Localism is a social movement often associated with “buy local” food initiatives or the prevention of big-box retail expansion. At its core, however, localism is also about fostering local independence by encouraging businesses to opt for local alternatives when making purchasing decisions. In this article, we develop and test hypotheses that organizations with stronger community-oriented identities are more likely to source locally and that this relationship is moderated by the importance of the focal firm’s purchasing decisions. Results support the (...) strong influence of identity but the conditional effect is unconfirmed. (shrink)

UK radioactive waste management policy making is currently taking place within a participatory and analytic- deliberative decision-making framework; one that seeks to integrate public and stakeholder values and perspectives with scientific and technical expertise. One important aspect of this socio-technical reframing of the radioactive waste problem is an explicit recognition that legitimate and defensible policy making must take into account important ethical issues if it is to be a success. Thus, there is a need for tools to incorporate (...) adequate assessment of ethical issues in a way that is compatible with this approach. The ' ethical matrix ' is one such tool used recently to address a range of agricultural and natural resource issues that shows promise for this field. This paper assesses the strengths and limitations of the matrix and outlines a framework for the development of alternative tools to better satisfy the needs of ethical assessment in radioactive waste management decision making processes. (shrink)

BackgroundDespite the recognition that developing artificial intelligence (AI) that is trustworthy is necessary for public acceptability and the successful implementation of AI in healthcare contexts, perspectives from key stakeholders are often absent from discourse on the ethical design, development, and deployment of AI. This study explores the perspectives of birth parents and mothers on the introduction of AI-based cardiotocography (CTG) in the context of intrapartum care, focusing on issues pertaining to trust and trustworthiness.MethodsSeventeen semi-structured interviews were conducted with birth parents (...) and mothers based on a speculative case study. Interviewees were based in England and were pregnant and/or had given birth in the last two years. Thematic analysis was used to analyze transcribed interviews with the use of NVivo. Major recurring themes acted as the basis for identifying the values most important to this population group for evaluating the trustworthiness of AI.ResultsThree themes pertaining to the perceived trustworthiness of AI emerged from interviews: (1) trustworthy AI-developing institutions, (2) trustworthy data from which AI is built, and (3) trustworthy decisions made with the assistance of AI. We found that birth parents and mothers trusted public institutions over private companies to develop AI, that they evaluated the trustworthiness of data by how representative it is of all population groups, and that they perceived trustworthy decisions as being mediated by humans even when supported by AI.ConclusionsThe ethical values that underscore birth parents and mothers’ perceptions of trustworthy AI include fairness and reliability, as well as practices like patient-centered care, the promotion of publicly funded healthcare, holistic care, and personalized medicine. Ultimately, these are also the ethical values that people want to protect in the healthcare system. Therefore, trustworthy AI is best understood not as a list of design features but in relation to how it undermines or promotes the ethical values that matter most to its end users. An ethical commitment to these values when creating AI in healthcare contexts opens up new challenges and possibilities for the design and deployment of AI. (shrink)

Freedom of information laws promote transparency by permitting individuals and organizations to obtain government documents. However, exemptions from disclosure are necessary to protect privacy and to permit government officials to deliberate freely. Deliberative language is often the most challenging and burdensome exemption to detect, leading to high processing costs and delays in responding to open-records requests. This paper describes a novel deliberative-language detection model trained on a new annotated training set. The deliberative-language detection model is a component of a (...) class='Hi'>decision-support system for open-records requests under the US Freedom of Information Act, the FOIA Assistant, that ingests documents responsive to an open-records requests, suggests passages likely to be subject to deliberative language, privacy, or other exemptions, and assists analysts in rapidly redacting suggested passages. The tool’s interface is based on extensive human-factors and usability studies with analysts and is currently in operational testing by multiple US federal agencies. (shrink)

Background Decision-making competence is a complex concept in the care for transgender and gender diverse adolescents, since this type of care concerns one’s developing gender identity and involves treatment options that often lack international consensus. Even despite competence assessments, moral challenges arise in the decision-making process. Here, traditional forms of clinical ethics support such as moral case deliberation might not fit as these do not provide thematic guidance. This study therefore aimed to develop a practice-oriented ethics (...) class='Hi'>support tool to assist care providers when dealing with moral challenges around decision-making competence in transgender adolescent care. Methods The study followed a participatory design to develop a tool in close collaboration with care providers; they had a say in all phases of development and dissemination. Firstly, nine care providers were interviewed about experienced moral challenges and needs for ethics support. Based on this, the structure and content of the tool was constructed and discussed in two focus group meetings, after which four care providers tested the tool and additional feedback was collected from the team and an advisory board. The final tool was presented to all Dutch care providers in transgender adolescent care. Results Care providers expressed a need for guidance in defining and assessing decision-making competence. Main moral challenges concerned discussing fertility options with young clients, dealing with co-occurring mental health difficulties and the decision-making role of parents. The final tool, named the Competence Consultant, is an interactive pdf containing four parts: (1) Clarify information; (2) Identify doubts and moral questions; (3) Guidance for conversations and (4) Overview and Conclusions. Discussion Developing an ethics support tool in a controversial care setting is highly relevant as it aims to help individual care providers in defining, discussing and dealing with their moral challenges in actual practice. The ‘Competence Consultant’ for transgender care providers contributes to their moral sensitivity and moral competence. It is an example of the development of innovative and integrative forms of thematic ethics support. (shrink)

Decision makers in banking, insurance or employment mitigate many of their risks by telling “good” individuals and “bad” individuals apart. Laws codify societal understandings of which factors are legitimate grounds for differential treatment —or are considered unfair discrimination, including gender, ethnicity or age. Discrimination-aware data mining implements the hope that information technology supporting the decision process can also keep it free from unjust grounds. However, constraining data mining to exclude a fixed enumeration of potentially discriminatory features is insufficient. (...) We argue for complementing it with exploratory DADM, where discriminatory patterns are discovered and flagged rather than suppressed. This article discusses the relative merits of constraint-oriented and exploratory DADM from a conceptual viewpoint. In addition, we consider the case of loan applications to empirically assess the fitness of both discrimination-aware data mining approaches for two of their typical usage scenarios: prevention and detection. Using Mechanical Turk, 215 US-based participants were randomly placed in the roles of a bank clerk or a citizen / policy advisor. They were tasked to recommend or predict the approval or denial of a loan, across three experimental conditions: discrimination-unaware data mining, exploratory, and constraint-oriented DADM. The discrimination-aware tool support in the eDADM and cDADM treatments led to significantly higher proportions of correct decisions, which were also motivated more accurately. There is significant evidence that the relative advantage of discrimination-aware techniques depends on their intended usage. For users focussed on making and motivating their decisions in non-discriminatory ways, cDADM resulted in more accurate and less discriminatory results than eDADM. For users focussed on monitoring for preventing discriminatory decisions and motivating these conclusions, eDADM yielded more accurate results than cDADM. (shrink)

Although clinical ethics support services are becoming increasingly prevalent in Europe and North America, they remain an uncommon feature of the Irish healthcare system and Irish health professionals lack formal support when faced with ethically challenging cases. We have developed a variant on existing clinical ethics decision-making tools which is designed to build capacity and confidence amongst Irish practitioners and enable them to confront challenging situations in the absence of any dedicated support structure. The tool (...) provided below follows a transparent stepwise procedure which avoids an overcomplicated analysis while remaining sensitive to the complexity of the issues addressed. The novelty of the tool lies in the explicit association it makes between each step in the process and one or more responsibilities based on established norms of ethical decision-making in the public domain. (shrink)

Background Given that AI-driven decision support systems (AI-DSS) are intended to assist in medical decision making, it is essential that clinicians are willing to incorporate AI-DSS into their practice. This study takes as a case study the use of AI-driven cardiotography (CTG), a type of AI-DSS, in the context of intrapartum care. Focusing on the perspectives of obstetricians and midwives regarding the ethical and trust-related issues of incorporating AI-driven tools in their practice, this paper explores the (...) conditions that AI-driven CTG must fulfill for clinicians to feel justified in incorporating this assistive technology into their decision-making processes regarding interventions in labor. Methods This study is based on semi-structured interviews conducted online with eight obstetricians and five midwives based in England. Participants were asked about their current decision-making processes about when to intervene in labor, how AI-driven CTG might enhance or disrupt this process, and what it would take for them to trust this kind of technology. Interviews were transcribed verbatim and analyzed with thematic analysis. NVivo software was used to organize thematic codes that recurred in interviews to identify the issues that mattered most to participants. Topics and themes that were repeated across interviews were identified to form the basis of the analysis and conclusions of this paper. Results There were four major themes that emerged from our interviews with obstetricians and midwives regarding the conditions that AI-driven CTG must fulfill: (1) the importance of accurate and efficient risk assessments; (2) the capacity for personalization and individualized medicine; (3) the lack of significance regarding the type of institution that develops technology; and (4) the need for transparency in the development process. Conclusions Accuracy, efficiency, personalization abilities, transparency, and clear evidence that it can improve outcomes are conditions that clinicians deem necessary for AI-DSS to meet in order to be considered reliable and therefore worthy of being incorporated into the decision-making process. Importantly, healthcare professionals considered themselves as the epistemic authorities in the clinical context and the bearers of responsibility for delivering appropriate care. Therefore, what mattered to them was being able to evaluate the reliability of AI-DSS on their own terms, and have confidence in implementing them in their practice. (shrink)

Operating universities under pandemic conditions is a complex undertaking. The Artificial University responds to this need. TAU is a configurable, open-source computer simulation of a university using a contact network based on publicly available information about university classes, residences, and activities. This study evaluates health outcomes for an array of interventions and testing protocols in an artificial university of 6,500 students, faculty, and staff. Findings suggest that physical distancing and centralized contact tracing are most effective at reducing infections, but there (...) is a tipping point for compliance below which physical distancing is less effective. If student compliance is anything short of high, it helps to have separate buildings for quarantining infected students, thereby gracefully increasing compliance. Hybrid in-person and online classes and closing fitness centers do not significantly change cumulative infections but do significantly decrease the number of the infected at any given time, indicating strategies for “flattening the curve” to protect limited resources. Supplementing physical distancing with centralized contact tracing decreases infected individuals by an additional 14%; boosting frequency of testing for student-facing staff yields a further 7% decrease. A trade-off exists between increasing the sheer number of infection tests and targeting testing for key nodes in the contact network. There are significant advantages to getting and acting on test results quickly. The costs and benefits to universities of these findings are discussed. Artificial universities can be an important decision support tool for universities, generating useful policy insights into the challenges of operating universities under pandemic conditions. (shrink)

Contemporary medical diagnostics has a dynamic moral landscape, which includes a variety of agents, factors, and components. A significant part of this landscape is composed of information technologies that play a vital role in doctors’ decision-making. This paper focuses on the so-called Intelligent Decision-Support System that is widely implemented in the domain of contemporary medical diagnosis. The purpose of this article is twofold. First, I will show that the IDSS may be considered a moral agent in the (...) practice of medicine today. To develop this idea I will introduce the approach to artificial agency provided by Luciano Floridi. Simultaneously, I will situate this approach in the context of contemporary discussions regarding the nature of artificial agency. It is argued here that the IDSS possesses a specific sort of agency, includes several agent features (e.g. autonomy, interactivity, adaptability), and hence, performs an autonomous behavior, which may have a substantial moral impact on the patient’s well-being. It follows that, through the technology of artificial neural networks combined with ‘deep learning’ mechanisms, the IDSS tool achieves a specific sort of independence (autonomy) and may possess a certain type of moral agency. Second, I will provide a conceptual framework for the ethical evaluation of the moral impact that the IDSS may have on the doctor’s decision-making and, consequently, on the patient’s wellbeing. This framework is the Object-Oriented Model of Moral Action developed by Luciano Floridi. Although this model appears in many contemporary discussions in the field of information and computer ethics, it has not yet been applied to the medical domain. This paper addresses this gap and seeks to reveal the hidden potentialities of the OOP model for the field of medical diagnosis. (shrink)

The requirement for anthropocentric, or human-centred decision support is outlined, and the IDIOMS management information tool, which implements several human-centred principles, is described. IDIOMS provides a flexible decision support environment in which applications can be modelled using both ‘objective’ database information, and user-centred ‘subjective’ and contextual information. The system has been tested on several real applications, demonstrating its power and flexibility.

At the Donald Berman Laboratory for Information Technology and Law, La TrobeUniversity Australia, we have been building legal decision support systems for a dozenyears. Whilst most of our energy has been devoted to conducting research in ArtificialIntelligence and Law, over the past few years we have increasingly focused uponbuilding legal decision support systems that have a commercial focus.In this paper we discuss the evolution of our systems. We begin with a discussion ofrule-based systems and discuss the (...) transition to hybrid rule-based/case-based systems.We next discuss how we have used machine learning in building legal decision supportsystems. Our focus on using machine learning led us to investigate the domains ofexplanation and argumentation. We conclude by discussing our current work onbuilding negotiation support systems and tools for constructing web-based legaldecision support systems. (shrink)

In light of the potential long-term societal and economic benefits of novel nano-enabled products, there is an evident need for research and development to focus on closing the gap in nano-materials safety. Concurrent reflection on the impact of decision-making tools, which may lack the capability to assist sophisticated judgements around the risks and benefits of the introduction of novel products, is essential. This paper addresses the potential for extant decision support tools to default to a (...) precautionary principle position in the face of uncertainty. A more utilitarian-based approach could be facilitated by adding simple methods to formulate realistic hypotheses, which would assist non-specialists to make more nuanced decisions in terms of managing the risks of introducing new NMs. A decision support analytical framework is applied to identify the potential risks and benefits of novel nano-enabled products such as textiles with in-built enhanced antimicrobial activity for the prevention of nosocomial infections produced by spray or sonochemical coating possesses. While the results demonstrate valuable societal and environmental benefits compared to conventional products, due to uncertainty regarding the possible hazard to humans, sizable risks were identified in some cases due to the precautionary principle. (shrink)

The Ethical Matrix was developed to help decision-makers explore the ethical issues raised by agri-food biotechnologies. Over the decade since its inception the Ethical Matrix has been used by a number of organizations and the philosophical basis of the framework has been discussed and analyzed extensively. The role of tools such as the Ethical Matrix in public policy decision-making has received increasing attention. In order to further develop the methodological aspects of the Ethical Matrix method, work was (...) carried out to study the potential role of the Ethical Matrix as a decision support framework. When considering which frameworks to apply when analyzing the ethical dimensions of the application of agri-food biotechnologies, it is important to clarify the substantive nature of any prospective framework. In order to further investigate this issue, reflections on the neologism “ethical soundness” of an ethical framework are presented here. This concept is introduced in order to provide more structured evaluations of a range of ethical tools, including ethical frameworks such as the Ethical Matrix. As well as examining the philosophical dimensions of the method, theoretical analysis and literature studies were combined with stakeholder engagement exercises and consultations in order to review the Ethical Matrix from a user perspective. This work resulted in the development of an Ethical Matrix Manual, which is intended to act as a guide for potential user groups. (shrink)

Decision-makers in governments, enterprises, businesses and agencies or individuals, typically, make decisions according to various regulations, guidelines and policies based on existing records stored in various databases, in particular, relational databases. To assist decision-makers, an expert system, encompasses interactive computer-based systems or subsystems to support the decision-making process. Typically, most expert systems are built on top of transaction systems, databases, and data models and restricted in decision-making to the analysis, processing and presenting data and information, (...) and they do not provide support for the normative layer. This paper will provide a solution to one specific problem that arises from this situation, namely the lack of tool/mechanism to demonstrate how an expert system is well-suited for supporting decision-making activities drawn from existing records and relevant legal requirements aligned existing records stored in various databases.We present a Rule-based reporting systems architecture, which is intended to integrate databases, in particular, relational databases, with a logic-based reasoner and rule engine to assist in decision-making or create reports according to legal norms. We argue that the resulting RuleRS provides an efficient and flexible solution to the problem at hand using defeasible inference. To this end, we have also conducted empirical evaluations of RuleRS performance. (shrink)

Background and PurposeMany critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients’ preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission (...) and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making. Before introducing the tool into the admissions routine, the staff were educated about its use and value to the decision-making process.Project and MethodsThe study was to determine if early use of a simple method of identifying a patient’s surrogate and treatment preferences might impact length of stay (LOS) and total hospital charges. A pre- and post-intervention study design was used. Nurses completed the surrogacy information tool for all patients upon admission to the neuroscience ICU. Subjects (total N=203) were critically ill patients who had been on a mechanical ventilator for 96 hours or longer, or in the ICU for seven days or longer. The project included staff education on biomedical ethics, critical communication skills, early identification of families and staff in crisis, and use of a simple tool to document patients’ surrogates and previously expressed care wishes. Data on hospital LOS and hospital charges were collected through a retrospective review of medical records for similar four-month time frames pre- and post-implementation of the assessment tool.ResultsSignificant differences were found between pre- and post-groups in terms of hospital LOS (F=6.39, p=.01) and total hospital charges (F=7.03, p=.009).ConclusionsProject findings indicate that the use of a simple admission assessment tool, supported by staff education about its completion, use, and available resources, can decrease LOS and lower total hospital charges. The reasons for the difference between the pre- and post-intervention groups remain unclear. Further research is needed to evaluate if the quality of communications between patients, their legally authorized representatives, and clinicians—as suggested in the literature—may have played a role in decreasing LOS and total hospital charges. (shrink)

A new Clinical Ethics Advisory Group was created to contribute to NHS Trust policies and guidelines in response to ethical issues arising from the COVID-19 pandemic. An ethical analysis framework used in medical education, the CoRE-Values Compass and Grid, was adapted to form a step-wise ‘ABC’ decision-making process. CEAG members found the framework simple to understand and use and the model facilitated time-efficient decisions that were explicitly justifiable on moral, ethical, professional and legal grounds. The adapted CoRE-Values framework might (...) help facilitate decision-making processes for similar new clinical ethics advisory or support committees. (shrink)

Standpoint epistemology, the view that social identity is relevant to knowledge-acquisition, has been consigned to the margins of mainstream philosophy. In part, this is because the principles of standpoint epistemology are taken to be in opposition to those which guide traditional epistemology. One goal of this paper is to tease out the characterization of traditional epistemology that is at odds with standpoint epistemology. The characterization of traditional epistemology that I put forth is one which endorses the thesis of intellectualism, the (...) view that knowledge does not depend on non-epistemic features. I then suggest that two further components – the atomistic view of knowers and aperspectivalism – can be usefully interpreted as supporting features of intellectualism. A further goal of this paper is to show that we ought to resist this characterization of traditional epistemology. I use pragmatic encroachment as a dialectical tool to motivate the denial of intellectualism, and consequently, the denial of both supporting components. I then attempt to show how it is possible to have a view, similar to pragmatic encroachment, that takes social identity, rather than stakes, to be the feature that makes a difference to what a person is in a position to know. (shrink)

This special issue of the Journal of Agricultural and Environmental Ethics presents so-called ethical tools that are developed to support systematic public deliberations about the ethical aspects of agricultural biotechnologies. This paper firstly clarifies the intended connotations of the term “ethical tools” and argues that such tools can support liberal democracies to cope with the issues that are raised by the application of genetic modification and other modern biotechnologies in agriculture and food production. The paper (...) secondly characterizes the societal discussion on agricultural biotechnology and defends the thesis that normative perspectives fuel this discussion, so one cannot come to grips with this discussion if one neglects these perspectives. The paper thirdly agrues that no such thing exists as “one” societal debate in which these issues should be discussed. There are several interwined debates, and different actors participate in different discourses. Some practical instruments are necessary in order to include the right issues in these debates. These instruments will be coined as “ethical tools,” since they are practical instruments that can be used (tools) in order to support debates and deliberative structures for a systematic engagement with ethical issues (hence, ethical tools). Finally, the paper clarifies the ethics of these ethical tools and presents the tools as discussed in the remainder of this special issue: 1) tools to include ethical issues in public consulation and involvement; 2) tools to support systematic reflection upon ethical issues in decision-making; and 3) tools to support explicit communication about values in the food chain. (shrink)

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

The Patients Changing Things Together (PATCHATT) programme supports individuals with a life-limiting illness to lead a change that matters to them. Individuals join a facilitated online peer support group to identify an issue they feel strongly about, plan for change and take action to bring that change about. The programme is developed and guided by a Programme Advisory Group with clinical and lay membership. This article charts the trialling of the patients changing thing together ethics pack, designed to (...) class='Hi'>support all members of the Programme Advisory Group in taking an equal role in ethical decision-making as they guide the programme's ongoing development. As a trial of its efficacy, the pack was used by the author to consider an ethical dilemma at the heart of the development of the Patients Changing Things Together programme, that is, is it ethical to offer a community palliative care programme which has the potential to bring participants harm as well as good? The author reports a strong ethical argument for offering this programme, while concluding the need for the Programme Advisory Group to make the final decision, using the Patients Changing Things Together ethics pack to consider the results of the evaluation of the programme's pilot. The article concludes that this pack provides an effective tool to guide ethical novices through the ethical complexities of developing a community-based palliative care intervention programme. It raises the issue that such inclusivity is achieved through a normative decision-making process which denies the fluidity and creativity which may inform the best ethical decision-making practice. (shrink)

Standpoint epistemology is committed to the view that some epistemic advantage can be drawn from the position of powerlessness. Call this theepistemic privilege thesis. This thesis stands in need of explication and support. In providing that explication and support, I first distinguish between two readings of the thesis: the thesis that marginalized social locations confer some epistemic advantages (the epistemic advantage thesis) and the thesis that marginalized standpoints generate better, more accurate knowledge (the standpoint thesis). I then develop (...) the former by appealing to the notion of epistemic peers available in the disagreement literature. I next turn to the latter thesis, arguing that consciousness-raising plays an analogous role in the achievement of a standpoint as training does in the achievement of expertise. The upshot of this analysis is that it clarifies that while marginalization is necessary (though not sufficient) for epistemic advantage, it is neither necessary nor sufficient for epistemic privilege. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Learning in Dramatic and Virtual Worlds:What Do Students Say About Complementarity and Future Directions?John O'Toole (bio) and Julie Dunn (bio)A top financial backer has arrived to determine which team of computer interaction designers has developed the most exciting and innovative proposal for the Everest component of the Virtually Impossible Computer Company's Conquerors of the World Series. Tension is high as the presentations begin, but this tension soon turns to (...) outright conflict as some proposals suggest George Mallory as the conqueror, and the financial backer will have none of him. The backer, it seems, has her own agenda and is determined to allow for only one view of history—the one that records Sir Edmund Hillary as a New Zealand hero and the only real conqueror of the tallest mountain on earth. The designers become more and more agitated until suddenly someone bangs their hand on the table and calls out, "Hang on... just because you've got the money doesn't mean... kids need to learn about both these men... they need to learn about history." With that the drama is cut by the teacher. The deep understandings about "history's purchased page" that can be generated when drama and computers are brought together for learning have been made explicit... but could these same outcomes have been achieved using just one of these approaches?IntroductionThe research explored within this article was generated as part of the Media Station, a project funded by the Australasian Collaborative Research Centre for Interaction Design (ACID), with an overall mission to investigate the potential of massively multiplayer online games for learning. This particular subproject, History's Purchased Page, saw researchers from interaction design [End Page 89] and drama education come together with a group of young learners to investigate their perceptions of the complementarity of computers and live classroom drama and to brainstorm future possibilities for applying computer-based technologies to drama-based learning. We sought to discover the following:• What do young learners say about how they experience and value learning in a context involving a combination of drama and computers?• What ideas do these young learners have about how future technologies might enrich the complementarity of this combination?As the drama researchers involved in this project, we had been experimenting with this perhaps slightly unusual combination for over a decade by incorporating computers into a number of our drama units within our primary textbook Pretending to Learn.1 Our goal in these experimentations had always been to enrich the classroom drama experience by taking advantage of the information capacity of the Internet and other computer-based resources, including databases. For example, we had used The First Fleet Database2 to support a drama unit where the learners take on the role of convicts arriving in Australia in 1788. We discovered that this material, combined with other documentation and historical materials available via the Internet, greatly enhanced not only the historical accuracy of the work but also the level of engagement experienced by the learners when in role. Therefore, we were very keen to extend this work by exploring new possibilities and were especially keen to develop a better understanding of what the learners made of this interactivity.In recent years the partnering of these two quite different approaches to learning has developed quite a research following, and a number of drama teachers and researchers have become interested in the complementarity of these ways of learning.3 At the same time, researchers and designers from the field of computer-assisted learning have also noted these connections. This goes back to the work of Brenda Laurel, who first drew attention to the intriguing links between computers and theatre in her now famous text Computers as Theatre.4 With the rapid growth of interactive learning tools such as 3-D immersive worlds, blogs, and online voice and text chat spaces, the opportunities for exploration of these connections have also grown, with each of these offering exciting new possibilities when used in conjunction with the highly interactive and engaging strategies of process drama.Process drama is a way of group learning, through whole-class improvised drama, with students (and sometimes the... (shrink)

Energy and Social Change results from the Twenty Year Forecast Project, directed by the author and conducted trhough the University of Southern California Center for Futures Research. Unlike many more gloomy predictions, this study takes a step back from pessimism. It offers instead a realistic perspective tempered with a modicum of optimism.The report's special contribution to the energy debate lies in its call for a redirection of attention to options that are realizable within the framework--and the limits--of the existing system. (...) Advocating higher energy prices and more incentives for increased competition in the domestic energy market, the author supports a resurgence of the free enterprise system. The price of energy will and should increase in order to control waste, although the rise in costs will be mitigated by the gradual pace. In the long term, however, we should strive for a "quality economy" characterized in part by its reduced inefficiency and more meaningful jobs. Three of the ways in which this might be accomplished are shifting to an electrically based economy, developing alternative forms of energy, and switching to technologies more appropriate to the future environment.Sure to generate discussion, this analysis will prove useful in considerations of energy policy and the social impact of technological change. (shrink)

Military employees face all sorts of moral dilemmas in their work. The way they resolve these dilemmas—how they decide to act based on their moral deliberations—can have a substantial impact both on society and on their personal lives. Hence, it makes sense to support military employees in dealing with these dilemmas. Military organizations already support their personnel by adopting compliance‐based approaches that focus, for instance, on enforcing moral rules. At the same time, however, they struggle to develop value‐based (...) approaches that could foster moral learning by improving employees' understanding of personal values, others' values, and their responsibility for others. Consequently, military employees are not adequately supported in their ethical decision‐making when confronted with complex situations. To address this issue, drawing on a design research approach, we develop and evaluate the use of a value‐based reflection tool to support military employees with their moral decision‐making. The design and evaluation of the value‐based reflection tool were informed by five semistructured interviews, notes on 45 joint reflection meetings with trainers, and evaluation notes of 755 participants. Our findings suggest the value‐based reflection tool is a promising way to foster actors' moral competence in organizational settings by triggering the social mechanisms of reflection, empathy, and psychological safety. This study is the first to illustrate that value‐based ethics support can complement compliance‐based ethics support in a military organization. Furthermore, it demonstrates design research's potential to develop actionable knowledge for ethics support practices in organizations. (shrink)

Citizens can be meaningfully involved in multiple phases of the urban planning process from decision-making to implementation via a dedicated online platform through which they can interact with planners and decision-makers. In historical contexts, local people are essential resources for decision-makers seeking critical local information needed for effective planning and intervention—including what those citizens recall from the past about the area’s social values and the built environment and what they imagine and hope for their neighborhood’s future. This (...) public knowledge, collected through storytelling and mapping, can play a fundamental role in shaping the framework for neighborhood rehabilitation plans. As a foundation for designing an online visual questionnaire to collect local knowledge and understand the views and expectations of local people, this study focuses on theoretical ideas to define a framework for an online visual questionnaire tool. The tool presented provides a common visual language that people can easily understand and use whatever their social class, education, or background. It also has the benefit of enabling citizens and planners to interact directly regardless of their geographical location. To proposing a framework for the online visual questionnaire, the first step was to review some existing visual tools and methods, including analog used for community engagement and digital used in urban planning to encourage and support public participation. Through an analysis of these methods, some important variables and criteria were identified that further our understanding of citizens’ perceptions of their neighborhoods. The next step, as part of a larger study, will be examining a historical public space, including a bazaar, hammam, and cistern—located in the historical context of Yazd— a central city in Iran registered as a cultural heritage site by UNESCO— as a case study with the larger goal of identifying some specific. (shrink)

BackgroundHealthcare providers have to make ethically complex clinical decisions which may be a source of stress. Researchers have recently introduced Artificial Intelligence (AI)-based applications to assist in clinical ethical decision-making. However, the use of such tools is controversial. This review aims to provide a comprehensive overview of the reasons given in the academic literature for and against their use.MethodsPubMed, Web of Science, Philpapers.org and Google Scholar were searched for all relevant publications. The resulting set of publications was title (...) and abstract screened according to defined inclusion and exclusion criteria, resulting in 44 papers whose full texts were analysed using the Kuckartz method of qualitative text analysis.ResultsArtificial Intelligence might increase patient autonomy by improving the accuracy of predictions and allowing patients to receive their preferred treatment. It is thought to increase beneficence by providing reliable information, thereby, supporting surrogate decision-making. Some authors fear that reducing ethical decision-making to statistical correlations may limit autonomy. Others argue that AI may not be able to replicate the process of ethical deliberation because it lacks human characteristics. Concerns have been raised about issues of justice, as AI may replicate existing biases in the decision-making process.ConclusionsThe prospective benefits of using AI in clinical ethical decision-making are manifold, but its development and use should be undertaken carefully to avoid ethical pitfalls. Several issues that are central to the discussion of Clinical Decision Support Systems, such as justice, explicability or human–machine interaction, have been neglected in the debate on AI for clinical ethics so far.Trial registrationThis review is registered at Open Science Framework (https://osf.io/wvcs9). (shrink)

Innovative research on decision making under ‘deep uncertainty’ is underway in applied fields such as engineering and operational research, largely outside the view of normative theorists grounded in decision theory. Applied methods and tools for decision support under deep uncertainty go beyond standard decision theory in the attention that they give to the structuring of decisions. Decision structuring is an important part of a broader philosophy of managing uncertainty in decision making, and (...) normative decision theorists can both learn from, and contribute to, the growing deep uncertainty decision support literature. (shrink)

The perspective of online dispute resolution is to develop an online electronic system aimed at solving out-of-court disputes. Among ODR schemes, eMediation is becoming an important tool for encouraging the positive settlement of an agreement among litigants. The main motivation underlying the adoption of eMediation is the time/cost reduction for the resolution of disputes compared to the ordinary justice system. In the context of eMediation, a fundamental requirement that an ODR system should meet relates to both litigants and mediators, i.e. (...) to enable an informed negotiation by informing the parties about the rights and duties related to the case. In order to match this requirement, we propose an information retrieval system able to retrieve relevant court decisions with respect to the disputant case description. The proposed system combines machine learning and natural language processing techniques to better match disputant case descriptions with court decisions. Experimental results confirm the ability of the proposed solution to empower court decision retrieval, enabling therefore a well-informed eMediation process. (shrink)

The co-occurrence of stress-induced posttraumatic stress disorder and obesity is common, particularly among military personnel but the link between these conditions is unclear. Individuals with comorbid PTSD and obesity manifest other physical and psychological problems, which significantly diminish their quality of life. Current understanding of the pathways connecting stress to PTSD and obesity is focused largely on behavioral mediators alone with little consideration of the biological regulatory mechanisms that underlie their co-occurrence. In this work, we leverage prior knowledge to systematically (...) highlight such bio-behavioral mechanisms and inform on the design of confirmatory pilot studies. We use natural language processing to extract documented regulatory interactions involved in the metabolic response to stress and its impact on obesity and PTSD from over 8 million peer-reviewed papers. The resulting network describes the propagation of stress to PTSD and obesity through 34 metabolic mediators using 302 documented regulatory interactions supported by over 10,000 citations. Stress jointly affected both conditions through 21 distinct pathways involving only two intermediate metabolic mediators out of a total of 76 available paths through this network. Moreover, oxytocin, Neuropeptide-Y, and cortisol supported an almost direct propagation of stress to PTSD and obesity with different net effects. Although stress upregulated both NPY and cortisol, the downstream effects of both markers are reported to relieve PTSD severity but exacerbate obesity. The stress-mediated release of oxytocin, however, was found to concurrently downregulate the severity of both conditions. These findings highlight how a network-informed approach that leverages prior knowledge might be used effectively in identifying key mediators like OXT though experimental verification of signal transmission dynamics through each path will be needed to determine the actual likelihood and extent of each marker’s participation. (shrink)

The faces of both adults and children can be classified accurately by sex, even in the absence of sex‐stereotyped social cues such as hair and clothing (Wild et al., 2000). Although much is known from psychological and computational studies about the information that supports sex classification for adults' faces, children's faces have been much less studied. The purpose of the present study was to quantify and compare the information available in adults' versus children's faces for sex classification and to test (...) alternative theories of how human observers distinguish male and female faces for these different age groups. We implemented four computational/neural network models of this task that differed in terms of the age categories from which the sex classification features were derived. Two of the four strategies replicated the advantage for classifying adults' faces found in previous work. To determine which of these strategies was a better model of human performance, we compared the performance of the two models with that of human subjects at the level of individual faces. The results suggest that humans judge the sex of adults' and children's faces using feature sets derived from the appropriate face age category, rather than applying features derived from another age category or from a combination of age categories. (shrink)

The faces of both adults and children can be classified accurately by sex, even in the absence of sex‐stereotyped social cues such as hair and clothing (Wild et al., 2000). Although much is known from psychological and computational studies about the information that supports sex classification for adults' faces, children's faces have been much less studied. The purpose of the present study was to quantify and compare the information available in adults' versus children's faces for sex classification and to test (...) alternative theories of how human observers distinguish male and female faces for these different age groups. We implemented four computational/neural network models of this task that differed in terms of the age categories from which the sex classification features were derived. Two of the four strategies replicated the advantage for classifying adults' faces found in previous work. To determine which of these strategies was a better model of human performance, we compared the performance of the two models with that of human subjects at the level of individual faces. The results suggest that humans judge the sex of adults' and children's faces using feature sets derived from the appropriate face age category, rather than applying features derived from another age category or from a combination of age categories. (shrink)

Today, French public debate and bioethics research reflect an ongoing controversy about eugenics. The field of reproductive medicine is often targeted as pre-implantation genetic diagnosis (PGD), prenatal diagnosis, and prenatal detection are accused of drifting towards eugenics or being driven by eugenics considerations. This article aims at understanding why the charge against eugenics came at the forefront of the ethical debate. Above all, it aims at showing that the charge against prenatal diagnosis is groundless. The point of view presented in (...) this article has been elaborated jointly by a geneticist and a philosopher. Besides a survey of the medical, bioethical, philosophical and social sciences literature on the topic, the methodology is founded on a joint analysis of geneticist’s various consults. Evidence from office visits demonstrated that prenatal diagnosis leads to case-by-case decisions. As we have suggested, this conclusion does not mean that prenatal diagnosis is devoid of ethical issues, and we have identified at least two. The first is related to the evaluation of a decision to abort. The second line of ethical questions arises from the fact that the claim for “normality” hardly hides normative and ambiguous views about disability. As a conclusion, ethical dilemmas keep being noticeable in the field of reproductive medicine and genetic counselling, but an enquiry about eugenic tendencies probably does not allow us to understand them in the proper way. (shrink)

We argue that providing cumulative risk as an estimate of the uncertainty in dynamically changing risky environments can help decision-makers meet mission-critical goals. Specifically, we constructed a simplified aviation-like weather decision-making task incorporating Next-Generation Radar images of convective weather. NEXRAD radar images provide information about geographically referenced precipitation. NEXRAD radar images are used by both pilots and laypeople to support decision-making about the level of risk posed by future weather-hazard movements. Using NEXRAD, people and professionals have (...) to infer the uncertainty in the meteorological information to understand current hazards and extrapolate future conditions. Recent advancements in meteorology modeling afford the possibility of providing uncertainty information concerning hazardous weather for the current flight. Although there are systematic biases that plague people’s use of uncertainty information, there is evidence that presenting forecast uncertainty can improve weather-related decision-making. The current study augments NEXRAD by providing flight-path risk, referred to as the Risk Situational Awareness Tool. RSAT provides the probability that a route will come within 20 NMI radius of hazardous weather within the next 45 min of flight. The study evaluates four NEXRAD displays integrated with RSAT, providing varying levels of support. The “no” support condition has no RSAT. The “baseline” support condition employs an RSAT whose accuracy is consistent with current capability in meteorological modeling. The “moderate” support condition applies an RSAT whose accuracy is likely at the top of what is achievable in meteorology in the near future. The “high” support condition provides a level of support that is likely unachievable in an aviation weather decision-making context without considerable technological innovation. The results indicate that the operators relied on the RSAT and improved their performance as a consequence. We discuss the implications of the findings for the safe introduction of probabilistic tools in future general aviation cockpits and other dynamic decision-making contexts. Moreover, we discuss how the results contribute to research in the fields of dynamic risk and uncertainty, risk situation awareness, cumulative risk, and risk communication. (shrink)

Deep learning models are powerful tools for representing the complex learning processes and decision-making strategies used by humans. Such neural network models make fewer assumptions about the underlying mechanisms thus providing experimental flexibility in terms of applicability. However, this comes at the cost of involving a larger number of parameters requiring significantly more data for effective learning. This presents practical challenges given that most cognitive experiments involve relatively small numbers of subjects. Laboratory collaborations are a natural way to (...) increase overall dataset size. However, data sharing barriers between laboratories as necessitated by data protection regulations encourage the search for alternative methods to enable collaborative data science. Distributed learning, especially federated learning, which supports the preservation of data privacy, is a promising method for addressing this issue. To verify the reliability and feasibility of applying FL to train neural networks models used in the characterization of decision making, we conducted experiments on a real-world, many-labs data pool including experiment data-sets from ten independent studies. The performance of single models trained on single laboratory data-sets was poor. This unsurprising finding supports the need for laboratory collaboration to train more reliable models. To that end we evaluated four collaborative approaches. The first approach represents conventional centralized learning and is the optimal approach but requires complete sharing of data which we wish to avoid. The results however establish a benchmark for the other three approaches, federated learning, incremental learning, and cyclic incremental learning. We evaluate these approaches in terms of prediction accuracy and capacity to characterize human decision-making strategies. The FL-based model achieves performance most comparable to that of the CL-based model. This indicates that FL has value in scaling data science methods to data collected in computational modeling contexts when data sharing is not convenient, practical or permissible. (shrink)

This article reviews suggestions for how ethical tools are to be evaluated and argues that the concept of ethical soundness as presented by Kaiser et al. is unhelpful. Instead, it suggests that the quality of an ethical tool is determined by how well it achieves its assigned purpose. Those are different for different tools, and the article suggests a categorization of such tools into three groups. For all ethical tools, it identifies comprehensiveness and user-friendliness as crucial. (...) For tools that have reaching a decision in a democratic context as a main purpose, it identifies transparency, guiding users toward a decision and justification of the decision-supporting mechanism. For tools that aim to engage the public, it identifies procedural fairness as essential. It also notes that the scope of use for ethical tools is limited to the same moral community, and that this feature is frequently overlooked. (shrink)

Decision-making capacity is the gatekeeping element for a patient’s right to self-determination with regard to medical decisions. A DMC evaluation is not only conducted on descriptive grounds but is an inherently normative task including ethical reasoning. Therefore, it is dependent to a considerable extent on the values held by the clinicians involved in the DMC evaluation. Dealing with the question of how to reasonably support clinicians in arriving at a DMC judgment, a new tool is presented that fundamentally (...) differs from existing ones: the U-Doc. By putting greater emphasis on the judgmental process rather than on the measurement of mental abilities, the clinician as a decision-maker is brought into focus, rendering the tool more of an evaluation guide than a test instrument. In a qualitative study, the perceived benefits of and difficulties with the tool have been explored. The findings show on the one hand that the evaluation aid provides basic orientation, supports a holistic perspective on the patient, sensitizes for ethical considerations and personal biases, and helps to think through the decision, to argue, and to justify one’s judgment. On the other hand, the room for interpretation due to absent operationalisations, related ambiguities, and the confrontation with one’s own subjectivity may be experienced as unsettling. (shrink)

Faces provide information about a person's identity, as well as their sex, age, and ethnicity. People also infer social and personality traits from the face — judgments that can have important societal and personal consequences. In recent years, deep convolutional neural networks (DCNNs) have proven adept at representing the identity of a face from images that vary widely in viewpoint, illumination, expression, and appearance. These algorithms are modeled on the primate visual cortex and consist of multiple processing layers of simulated (...) neurons. Here, we examined whether a DCNN trained for face identification also retains a representation of the information in faces that supports social‐trait inferences. Participants rated male and female faces on a diverse set of 18 personality traits. Linear classifiers were trained with cross validation to predict human‐assigned trait ratings from the 512 dimensional representations of faces that emerged at the top‐layer of a DCNN trained for face identification. The network was trained with 494,414 images of 10,575 identities and consisted of seven layers and 19.8 million parameters. The top‐level DCNN features produced by the network predicted the human‐assigned social trait profiles with good accuracy. Human‐assigned ratings for the individual traits were also predicted accurately. We conclude that the face representations that emerge from DCNNs retain facial information that goes beyond the strict limits of their training. (shrink)

Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in (...) maternity care. Discussion between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

As we increasingly delegate decision-making to algorithms, whether directly or indirectly, important questions emerge in circumstances where those decisions have direct consequences for individual rights and personal opportunities, as well as for the collective good. A key problem for policymakers is that the social implications of these new methods can only be grasped if there is an adequate comprehension of their general technical underpinnings. The discussion here focuses primarily on the case of enforcement decisions in the criminal justice system, (...) but draws on similar situations emerging from other algorithms utilised in controlling access to opportunities, to explain how machine learning works and, as a result, how decisions are made by modern intelligent algorithms or 'classifiers'. It examines the key aspects of the performance of classifiers, including how classifiers learn, the fact that they operate on the basis of correlation rather than causation, and that the term 'bias' in machine learning has a different meaning to common usage. An example of a real world 'classifier', the Harm Assessment Risk Tool (HART), is examined, through identification of its technical features: the classification method, the training data and the test data, the features and the labels, validation and performance measures. Four normative benchmarks are then considered by reference to HART: (a) prediction accuracy (b) fairness and equality before the law (c) transparency and accountability (d) informational privacy and freedom of expression, in order to demonstrate how its technical features have important normative dimensions that bear directly on the extent to which the system can be regarded as a viable and legitimate support for, or even alternative to, existing human decision-makers. (shrink)

This book deals with the theoretical, methodological, and empirical implications of bounded rationality in the operation of institutions. It focuses on decisions made under uncertainty, and presents a reliable strategy of knowledge acquisition for the design and implementation of decision-support systems. Based on the distinction between the inner and outer environment of decisions, the book explores both the cognitive mechanisms at work when actors decide, and the institutional mechanisms existing among and within organizations that make decisions fairly predictable. (...) While a great deal of work has been done on how organizations act as patterns of events for (boundedly) rational decisions, less effort has been devoted to study under which circumstances organizations cease to act as such reliable mechanisms. Through an empirical strategy on open-ended response data from a survey among junior judges, the work pursues two main goals. The first one is to explore the limits of "institutional rationality" of the Spanish lower courts on-call service, an optimal scenario to observe decision-making under uncertainty. The second aim is to achieve a better understanding of the kind of uncertainty under which inexperienced decision-makers work. This entails exploring the demands imposed by problems and the knowledge needed to deal with them, making this book also a study on expertise achievement in institutional environments. This book combines standard multivariate statistical methods with machine learning techniques such as multidimensional scaling and topic models, treating text as data. Doing so, the book contributes to the collaboration between empirical social scientific approaches and the community of scientists that provide the set of tools and methods to make sense of the fastest growing resource of our time: data. (shrink)

Public decisions concerning large projects with detrimental environmental or heritage impacts involve value conflicts which stem from the diverse interests and variety of ways of evaluating the costs and benefits of such projects. They are also framed by institutionalised procedures and practices which favour certain concerns to the detriment of others. This paper aims to contribute towards a better understanding of how these procedures and practices, namely decision support tools such as the Environmental Impact Assessment (EIA), tend (...) to shape public decision-making processes in particular ways. It draws on a study of the public controversy surrounding the Foz Tua dam in Portugal, with a focus on the values upheld by the different parties in the controversy and their interplay in the production of justifications, specifically the actors’ positions on values and value conflicts and the restrictions posed by institutionalised public decision-making procedures on the expression and consideration of certain values. (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-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)

The concept of transformative decision rules provides auseful tool for analyzing what is often referred to as the`framing', or `problem specification', or `editing' phase ofdecision making. In the present study we analyze a fundamentalaspect of transformative decision rules, viz. permutability. A setof transformative decision rules is, roughly put, permutable justin case it does not matter in which order the rules are applied.It is argued that in order to be normatively reasonable, sets oftransformative decision rules have to (...) satisfy a number ofstructural conditions that together imply permutability. Thisformal result gives support to a non-sequential theory of framing,i.e., a theory which prescribes no uniform order in which differentsteps in the framing process have to be performed. (shrink)

Developers and designers make all sorts of moral decisions throughout an innovation project. In this article, we describe how teams of developers and designers engaged with ethics in the early phases of innovation based on case studies in the SUBCOP project. For that purpose, Value Sensitive Design will be used as a reference. Specifically, we focus on the following two research questions: How can researchers/developers learn about users’ perspectives and values during the innovation process? and How can researchers/developers take into (...) account these values, and related design criteria, in their decision-making during the innovation process? Based on a case study of several innovation processes in this project, we conclude the researchers/developers involved are able to do something similar to VSD, supported by relatively simple exercises in the project, e.g., meetings with potential end-users and discussions with members of the Ethical Advisory Board of the project. Furthermore, we also found—possibly somewhat counterintuitively—that a commercial, with its focus on understanding and satisfying customers’ needs, can promote VSD. (shrink)

As a learning tool, argument and decision maps enable students to hone their interpretive and analytical skills. This paper illustrates one effective approach to teaching the diagrammat­ic conventions used in a powerful decision and argument mapping methodology. The twenty example maps included begin with a configuration illustrating one reason offered in support of a conclusion, and build to highly complex maps illustrating the analyses of real world decisions as recorded in interviews and official documents. Using their interpretive (...) and analytical skills, and the simple conventions taught and illustrated here, students and researchers are able to build and to refine maps that show simple arguments, lines of reasoning, unspoken but implicit as­sumptions, pro and con argumentation, individual and group decision making, the influences of reactive cognitive heuristics on decision making, the use of various familiar valid and fallacious inference patterns, and the bolstering phenomenon associated with the use of multiple arguments in support of a given option. (shrink)

Photo ID 72893750 © Rawpixelimages|Dreamstime.com ABSTRACT Solidarity is a concept increasingly employed in bioethics whose application merits further clarity and explanation. Given how vital cooperation and community-level care are to mitigating communicable disease transmission, we use lessons from the COVID-19 pandemic to reveal how solidarity is a useful descriptive and analytical tool for public health scholars, practitioners, and policymakers. Drawing upon an influential framework of solidarity that highlights how solidarity arises from the ground up, we reveal how structural forces can (...) impact the cultivation of solidarity from the top down, particularly through ensuring robust access to important social determinants of health. Public health institutions can support solidarity movements among individuals and communities by adopting a lens of social justice when considering public health priorities and, in turn, promote health equity. INTRODUCTION Over the past two decades, scholars have invoked the concept of solidarity when assessing a wide range of topics in bioethics, from CRISPR-Cas9 technology to organ donation to structural racism.[1] However, the growing literature on solidarity has not fully examined the roles and responsibilities of institutions and governments in fostering solidarity, especially regarding public health measures that implicate entire populations. We argue that it remains unclear how public health institutions should engage with solidarity and how their engagement will affect public health and its ethics. We first take Prainsack and Buyx’ three-tiered framework as an analytical starting point.[2] We then explore how public health institutions can foster solidarity by carefully considering factors that may bolster it on an interpersonal, community, and national scale. We conclude that public health institutions should adopt a lens of social justice to promote solidarity at the interpersonal and community levels, thereby promoting equity in future public health efforts. BACKGROUND Calls for solidarity in bioethics raise longstanding normative questions about the nature and limits of our duties to one another and how to weigh autonomy over considerations of justice.[3] Though the term is diversely applied, Prainsack and Buyx propose a potentially unifying definition in the 2011 Nuffield Council report, “Solidarity: Reflections On An Emerging Concept in Bioethics.” The report defines solidarity as an activity involving “shared practices reflecting a collective commitment to carry financial, social, emotional, and or other ‘costs’ to assist others.” Their conceptualization also includes important features that distinguish solidarity from other values like empathy or altruism: solidarity emphasizes action rather than mere internal feeling and recognition of connection as motivation.[4] Bioethicists have since applied this conceptualization when analyzing issues in public and global health, given that population-level efforts need cooperation from individuals and communities. Prainsack and Buyx further note that solidarity is relevant in bioethics discourses about justice and equity, in support of providing aid to low- and middle-income countries, and as a value exemplified by European welfare states.[5] Other bioethicists have argued that promoting solidarity can contribute to community engagement, partnership with Tribal communities, and global health equity.[6] Most recently, scholars have applied solidarity as a lens to assess the COVID-19 pandemic, highlighting the pitfalls of national mitigation efforts and global disparities in disease outcomes.[7] I. Solidarity at Three Levels It seems impossible to foster solidarity in public health if we cannot identify it in general contexts. Prainsack and Buyx articulate three levels of solidarity: interpersonal solidarity, group solidarity, and legal or contractual codifications of solidarity.[8] They argue that each level inherently informs the one ‘above’ it in a unilateral direction. In other words, solidarity is fundamentally a bottom-up phenomenon. Solidarity among individuals influences group norms, which then have the potential to shape policy and institutional practice.[9] Within the Prainsack and Buyx framework, it would seem nonsensical to posit how solidarity might be expressed vertically or from the “top down.” It appears intuitively odd to imagine how a government entity might ‘be’ in solidarity with a person or group if solidarity requires some cognition about their condition per Prainsack and Buyx’ definition. Some have argued that solidarity does not seem like something that one can impose, as instances of it arise from agents recognizing and acting upon some bond rather than in response to a command. Indeed, people may be rightfully hesitant to engage in solidarity if the official messaging is overly paternalistic or coercive.[10] However, some authors have countered that governments can express solidarity through enacting structural and policy changes, though it is ambiguous how these actions are distinct from a justice-driven approach.[11] If a bottom-up approach is thus the most practical means of achieving policy that reflects solidarity, then it does not add much to public health. Institutions would be ineffective without the population’s initiation of the corresponding social norms. However, we find this conclusion overly pessimistic. Fostering a culture of solidarity to improve public health has potential merit. Prainsack and Buyx’ framework overlooks how public health actors can influence solidarity between individuals and across communities. To clarify, we agree with the view that solidarity is a bottom-up phenomenon. Solidarity may not be able to originate in a top-down fashion, but we suggest that public health institutions can take a more active role in providing the public with accurate information, promoting social justice, and intervening in the social determinants of health. II. The COVID-19 Pandemic as a Case Study Lessons learned from the ongoing COVID-19 pandemic support our argument. The pandemic deepened socioeconomic disparities in the US and hindered access to vital resources such as food, housing, and healthcare.[12] Prainsack recently noted: “[n]ext to the immediate health effects of the virus, poverty and grave inequalities have been the root causes of human suffering during the pandemic.”[13] Prior to the pandemic, many rural and low-income populations lacked reliable access to the internet and devices like laptops or smartphones. This continued lack of access restricts the flow of information and prevents people from accessing telemedicine services.[14] Preexisting social, political, and health inequities worsened health outcomes among many marginalized racial and ethnic groups. It is well-documented that communities of color, including Black, American Indian or Alaska Native, and Latinx populations, had greater COVID-related mortality and morbidity due to the effects of structural racism.[15] Although federal US agencies such as the Centers for Disease Control and Prevention enacted laws that provided safety nets (e.g., the Federal Eviction Moratorium), the majority of such programs have ended, leaving many with little assistance and the threat of further hardship.[16] These disparities are relevant because Prainsack, Buyx, and others note that solidarity arises from agents recognizing and acting on some perceived attainable collective goal(s). Income inequality and disparate access to food, education, and health care may lead people to consider public health goals unattainable. This could limit the desire to work toward those goals collectively.[17] The existing literature on collective action theory supports this intuition. It emphasizes that structural conditions, such as an absence of perceived hope for social change among a group, can lead to low ‘group efficacy’ and little willingness to cooperate, both within and across socioeconomic strata.[18] The pandemic spurred countless messages from public health agencies. The messaging did not recognize or attend to the different material realities and circumstances of the US population. How can people feel comfortable getting vaccinated if they deeply distrust the government, including public health institutions? How can people remain motivated to wear masks and distance themselves if they cannot afford basic necessities and work jobs without adequate pay and leave policies? We ask these questions to illustrate how socioeconomic disparities can marginalize people if they feel ignored, apathetic, or resentful of those better off or those in power whom they perceive to “not be doing enough.” This marginalization precludes the formation of solidarity. There are instances when a population has disparate access to resources and social capital, but solidarity may still emerge from a shared goal or vision for the future. For example, a heterogeneous population living in the same town may come together to protest an environmental injustice that impacts their water supply with the common goal of securing access to safe drinking water. However, many populations in the US failed to recognize shared goals of this kind during the COVID-19 pandemic. A significant minority of the US population was reluctant to acknowledge the severity of COVID-19 infection and thus refused to participate in efforts to mitigate its spread. Even between groups who shared the goal of slowing COVID-19 transmission, the methods were widely debated. Approximately 20 percent of the adult population eligible for vaccination remains unvaccinated.[19] Governmental bodies responsible for disseminating information, coordinating the allocation of resources, and establishing guidelines have a large role in mediating these disagreements and intervening in socioeconomic conditions that impact people's ability and willingness to engage in solidarity. III. Solidarity, Social Justice, and the Role of Public Health Institutions Adopting a lens of social justice provides further insights into how public health actors impact solidarity. Powers and Faden argue that the “foundational moral justification for the social institution of public health is social justice.”[20] Their theory of social justice has two aims. First, it ensures that everyone has a sufficient amount of the six core elements of well-being and that public health institutions are responsible for “adopting policies and creating environments” where all can flourish.[21] Second, public health institutions should distribute resources meant to promote well-being and focus on the “needs of those who are the most disadvantaged.”[22] Public health institutions should enact policies that address injustice. In doing so, public health institutions can seed the opportunity to build solidarity from the bottom up. Equipping individuals and communities with resources will foster cooperation and adherence to policies that require solidarity, such as masking and vaccination. This is consistent with arguments illustrating how institutions such as Tribal governments promote the conditions needed for their group, and especially its most vulnerable members, to flourish.[23] Addressing social determinants of health with a social justice lens will create the circumstances under which more individuals and groups can find common causes and foster solidarity. In the long run, such efforts may result in the establishment of values and practices from the bottom up. There are societal and public health preconditions required before institutions can expect their audience to act in solidarity with one another. Through their great influence over information and resources, public institutions do have the power to impact what values are most widespread. Furthermore, public health may foster trust and hope, which are important psychosocial factors that influence collective action,[24] if policies increase access to resources that promote well-being. Messaging efficacy also depends on the context of public trust, education, and whether the institutions meet one’s basic needs. Disparate messaging across different public institutions may confuse or disillusion individuals. To apply our theory of solidarity to the decision to vaccinate, a policy would be to foster conditions that facilitate access to vaccines and information about vaccine efficacy instead of imposing a top-down mandate without first eliciting public trust. IV. Counterargument Some argue that discordant public health messaging, ineffective government, and inadequate social programs can also bring people together under pressure and foster solidarity. One may argue that the most powerful motivators towards solidarity are strife and disparity, as evidenced throughout history. During the pandemic alone, political struggle and personal hardship inspired solidarity in the US, from individual neighbors helping each other to mutual aid groups forming across communities. We thus do not claim that solidarity is possible only when our government programs and public health institutions are most effective. We instead point out that solidarity can be further hindered when people feel alienated, hopeless, and pitted against each other. CONCLUSION Many competing conceptualizations of solidarity persist in the bioethics literature, and Prainsack and Buyx offer one compelling framework that public health ethicists continue to draw upon.[25] However, their framework fails to acknowledge how public health institutions impact interpersonal and group solidarity. Public health institutions can foster solidarity through actions other than mere messaging, invoking catchphrases like “we are all in this together.” Efforts to address socioeconomic preconditions and alleviate health disparities can cultivate group solidarity. As we saw during the pandemic, cooperation and solidarity go hand-in-hand with disease mitigation efforts; solidarity has clear intrinsic value.[26] As this relationship becomes more apparent, we will continue to see attempts from public health institutions to foster or invoke solidarity. Therefore, public health institutions would be remiss to ignore their role in addressing the social determinants of health. Adopting a social justice lens when planning public health interventions will clarify and strengthen their role in facilitating solidarity. Ultimately, if health disparities continue to persist or widen, it is very hard to imagine how group solidarity can ever be achieved. The widescale adoption of many public health measures needed to promote health and well-being would be conducive to solidarity. - Disclaimer: The opinions expressed are the authors’ and do not represent the views of the NIH, DHHS, or the U.S. government. 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