In recent years, attention to researchers’ scientific misconduct has increased dramatically. Although existing research reflects a shared value that occupational calling is an ethical good (i.e., being more likely to make ethical choices), no empirical study has yet examined the ethical outcomes of occupational calling. Drawing on the integrated ethical decision-making model (I-EDM), this study first investigated _whethe_r occupational calling inhibits researchers’ unethical decision-making. Secondly, it examined _why_ and _when_ occupational calling relates to researchers’ unethical (...) class='Hi'>decision-making. The findings from a four-wave survey, with 257 researchers working in research roles in universities in China, reveal that occupational calling (time 1) inhibits researchers’ unethical decision-making (time 4). Moral disengagement (time 3) provides an explanation for the negative link between occupational calling (time 1) and unethical decision-making (time 4). The moderated mediation analysis further shows that the inhibitory effect of occupational calling (time 1) on researchers’ unethical decision-making (time 4) disappears when the work-unit structure (time 2) is perceived to be organic. These findings provide meaningful theoretical and practical implications for research and practice. (shrink)

ver since the traditional criteria for medical decision-making capacity (understanding, appreciation, reasoning, evidencing a choice) were formulated, they have been criticized for not taking sufficient account of emotions or values that seem, according to the critics and in line with clinical experiences, essential to decision-making capacity. The aim of this paper is to provide a nuanced and structured overview of the arguments provided in the literature emphasizing the importance of these factors and arguing for their inclusion (...) in competence evaluations. Moreover, a broader reflection on the findings of the literature is provided. Specific difficulties of formulating and measuring emotional and valuational factors are discussed inviting reflection on the possibility of handling relevant factors in a more flexible, case-specific, and context-specific way rather than adhering to a rigid set of operationalized criteria. (shrink)

This book is the most comprehensive treatment available of one of the most urgent - and yet in some respects most neglected - problems in bioethics: decision-making for incompetents. Part I develops a general theory for making treatment and care decisions for patients who are not competent to decide for themselves. It provides an in-depth analysis of competence, articulates and defends a coherent set of principles to specify suitable surrogate decisionmakers and to guide their choices, examines the (...) value of advance directives, and investigates the role that considerations of cost ought to play in decisions concerning incompetents. Part II applies this theoretical framework to the distinctive problems of three important classes of individuals, many of whom are incompetent: minors, the elderly and psychiatric patients. The authors' approach combines a probing analysis of fundamental issues in ethical theory with a sensitive awareness of the concrete realities of health care institutions and the highly personal and individual character of difficult practical problems. Its broad scope will appeal to health professionals, moral philosophers and lawyers alike. (shrink)

For many years the prevailing paradigm for medical decision making for children has been the best interest standard. Recently, some authors have proposed that Mill’s “harm principle” should be used to mediate or to replace the best interest standard. This article critically examines the harm principle movement and identifies serious defects within the project of using Mill’s harm principle for medical decision making for children. While the harm principle proponents successfully highlight some difficulties in present-day use (...) of the best interest standard, the use of the harm principle suffers substantial normative and conceptual problems. A medical decision-making framework for children is suggested, grounded in the four principles. It draws on the best interest standard, incorporates concepts of harm, and provides two questions that can act as guide and limit in medical decision making for children. (shrink)

Incommensurability is the impossibility to determine how two options relate to each other in terms of conventional comparative relations. This book features new research on incommensurability from philosophers who have shaped the field into what it is today, including John Broome, Ruth Chang and Wlodek Rabinowicz. The book covers four aspects relating to incommensurability. In the first part, the contributors synthesize research on the competing views of how to best explain incommensurability. Part II illustrates how incommensurability can help us deal (...) with seemingly insurmountable problems in ethical theory and population ethics. The contributors address the Repugnant Conclusion, the Mere Addition Paradox and so-called Spectrum Arguments. The chapters in Part III outline and summarize problems caused by incommensurability for decision theory. Finally, Part IV tackles topics related to risk, uncertainty and incommensurability. Value Incommensurability: Ethics, Risk, and Decision-Making will be of interest to researchers and advanced students working in ethical theory, decision theory, action theory, and philosophy of economics. (shrink)

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon (...) the notion of capacity is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)

Is the sense of smell a source of aesthetic perception? Traditional philosophical aesthetics has centered on vision and audition but eliminated smell for its subjective and inherently affective character. This article dismantles the myth that olfaction is an unsophisticated sense. It makes a case for olfactory aesthetics by integrating recent insights in neuroscience with traditional expertise about flavor and fragrance assessment in perfumery and wine tasting. My analysis concerns the importance of observational refinement in aesthetic experience. I argue that the (...) active engagement with stimulus features in perceptual processing shapes the phenomenological content, so much so that the perceptual structure of trained smelling varies significantly from naive smelling. In a second step, I interpret the processes that determine such perceptual refinement in the context of neural decision-making processes, and I end with a positive outlook on how research in neuroscience can be used to benefit philosophical aesthetics. (shrink)

Algorithmic decision-making increasingly shapes people's daily lives. Given that such autonomous systems can cause severe harm to individuals and social groups, fairness concerns have arisen. A human-centric approach demanded by scholars and policymakers requires considering people's fairness perceptions when designing and implementing algorithmic decision-making. We provide a comprehensive, systematic literature review synthesizing the existing empirical insights on perceptions of algorithmic fairness from 58 empirical studies spanning multiple domains and scientific disciplines. Through thorough coding, we systemize the (...) current empirical literature along four dimensions: (1) algorithmic predictors, (2) human predictors, (3) comparative effects (human decision-making vs. algorithmic decision-making), and (4) consequences of algorithmic decision-making. While we identify much heterogeneity around the theoretical concepts and empirical measurements of algorithmic fairness, the insights come almost exclusively from Western-democratic contexts. By advocating for more interdisciplinary research adopting a society-in-the-loop framework, we hope our work will contribute to fairer and more responsible algorithmic decision-making. (shrink)

In this paper we address the question of when a researcher is justified in describing his or her artificial agent as demonstrating ethical decision-making. The paper is motivated by the amount of research being done that attempts to imbue artificial agents with expertise in ethical decision-making. It seems clear that computing systems make decisions, in that they make choices between different options; and there is scholarship in philosophy that addresses the distinction between ethical decision-making (...) and general decision-making. Essentially, the qualitative difference between ethical decisions and general decisions is that ethical decisions must be part of the process of developing ethical expertise within an agent. We use this distinction in examining publicity surrounding a particular experiment in which a simulated robot attempted to safeguard simulated humans from falling into a hole. We conclude that any suggestions that this simulated robot was making ethical decisions were misleading. (shrink)

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon (...) the notion of capacity is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)

In this paper, we propose a new hybrid neutrosophic multi criteria decision making (MCDM) framework that employs a collection of neutrosophic analytical network process (ANP), and order preference by similarity to ideal solution (TOPSIS) under bipolar neutrosophic numbers. The MCDM framework is applied for chief executive officer (CEO) selection in a case study at the Elsewedy Electric Group, Egypt. The proposed approach allows us to assemble individual evaluations of the decision makers and therefore perform accurate personnel selection. (...) The outcomes of the proposed method are compared with those of the related works such as weight sum model (WSM), weight product model (WPM), analytical hierarchy process (AHP), multiobjective optimization based on simple ratio analysis (MOORA) and ANP methods to prove and validate the results. (shrink)

This review summarizes the empirical ethical decision-making (EDM) research in business published between 2012 and 2022. Utilizing Rest's (Moral development: advances in research and theory, Praeger, New York, 1986) four-step model for EDM and Jones' (Acad Manag Rev, 16(2): 366-395, 1991) theory of moral intensity, 85 articles, resulting in 388 findings, were analyzed. Empirical findings in awareness, intent, judgment, and behavior were categorized by their application to individual and organizational factors resulting in the application of 624 and 62 (...) factors, respectively. A maturing of the research environment is seen through the need for grouping individual factors into themes, essentially forming new connections within EDM research. This article prioritizes new factors and themes, such as bad behaviors, customers and selling, fantasy and imagination, and negative experiences. Additionally, new research in reoccurring themes such as demographics, feelings, personality, and power have elements that were seen in prior reviews but are more nuanced in the current. Furthermore, this quinary review discusses the evolution of EDM research highlighting the relationships studied and modifiers and mediators used. These themes help shape the landscape of EDM research by illustrating the intersectionality of variables. This article advances the understanding of how these foundational models are being nuanced to understand more deeply the EDM process. A call for future research incorporating intersectionality, the continued pursuit of complex relationships, longitudinal research, and major societal and organizational movements is included. Research into the effects of underrepresented demographics such as gender identity, veteran status, and ability is suggested. Furthermore, we question whether Rest (1986) and Jones' (1991) models are inherently Western and if comparing outcomes with a decolonialized research method might give insight into EDM. We present this latest 10-year collection of EDM empirical research based on Rest (1986) and Jones (1991) as a tool for new and future scholars to utilize in their research endeavors. (shrink)

This research examines the necessary condition of emotions in predicting consumer ethical decision-making, using a new multiplicative method for identifying and measuring the necessary condition in data sets—Necessary Condition Analysis (NCA). Based on a sample of over four hundred individuals, and combining three different consumption scenarios involving ethical issues, our findings demonstrate that emotions are a necessary condition for consumer ethical decisions and behaviours. In addition, the results show that higher levels of consumer ethical decisions can only be (...) achieved if happiness, gladness and satisfaction increase towards a minimum level of necessity. The findings provide empirical support for the essential role of emotions in predicting consumer ethical decision-making. Furthermore, this research identifies the emotional thresholds without which ethical choices cannot occur and then explains why individuals sometimes behave ethically but other times do not. In addition, this is a first contribution applying NCA to consumer ethics. (shrink)

The state of the art of contemporary philosophy and psychiatry is reviewed. Section 1 describes the new field as an international open society of ideas. Section 2 introduces values-based practice. Although originally a philosophy-into-practice initiative, values-based practice is now developing more strongly in areas of bodily medicine such as surgery. An example from surgery illustrates how values-based practice has been implemented as a partner to evidence-based practice in supporting shared clinical decision-making as the basis of best practice in (...) contemporary person-centered clinical care. Section 3 explores the difficulties presented by implementing values-based practice in mental health as illustrated by a case example of anorexia. This shows that these difficulties derive from the particularly intense challenges of values pluralism presented by anorexia. The resources of phenomenology provide the basis for an effective response to these challenges. Section 4 generalizes the argument of Section 3 showing that an effective response to the wider range of challenges of values pluralism arising across the board in mental health is available from the resources of the international open society of ideas of contemporary philosophy and psychiatry. The article concludes with a promissory note on values and a cautionary note on science. (shrink)

Over the past 50 years decision making research in team invasion sport has been dominated by three research perspectives,information processing,ecological dynamics, andnaturalistic decision making. Recently, attempts have been made to integrate perspectives, as conceptual similarities demonstrate the decision making process as an interaction between a players perception of game information and the individual and collective capability to act on it. Despite this, no common ground has been found regarding what connects perception and action during (...) performance. The differences between perspectives rest on the role of stored mental representations, that may, or may not facilitate the retrieval of appropriate responses in time pressured competitive environments. Additionally, in team invasion sports like rugby union, the time available to players to perceive, access memory and act, alters rapidly between specific game situations. Therefore, the aim of this study was to examine theoretical differences and the mechanisms that underpin them, through the vehicle of rugby union. Sixteen semi-elite rugby union players took part in two post-game procedures to explore the following research objectives; (i) to consider how game situations influence players perception of information; (ii) to consider how game situations influence the application of cognitive mechanisms whilst making decisions; and (iii) to identify the influence of tactics and/or strategy on player decision making. Deductive content analysis and elementary units of meaning derived from self-confrontation elicitation interviews indicate that specific game situations such as; the lineout, scrum or open phases of play or the tackle situation in attack or defence all provide players with varying complexity of perceptual information, formed through game information and time available to make decisions. As time increased, players were more likely to engage with task-specific declarative knowledge-of the game, stored as mental representations. As time diminished, players tended to diagnose and update their knowledge-in the game in a rapid fashion. Occasionally, when players described having no time, they verbalised reacting on instinct through a direct connection between perception and action. From these findings, clear practical implications and directions for future research and dissemination are discussed. (shrink)

Decision making is an area of profound importance to a wide range of specialities - for psychologists, economists, lawyers, clinicians, managers, and of course philosophers. Only relatively recently, though, have we begun to really understand how decision making processes are implemented in the brain, and how they might interact with our emotions. 'Emotion and Reason' presents a groundbreaking new approach to understanding decision making processes and their neural bases. The book presents a sweeping survey (...) of the science of decision making. It examines the brain mechanisms involved in making decisions, and controversially proposes that many of our perceptual actions are essentially decision making processes. Whether looking, listening, hearing, or moving, we choose to attend to certain stimuli, at the expense of others. In some psychiatric disorders the inability to respond selectively to certain stimuli can be harmful - such pathologies of decision making are additionally considered. Berthoz also considers how many decision making processes involve an internal dialogue with our other self, and how this dialogue with our "doppelganger" might be represented in the brain. He considers the important implications that a neuroscience of decision making can have for the judiciary - how we apportion blame and responsibility; for economics - with discussion of the growing field of neuroeconomics; and for theories of management. Lastly he examines decision making and creativity - if perception relies in part on decision making processes, how might this alter our view of the artistic process. Written by a neuroscientist of international fame and accessible for both scientists and non-scientists, this book is the most exhaustive examination of the science of decision making yet. (shrink)

Ethics plays an essential role in the philosophical framework of Abū Bakr al-Rāzī. Although most of his philosophical works have become extinct, two surviving works serve as primary sources for understanding his ethical theory. Although sharing certain foundational principles, these two works diverge in terms of ethical standards and exhibit distinct logical approaches to ethics, a facet that has largely remained unexplored within contemporary scholarly discourse. I aim to extract and reconstruct both of his ethical decision-making systems by (...) shedding light on the place of ethics in his philosophy, explaining the interconnection of the two ethical frameworks, reconstructing both of these ethical systems, and finally presenting them in patterns. (shrink)

This article concerns itself with the relationship between implicit moral cognitions and decisions in the realm of business ethics. Traditionally, business ethics research emphasized the effects of overt or explicit attitudes on ethical decision-making and neglected intuitive or implicit attitudes. Therefore, based on an implicit social cognition approach it is important to know whether implicit moral attitudes may have a substantial impact on managerial ethical decision-making processes. To test this thesis, a study with 50 participants was (...) conducted. In this study the participants were asked to work on a deliberative managerial ethical decision-making task, in which they had to decide on one of two options. Implicit moral attitudes towards the two options were measured using the implicit association test (IAT). A semantic differential scale was used to diagnose explicit moral attitudes towards the two options. Each step taken within the deliberative decision-making process, as well the decision itself, was assessed using a scoring model-based decision analysis and a decision-making questionnaire. The results of this study show that implicit moral attitude has a great influence on the deliberative ethical decision-making process. The derived conclusion is that complex and deliberative decision-making processes in the context of business ethics can be affected by implicit social cognitions such as implicit moral attitudes. (shrink)

When ethical decisions have to be taken in critical, complex medical situations, they often involve decisions that set the course for or against life-sustaining treatments. Therefore the decisions have far-reaching consequences for the patients, their relatives, and often for the clinical staff. Although the rich psychology literature provides evidence that reasoning may be affected by undesired influences that may undermine the quality of the decision outcome, not much attention has been given to this phenomenon in health care or ethics (...) consultation. In this paper, we aim to contribute to the sensitization of the problem of systematic reasoning biases by showing how exemplary individual and group biases can affect the quality of decision-making on an individual and group level. We are addressing clinical ethicists as well as clinicians who guide complex decision-making processes of ethical significance. Knowledge regarding exemplary group psychological biases (e.g. conformity bias), and individual biases (e.g. stereotypes), will be taken from the disciplines of social psychology and cognitive decision science and considered in the field of ethical decision-making. Finally we discuss the influence of intuitive versus analytical (systematical) reasoning on the validity of ethical decision-making. (shrink)

This paper is an attempt to understand how social knowledge affects human economic decision making. The paper discusses the nature of social knowledge in today’s context with special reference to how social knowledge influences consumers’ sentiments and their economic decisions. Social networks are being continuously flooded with various kinds of information and disinformation. Some of the information becomes knowledge for social network users who browse various kinds of content that are either entertaining or related to products and marketing. (...) Although reliability remains a critical issue regarding online information from social networks, it, however, provides some knowledge about diverse things, goods, and products being in use in different societies around the world. Some products advertised on social networks like Facebook may affect consumer decisions or provide information about new products. This paper presents a formal discussion on what social knowledge is and how it is originated, and what use it might have for such consumers. The paper designs a simplistic mathematical model for a theoretical understanding of the assumption that has practical implications regarding its utility in society. It is found that social networks generate enough social information that can influence user choice and preferences. The study has implications for both the users and the developers of social networking sites. (shrink)

Debates about dual-use research often turn on the potential for scientific research to be used to benefit or harm humanity. This dual-use potential is conventionally understood as the product of the magnitude of the harms and benefits of dual-use research, multiplied by their likelihood. This account, however, neglects important social aspects of the use of science and technology. In this paper, I supplement existing conceptions of dual-use potential to account for the social context of dual-use research. This account incorporates relational (...) and positional concerns that feature in the success or failure of dual-use. I then defend this account against foreseeable objections. (shrink)

The Truth and Reconciliation Commission of Canada made it clear that understanding the historical, social, cultural, and political landscape that shapes the relationships between Indigenous peoples and social institutions, including the health care system, is crucial to achieving social justice. How to translate this recognition into more equitable health policy and practice remains a challenge. In particular, there is limited understanding of ways to respond to situations in which conventional practices mandated by the state and regulated by its legal apparatus (...) come into direct conflict with the values and autonomy of Indigenous individuals, communities, and nations. In this paper, we consider two cases of conflict between Indigenous and biomedical perspectives to clarify some of the competing values. We argue for the importance of person‐ and people‐centered approaches to health care. These value conflicts must be understood at multiple levels to clarify their personal, social, cultural, and political dimensions. Taking into account the divergence between epistemic cultures and communities allows us to understand the multiple narratives deployed in decision‐making processes in clinical, community, and juridical contexts. Recognizing the knowledge claims of Indigenous peoples in health care can help clinicians avoid reinforcing the divides created by the structural and institutional legacy of colonialism. This analysis also provides ways to adjudicate conflicts in health care decision‐making by disentangling cultural, political, medical, and pragmatic issues to allow for respectful dialogue. Insofar as the engagement with cultural pluralism in health care rights is conducted with reciprocal recognition, the medical community and Indigenous peoples can address together the difficult question of how to integrate different epistemic cultures in the health care system. (shrink)

Emotions influence human decisions under risk and uncertainty, even when they are unrelated to the decisions, i.e. incidental to them. Empirical findings are mixed regarding the directions and sizes of the effects of discrete emotions such as fear, anger, or happiness. According to the Appraisal-Tendency Framework (ATF), appraisals of certainty and control determine why same-valence emotions can differentially alter preferences for risky and uncertain options. Building upon this framework of emotion-specific appraisals, we conducted a systematic review and meta-analysis of 28 (...) experimental studies on the effects of discrete incidental emotions on decision-making under risk and uncertainty. We evaluated potential moderators at the task and study levels. We find emotion-specific, moderately heterogeneous effects partially in line with the expectations of the ATF. The framing and financial consequences of choices, the type of choices, and the presence of other participants during the task do not moderate the effect. Our meta-analytic results support the differential influence of discrete, incidental emotions on decision-making under risk and uncertainty depending on appraisals other than valence. We discuss limited sample sizes and heterogeneity as reasons for the absence of significant moderators and encourage experimental investigations of individual differences in the susceptibility to incidental affective influences. (shrink)

An assessment of decision-making capacity is the accepted procedure for determining when a person is not competent. An inferential gap exists between the criteria for capacity specific abilities and the legal requirements to understand relevant information and appreciate the consequences of a decision. This gap extends to causal influences on a person'scapacity to decide. Using a published case of depression, we illustrate that assessors' uses of diagnostic information is frequently not up to the task of bridging this (...) inferential gap in a justifiable way. We then describe cases of faulty judgement which challenge the understanding of diagnostic causal influences. These cases help to clarify the nature of the expertise required for capacity assessments. In practice, the requirements of decision-making capacity are often abandoned to other considerations due to a lack of requisite expertise. The legal policy supporting decision-making capacity as a means to protective intervention is justified only if the requisite expertise is developed. We propose the requisite expertise to be developed in the long term as a distinct multidisciplinary endeavour. (shrink)

Research using economic decision-making tasks has established that direct reciprocity plays a role in prosocial decision-making: people are more likely to help those who have helped them in the past. However, less is known about how considerations of mutual exchange influence decisions even when the other party’s actions are unknown and direct reciprocity is therefore not possible. Using a two-party economic task in which the other’s actions are unknown, study 1 shows that prosociality critically depends on (...) the potential for mutual exchange; when the other person has no opportunity to help the participant, prosocial behavior is drastically reduced. In study 2, we find that theories regarding the other person’s intentions influence the degree of prosociality that participants exhibit, even when no opportunity for direct reciprocity exists. Further, beliefs about the other’s intentions are closely related to one’s own motivations in the task. Together, the results support a model in which prosociality depends on both the social conditions for mutual exchange and a mental model of how others will behave within these conditions, which is closely related to knowledge of the self. (shrink)

Richard Martin's aim in this paper is to present a critical method of making ethical decisions in a medical context. He feels that such a reflective method provides the best means of making the appropriate decisions in given situations. It is based on Dr Martin's experience in applying ethical theory while collaborating with physicians in the daily course of clinical practice. Through his giving of a functional definition of medical ethics, his descriptions of an analytical model, the significance (...) of values for clinical decision-making and the advocacy role of medical ethicists and their relationships with clinicians, Richard Martin sets out his own value-intention as regards an ideal decision process. He stresses that his argument is of particular importance to his fellow ethicists who should continuously and vigorously examine the creative interaction of faith and fact in their own inquiry and action. Dr Martin concludes by stating that physicians and ethicists can work together to accomplish their common aim, which is, of course, the health and well-being of the patient. (shrink)

Many decisions involve multiple stages of choices and events, and these decisions can be represented graphically as decision trees. Optimal decision strategies for decision trees are commonly determined by a backward induction analysis that demands adherence to three fundamental consistency principles: dynamic, consequential, and strategic. Previous research found that decision-makers tend to exhibit violations of dynamic and strategic consistency at rates significantly higher than choice inconsistency across various levels of potential reward. The current research extends these (...) findings under new conditions; specifically, it explores the extent to which these principles are violated as a function of the planning horizon length of the decision tree. Results from two experiments suggest that dynamic inconsistency increases as tree length increases; these results are explained within a dynamic approach–avoidance framework. (shrink)

This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change (...) as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans’ (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor’s (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally. (shrink)

We are living in an unprecedented era of biomedical revolution. Medicine is remaking humans, and controversy surrounds such topics as abortion, artificial organs, brain circuitry, eugenics, euthanasia, and gene therapy. At the same time, medical advances are posing complex ethical problems for both patients and professionals. The most comprehensive and up-to-date collection of its kind, Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases explores fundamental ethical questions arising from real situations faced by health professionals, patients, and others. (...) Featuring a wide range of more than 100 case studies drawn from current events, court cases, and physicians' experiences, the book is divided into three parts. Part I presents a basic framework for ethical decision-making in healthcare, covering such issues as separating evaluative questions from questions of fact; distinguishing between ethical and nonethical evaluations; and identifying the source of ethical judgments. Expanding upon this framework, Part II explains the ethical principles: beneficence and nonmaleficence, justice, respect for autonomy, veracity, fidelity, and avoidance of killing. Parts I and II provide students with the background to analyze the ethical dilemmas presented in Part III, which features cases on a broad spectrum of issues including abortion, genetics, mental health, confidentiality, health insurance, experimentation on humans, the right to refuse treatment, and death and dying. Each case is accompanied by the authors' commentary, which guides students in considering the issues. Ideal for undergraduate and graduate courses in biomedical ethics, bioethics, and medical ethics, Case Studies in Biomedical Ethics incorporates opening text boxes in each chapter that cross-reference relevant cases in other chapters. It also includes an appendix of important ethical codes and a glossary of key terms. (shrink)

An influential objection to the view that intentions are non-derivatively relevant to the moral permissibility of actions states that if intentions were relevant to permissibility in such a way, one would have to take them into account in decision making, which would be odd (in some morally relevant sense of ‘oddness’). The paper outlines and assesses three candidates for the oddness: that considering intentions in decision making is an unordinary practice, that it is impossible or conceptually (...) confused, and that it assigns intentions the weight as moral considerations that they intuitively do not have. The paper rejects the first two and shows that the third is probably what motivates most critics of the relevance of intentions who raise this objection. If this is correct, the objection is a non-starter as it assumes what it has to prove. Towards the end, it is argued that the objection does not serve as a plausible error theory either. (shrink)

In a rigorous systematic review, Dukhanin and colleagues categorize metrics and evaluative tools of the engagement of patient, public, consumer, and community in decision-making in healthcare institutions and systems. The review itself is ably done and the categorizations lead to a useful understanding of the necessary elements of engagement, and a suite of measures relevant to implementing engagement in systems. Nevertheless, the question remains whether the engagement of patient representatives in institutional or systemic deliberations will lead to improved (...) clinical outcomes or increased engagement of individual patients themselves in care. Attention to the conceptual foundations of patient engagement would help make this systematic review relevant to the clinical care of patients. (shrink)

Decision-making Capacity matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that dmc matters because autonomy matters. And this is thought to justify dmc as a gatekeeper for autonomy – whereby autonomy concerns arise if but only if a patient has dmc. But appeals to autonomy invoke two distinct concerns: concern for authenticity – concern that a choice is consistent with an individual’s commitments; (...) and concern for sovereignty – concern that an individual exercises control over that which is hers to control. Here, I argue, neither concern can alone explain why dmc matters. Instead, dmc matters because it indicates a harmony between the two concerns – the demands of each concern are more likely to agree if a patient has dmc. This vindicates the standard story, but also makes clear that dmc is an inappropriate gatekeeper for autonomy. (shrink)

Ethical decision-making descriptive theoretical models often conflict with each other and typically lack comprehensiveness. To address this deficiency, a revised EDM model is proposed that consolidates and attempts to bridge together the varying and sometimes directly conflicting propositions and perspectives that have been advanced. To do so, the paper is organized as follows. First, a review of the various theoretical models of EDM is provided. These models can generally be divided into rationalist-based ; and non-rationalist-based. Second, the proposed (...) model, called ‘Integrated Ethical Decision Making,’ is introduced in order to fill the gaps and bridge the current divide in EDM theory. The individual and situational factors as well as the process of the proposed model are then described. Third, the academic and managerial implications of the proposed model are discussed. Finally, the limitations of the proposed model are presented. (shrink)

Decision-Making Capacity First published Tue Jan 15, 2008; substantive revision Fri Aug 14, 2020 In many Western jurisdictions the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own medical decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This question has to (...) do with what is commonly called “decisional capacity”, a central concept in health care law and ethics, and increasingly an independent topic of philosophical inquiry. -/- Decisional capacity can be defined as the ability of subjects to make their own medical decisions. Somewhat similar questions of capacity arise in other contexts, such as capacity to stand trial in a court of law and the ability to make decisions that relate to personal care and finances. However, the history behind the more general legal notions of capacity to stand trial and capacity to manage one’s life is different and operates somewhat differently in law (Roth, Meisel, & Litz 1977; Zapf & Roesch 2005). For the purposes of this discussion the notion of decisional capacity will be limited to medical contexts only; most notably, those where decisions to consent or to refuse treatment or participation in clinical research are concerned. (shrink)

Decision-making capacity (DMC) plays an important role in clinical practice—determining, on the basis of a patient’s decisional abilities, whether they are entitled to make their own medical decisions or whether a surrogate must be secured to participate in decisions on their behalf. As a result, it’s critical that we get things right—that our conceptual framework be well-suited to the task of helping practitioners systematically sort through the relevant ethical considerations in a way that reliably and transparently delivers correct (...) verdicts about who should and should not have the authority to make their own medical decisions. Unfortunately, however, the standard approach to DMC does not get things right. It is of virtually no help in identifying and clarifying the relevant ethical considerations. And, embedded in the prevailing anti-paternalist paradigm, DMC assessments obfuscate and distort the underlying ethical justification for granting or withholding decisional authority. Here, we describe the core commitments of the standard approach to DMC and then highlight three problems with it. We then argue that these problems are significant enough that they call for more than merely tinkering and fine tuning—variations of the standard approach cannot adequately address them. Instead, we should ditch DMC. (shrink)

Decision making is a key activity, perhaps the most important activity, in the practice of healthcare. Although physicians acquire a great deal of knowledge and specialised skills during their training and through their practice, it is in the exercise of clinical judgement and its application to individual patients that the outstanding physician is distinguished. This has become even more relevant as patients become increasingly welcomed as partners in a shared decision making process. This book translates the (...) research and theory from the science of decision making into clinically useful tools and principles that can be applied by clinicians in the field. It considers issues of patient goals, uncertainty, judgement, choice, development of new information, and family and social concerns in healthcare. It helps to demystify decision theory by emphasizing concepts and clinical cases over mathematics and computation. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that (...) supported decision-making would be better understood as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

Decision-making assisted by algorithms developed by machine learning is increasingly determining our lives. Unfortunately, full opacity about the process is the norm. Would transparency contribute to restoring accountability for such systems as is often maintained? Several objections to full transparency are examined: the loss of privacy when datasets become public, the perverse effects of disclosure of the very algorithms themselves (“gaming the system” in particular), the potential loss of companies’ competitive edge, and the limited gains in answerability to (...) be expected since sophisticated algorithms usually are inherently opaque. It is concluded that, at least presently, full transparency for oversight bodies alone is the only feasible option; extending it to the public at large is normally not advisable. Moreover, it is argued that algorithmic decisions preferably should become more understandable; to that effect, the models of machine learning to be employed should either be interpreted ex post or be interpretable by design ex ante. (shrink)

Our research’s aim is to assess the effect of cultural factors on business ethical decision-making process in a Western cultural context and in a non-Western cultural context. Specifically, this study investigates ethical perceptions, religiosity, personal moral philosophies, corporate ethical values, gender, and ethical intentions of U.S. and Moroccan business managers. The findings demonstrate that significant differences do exist between the two countries in idealism and relativism. Moroccan managers tend to be more idealistic than the U.S. managers. There is (...) a strong positive relationship between religiosity and idealism. There were mixed findings in examining the correlates of religiosity and various components of ethical intentions. Moroccan managers were more homogenous in their corporate ethical values than were the U.S. managers. The results demonstrate that (in general) idealism is a good predictor of ethical intentions and behaviors. Additionally, managers from the two countries differed in the degree of relationship between perceptions and intentions in three of the four scenarios. This study’s results confirm other research findings that, in general, female business managers have higher ethical sensitivity in terms of their ethical judgment than their male counterparts. Managerial implications are also discussed. (shrink)