This text provides a unique collection of case studies across a wide range of organizations (higher education, K-12 education, military, state and local government administration, non-profit institutions, and agency management, etc.). These cases examine ethical decision-making and organizational and leadership behavioral concepts that are practiced in these organizations. The cases cover topics facing our workforce today and ask the reader to solve the dilemma. Through a discussion of these cases, students apply decision making and organizational (...) and leadership strategies to analyze each case and therefore gain a better understanding of how to effectively lead and manage within their organizations. This text challenges students to think critically and analytically. Students are encouraged to reflect on options a practitioner could use to solve the problem. All of the cases end with an open scenario and a set of questions, allowing students to offer a wide range of opinions and participate in reflective and robust discussions. (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)

This case study details how and why integrating storytelling, empathy, and inclusive practice shifted QSuper, a large Australian finance organisation, from minimal awareness to moral awareness then moral capability in the delivery of services to Indigenous customers. During the Royal Commission into Misconduct in the Banking, Superannuation, and Financial Services Industry, QSuper were recognised for their exemplary service with Indigenous customers (Hayne, Interim report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of (...) Australia, 2018; _Transcript of Proceedings, 13 August_, Commonwealth of Australia, 2018). This position was in stark contrast to the inaccessible service offerings of other financial organisations where some used predatory practices to sell unethical financial products to Indigenous Australians (Hayne, Interim report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of Australia, 2018; Hayne, Final report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of Australia, 2019a). Storytelling garned from visiting customers in remote communities and other meaningful activities involving inclusive practice to facilitate ethical decision-making in finance is different to standard functionalist finance approaches (Schinckus, Int Rev Financ Anal 40:103–106, 2015). Two empathetic questions asked within QSuper complementing the storytelling, were: “What is the right thing to do by the customer?” and “How would I feel if this were my mother?” Exploration into the lived reality of moral capacity is important based on the Commission finding many of the 490,000 finance staff do not know how to provide ethical services to vulnerable customers, in particular remote Indigenous customers (Australian Bureau of Statistics. Labour force, Australia, detailed. ABS. Retrieved from https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed /latest-release, 2021; Hayne, Final report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of Australia, 2019a). Furthermore, there is minimal literature on the role of Indigenous storytelling to heighten moral awareness in the finance industry which was found to lead to better ethical outcomes. (shrink)

Walton offers a comprehensive, flexible model for physician-patient decision making, the first such tool designed to be applied at the level of each particular case. Based on Aristotelian practical reasoning, it develops a method of reasonable dialogue, a question- and-answer process of interaction leading to informed consent on the part of the patient, and to a decision--mutually arrived at--reflecting both high medical standards and the patient's felt needs. After setting forth his model, he applies it to (...) three vital ethical issues: acts of omission, the cessation of treatment, and possible side effects of treatments. In the final chapter, Walton shows how his method functions in light of the real-life complexities of the clinical encounter and how it bears on ethical questions concerning health-care policy, attitudes toward treatment and toward the medical profession, reasonableness of expectations, and the setting of realistic goals of treatment. (shrink)

The use of visual attention for evaluating consumer behavior has become a relevant field in recent years, allowing researchers to understand the decision-making processes beyond classical self-reports. In our research, we focused on using eye-tracking as a method to understand consumer preferences in children. Twenty-eight subjects with ages between seven and twelve years participated in the experiment. Participants were involved in two consecutive phases. The initial phase consisted of the visualization of a set of stimuli for decision- (...) class='Hi'>making in an eight-position layout called Alternative Forced-choice. Then the subjects were asked to freely analyze the set of stimuli, they needed to choose the best in terms of preference. The sample was randomly divided into two groups balanced by gender. One group visualized a set of icons and the other a set of toys. The final phase was an independent assessment of each stimulus viewed in the initial phase in terms of liking/disliking using a 7-point Likert scale. Sixty-four stimuli were designed for each of the groups. The visual attention was measured using a non-obstructive eye-tracking device. The results revealed two novel insights. Firstly, the time of fixation during the last 4 visits to each stimulus before the decision-making instant allows us to recognize the icon or toy chosen from the eight alternatives with a 71.2% and 67.2% of accuracy respectively. The result supports the use of visual attention measurements as an implicit tool to analyze decision-making and preferences in children. Secondly, eye movement and the choice of liking/disliking choice are influenced by stimuli design dimensions. The icon observation results revealed how gender samples have different fixation and different visit times which depend on stimuli design dimension. The toy observations results revealed how the materials determinate the largest amount fixations, also, the visit times were differentiated by gender. This research presents a relevant empirical data to understand the decision-making phenomenon by analyzing eye movement behavior. The presented method can be applied to recognize the choice likelihood between several alternatives. Finally, children's opinions represent an extra difficulty judgment to be determined, and the eye-tracking technique seen as an implicit measure to tackle it. (shrink)

BackgroundInformed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent forms. The aim of this study is to assess the capacity of addicted individuals to provide consent to research.Methods53 subjects with DSM-5 diagnoses of a Substance Use Disorder and 50 non psychiatric comparison subjects participated in the survey from December 2014 to March 2015. This cross-sectional study was carried out (...) at a community-based Outpatient Treatment Center and at an urban-located Health Centre in Spain. A binary judgment of capacity/incapacity was made guided by the MacArthur Competence Assessment Tool for Clinical Research and a clinical interview. Demographics and clinical characteristics were assessed by cases notes and the Mini-Mental State Examination, the Global Assessment Functional Scale and the Clinical Global Impression Scale.ResultsNPCs performed the best on the MacCAT–CR, and patients with SUD had the worst performance, particularly on the Understanding and Appreciation subscales. 32.7 % SUD people lacked research-related decisional capacity. There were no statistically significant differences between the groups in terms of capacity to consent to research.ConclusionsThe findings of our study provide evidence that a large proportion of individuals with SUD had decisional capacity for consent to research. It is therefore inappropriate to draw conclusions about capacity to make research decisions on the basis of a SUD diagnosis. In the absence of advanced cognitive impairment, acute withdrawal or intoxication, we should assume that addicted persons possess decision-making capacity. Thus, the view that people with SUD would ipso facto lose decision-making power for research consent is flawed and stigmatizing. (shrink)

A model for ethical problem solving -- Values in health and illness -- What is the source of moral judgments? -- Benefiting the patient and others : duty to do good and avoid harm -- Justice : allocation of health resources -- Autonomy -- Veracity : honesty with patients -- Fidelity : promise-keeping, loyalty to patients, and impaired professionals -- Avoidance of killing -- Abortion, sterilization, and contraception -- Genetics, birth, and the biological revolution -- Mental health and behavior control (...) -- Confidentiality : ethical disclosure of medical information -- Organ transplants -- Health insurance, health system planning, and rationing -- Experimentation on human subjects -- Consent and the right to refuse treatment -- Death and dying. (shrink)

Toward evidence‐based policy decisions: a case study of nursing health human resources in Ontario, CanadaThis paper reflects how health services research ‘evidence’ was used to influence decisions in the province of Ontario, Canada. The process involved interaction among a variety of stakeholders and decision‐makers with researchers to reduce uncertainty and to substantiate emerging service provision issues in the province. The issues presented here focus specifically on an analysis of the nursing situation completed in 1998 for the Minister of (...) Health’s Nursing Task Force, which examined key issues in service delivery. The issues were: restructured work environments; nurse supply and declining enrollments; labour trends and utilization of the nursing workforce; patient acuity and complexity of work environments and the influence on workload; and the paucity of reliable and valid data bases for analysis of nursing’s contribution to the health system. Ontarians can be confident that the Task Force recommendations were born from solid research‐based evidence and now the challenge becomes to monitor the implementation of these resolutions over time. (shrink)

Providing a vibrant four-color design, market-leading BUSINESS ETHICS: ETHICAL DECISION MAKING AND CASES, Ninth Edition, thoroughly covers the complex environment in which managers confront ethical decision making. Using a proven managerial framework, this accessible, applied text addresses the overall concepts, processes, and best practices associated with successful business ethics programs--helping readers see how ethics can be integrated into key strategic business decisions. Thoroughly revised, the new ninth edition incorporates coverage of new legislation affecting business ethics, the (...) most up-to-date examples, and the best practices of high-profile organizations. It also includes 20 all-new or updated original case studies. (shrink)

Since the early Gestaltists there has been a strong interest in the question of how problem solvers get stuck in a mental impasse. A key idea is that the repeated activation of a successful strategy from the past results in a mental set (‘Einstellung’) which determines and constrains the option space to solve a problem. We propose that this phenomenon, which mostly was tested by fairly restricted experiments in the lab, could also be applied to more complex problem constellations and (...) naturalistic decision making. We aim at scrutinizing and reconstructing how a mental set determines the misinterpretation of facts in the field of political decision making and leads in consequence to wrong expectations and an ill-defined problem representation. We will exemplify this psychological mechanism considering a historical example, namely the unexpected stabilization of the Franco regime at the end of World War II and its survival thereafter. A specific focus will be drawn to the significant observation that erroneous expectations were taken as the basis for decisions. This is congruent with the notion that in case of discrepancy between preconceived notions and new information, the former prevails over the new findings. Based on these findings, we suggest a theoretical model for expectation violation in political decision making and develop novel approaches for cognitive empirical research on the mechanisms of expectation violation and its maintenance in political decision making processes. (shrink)

BackgroundIn terms of ethical decision making, every clinical case, when seen as an ethical problem, may be analyzed by means of four topics: medical indications, patient preferences, quality of life, contextual features. The aim of this study was to compare the performance of 4th year dental students on Ethical Decision Making before and after a course on ethics.MethodsFourth year dental students from academic year 2013–2014 participated in the study. A 3-h lecture, which was about four (...) topics approach to clinical ethical case analysis, was given to the students. The lecture was based on case scenarios related with dental ethics. After the completion of lectures,a case scenario was presented to the students to assess their ethical decision making abilities. At the end of the exam, four topics and ethical judgment were evaluated. Their performances on this examination were evaluated before and after lectures. Statistical evaluation was performed with the significance level set at p 0.05). The mean total score of the students after the course was significantly higher than before course.ConclusionMore lectures should be implemented to the curriculum to increase the student awareness of ethical issues and to reach the ultimate goals of dental education. (shrink)

In late January of 1987, the State Treasurer of Pennsylvania, R. Budd Dwyer, shot himself to death in front of a dozen reporters and camera crews during a news conference in his office. Much was subsequently made in the popular press, and within the profession, about the difficult ethical decision television journalists were faced with in determining how much of the very graphic suicide tape to air. A review of the literature in this area suggests, however, that journalists have (...) established a set of relatively detailed conventions for dealing with events involving graphic depictions of death. Analysis of the Dwyer tape and interviews conducted with Pennsylvania television news directors show that eighteen of the twenty stations in the state that carry news used basically the same type and amount of footage in their evening newscasts. One decided to use no tape. One showed the moment of death. When the story broke around noon, two additional stations showed the moment of suicide, but they revised their story for the evening program. In addition, the wide majority of news directors interviewed said they had little difficulty in deciding how to edit the tape. The processing of the Dwyer story suggests that any ethical dilemmas faced by journalists during decision making were put aside for later consideration. The material was edited quickly and according to similar patterns, or conventions, around the state. The study suggests greater attention be given to the definition and interaction of personal professional values, in the ethical sense, and norms of news processing, in the sociological sense. (shrink)

Data mining, as an essential part of artificial intelligence, is a powerful digital technology, which makes businesses predict future trends and alleviate the process of decision-making and enhancing customer experience along their digital transformation journey. This research provides a practical implication – a case study - to provide guidance on analyzing information and predicting repairs in home appliances after sales services business. The main benefit of this practical comparative study of various classification algorithms, by using the Weka (...) tool, is the analysis of information and the prediction of repairs in the home appliances after sales services business. The comparison of algorithms is performed considering different parameters, such as the mean absolute error, root mean square error, relative absolute error and root relative squared error, receiver operating characteristic area, accuracy, Matthews’s correlation coefficient, precision-recall curve, precision, F-measure, recall and statistical criteria. Five classification algorithms such as the Naive Bayes, J48, random forest, K-Nearest Neighbor, and logistic regression were implemented in the dataset. J48 has proved to provide the best accuracy and the lowest error among the other examined algorithms applied to a home appliances after sales services dataset to predict repairs based on product guarantee period. The extracted information and results of an after sales services business by using data mining techniques prove to alleviate the process of streamlining decision-making and provide reliable predictions, especially for the customers, as well as increase businesses’ efficiency along their digital transformation journey. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

BackgroundFor children with life-limiting conditions who are unable to participate in decision-making, decisions are made for them by their parents and paediatricians. Shared decision-making is widely recommended in paediatric clinical care, with parents preferring a collaborative approach in the care of their child. Despite the increasing emphasis to adopt this approach, little is known about the roles and responsibilities taken by parents and paediatricians in this process. In this study, we describe how paediatricians approach decision- (...) class='Hi'>making for a child with a life-limiting condition who is unable to participate in decision-making for his/herself.MethodsThis qualitative phenomenological study involved 25 purposively sampled paediatricians. Verbatim transcripts from individual semi-structured interviews, conducted between mid-2019 and mid-2020, underwent thematic analysis. Interviews were based around a case vignette matched to the clinical experience of each paediatrician.ResultsTwo key themes were identified in the exploration of paediatricians' approach to decision-making for children with life-limiting conditions: there is a spectrum of paediatricians’ roles and responsibilities in decision-making, and the specific influences on paediatricians’ choice of approach for end-of-life decisions. In relation to, analysis showed four distinct approaches: non-directed, joint, interpretative, and directed. In relation to, the common factors were: harm to the child, possible psychological harm to parents, parental preferences in decision-making, and resource allocation.ConclusionsDespite self-reporting shared decision-making practices, what paediatricians often described were physician-led decision-making approaches. Adopting these approaches was predominantly justified by paediatricians’ considerations of harm to the child and parents. Further research is needed to elucidate the issues identified in this study, particularly the communication within and parental responses to physician-led approaches. We also need to further study how parental needs are identified in family-led decision-making approaches. These nuances and complexities are needed for future practice guidance and training around paediatric decision-making.Trial registration: Not applicable. (shrink)

As technology advances, and the life and death consequences of its failure become more and more removed from proximate human action, technology management requires greater degrees of ethical awareness and the management of safety becomes a matter of corporate ethical imperative. The corporate ethical imperative includes ethical mandates to take no action which places the lives of others at risk and to inform persons of dangers to their physical safety of which they may otherwise be unaware when one possesses information (...) relevant to the safety of others such that, with the possession of that knowledge, the others can make decisions relevant to protecting their safety, or if others fail to take such action, to take upon oneself the responsibility of taking such action. The ethical duty of primum non nocere implies the corresponding right of the life risking participant to be informed of the kind and degree of risk to which they are to be exposed and the freedom to refuse to take such risk without prejudice. The corporate ethical imperative is to hold human life precious and to uphold that imperative through selectively non-acting, properly informing and acting. The case of the Challenger disaster is utilised as an illustration of decision making which violated these ethical precepts. (shrink)

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. (...) Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sensemaking processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed. (shrink)

What factors in the organizational culture of an ethically exemplary corporation are responsible for encouraging ethical decision making? This question was analyzed through an exploratory case study of a top pharmaceutical company that is a global leader in ethics. The participating organization is renowned in public opinion polls of ethics, credibility, and trust. This research explored organizational culture, communication in issues management and public relations, management theory, and deontological or utilitarian moral philosophy as factors that might encourage (...) ethical analysis. Our understanding of organiza tional ethics is enhanced by elucidating factors the case revealed as encouraging ethical analysisan organizational culture that emphasizes the importance of ethics, Theory Y management, a symmetrical worldview valuing innovation and dialogue, a counseling role for issues management or public relations in the dominant coalition, rewarding ethical behavior, ethical analysis using moral philosophy, consistency between individual values and organizational philosophy, and ethics training. These factors, and perhaps others as yet unidentified, worked together to create an environment that encouraged ethical decision making at the exemplar organization. (shrink)

The teaching of ethics in science within the disciplines provides an avenue to deepen students’ scientific understanding and to develop their critical thinking skills. This study showcases a module which connects ethics to science within a large introductory geoscience course. The module components, a tutorial plus homework assignment and an exam question, require students to decide on ethical issues using a 5-step approach that mirrors the scientific decision-making process. The assignment is graded using a developed rubric. An analysis (...) of exam question responses reveals that students correctly identify stakeholders and mention contributions by geoscientists, but have difficulties recognizing their own assumptions. Furthermore, many acknowledge the complexity of the ethical issue at hand. The module provides an example of how disciplinary instructors can include ethics in their teaching and assess students’ ethical decision-making process. (shrink)

Advanced systems engineering has traditionally paid little attention to ethical concerns relative to other technical and non-technical issues. This is particularly evident in systems analysis, design, and development methodologies. This paper asks if it is possible that the lack of emphasis upon ethical considerations in development methodologies can result in the failure of advanced technology development projects? In order to explore this contention, the paper sets out the findings of a case study of a large-scale advanced technology project in (...) a multinational engineering company involving the implementation of an enterprise resource planning system. The research examined the extent to which ethical issues emerged in the project and assesses the impact of ethical considerations upon the technology development process and its outcomes. Evidence is presented which shows how ethical concerns clearly impacted upon the outcome of the project, supporting the contention that ethics was a success factor in the case presented. However, it was also clear that the kinds of ethical considerations that emerged were highly complex, and associated with an “ethics of care”. The findings suggested that researchers should examine the potential of an “ethics of care” as a way of complimenting the “ethics of rights” currently dominant within engineering ethics. (shrink)

The danger of human operators devolving responsibility to machines and failing to detect cases where they fail has been recognised for many years by industrial psychologists and engineers studying the human operators of complex machines. We call it “the control problem”, understood as the tendency of the human within a human–machine control loop to become complacent, over-reliant or unduly diffident when faced with the outputs of a reliable autonomous system. While the control problem has been investigated for some time, up (...) to this point its manifestation in machine learning contexts has not received serious attention. This paper aims to fill that gap. We argue that, except in certain special circumstances, algorithmic decision tools should not be used in high-stakes or safety-critical decisions unless the systems concerned are significantly “better than human” in the relevant domain or subdomain of decision-making. More concretely, we recommend three strategies to address the control problem, the most promising of which involves a complementary coupling between highly proficient algorithmic tools and human agents working alongside one another. We also identify six key principles which all such human–machine systems should reflect in their design. These can serve as a framework both for assessing the viability of any such human–machine system as well as guiding the design and implementation of such systems generally. (shrink)

In order to strengthen RI in the private sector, it is imperative to understand how companies organise this process, where it takes place, and what considerations and motivations are central in the innovation process. In this chapter, the questions of whether and where normative considerations play a role in the innovation process, and whether dimensions of RI are present in the innovation process, are addressed. In order answer these research questions, a theoretical framework is developed based on Jones’s theory of (...) ethical decision making and Cooper’s stagegate model of innovation management. In order to answer the research questions, a specific case of innovations that contribute to public health is explored, namely, that of food companies that participate in a Front-of-Pack logo for healthier food. As the use of healthy food logos does not necessarily have a positive impact on sales and profits, it is expected that in the decision-making process, as part of their innovation process, companies make several trade-offs between economic, technical and moral factors. As the social-ethical values at stake in corporate innovation processes have remained to a large extent unexplored in research on innovation management, the aim of this chapter is to identify the motivations and barriers for companies embracing and continuing a FoP logo for healthier food, and to assess whether ethical considerations play a role in this innovation process. From the findings in this research, it will become clear that although the studied companies participated in a programme for healthy food and thus are responsive to the needs of society, and although the companies feel responsible for public health, ethical considerations do not play a central role in the operational innovation process. Instead, technical and economic considerations seem to prevail in the operational innovation process. Furthermore, none of the procedural dimensions of RI seems to be present at this level in the innovation trajectory. It is argued that this may be an indication that the ethical decision-making process for RI is not located at the level of the operational innovation process itself, but is something that might be located on a higher strategic level in the company. It is at this level that the moral decision is taken to adopt the FoP logo and to engage in the RI process. The findings cast a new light on the discourse on RI in general, and in the private sector in particular. (shrink)

This is a new edition of a classic textbook in health care ethics, one that offers an alternative to the principle-based approach from Beauchamp and Childress (Principles of Biomedical Ethics, now in its seventh edition from OUP) and traditional Catholic approaches of Ashley and O'Rourke. In the early chapters Devettere spells out the meaning of ethics and the importance of prudential reasoning in seeking the good life. The rest of the book deals with issues and cases, including determinations of life (...) and death, reproduction and research and genetics, and the distribution of health care. In this fourth edition Devettere updates all chapters and adds new cases and new sections on the following: neuroscience, social psychology, overriding advance directives, studies on the fetus, the palliative care movement, cardiopulmonary resuscitation, pharmacists and reproductive issues, prenatal life and abortion, neonatal testing and mandatory vaccinations, the US governments' STD research in Guatemala, the emergence of biobanks, facial transplantations, genetic testing, legal issues around the Affordable Care Act, and more. This is an accessible and comprehensive textbook covering all aspects of the field. (shrink)

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical (...) class='Hi'>decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

This dissertation is a study of recent court decisions which have held that persons possess a fundamental right of autonomous decision-making in the matters of abortion and refusal or termination of treatment for certain conditions. The courts have held that even persons who are incompetent to form their own decisions possess this protected right of decision-making, and they have held several contradictory views as to who should form this decision in their place. This dissertation examines (...) the court cases, the nature of the decision to be made, and the various forums proposed as the locus of decision-making authority and determines that the only appropriate forum is the primary moral community of the incompetent person for whom the decision is being made. (shrink)

This Element introduces the philosophical literature on models, with an emphasis on normative considerations relevant to models for decision-making. Chapter 1 gives an overview of core questions in the philosophy of modeling. Chapter 2 examines the concept of model adequacy for purpose, using three examples of models from the atmospheric sciences to describe how this sort of adequacy is determined in practice. Chapter 3 explores the significance of using models that are not adequate for purpose, including the purpose (...) of informing public decisions. Chapter 4 provides a basic framework for values in modelling, using a case study to highlight the ethical challenges in building models for decision making. It concludes by establishing the need for strategies to manage value judgments in modelling, including the potential for public participation in the process. (shrink)

Objectives: The objectives of the study were to assess similarities and differences between breast cancer patients and their husbands in terms of doctor-patient/spouse relationships and shared decision making; and to investigate the association between breast cancer patients and husbands in terms of preference of type of doctor, doctor-patient relationship, and shared decision making regarding medical treatment. Method: Fifty-seven women with breast cancer, and their husbands, completed questionnaires measuring doctor-patient/spouse relationships, and decision making regarding medical (...) treatment. Results: Patients believe they have a key role in the medical decision-making process and that the participation of their husbands, and their agreement with the decision, is important. Both breast cancer patients and their husbands prefer a shared decision-making process to paternalistic or autonomy-based approaches. Conclusion: In contrast to legal and bioethical approaches, which focus on the patient as the primary decision maker, this study reflects a practical recognition of the role of the breast cancer patient's husband in the decision-making process. It also reflects a relational rather than an individualistic perception of patient autonomy. (shrink)

Integrating theory with case studies, this book examines the practical application of moral theory in clinical decision-making through 40 composite cases based on actual clinical experience. Complex, realistic, and challenging, these examples contain the multiplicity of factors faced in clinical crises, making this a superb exploration of the ways in which theory relates to actual life-or-death situations.

This case study chronicles the pedagogical decision making of one high school teacher, Mr. Diego de la Vega, a pseudonym, as he teaches about race and racism in his elective social studies class, Race, Gender, and Ethnicity. De la Vega draws upon his own racial biography and experiences with race/ism to engage with high school students around racialized content. A conceptual framework grounded in racial identity development theory is used. This snapshot of racial pedagogical decision (...) class='Hi'>making, or RPDM, features a discussion of implications for social studies pedagogy to promote racial identity development in the classroom. (shrink)

The present study aimed at investigating the heavy metals concentrations in the soils around “Larga de Sus” abandoned mine (Zlatna, Romania), evaluating the potential ecological risk of heavy metal pollution and highlighting ethical aspects related to risk assessment, ecological restoration, and soil remediation. The results of the chemical analysis showed that the soil in the study area is highly polluted with heavy metals since the average concentrations of Pb (32.4–2318.1 mg/kg), and Ni (321.6–562.8 mg/kg) in soil exceed their corresponding threshold (...) established by the Romanian legislation. The potential ecological risk index method developed by Hakanson was used to assess the potential risk of heavy-metal pollution. The results indicated that Pb and Ni showed severe and considerable potential ecological risk, while Cr had lightly ecological risk. In this case, remediation should be focused only on Pb or on all heavy metals even if they have lightly ecological risk? A scientific management technique cannot logically prescribe which choices should be selected. The interaction between human activity and the environment is complicated and difficult to quantify and risk management cannot and should not be based simply on risk assessment results. What is needed to make the right choice of the most appropriate alternative that fits our personality, culture, religion, and desires? The moral and ethical implications of ecological restoration and soil remediation (e.g. tolerance of uncertainty, responsibility, moral duty, etc.) have to be incorporated within the decision-making process in order to make optimum sustainable decisions and to achieve real environmental protection. (shrink)

The present study aimed at investigating the heavy metals concentrations in the soils around “Larga de Sus” abandoned mine, evaluating the potential ecological risk of heavy metal pollution and highlighting ethical aspects related to risk assessment, ecological restoration, and soil remediation. The results of the chemical analysis showed that the soil in the study area is highly polluted with heavy metals since the average concentrations of Pb, and Ni in soil exceed their corresponding threshold established by the Romanian legislation. The (...) potential ecological risk index method developed by Hakanson was used to assess the potential risk of heavy-metal pollution. The results indicated that Pb and Ni showed severe and considerable potential ecological risk, while Cr had lightly ecological risk. In this case, remediation should be focused only on Pb or on all heavy metals even if they have lightly ecological risk? A scientific management technique cannot logically prescribe which choices should be selected. The interaction between human activity and the environment is complicated and difficult to quantify and risk management cannot and should not be based simply on risk assessment results. What is needed to make the right choice of the most appropriate alternative that fits our personality, culture, religion, and desires? The moral and ethical implications of ecological restoration and soil remediation have to be incorporated within the decision-making process in order to make optimum sustainable decisions and to achieve real environmental protection. (shrink)

Setting optimal significance levels that minimize Type I and Type II errors allows for more transparent and well‐considered statistical decision making compared to the traditional α = 0.05 significance level. We use the optimal α approach to re‐assess conclusions reached by three recently published tests of the pace‐of‐life syndrome hypothesis, which attempts to unify occurrences of different physiological, behavioral, and life history characteristics under one theory, over different scales of biological organization. While some of the conclusions reached using (...) optimal α were consistent to those previously reported using the traditional α = 0.05 threshold, opposing conclusions were also frequently reached. The optimal α approach reduced probabilities of Type I and Type II errors, and ensured statistical significance was associated with biological relevance. Biologists should seriously consider their choice of α when conducting null hypothesis significance tests, as there are serious disadvantages with consistent reliance on the traditional but arbitrary α = 0.05 significance level. (shrink)

This research aims to study possible effects or impacts of COVID-19 in the context of a democratic organizational system analyzing how COVID-19 has influenced employees’ perception of their participation in decision-making and its impact on some psychological outcomes and emotions. COVID-19 has accelerated the process of implementation of new frameworks at work that have generated the modification of culture and employee management practices. Our hypothesis are, on the one hand, that COVID-19 has generated changes in participation structures and (...) internal communication mechanisms, having to make modifications not to deteriorate the perception of employees about their participation in decision making. On the other hand, COVID-19 has generated changes in the psychological outcomes and emotions of the employees. In the study, we analyze a cooperative belonging to the MONDRAGON cooperative group, where participation in decision-making and ownership is in its DNA. Through qualitative and quantitative methodologies, involving 42 employees, we investigate firstly, how COVID-19 has affected perceptions about participation in decision-making analyzing what role has played internal communication in these perceptions. Secondly, we investigate how COVID-19 has affected psychological outcomes and emotions. In this case, the perceptions arising from participation in decision-making focus on the assessment that participators make of the governance channels and the day-to-day meetings. Therefore, their appropriateness seems to be a key factor in the perception of participation in the COVID-19 era. Differences have been detected between the perceptions of blue and white collar employees. Such differences have also been founded in the psychological outcomes and emotions. Although this is a single case study, the analysis carried out provides elements of reflection to modify and restructure the decision-making and participation mechanisms, adapting them to the needs of blue and white collar employees in order to “guarantee” the expected outcomes. (shrink)

Over the past decade, the ideal model of shared decision-making has been increasingly promoted as the preferred standard of doctor-patient communication in medical consultation. The model advocates a treatment decision-making process in which the doctor and his patient are considered coequal partners that carefully negotiate the treatment options available in order to ultimately reach a treatment decision that is mutually shared. Thereby, the model notably leaves room for—and stimulates—argumentative discussions to arise in the context of (...) medical consultation. A paradigm example of a discussion that often emerges between doctors and their patients concerns antibiotics as a method of treatment for what is presumed to be a viral infection. Whereas the doctor will generally not encourage treatment with antibiotics, patients oftentimes prefer the medicine to other methods of treatment. In this paper, two cases of such antibiotic-related discussions in consultation are studied using insights gained in the extended pragma-dialectical theory to argumentation. It is examined how patient and physician maneuver strategically in order to maintain a balance between dialectical reasonableness and rhetorical effectiveness, as well as an equilibrium between patient participation and evidence-based medication, while arguing a case for and against antibiotics respectively. (shrink)

This case study discusses the challenges of end-of-life decision-making in practice, focusing on the delicate balance between medical paternalism, shared decision-making, and the rights of surrogate decision makers. The family initially struggles to grasp the severity of their loved one’s medical condition but a pivotal moment during the Goals of Care meeting brings sudden clarity. This case explores the appropriateness and implications of the practice of informed non-dissent; and our analysis suggests that it (...) is inappropriate unless there is compelling evidence for decision paralysis. Practical strategies are offered that facilitate compassionate dying care within the constraints of clinical urgency. (shrink)

This study uses judgment and decision-making (JDM) perspective with the help of framing and schema literature from cognitive psychology to evaluate how managers behave when problems with unethical overtones are presented to them in a managerial frame rather than an ethical frame. In the proposed managerial model, moral judgment of the situation is one of the inputs to managerial judgment, among several other inputs regarding costs and benefits of various alternatives. Managerial judgment results in managerial intent leading to (...) managerial action. The model and the effects of taking an ethics course on ethical and managerial judgment and managerial intent were then indirectly tested in this study, wherein subjects judged the ethical wrongness, managerial badness, and the managerial intent regarding decisions made in a case. Forty-nine MBA students analyzed a case involving budget-based bonuses and production, in which the ethical issue evolved over three stages. It appears from the Path-analysis results that managerial judgment mediated between moral judgment and the judgment of managerial intent as suggested by the proposed model, and that taking an ethics course directly affected managerial judgment but did not affect the moral judgment. Additionally, in the first stage of decision-making (early stage of a developing “ethical slippery slope”), moral judgment did not significantly influence managerial judgment. However, students with ethics course still were more inclined to judge the decision as managerially bad as compared to others, indicating that they were more aware or sensitive to the moral issues involved. (shrink)

My colleagues and I in Birmingham are always on the lookout for an undergraduate textbook for our medical students, which was why I agreed to review this book. By and large it is pitched at an undergraduate audience and covers many of the areas that one might expect to find in a UK undergraduate medical course (consent, making decisions for the incompetent, end-of-life issues, beginning-of-life issues, research, transplantation and medical genetics). It also has a chapter on managed care, which (...) is less relevant to a UK audience but is interesting none the less. (The case study for the chapter on James Adams who, it is alleged, lost both his hands and feet as a …. (shrink)

Can findings from psychology and cognitive neuroscience about the neural mechanisms involved in decision-making can tell us anything useful about the commonly-understood mental phenomenon of making voluntary choices? Two philosophical objections are considered. First, that the neural data is subpersonal, and so cannot enter into illuminating explanations of personal level phenomena like voluntary action. Secondly, that mental properties are multiply realized in the brain in such a way as to make them insusceptible to neuroscientific study. The paper (...) argues that both objections would be weakened by the discovery of empirical generalisations connecting subpersonal properties with the personal level. It gives three case studies that furnish evidence to that effect. It argues that the existence of such interrelations are consistent with a plausible construal of the personal-subpersonal distinction. Furthermore, there is no reason to suppose that the notion subpersonal representation relied on in cognitive neuroscience illicitly imports personal-level phenomena like consciousness or normativity, or is otherwise explanatorily problematic. (shrink)

Case studies and first-person stories about decision-making, written by professionals in the field, bring a uniquely personal touch to this valuable text.

This paper will examine the effects of gender, age, work experience, academic status and legality on certain ethical decisions. Six scenarios representing ethical dilemmas were presented to both undergraduate and MBA students in an attempt to determine if various demographic factors influenced ethical decision making. While some past studies have suggested that gender has an important effect on ethical decision making, this study does not completely support this conclusion and suggests that age and/or length of work (...) experience should be included in any study of ethical decision making.The legality of the decisions was determined and compared to the reason given by the students for their decisions. In some cases the choice made by a majority of the students was not the one that was supported by the legal authorities which suggests that there may be conflicts between the ethical system of the respondents and the behavior expected of them by society. (shrink)

Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We report (...) on the difficult task of operationalizing the principles of beneficence, non-maleficence and patient autonomy, and describe how we selected suitable input parameters that we extracted from a training dataset of clinical cases. The first performance results are promising, but an algorithmic approach to ethics also comes with several weaknesses and limitations. Should one really entrust the sensitive domain of clinical ethics to machine intelligence? (shrink)

Using artificial intelligence (AI) to make decisions in human resource management (HRM) raises questions of how fair employees perceive these decisions to be and whether they experience respectful treatment (i.e., interactional justice). In this experimental survey study with open-ended qualitative questions, we examine decision making in six HRM functions and manipulate the decision maker (AI or human) and decision valence (positive or negative) to determine their impact on individuals’ experiences of interactional justice, trust, dehumanization, and perceptions (...) of decision-maker role appropriate- ness. In terms of decision makers, the use of human decision makers over AIs generally resulted in better perceptions of respectful treatment. In terms of decision valence, people experiencing positive over negative decisions generally resulted in better perceptions of respectful treatment. In instances where these cases conflict, on some indicators people preferred positive AI decisions over negative human decisions. Qualitative responses show how people identify justice concerns with both AI and human decision making. We outline implications for theory, practice, and future research. (shrink)

In this paper, we explore the philosophical and theological issues that arise when a ‘religious’ process of decision-making, which is normally taken to require specific theological commitments both for its successful use and for its coherent explanation, is transferred into ‘secular’ contexts in which such theological commitments are not shared. Using the example of Quaker Business Method, we show how such a move provokes new theological questions, as well as questions for management studies.

This study examines the communication strategies employed by MeritCare's public relations staff during the fen-phen case. The ethic of significant choice was the primary lens for the study. The study revealed that MeritCare's public relations staff members believed they did, in fact, follow the ethic of significant choice. Specifically, they perceived that the biases held by staff helped maintain the public's safety as the primary issue during the fen-phen events. They also believed that their communication strategies allowed them to (...) avoid ambiguity and emotionalized language. Finally, the staff members felt that teaming with Mayo Clinic in Rochester, Minnesota enabled them to influence the marketplace of ideas by capitalizing on the credible standing of Mayo Clinic. (shrink)