The paper reflects on the methods democratic systems use for arriving at decisions. The most popular ones are elections where the majority rules and deliberative democracy. I argue that both of these do not measure up to the demands of democracy. Whether we use voting with majority rule or deliberative methods, only a portion of the citizenry is allowed to rule itself; minorities are always excluded. Instead of voting with majority ruler or deliberative methods, I suggest that (...) we employ mediation to reach agreement in democratic publics. (shrink)

The paper reflects on the methods democratic systems use for arriving at decisions. The most popular ones are elections where the majority rules and deliberative democracy. I argue that both of these do not measure up to the demands of democracy. Whether we use voting with majority rule or deliberative methods, only a portion of the citizenry is allowed to rule itself; minorities are always excluded. Instead of voting with majority ruler or deliberative methods, I suggest that (...) we employ mediation to reach agreement in democratic publics. (shrink)

In this companion piece to 'On the Philosophy of Group Decision Methods I: The Non-Obviousness of Majority Rule', we take a closer look at some competitors of majority rule. This exploration supplements the conclusions of the other piece, as well as offers a further-reaching introduction to some of the challenges that this field currently poses to philosophers.

Majority rule is often adopted almost by default as a group decision rule. One might think, therefore, that the conditions under which it applies, and the argument on its behalf, are well understood. However, the standard arguments in support of majority rule display systematic deficiencies. This article explores these weaknesses, and assesses what can be said on behalf of majority rule.

This article investigates the relationship among the weak Pareto principle, the strong Pareto principle, and positive responsiveness in the context of voting. First, it is shown that under a mild domain condition, if an anonymous and neutral collective choice rule (CCR) is complete and transitive, then the weak Pareto principle and the strong Pareto principle are equivalent. Next, it is shown that under another mild domain condition, if a neutral CCR is transitive, then the strong Pareto principle and positive responsiveness (...) are equivalent. By applying these results, we obtain a new characterization of the method of majority decision. (shrink)

The aggregation of consistent individual judgments on logically interconnected propositions into a collective judgment on the same propositions has recently drawn much attention. Seemingly reasonable aggregation procedures, such as propositionwise majority voting, cannot ensure an equally consistent collective conclusion. The literature on judgment aggregation refers to such a problem as the \textit{discursive dilemma}. In this paper we assume that the decision which the group is trying to reach is factually right or wrong. Hence, we address the question of (...) how good the various approaches are at selecting the right conclusion. We focus on two approaches: distance-based procedures and a Bayesian analysis. They correspond to group-internal and group-external decision-making, respectively. We compare those methods in a probabilistic model, demonstrate the robustness of our results over various generalizations and discuss their applicability in different situations. The findings vindicate (i) that in judgment aggregation problems, reasons should carry higher weight than conclusions and (ii) that considering members of an advisory board to be highly competent is a better strategy than to underestimate their advice.". (shrink)

Background: Pediatric guidelines recommend that children and adolescents participate in a developmentally appropriate way in end-of-life decision making. Shared decision making in pediatrics is unique because of the triadic relationship of patient, parents, and physician. The involvement of the patient may vary on a continuum from no involvement to being the sole decision maker. However, the effects of child participation have not been thoroughly studied. The aims of this literature review are to identify studies on end-of-life (...) class='Hi'>decision making in pediatrics, to explore patient participation, and to assess the effects of such participation. Methods: Five databases—PubMed, PsycInfo, Medline, CINAHL, and Sociological Abstract—were searched for empirical studies on end-of-life decision making in pediatrics. Selected articles fulfilling the criteria were assessed for type of decision, participants’ characteristics, reports on participation of the minor patient, and outcome. Results: Fifty-seven articles on end-of-life decision making in pediatrics were identified. The majority of papers (n = 43, 75%) investigated parents’ and clinicians’ perspectives, while only 14 articles (25%) included perspectives of children and adolescents. Twenty-two articles (39%) reported some details on various forms of children's participation (e.g., receive information, plan care details, consulted before or after a decision was made). Positive (e.g., respect for patient's preferences) and negative (e.g., conflict due to diverging opinions) effects of children's participation in end-of-life decision making were reported. Conclusions: This systematic review highlights the need for research to identify factors that contribute to a favorable participation of minors in decision-making processes, as well as strategies to solve possible conflicts. More research should take into account the dynamics in the triadic process of decision making and emphasize children and adolescents’ perspectives. A better understanding of how to meaningfully involve children and adolescents in end-of-life decision making could facilitate the practice of patient participation in pediatrics. (shrink)

Background While there are many guidelines on how to make ethical decisions at the end of life, there is little evidence regarding the quality of this sort of ethical guidelines. Objectives First, this study aims to demonstrate the conceptual transferability of the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument for the quality assessment of ethical guidelines. Second, it aims to illustrate the status quo of the quality of guidelines on end-of-life decision-making by using the AGREE instrument in (...) a first practice test. Method The transferability of the AGREE instrument on the quality assessment of ethical guidelines is demonstrated by conceptual analysis. Guidelines on end-of-life decisions in medicine are identified through a systematic search in MEDLINE (from June 1999 to June 2009). The quality of all included guidelines was assessed with a slightly modified AGREE instrument. Results Of 103 guidelines identified, 34 were included as relevant. The majority of the guidelines analysed in this study were assessed as qualitatively insufficient in five out of six AGREE quality domains. A few guidelines demonstrated, however, that a high level of quality in accordance with the AGREE requirements is possible. Conclusion This review concludes that the quality of many ethical guidelines should and can be improved in all quality domains specified by the AGREE instrument. Furthermore, conceptual analysis indicates that a slightly modified AGREE instrument is transferable to the comprehensive evaluation of the quality of ethical guidelines. Nevertheless, future research is needed to improve the assessment of the presentation of the guidelines' normative basis. (shrink)

This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health (...) professionals’ understanding and preferences related to advance directives. In addition, the study sought to explore the views of health care professionals of the application of Advance Directives in clinical practice in Lithuania. A cross-sectional survey was conducted by interviewing 478 health professionals based at major health care centers in Kaunas district, Lithuania. The design of the study included the use of a questionnaire developed for this study and validated by a pilot study. The collected data were analyzed using standard descriptive statistical methods. The analysis of knowledge about AD revealed some statistically significant differences when comparing the respondents’ profession and gender. The analysis also indicated key emerging themes among respondents including tranquility of mind, the longest possible life expectancy and freedom of choice. Further, the study findings revealed that more than half of the study participants preferred to express their will while alive by using advance directives. The study findings revealed a low level of knowledge on advance directives among health professionals. Most health professionals agreed that AD’s improved end-of-life decision making while the majority of physicians appreciated AD as the best tool for sharing responsibilities in clinical practice in Lithuania. More physicians than nurses preferred the presence of advance directives to support their decision making in end-of-life situations. (shrink)

Objectives Potentially life-shortening medical end-of-life practices ) remain subject to conceptual vagueness. This study evaluates how physicians label these practices by examining which of their own practices they label as euthanasia or sedation.Methods We conducted a large stratified random sample of death certificates from 2007 . The physicians named on the death certificate were approached by means of a postal questionnaire asking about ELDs made in each case and asked to choose the most appropriate label to describe the ELD. Response (...) rate was 58.4%.Results In the vast majority of practices labelled as euthanasia, the self-reported actions of the physicians corresponded with the definition in the Belgian euthanasia legislation; practices labelled as palliative or terminal sedation lack clear correspondence with definitions of sedation as presented in existing guidelines. In these cases, an explicit life-shortening intention by means of drug administration was present in 21.6%, life shortening was estimated at more than 24 h in 51% and an explicit patient request was absent in 79.7%.Discussion Our results suggest that, unlike euthanasia, the concept of palliative or terminal sedation covers a broad range of practices in the minds of physicians. This ambiguity can be a barrier to appropriate sedation practice and indicates a need for better knowledge of the practice of palliative sedation by physicians. (shrink)

In this paper I argue that the trolley method of moral philosophy has three shortcomings not yet adequately addressed in the literature. First, trolley problems highlight high stakes ethical decisions. These decisions do not represent the majority of ethical decisions made by most people, and thus, the trolley method ignores most of moral life. Second, the trolley method operates by way of a faux-anonymization of moral agents. This process leads to descriptions of moral agents being unwittingly (...) supplied by those to whom the problems are presented and thereby the formation of a paradigmatic moral agent which excludes a considerable number of real world moral persons. Lastly, the trolley method mischaracterizes what most moral decision-making is like by presenting a moral agent's decision as isolated, uninfluenced, and made with full self-awareness. (shrink)

Background: Decisions of patients, families, and health care providers about medical care at the end of life depend on many factors, including the societal culture. A pan-European study was conducted to determine the frequency and types of end of life practices in European intensive care units , including those in Israel. Several results of the Israeli subsample were different to those of the overall sample.Objective: The objective of this article was to explore these differences and provide a possible explanation based (...) on the impact of culture on end of life decision making.Method: All adult patients admitted consecutively to three Israeli ICUs who died or underwent any limitation of life saving interventions between 1 January 1999 and 30 June 2000 were studied prospectively . These patients were compared with a similar sample taken from the larger study carried out in 37 European ICUs. Patients were followed until discharge, death, or 2 months from the decision to limit therapy. End of life decisions were prospectively organised into one of five mutually exclusive categories: cardiopulmonary resuscitation , brain death, withholding treatment, withdrawing treatment, and active shortening of the dying process . The data also included patient characteristics , specific therapies limited, and the method of SDP.Results: The majority of patients had treatment withheld, none underwent SDP, 62 received CPR , 31 had brain death , and 18 underwent withdrawal of treatment . The primary reason given for limiting treatment was that the patient was unresponsive to therapy . End of life discussions were held with 132 families , the vast majority of which revolved around withholding treatment and the remainder concerned withdrawing treatment .There was a statistically significant association between the type of end of life decision and region—that is, the northern region of Europe, the central region, the southern region, and Israel.Conclusions: Regional culture plays an important part in end of life decision making. Differences relating to end of life decision making exist between regions and these differences can often be attributed to cultural factors. Such cultures not only affect patients and their families but also the health care workers who make and carry out such decisions. (shrink)

Purpose The debate about the end-of-life care decision is becoming a serious ethical and legal concern in the Far-Eastern countries of Korea, China and Japan. However, the issues regarding end-of-life care will reflect the cultural background, current medical practices and socioeconomic conditions of the countries, which are different from Western countries and between each other. Understanding the genuine thoughts of patients who are critically ill is the first step in confronting the issues, and a comparative descriptive study of these (...) perspectives was conducted by collaboration between researchers in all three countries. Methods Surveys using self-reporting paper questionnaire forms were conducted from December 2008 to April 2009 in Korea (six hospitals in two regions), China (five hospitals in four regions) and Japan (nine hospitals in one region). The subjects were patients who were critically ill who had been diagnosed as having cancer. A total of 235 participants (Korea, 91; China, 62; Japan, 52) were eventually recruited and statistically analysed. Results Most respondents had sometimes or often thought of their own death, mostly fear of ‘separation from loved ones’. They wanted to hear the news regarding their own condition directly and frankly from the physician. A quarter of them preferred making end-of-life care decisions by themselves, while many respondents favoured a ‘joint decision’ with their family members. The most favoured proxy decision maker was the spouse, followed by the children. Most admitted the necessity of ‘advance directives’ and agreed with artificial ventilation withdrawal in irreversible conditions. The most common reason was ‘artificial prolongation of life is unnecessary’. Most respondents agreed with the concept of active euthanasia; however, significant differences were sometimes observed in the responses according to variables such as patient's country of origin, age, gender and education level. Conclusion Patients in Far-Eastern countries gave various responses regarding end-of-life care decisions. Although familial input is still influential, most patients think of themselves as the major decision maker and accept the necessity of advance directives with Westernization of the society. Artificial ventilation withdrawal and even active euthanasia may be acceptable to them. (shrink)

Many voting rules and, in particular, the plurality rule and Condorcet-consistent voting rules satisfy the simple-majority decisiveness property. The problem implied by such decisiveness, namely, the universal disregard of the preferences of the minority, can be ameliorated by applying unbiased scoring rules such as the classical Borda rule, but such amelioration has a price; it implies erosion in the implementation of the widely accepted majority principle . Furthermore, the problems of majority decisiveness and of the erosion in (...) the majority principle are not necessarily severe when one takes into account the likelihood of their occurrence. This paper focuses on the evaluation of the severity of the two problems, comparing simple-majoritarian voting rules that allow the decisiveness of the smallest majority larger than 1/2 and the classical Borda method of counts. Our analysis culminates in the derivation of the conditions that determine, in terms of the number of alternatives k, the number of voters n, and the relative (subjective) weight assigned to the severity of the two problems, which of these rules is superior in light of the dual majoritarian approach. (shrink)

Doctors are regularly confronted with requests for sterilisation of mentally handicapped people who cannot give consent for themselves. They ought to act in a medical vacuum because there doesn't exist a consensus about a model for decision making on this matter. In this article a model for decision making is proposed, based on a review of the literature and our own research data. We have attempted to select and classify certain factors which could enable us to arrive at (...) an ethically justifiable method of making a medical decision. In doing so we distinguish two major criteria: heredity and parenting competence, and six minor criteria: conception risk, IQ, age, personality, medical aspects and prognosis and finally support and guidance for the mentally handicapped person. The major criteria give rise to a "situation of necessity". In this situation the physician is confronted with a conflict of values and interests. The minor criteria are of an entirely different ethical order. They can only be considered once the major criteria have created a "situation of necessity". Ultimately it comes down to deciding whether the benefits of sterilisation outweigh the drawbacks and whether the means are appropriate to the end, where efficient contraception is the end and irreversible sterilisation is the means. (shrink)

We consider scenarios with distributed decision processes, e.g., coupled majorities and personal union in parliament chambers, supranational decisions and supervisory boards. When computing the adoption rate for reaching a decision in these scenarios, multiple linear inequality restrictions in combinatorial countings are present. These rates cannot be computed in closed form. We introduce a general method for incorporating multiple inequality conditions in multiple majority decisions, which significantly reduces the number of involved summations and removes restrictions on the (...) summation indices. Exact solutions are provided through integral representations which can be evaluated numerically, and unrestricted, contracted sums over discrete events. Further, we provide methods to reduce the number of necessary summations by splitting or recurring the original problem to easier sub-problems. For five dedicated scenarios, full results are given which indeed require a single unrestricted summation only. (shrink)

This work aims to increase the consumption of online tourism products and promote the development of the tourism economy. Based on this, it first analyses the Internet market under the guidance of consumer psychology. Then, the influencing factors of online product decision-making for the tourism economy are discussed. Finally, based on the above analysis, it discusses and evaluates the main factors affecting the consumption of online travel products. The research method of this work is set based on psychology (...) so that it can analyze the psychological state of consumers more deeply and promote the development of the consumer market. The results show that the main factors affecting the consumption of online travel products include online travel platforms and user characteristics. Specifically, approximately 80% of users consume online travel products based on platform reviews, approximately 10% of users consume online travel products based on platform recommended content, and approximately 5% of users consume online travel products based on platform search content. Users vary mainly by age, gender, and region and have different preferences for different platforms. Among the four major platforms, Ctrip occupies the most consumers. The conclusion is that the main way to develop the tourism economy is to build a better online travel platform. At the same time, it is necessary to promote online tourism according to the characteristics of users and increase the marketing of online tourism products. This work not only provides a reference for promoting online tourism product marketing but also helps to promote the development of the tourism economy. (shrink)

In relation to moral judgment, it is the 'reasoning' and 'intuition' of human representative decision mechanism in cognitive science. The first type is intuitive and automatical way of thinking, and second is ratiocinative and reflecting one. Kohlberg asserted that the most powerful impetus comes from moral reasoning to lead moral judgment and behavior. Haidt explained that intuition plays an leading role and reasoning charges only role of post-justification, in the almost majority of moral situation, via social intuitionism model. (...) Greene elucidates that deontological judgement is deduced intuitively by emotional response automatic and immediately, and judgment due to result does so by reasoning, conscious and reflecting cognitive reaction, through dual process theory. Kahneman maintains that humans make incomplete and irrational judgment, because they have incomplete ability of information processing inherently. To make good judgment, there are so many data to be processed, and we need to make decisions rapidly. Therefore, we use, so-called 'shortcut of judgment' of heuristic, that is, intuition. They acknowledges biased intuition as subject to overcome and upholds the effect of intuition used widely in decision-making at the same time. On the other hand, Gigerenzer claims that it does not necessarily define intuition as source of irrational bias and needs to think it as useful environmental adaptation tool box. In current moral education, the reasoning education is being utilized as core factor to enhance the ability of moral judgment. However, according to the opinions of intuitionist along with Haidt, it suggests strongly that it is not so useful the method of moral education based on reasoning in making moral judgment. This might be clearly significant challenge to moral education. It is because that it supports Haidt's argument that plays an important role for intuition resulting from emotion in moral decision making by many empirical studies recently. In this study, it argues that it guards against the view of underestimating role of moral reasoning, and reasoning could be utilized significantly in decision-making. Reasoning used in situation requiring more complex deliberation differs from intuition system used in context to make rapid decision more effectively, in its roles. (shrink)

The basic axioms or formal conditions of decision theory, especially the ordering condition put on preferences and the axioms underlying the expected utility formula, are subject to a number of counter-examples, some of which can be endowed with normative value and thus fall within the ambit of a philosophical reflection on practical rationality. Against such counter-examples, a defensive strategy has been developed which consists in redescribing the outcomes of the available options in such a way that the threatened axioms (...) or conditions continue to hold. We examine how this strategy performs in three major cases: Sen's counterexamples to the binariness property of preferences, the Allais paradox of EU theory under risk, and the Ellsberg paradox of EU theory under uncertainty. We find that the strategy typically proves to be lacking in several major respects, suffering from logical triviality, incompleteness, and theoretical insularity. To give the strategy more structure, philosophers have developed “principles of individuation”; but we observe that these do not address the aforementioned defects. Instead, we propose the method of checking whether the strategy can overcome its typical defects once it is given a proper theoretical expansion. We find that the strategy passes the test imperfectly in Sen's case and not at all in Allais's. In Ellsberg's case, however, it comes close to meeting our requirement. But even the analysis of this more promising application suggests that the strategy ought to address the decision problem as a whole, rather than just the outcomes, and that it should extend its revision process to the very statements it is meant to protect. Thus, by and large, the same cautionary tale against redescription practices runs through the analysis of all three cases. A more general lesson, simply put, is that there is no easy way out from the paradoxes of decision theory. (shrink)

BackgroundRelatives have no formal position in the practice of euthanasia and physician-assisted suicide (EAS) according to Dutch legislation. However, research shows that physicians often involve relatives in EAS decision-making. It remains unclear why physicians do (not) want to involve relatives. Therefore, we examined how many physicians in the Netherlands involve relatives in EAS decision-making and explored reasons for (not) involving relatives and what involvement entails.MethodsIn a mixed-methods study, 746 physicians (33% response rate) completed a questionnaire, and 20 were (...) interviewed. The questionnaire included two statements on relatives’ involvement in EAS decision-making. Descriptive statistics were used, and multivariable logistic regression analyses to explore characteristics associated with involving relatives. In subsequent interviews, we explored physicians’ views on involving relatives in EAS decision-making. Interviews were thematically analysed.ResultsThe majority of physicians want to know relatives’ opinions about an EAS request (80%); a smaller group also takes these opinions into account in EAS decision-making (35%). Physicians who had ever received an explicit EAS request were more likely to want to know opinions and clinical specialists and elderly care physicians were more likely to take these opinions into account. In interviews, physicians mentioned several reasons for involving relatives: e.g. to give relatives space and help them in their acceptance, to tailor support, to be able to perform EAS in harmony, and to mediate in case of conflicting views. Furthermore, physicians explained that relatives’ opinions can influence the decision-making process but cannot be a decisive factor. If relatives oppose the EAS request, physicians find the process more difficult and try to mediate between patients and relatives by investigating relatives’ objections and providing appropriate information. Reasons for not taking relatives’ opinions into account include not wanting to undermine patient autonomy and protecting relatives from a potential burdensome decision.ConclusionsAlthough physicians know that relatives have no formal role, involving relatives in EAS decision-making is common practice in the Netherlands. Physicians consider this important as relatives need to continue with their lives and may need bereavement support. Additionally, physicians want to perform EAS in harmony with everyone involved. However, relatives’ opinions are not decisive. (shrink)

The purpose of this study is to expand our understanding of the factors that influence ethical behavioral intentions of public accountants. Recent scandals have dominated the news and have caused legislators, regulators and the public to question the role of the accounting profession. Legislative changes have brought about major structural changes in the profession and continued scrutiny will surely lead to further changes. Thus, developing an understanding of the personal and contextual factors that influence ethical decisions is critical. An extension (...) of the theory of planned behavior [Ajzen, I.: 1985, Action Control-From Cognition to Behavior ], the model used in this study examined the influence of personal, social and organizational factors on ethical intentions. Specifically, the individual level model tested direct eects of attitudes, subjective norms, perceived behavioral control, moral sensitivity and ethical climate. Professionals from five accounting firms completed a survey that measured responses to ethical dilemmas related to the public accounting domain. To minimize the potential impact of common method bias, the survey instrument was administered in two phases. Hypotheses were evaluated using a structural modeling technique, partial least squares. Results show strong support for a direct relationship between attitudes and ethical intentions. The proposed direct eect of subjective norms was not supported. However, a significant relationship between subjective norms and attitudes was found. Professionals' attitudes towards ethical issues clearly influence intentions. Moreover, this study illustrates the potential influence of social factors in attitude formation. Future research should explore the factors in the public accounting domain that most strongly influence attitude formation. This study suggests that the theory of reasoned action oers a useful framework for exploring these issues. (shrink)

The aim of this paper is to argue that intuitive methods of moral decision making are objective tools on the grounds that they are reasons based. First, I will conduct a preliminary analysis in which I highlight the acceptance of methodological pluralism in the practice of medical ethics. Here, the point is to show the possibility of using intuitive methods given the pluralism framework. Second, I will argue that the best starting point of elaborating such methods is a bottom-up (...) perspective. Third, I will address the worry of subjectivism. Under the influence of certain rationalist positions and recent developments in cognitive science and moral psychology, one might think that intuitive methods of moral decision making are essentially subjective and emotion based. If moral intuitions are the result of emotional reactions and intuitive reasoning is emotionally driven, then there are reasons to believe intuitive methods are subjective and relative to particular psychological constitution. Against this picture, I will argue that intuitive methods of moral decision making are essentially reasons-based. A Wittgensteinian approach will show that intuitive methods of moral decision making are conceptually linked with criteria of morality. (shrink)

Background Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses’ moral reasoning, moral distress and moral sensitivity. Methods In this randomized clinical trial study with a pre- (...) and post-test design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals. Results Adjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238–15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171–2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15–5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043–12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454–16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015–0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015–0.547, P = 0.009). Conclusions The results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students. Registration This randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016. (shrink)

This study analyzed the national data on life-sustaining treatment decisions from 2018 to 2020 to find out the characteristics of South Korea’s end-of-life procedure according to the decision-making approach and process. We collected the data of 84,422 patients registered with the National Agency for Management of Life-sustaining Treatment. We divided the patients into four groups (G1, G2, G3, and G4) according to the decision-making approach. A descriptive analysis of each group was conducted using indicators such as the patient’s (...) age, status, diagnosis, and content of forgoing life-sustaining treatment. Additionally, logistic regression analysis was performed by dividing the patients into self-determining (G1, G2) and non-self-determining patients (G3, G4). Cancer was the most common diagnosis for each group. The period from life-sustaining treatment decision to implementation was 10.76, 1.01, 0.86, and 1.19 days for G1, G2, G3, and G4, respectively. In the logistic regression analysis, the self-determination ratio was higher for 40–49 years old and lower for cardiovascular disease and gastrointestinal disease. Age was has a major impact on life-sustaining treatment decisions (LSTD), and with increase in age, the family, and not the patient, made the LSTD. The LSTD method also differed depending on the disease. The self-determination rates of patients with circulatory or digestive diseases were somewhat lower than that of those with neoplastic diseases. The period from decision-making to implementation is short for end-of-life care. (shrink)

In reviewing the contents of the first to five speakers, we back up to the United States in writing "real and reasonable method" when the issues faced in: scientific research methods than in the general concept Concept in humanities research methods; and people in the academic literature on the low-order. We first consider how the amount of Dilthey and Heidegger deal with these issues. Ⅰ. Natural sciences and humanities approach argue Dilthey tried to explain the expression of human literature, (...) there is a independent but equally effective method of theoretical foundation. In German, Geisteswissenschaften range widely from the arts and sociology. The rise of hermeneutics, Dilthey, in his famous thesis, the mean deep to begin with Homer to explain the hope臘who traveled through Roman times and hope臘. However, Dilthey still seek to achieve "universal and effective " results, which makes him turn to the scientific method. Heidegger's teacher, Hu stopper Seoul , rather than with the mathematical background of the humanities, to use phenomenology to philosophy as a "rigorous science ". Conversely, neural science and philosophy with Heidegger humanities background. This makes Heidegger's hermeneutics of Dilthey and his interest. Heidegger was a critic of scientific objectivity, and even have commentaries description: "Scientists do not think" . His search for the source of the problem of modernity to Descartes who, because of Cartesian subjectivity of the world as a projection. Ⅱ. Up to the U.S. desire to restore the respect for human studies of up to U.S. desire to restore respect for the human sciences, but he does not find the key steps in Dilthey, but in Heidegger's "Art works of origin >. Ⅲ. Up to the United States after the Western aesthetic of Kant's critique of Gadamer to use his real art of management for the new hole to criticize the police after Kant the aesthetic development. This is the "true management and methods" section of the important elements. Ⅳ. Heidegger in breakthrough in the art lecture on Heidegger, providing up to restore the emphasis on the United States who required breakthrough in the planning literature. Ⅴ. Methods exist regardless hermeneutics the implications of Gadamer's philosophical hermeneutics can be seen as a new understanding of the analysis, so that his exposure to critical science and humanities in the nature of the two methods. Ⅵ. The universality of hermeneutics Gadamer in the "real and reasonable method" after the publication of a thesis advocated, he analyzed the universality of understanding can be applied in science and humanities in the training. Regardless of this guide provide us some background to explore the "real management and methods" in the 14 key concepts, these concepts will be in the seventh, eight speakers presented. After reviewing the content of Lectures 1-5, we turn to the issue that Gadamer was confronting when he wrote Truth and Method: the general sense of the superiority of scientific methods of research over humanistic methods, and the lower status of the humanities in academe . We first consider this issue in Dilthey and Heidegger. Section Ⅰ: The Contest over Methods in the Natural and Human Sciences Dilthey attempted to articulate a separate but equally valid methodological basis for interpretation in the humanities. In Germany, the range of the Geisteswissenschaften was wide, from art to sociology. In his famous essay on the rise of hermeneutics, Dilthey started, significantly, with the Greek interpreters of Homer and moved up through Greek and Roman times. Nevertheless, Dilthey was still seeking to achieve "universally valid" results , which moved him in the direction of scientific methods. Heidegger's teacher, Husserl, had a background in mathematics rather than the humanities and wanted to use phenomenology to make philosophy into a "rigorous science." Heidegger, in contrast, had a humanistic background in theology and philosophy and especially Greek philosophy. This caused him to be interested in Dilthey and his hermeneutics. Heidegger was a critic of scientific objectivity and once even remarked, "The scientist does not think." He traced the problems of modernity back to Descartes, who saw the world as a projection of his subjectivity. Section Ⅱ. Gadamer's Desire to Restore Respect to the Human Studies Gadamer desired to restore re spect to the human sciences, but he found the decisive step for doing so not in Dilthey but in Heidegger's The Origin of the Work of Art. Section Ⅲ: Gadamer's critique of Western aesthetics since Kant Gadamer used his new insight into the truth of art to criticize the development of aesthetics since Kant. This is a major element in the first section of Truth and Method. Section Ⅳ: Heidegger's Breakthrough in "The Origin of the Artwork" Heidegger's lectures on art offered Gadamer the breakthrough he needed in his project of restoring respect to the humanities. Section Ⅴ: The Implications of an Ontological Hermeneutics for Method Gadamer's new philosophical hermeneutics as an analysis of understanding put him in a position to criticize method per se in both the sciences and humanities. Section Ⅵ: The Universality of Hermeneutics In an essay published after Truth and Method Gadamer moved toward asserting the universality of his analysis of understanding as applying both to scientific disciplines and to the humanities. Understanding here was understanding universally, in general, in all respects. With this introduction we have some background for exploring the fourteen key concepts in Truth and Method itself that will be presented in lectures 7 and 8. (shrink)

BackgroundHospitalized older adults frequently have impaired cognition and must rely on surrogates to make major medical decisions. Ethical standards for surrogate decision making are well delineated, but little is known about what factors surrogates actually consider when making decisions.ObjectivesTo determine factors surrogate decision makers consider when making major medical decisions for hospitalized older adults, and whether or not they adhere to established ethical standards.DesignSemi-structured interview study of the experience and process of decision making.SettingA public safety-net hospital and (...) a tertiary referral hospital in a large city in the Midwest United States.ParticipantsThe study included 35 surrogates with a recent decision-making experience for an inpatient aged 65 or older.MeasurementsThe key factors that surrogates considered when making decisions. Interview transcripts were coded and analyzed using the grounded theory method of qualitative analysis.ResultsSurrogates considered patient-centered factors and surrogate-centered factors. Patient-centered factors included: respecting the patient’s input, using past knowledge of the patient to infer the patient’s wishes, and consider ing what is in the patient’s best interests. Some surrogates expressed a desire for more information about the patient’s prior wishes. Surrogate-centered factors included: surrogate’s wishes as a guide, surrogate’s religious beliefs and/or spirituality, surrogate’s interests, and family consensus.ConclusionOur study indicates that surrogate decision making is more complex than the standard ethical models, which are limited to considerations of the patient’s autonomy and beneficence. Because surrogates also imagine what they would want under the circumstances and consider their own needs and preferences, models of surrogate decision making must account for these additional considerations. Surrogates’ desire for more information about patients’ preferences suggests a need for greater advance care planning. (shrink)

Background: With multiple options available today to become a parent, how does the matter of genetic relatedness factor into adolescent cancer patients’ fertility preservation decision making? This study reports on and normatively analyzes this aspect of FP decision making. Methods: A convenience sample of Israeli adolescent cancer survivors and their parents were invited to participate in individual, semi-structured interviews. Results: In discussing the importance of genetic relatedness to future children or grandchildren, participants repeatedly brought up the interrelated issues (...) of nature, normalcy, and personal identity. Regardless of preference or ambivalence for genetic relatedness, the majority of participants were aware of alternative parenting options and noted both their advantages and disadvantages. However, knowledge of alternative parenting options was not uniform. Conclusions: To ensure that adolescent patients and their parents make informed FP decisions that meet their personal goals and values, it is important for physicians to discuss alternative parenting options with them in a culturally sensitive manner. Greater credence also should be given to those who question the importance of genetic relatedness. (shrink)

In light of the so-called ‘chaos theorems’ from social choice theory, William Riker argues that the indeterminacy of majority rule leads to voting cycles making democratic decisions arbitrary and meaningless. Moreover, when the core is empty, majority instability correlates with the level of conflict among actors. This study uses laboratory committee decision-making experiments to provide an empirical test of both aspects of Riker’s argument. Committees make repeated majority decisions over 20 periods picking points from a two-dimensional (...) policy space. The experiment manipulates committee members’ preferences and thus varies the existence of a core and the level of conflict between group members. The experimental results contradict Riker’s interpretation of the chaos theorems’ implications. Thus, the core exhibits less attraction than generally assumed. Moreover, an empty core is not associated with increased majority rule instability. Instead, conflicting preferences lead to more instability irrespective of the existence of an equilibrium. (shrink)

The purpose of this study is to expand our understanding of the factors that influence ethical behavioral intentions of public accountants. Recent scandals have dominated the news and have caused legislators, regulators and the public to question the role of the accounting profession. Legislative changes have brought about major structural changes in the profession and continued scrutiny will surely lead to further changes. Thus, developing an understanding of the personal and contextual factors that influence ethical decisions is critical. An extension (...) of the theory of planned behavior [Ajzen, I.: 1985, Action Control-From Cognition to Behavior (Springer, Heidelberg)], the model used in this study examined the influence of personal, social and organizational factors on ethical intentions. Specifically, the individual level model tested direct effects of attitudes, subjective norms, perceived behavioral control, moral sensitivity and ethical climate. Professionals from five accounting firms completed a survey that measured responses to ethical dilemmas related to the public accounting domain. To minimize the potential impact of common method bias, the survey instrument was administered in two phases. Hypotheses were evaluated using a structural modeling technique, partial least squares. Results show strong support for a direct relationship between attitudes and ethical intentions. The proposed direct effect of subjective norms was not supported. However, a significant relationship between subjective norms and attitudes was found. Professionals’ attitudes towards ethical issues clearly influence intentions. Moreover, this study illustrates the potential influence of social factors in attitude formation. Future research should explore the factors in the public accounting domain that most strongly influence attitude formation. This study suggests that the theory of reasoned action offers a useful framework for exploring these issues. (shrink)

The ongoing explosion of interest in artificial intelligence is fueled in part by recently developed techniques in machine learning. Those techniques allow automated systems to process huge amounts of data, utilizing mathematical methods that depart from traditional statistical approaches, and resulting in impressive advancements in our ability to make predictions and uncover correlations across a host of interesting domains. But as is now widely discussed, the way that those systems arrive at their outputs is often opaque, even to the experts (...) who design and deploy them. Is it morally problematic to make use of opaque automated methods when making high-stakes decisions, like whether to issue a loan to an applicant, or whether to approve a parole request? Many scholars answer in the affirmative. However, there is no widely accepted explanation for why transparent systems are morally preferable to opaque systems. We argue that the use of automated decision-making systems sometimes violates duties of consideration that are owed by decision-makers to decision-subjects, duties that are both epistemic and practical in character. Violations of that kind generate a weighty consideration against the use of opaque decision systems. In the course of defending our approach, we show that it is able to address three major challenges sometimes leveled against attempts to defend the moral import of transparency in automated decision-making. (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)

The combination of individual judgments on logically interconnected propositions into a collective decision on the same propositions is called judgment aggregation. Literature in social choice and political theory has claimed that judgment aggregation raises serious concerns. For example, consider a set of premises and a conclusion in which the latter is logically equivalent to the former. When majority voting is applied to some propositions (the premises) it may give a different outcome than majority voting applied to another (...) set of propositions (the conclusion). This problem is known as the doctrinal paradox. The doctrinal paradox is a serious problem since it is not clear whether a collective outcome exists in these cases, and if it does, what it is like. Moreover, the two suggested escape-routes from the paradox - the so-called premise-based procedure and the conclusion-based procedure - are not, as I will show, satisfactory methods for group decision-making. In this paper I introduce a new aggregation procedure inspired by an operator defined in artificial intelligence in order to merge knowledge bases. The result is that we do not need to worry about paradoxical outcomes, since these arise only when inconsistent collective judgments are not ruled out from the set of possible solutions. (shrink)

Objectives: To study the attitudes of both medical and non-medical students towards the do-not-resuscitate decision in a university in Hong Kong, and the factors affecting their attitudes.Methods: A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.Results: A total of 766 students participated in the study. There were (...) statistically significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient’s own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.Conclusions: Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient’s own wish as most important in DNR decisions. Family wishes were considered less important than the patient’s own wishes. (shrink)

The practice of respecting patients’ autonomy is rooted in the healthcare professionals’ empathy for patients’ situations, without which appropriate supports to the patients during the informed consent process may be remarkably moderated. The purpose of this study was to explore elective surgery patients’ experiences during their decision-making process. This research was conducted using a phenomenological approach, and the data analysis was guided by Colaizzi’s method. A total of 17 participants were recruited from a hospital in southern Taiwan. Two (...) major themes emerged from the analyses: (a) a voluntary yet necessary alternative—to undergo a surgery and (b) alternatives compelled by the unalterable decision—the surgery. It was concluded that unless healthcare professionals can empathize with the distressed situation of their patients who are facing elective surgery, the practice of informed consent may become merely a routine. Nurses can be the best advocates for patients and facilitators to enhance communication between patients and healthcare personnel. (shrink)

The recent upsurge in “brain-training and perceptual-cognitive-training", proposing to improve isolated processes such as brain function, visual perception and decision-making, has created significant interest in elite sports practitioners, seeking to create an ‘edge’ for athletes. The claims of these related 'performance-enhancing industries' can be considered together as part of a process training approach proposing enhanced cognitive and perceptual skills and brain capacity, to support performance in everyday life activities, including sport. For example, the 'process-training industry' promotes the idea that (...) playing games not only makes you a better player, but also smarter, more alert, and a faster learner. In this position paper we critically evaluate the effectiveness of both types of process-training programmes in generalizing transfer to sport performance. These issues are addressed in three stages. First, we evaluate empirical evidence in support of perceptual-cognitive process training, and its application to enhancing sport performance. Second, we critically review putative modularised mechanisms underpinning this kind of training, addressing limitations and subsequent problems. Specifically, we consider merits of this highly specific form of training, which focuses on training of isolated processes such as cognitive processes (attention, memory, thinking) and visual perception processes, separately from performance behaviors and actions. We conclude that these approaches may, at best, may provide some 'general transfer' of underlying processes to specific sport environments, but lack 'specificity of transfer' to contextualize actual performance behaviors. A major weakness of process training methods is their focus on enhancing performance in body “modules” (e.g., eye, brain, memory, anticipatory sub-systems). What is lacking is evidence on how these isolated components are modified and subsequently interact with other process “modules”, which are considered to underlie sport performance. Finally, we propose how an ecological dynamics approach, aligned with an embodied framework of cognition undermines the rationale that modularised processes can enhance performance in competitive sport. An ecological dynamics perspective proposes that the body is a complex adaptive system, interacting with performance environments in a functionally integrated manner, emphasising that the inter-relation between motor processes, cognitive and perceptual functions and the constraints of a sport task is best understood at the performer-environment scale of analysis. (shrink)

In recent years, network security has become a major concern. Using the Internet to store and analyze data has become an integral aspect of the production and operation of many new and traditional enterprises. However, many enterprises lack the necessary resources to secure information security, and selecting the best network security service provider has become a real issue for many enterprises. This research introduces a novel decision-making method utilizing the 2-tuple linguistic complex q-rung orthopair fuzzy numbers to tackle (...) this issue. We propose the 2TLCq-ROF concept by combining the complex q-rung orthopair fuzzy set with 2-tuple linguistic terms, including the fundamental definition, operational rules, scoring, and accuracy functions. Aggregation operators are the fundamental mathematical approach used to combine various inputs into a single output. Taking into account the interaction between the attributes, we develop the 2TLCq-ROF Hamacher operators by using the innovative operational rules. These operators include the 2TLCq-ROFH weighted average, 2TLCq-ROFH ordered weighted average, 2TLCq-ROFH hybrid average, 2TLCq-ROFH weighted geometric, 2TLCq-ROFH ordered weighted geometric, and 2TLCq-ROFH hybrid geometric operators. In addition, we talk about the properties of 2TLCq-ROFH operators such as idempotency, commutativity, monotonicity, and boundedness and also examine their spatial cases. To tackle the problems of the 2TLCq-ROF multiattribute group decision-making environment, we develop a novel approach according to the COPRAS model. Finally, to validate the feasibility of the given strategy, we employ a quantitative example related to select the best network security service provider. In comparison with existing approaches, the developed decision-making algorithm is most extensively used and reduces the loss of information. (shrink)

Business ethics as an applied inquiry requires an expanded normative method which allows both philosophical and religious ethical considerations to be employed in resolving complex issues or cases. The proposed foundational normative method provides a comprehensive framework composed of major philosophical and religious ethical theories. An extensive rationale from the current trends in business ethics and metaethical considerations supports the development of this method which is illustrated in several case studies. By using this method, scholars and (...) business persons gain greater certitude about the ethical quality of their deliberations and decision making than what may be achieved with current nonsystematic or nascent normative methods. (shrink)

ALTHOUGH majority rule finds ready acceptance whenever groups make decisions, there are surprisingly few philosophically interesting arguments in support of it.1 Jeremy Waldron’s The Dignity of Legislation contains the most interesting recent defense of majority rule. Waldron combines his own argument from respect with May’s influential characterization of majority rule, tying both to a reinterpretation of a well-known passage from Locke’s Second Treatise (“the body moves into the direction determined by the majority of forces”). Despite its (...) impressive resourcefulness, Waldron’s defense is deficient, and one goal of this essay is to show how. Yet our main concern is not to criticize Waldron, but to demonstrate general deficiencies of arguments for majority rule and to suggest a strategy for a more adequate and more complete defense. Such arguments tend to have one of two weaknesses: Either they assume that collective decisionmaking is done in terms of ranking options and thus neglect both aggregation methods using more information than the relative standing of options in rankings (such as so-called positional methods) and rules that are not aggregation methods at all (such as fair-division procedures); or they also constitute arguments for other decision rules. In the first case, the argument is too narrow, in the second it is too broad. The narrowness problem is bigger than stated so far because arguments for majority rule tend to assume not only that decisions are made by ranking options, but also that only two options are to be ranked. Both problems arise for Waldron’s defense and leave it incomplete. Yet such incompleteness also characterizes the state of the art in arguing for majority rule. So in addition to.. (shrink)

A major problem for interpersonal aggregation is how to compare utility across individuals; a major problem for decision-making under normative uncertainty is the formally analogous problem of how to compare choice-worthiness across theories. We introduce and study a class of methods, which we call statistical normalization methods, for making interpersonal comparisons of utility and intertheoretic comparisons of choice-worthiness. We argue against the statistical normalization methods that have been proposed in the literature. We argue, instead, in favor of normalization of (...) variance: we claim that this is the account that most plausibly gives all individuals or theories ‘equal say’. To this end, we provide two proofs that variance normalization has desirable properties that all other normalization methods lack, though we also show how different assumptions could lead one to axiomatize alternative statistical normalization methods. (shrink)

In the basic model of Condorcet’s jury theorem and in the literature that follows, an odd-numbered group of voters is assumed so that the simple majority rule can be used. We show that this assumption is not necessary either in Condorcet’s basic model or in the general framework of dichotomous choice. We first apply simple majority rule to an even-numbered homogeneous fixed-size committee. We then provide a justification for using simple majority rule for an even-numbered heterogeneous fixed-size (...) committee when the competence structure of the committee members is not common knowledge. (shrink)

This study forms part of a larger research project examining the election process for the Nobel prizes for Physiology or Medicine at the Karolinska Institute in Stockholm, and the role and function of the prizes in early 20th century Swedish and international medicine. The purpose of the study is to clarify the decision-making process which led to the Nobel prize for Paul Ehrlich in 1908, for work on immunity. His award was preceded by the most dramatic conflict within the (...) prize authority concerning any prizewinner prior to World War I, and thus is apt to illuminate both the implicit and explicit criteria and the strategies used in the prize deliberations.Ehrlich's chemical ideas on the immune response were criticized by the physical chemist Svante Arrhenius who recommended the application of his disciplines's methods and principles on immunological problems. This criticisms were brought into the Nobel prize debate by J.E. Johansson, a physiologist who asserted that Ehrlich's research was of little scientific value and therefore not worthy of a prize. Yet the majority of the Institute, led by its chairmam, the chemist K.A.H. Mörner, succeeded in awarding Ehrlich. (shrink)

If ethics consultation services influence medical decisions it is important to evaluate how ethical dilemmas are dealt with by clinical ethics committees (CECs). Such evaluation is rare. This study presents a feasible and practical method of evaluating case discussions in CECs and the results emerging from the use of this method. A written presentation of an end-of-life dilemma was sent to all Norwegian ethics committees. The committees were asked to deal with the case as they would do if (...) it was a real case, and to prepare a written report of the discussion. A majority of the committees approached the case systematically. All emphasized the importance of good communication with the next of kin. However, their conclusions varied, medical facts were interpreted differently, possible patient suffering was dealt with differently, and some committees revealed insufficient legal knowledge. Such findings are useful in the future education of committee members. (shrink)

Selective mutism is an anxiety disorder in which an individual is unable to speak in certain social situations though may speak normally in other settings (Hua & Major, 2016 ). Selective mutism in adults is rare, though people with this condition might have other methods of communicating their needs outside of verbal communication. Healthcare professionals rely on a patient’s ability to communicate to establish if they have decision-making capacity. This commentary responds to a case of a young adult patient (...) with selective mutism and social anxieties that significantly limited his ability to communicate with anyone in the healthcare team. This required a creative, patient-centered approach to engage in meaningful communication. (shrink)

In his Populist Democracy: A Defence (1993), Torbjörn Tännsjö suggests, roughly, the following necessary and sufficient conditions for a democratic collective choice: If the majority of a given group of voters prefer A to B, then the collective choice is A rather than B; and if the majority of voters had preferred B to A, then the collective choice would have been B rather than A. Moreover, the preference of a voter is equated with the one she is (...) showing by the act of voting (e.g., by putting a ballot in a box). Tännsjö’s definition has the advantage of being simple, naturalistic, and, to the best of my knowledge, more exact that most other definitions proposed in the literature. As such, I think it is a useful starting point for a discussion of how to define democratic decision making. As we will see below, such a discussion can be quite illuminating and generate interesting and fruitful questions regarding how to understand democracy. Tännsjö claims that his definition is in line with common language use, i.e., that it is a lexical definition. Pace Tännsjö, I shall show that it departs from common language use since it has a number of counterintuitive implications in regards to which decisions and methods that are classified as democratic or undemocratic. I shall suggest a number of amendments to avoid these drawbacks and incorporate these amendments in a definition of a democratic collective choice. The result is a definition of a democratic decision that is superior to Tännsjö’s, or so we will argue. It will be acknowledged, however, that it still has some shortcomings that future efforts need to rectify, or that it might not be possible to give a 1 simple and naturalistic definition of democracy that is sufficiently in line with common language use. To avoid a possible misunderstanding, let me add that I don’t think there is necessarily one correct way of defining a democratic decision (although there might be a common kernel) and I certainly don’t suggest that the definition proposed here is the only way of explicating the ordinary language use of the term “democracy”.. (shrink)

After the death of Prophet Muhammad (p.b.u.h), one of the most significant debated topics of Muslims was the institution of caliphate. This institution caused crucial argumentations through the ages from Abu Bakr to Abd-al-Majid who was the hundreth khalifa. Some prominent issues in that regard as follows: How khalifa comes to power, who becomes khalifa, whether he is descended from Quraysh or not, which kind of traits khalifa should have, and how khalifa should behave in certain circumstances. While these arguments (...) were going on, caliphate was maintained based on the reign under some certain dynasties’ responsibilities after the Rashidun (rightly guided) Caliphs. Umayyads, Abbasids and Ottoman Dynasties were the most well-known ones of these dynasties. Throughout history, even though caliphate passed in one another’s hands among aforementioned dynasties, none of them did attempt to abolish this position. However, Turkish Muslims who became defeated with European occupation of non-western territories decided to abolish caliphate for the sake of modernization activities within the period of transition from imperialism to nation state. This decision brought about a trauma, which was much more critical than former argumentation around the position in Muslim world. Many congresses were organized in Islamic world in order to recover from this trauma. While this kind of quests were continuing, Muhammad Hamīdullah proposed “High Caliphate Council” in relation to rearrangement of caliphate in accordance with the conditions of Islamic countries. This proposal offers an applicable model to today’s modern nation states by establishing unity among them and leaving aside their conflicts and differences. This proposal offers a resolution of much-discussed matters of the position within the limits of principals. It also draws attention by showing a possibility of Islamic union in contemporary Islamic thought. Summary: The matters of who undertakes the management of societies, how rulers come to power and in what manners the rulers maintain the management have been discussed throughout history. It is seen that rulers adopted kingdom as regime before the period of the Prophet Muhammad (p.b.u.h). There was also two-person management. The discussions about this matter were also seen around khalifas who were the rulers of Muslims after the death of Prophet Muhammad (p.b.u.h). Some debated issues in that regards as follows: Who becomes khalifa, how he is elected, which traits he should possess, and so on. Caliphate continued its existence despite the discussions until the first quarter of the 14th Hijra era. Abolition of caliphate was a trauma for Muslims undoubtedly. From Anatolia to Egypt and from India to the Balkans, many attempts were carried out to recover from this trauma. However, this matter was oversimplified in the conditions of that period since it became a topic which was hushed over in just congresses and conventions. One of the people who wrote on this topic, which maintains its vitality even today was Muhammad Hamīdullah. He was an important Islamic scholar, a lawyer and a historian in Indian geography. Hamīdullah did deal caliphate by indicating its history broadly. The distinctive feature of Hamīdullah from others who wrote on this topic is that he also presented a considerable offer to solve the matter. In this sense, Hamīdullah experienced the trauma in his own life as all muslims did it with the abolition of caliphate. Hence he mentioned this matter in his writings in the mood of care and dignity of a scientist and also in feeling of a heartbroken muslim. Hamīdullah made clear that the method of election of the ruler differed throughout history. Indeed, the verses of Holy Qur’ān, the applications of the Prophet Muhammad (p.b.u.h) and the differences of Four Great Chaliphs on coming to power testified this claim. According to Hamīdullah, it is quite normal that the method of regime can vary according to the conditions of societies. He recommended acting based on timeless rules rather than the changes that vary according to conditions and places. He also stated that the regime which Islam approves is a combination of kingdom and democracy in his lines dealing with methods of regime. To him, kingdom is the method of regime of empire. Empire is the regime in which various nationalities live together with all their differences and interact with one another intensely and in which the rulers rule over wide borders. On the other hand, Islamic world lost its edges of empire, changed its regime and divided to nation states after the decline of the Ottoman Empire and Mughal Empire which were established by Muslims. On the contrary, westerners attempted to establish a head empire several times after building nation states in Europe. Some of them are UN, NATO, EU, to name but a few. In our opinion, in the transition process of Muslim rulers from empire to nation state, Hamīdullah made an offer to accomodate Islamic law in state law, Islamic politic and administrative principles in politics and administration practices, Islamic education system in education system, and principles of Islamic economics in economic decisions of government using the Prophet Muhammed’s life as a base. He also explained to Muslims that the method of regime can be changed and the essential matter is to apply Islamic management principles in such a new situation. He played a role in clearing the way for Muslims by indicating that the method of Islamic regime can be changed according to conditions but the principles of Islam are unalterable. To the writer of these lines, Hamīdullah intimates that it is not so true to stick to the form of the process in Muslim territories in which a compulsory transition from the empires or multinational social structures to the nation state structures have been experienced for the last two ages. However, the first matter to dwell on should be whether the ruler of the government behaves in accoradance with the principles of Islam or not. To Hamīdullah, the second matter is that even though Muslim countries had to enter in the process of becoming nation states, Muslims should make an effort to establish supra-state associations as required by Islam. In this respect, Hamīdullah’s proposal is “High Caliphate Council”. This council is a considerable offer presented to Muslim countries in the age when a universal caliphate is not possible and Muslims head towards a unified state form all over the world. Today, this offer recommends countries of which great majority is Muslims and in which Muslims are minority to meet on a common ground rather than conflict because of differences among them. The High Caliphate Council is an institute consists of presidents or hereditary administrators as leading and regular members and so it avoids regional competition. It is established by Muslim presidents who shares the chair alternately. Based on this, all Muslim presidents play a role altogether in this council without need to be Sunni, Shia, or from Quraysh. The High Caliphate Council is a reflection of a dream, which started a century and half a century ago but is required more today. It is also a reflection of the discourse of “Islamic Union” in Contemporary Islamic Thought. The Caliphate Council and International Islamic Legists’ Association, which is the first practical step of the council can be seen as the theory of a new world order based on the unity principle of Islam. Hamīdullah does not consider this order not only in the range of belief but also with the aim of institutionalizing ‘ijmā (consensus of Islamic legists) and qiyās(legal analogy). He stated that International Islamic Legists’ Association, which is a scientific institution could not be established beforetime by Muslims spread on three continents due to lacking of communication among them. However, thanks to today’s possibilities, the establishment of such association is easier today. Hamīdullah found dynamic solutions such these two institutions for the realization of caliphate, which is a religious necessity. He marked an era for Muslims in the period of time when they are on a quest. (shrink)

Background Reasonable disagreement about the role awarded to gamete donors in decision-making on the use of embryos created by gamete donation for research purposes emphasises the importance of considering the implementation of participatory, adaptive, and trustworthy policies and guidelines for consent procedures. However, the perspectives of gamete donors and recipients about decision-making regarding research with EGDs are still under-researched, which precludes the development of policies and guidelines informed by evidence. This study seeks to explore the views of donors (...) and recipients about who should take part in consent processes for the use of EGDs in research. Methods From July 2017 to June 2018, 72 gamete donors and 175 recipients completed a self-report structured questionnaire at the Portuguese Public Bank of Gametes. Agreement with dual consent was defined as the belief that the use of EGDs in research should be consented by both donors and recipients. Results The majority of participants were willing to donate embryos for research. Almost half of the donors and half of the recipients considered that a dual consent procedure is desirable. This view was more frequent among employed recipients than among non-employed. Donors were less likely to believe that only recipients should be involved in giving consent for the use of EGDs in research and were more frequently favourable to the idea of exclusive donors’ consent. Conclusions Divergent views on dual consent among donors and recipients indicate the need to develop evidence-based and ethically sustainable policies and guidelines to protect well-being, autonomy and reproductive rights of both stakeholder groups. More empirical research and further theoretical normative analyses are needed to inform people-centred policy and guidelines for shared decision-making concerning the use of EGDs for research. (shrink)

Der Autor analysiert die methodologische Grundlegung der Transzendentalphilosophie durch Fichte. Als entscheidenden Punkt arbeitet er den durch Fichte vollzogenen Paradigmenwechsel heraus Danach kommt der Systembegründung nicht mehr ein vorwissenschaftlicher Status zu, sondern diese wird Moment der Systemkonstitution und Systemkonstruktion. Das erlaubt Fichte, die philosophische Methode in ihrer Strenge von der Methode der Mathematik abzuheben. -/- The author analyzes the methodological basis of Fichte's transcendental philosophy. As a decisive point, he works out the paradigm shift that Fichte carried out. According to (...) this, the justification of the system no longer has a pre-scientific status, but becomes a moment of the system constitution and system construction. This allows Fichte to distinguish the philosophical method in its rigor from the method of mathematics. (shrink)