flaws and limitations, it critically assesses the (...) prominent theoretical models of Rest, Trevino, and Jones. Then, for decision making in organizations, the paper aims to posit a fresh moral theory that addresses the phenomenon from a comprehensive epistemological perspective. To do so, it steps back from those prominent models in order to review John Dewey’s “theory of moral life.” At the core of the proposed comprehensive theoretical framework are Dewey’s concepts of a “moral standard” and “valuation.” Finally, the paper shows how the Dewey‐based framework can both overcome the flaws and limitations that are identified in those prominent models and can enrich empirical research, therefore contributing to developing as a whole the ethical decision‐making field. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used (...) by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

Objectives: The objective of this study is to estimate the proportion of different types of end‐of‐life decisions (ELDs) of physicians in the city of Hasselt (Flanders, Belgium). The question is addressed to what degree these ELD meet legal constraints and the ethical requirements for prudent practice.Methodology: All physicians of the city of Hasselt who signed at least one death certificate in 1996 (N=166) received an anonymous self‐administered mail questionnaire per death case (max. 5/doctor)Results: the response rate was 55% (N=269). (...) In 37.3% of all cases at least one ELD was made (16.5% non‐treatment decisions; 16% potential life‐shortening by intensifying the treatment of pain and symptoms; 4.8% administration, supply or prescription of lethal drugs). In 59.5% of the cases were an ELD was made that decision was legally questionable. Patient characteristics were clearly related to the type of ELD. There was no influence of physician characteristics, except for commitment to life‐stance. In 71.3% of the cases the ELD was in no way discussed with the patient. 8.1% of the ELD‐cases were in response to a direct request from the patientConclusions: The incidences of ELDs in Hasselt are consistent with earlier findings. The study shows that religious commitment influences the behaviour of physicians at the end of their patients' life. The patient's and her family's entitlements to participation in the decision making process were rather poorly respected. (shrink)

We pose and resolve several vexing decision theoretic puzzles. Some are variants of existing puzzles, such as 'Trumped' (Arntzenius and McCarthy 1997), 'Rouble trouble' (Arntzenius and Barrett 1999), 'The airtight Dutch book' (McGee 1999), and 'The two envelopes puzzle' (Broome 1995). Others are new. A unified resolution of the puzzles shows that Dutch book arguments have no force in infinite cases. It thereby provides evidence that reasonable utility functions may be unbounded and that reasonable credence functions need not be countably (...) additive. The resolution also shows that when infinitely many decisions are involved, the difference between making the decisions simultaneously and making them sequentially can be the difference between riches and ruin. Finally, the resolution reveals a new way in which the ability to make binding commitments can save perfectly rational agents from sure losses. (shrink)

This paper considers whether individual companies have an ethical obligation to label their Genetically Modified (GM) foods. GM foods and ingredients pervade grocery store shelves, despite the fact that a majority of North Americans have worries about eating those products. The market as whole has largely failed to respond to consumer preference in this regard, as have North American governments. A number of consumer groups, NGO’s, and activist organizations have urged corporations to label their GM products. This paper asks whether, (...) in such a situation, individual corporations can be ethically required to take such unilateral action. We argue that they cannot. Given the lack of solid evidence for any risk to human health, and the serious market disadvantage almost surely associated with costly unilateral action, no individual company has an ethical obligation to label its GM foods. (shrink)

Without doctors being able to explain medical decisions to patients, I argue their use of black box AIs would erode the effective and respectful care they provide patients. In addition, I argue that physicians should use AI black boxes only for patients in dire straits, or when physicians use AI as a “co-pilot” (analogous to a spellchecker) but can independently confirm its accuracy. I respond to A.J. London’s objection that physicians already prescribe some drugs without knowing why they work.

Big decisions in a person’s life often affect the preferences and standards of a good life which that person’s future self will develop after implementing her decision. This paper argues that in such cases the person might lack any reasons to choose one way rather than the other. Neither preference-based views nor happiness-based views of justified choice offer sufficient help here. The available options are not comparable in the relevant sense and there is no rational choice to make. Thus, (...) ironically, in many of a person’s most important decisions the idea of that person’s good seems to have no application. (shrink)

In Australian end-of-life care, practicing euthanasia or physician-assisted suicide is illegal. Despite this, death hastening practices are common across medical settings. Practices can be clandestine or overt but in many instances physicians are forced to seek protection behind ambiguous medico-legal imperatives such as the Principle of Double Effect. Moreover, the way they conceptualise and experience such practices is inconsistent. To complement the available statistical data, the purpose of this study was to understand the reasoning behind how and why physicians in (...) Australia will hasten death. (shrink)