Recent theories on cognitive science have stressed the significance of moral intuition as a counter to and complementary part of moral reasoning in decision making. Thus, the aim of this paper is to create an integrated framework that can account for both intuitive and reflective cognitive processes, in order to explore the antecedents of ethical decision making. To do that, we build on Scholasticism, an important medieval school of thought from which descends the main pillars (...) of the modern Catholic social doctrine. Particularly, the focus will be on the scholastic concept of synderesis, which is an innate human faculty that constantly inclines decision makers toward universal moral principles. Managerial implications are discussed, stressing how a rediscovery of decision makers’ intuitive moral judgments could be relevant in the reflective thinking practice of managers’ ethical reasoning, thus saving them from rational insensitivity to ethical dilemmas. (shrink)

Suppose that three patients each independently confront the same high-stakes treatment decision. Perhaps it is an option to terminate a high-risk pregnancy, or to accept a blood transfusion after a catastrophic hemorrhage. Suppose further that the three patients approach their choice in radically different ways. The divergence lies not in the choice made, but in the pathway followed in arriving at it. P1 is a classic analytical reasoner. She enumerates the potential costs and benefits of each option, reviews the (...) probabilities, and makes a decision on the basis of her analysis. P2 does none of that analytical work. She has a settled and robust prior... (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)

How do business leaders make ethical decisions? Given the significant and wide-spread impact of business people’s decisions on multiple constituents, how they make decisions matters. Unethical decisions harm the decision makers themselves as well as others, whereas ethical decisions have the opposite effect. Based on data from a study on strategic decision making by 16 effective chief executive officers, I propose a model for ethical decision making in business in which reasoning and intuition interact through (...) forming, recalling, and applying moral principles necessary for long-term success in business. Following the CEOs in the study, I employ a relatively new theory, rational egoism, as the substantive content of the model and argue it to be consistent with the requirements of long-term business success. Besides explaining the processes of forming and applying principles, I briefly describe rational egoism and illustrate the model with a contemporary moral dilemma of downsizing. I conclude with implications for further research and ethical decision making in business. (shrink)

In recent years, increasing attention has been given to virtue ethics in business. Aristotle's thought is often seen as the basis of the virtue ethics tradition. For Aristotle, the idea of phronësis, or 'practical wisdom', lies at the foundation of ethics. Confucian ethics has notable similarities to Aristotelian virtue ethics, and may embody some similar ideas of practical wisdom. This article considers how ideas of moral judgment in these traditions are consistent with modern ideas about intuition in management decision (...) making. A hypothetical case is considered where the complexity of ethical decision making in a group context illustrates the importance of intuitive, phronësis-like judgment. It is then noted that both Aristotelian and Confucian virtue ethics include suggestions about support for moral decision making that are also consistent with modern theory. (shrink)

A patient’s decision-making capacity or competence is among the prerequisites for valid consent to medical treatment, and is regarded as the gatekeeping element in ensuring respect for patients’ self-determination. The issue is especially relevant in the case of vulnerable persons, such as patients who are cognitively or mentally impaired, and where medical decisions carry far-reaching consequences. As a grounding principle, DMC is a priori assumed, and challenged only when substantial doubts arise owing to observed or assumed deficiencies of (...) the capacities commonly considered relevant for competent decision making ; in this sense, the onus is on... (shrink)

There are a number of well-established concepts explaining decision-making. The sociology of wise practice suggests that thinking preferences like the use of intuition form a cornerstone of administrators’ virtuous practice and phronesis is a likely candidate to explain this behaviour. This contribution uses conceptual and theoretical resources from the behavioural sciences, administration as well as philosophy to account for individual level differences of employees regarding thinking preferences in administrative professions. The analysis empirically investigates the behavioural dimension preference for (...) intuition/preference for deliberation to cast empirical evidence on three different intuitive markers present among individuals who also prefer to use deliberation. We explore possible explanations for the differences and similarities of our global sample of 2227 workplace respondents who conceptually represent phronetic practitioners. The results show that many phronetic practitioners prefer the intuitive marker of unconscious thought, besides using deliberation. (shrink)

Intuitive-automatic processes are crucial for making judgements and decisions. The fascinating complexity of these processes has attracted many decision researchers, prompting them to start investigating intuition empirically and to develop numerous models. Dual-process models assume a clear distinction between intuitive and deliberate processes but provide no further differentiation within both categories. We go beyond these models and argue that intuition is not a homogeneous concept, but a label used for different cognitive mechanisms. We suggest that these (...) mechanisms have to be distinguished to allow for fruitful investigations of intuition. Specifically, we argue that researchers should concentrate on investigating the processes underlying intuition before making strong claims about its performance. We summarise current models for intuition and propose a categorisation according to the underlying cognitive processes: (a) associative intuition based on simple learning-retrieval processes, (b) matching intuition based on comparisons with prototypes/exemplars, (c) accumulative intuition based on automatic evidence accumulation, and (d) constructive intuition based on construction of mental representations. We discuss how this differentiation might help to clarify the relationship between affect and intuition and we derive a very general hypothesis as to when intuition will lead to good decisions and when it will go astray. (shrink)

The idea that there is a fundamental difference in value between persons and things, and that respecting this difference is an important moral requirement, has strong intuitive appeal. Kantian ethics is unique in placing this requirement at the center of a moral system and in explicating the conditions for complying with it. Unlike challenges to Kantian ethics that focus on tragic cases that pit respect for one person against respect for another, this paper focuses on the question of how (...) we can respect the value distinction between persons and things under conditions of uncertainty. After exploring why decision making under uncertainty is a neglected topic among Kantians and demonstrating how uncertainty challenges our ability to comply with this norm, we propose a notion of morally insignificant risk within a framework that allows agents to navigate real-world decisions involving material benefit and some risk to dignity without violating the Kantian’s core commitments. We conclude by exploring some of the challenges facing this approach. (shrink)

Intuitive-automatic processes are crucial for making judgements and decisions. The fascinating complexity of these processes has attracted many decision researchers, prompting them to start investigating intuition empirically and to develop numerous models. Dual-process models assume a clear distinction between intuitive and deliberate processes but provide no further differentiation within both categories. We go beyond these models and argue that intuition is not a homogeneous concept, but a label used for different cognitive mechanisms. We suggest that these (...) mechanisms have to be distinguished to allow for fruitful investigations of intuition. Specifically, we argue that researchers should concentrate on investigating the processes underlying intuition before making strong claims about its performance. We summarise current models for intuition and propose a categorisation according to the underlying cognitive processes: (a) associative intuition based on simple learning-retrieval processes, (b) matching intuition based on comparisons with prototypes/exemplars, (c) accumulative intuition based on automatic evidence accumulation, and (d) constructive intuition based on construction of mental representations. We discuss how this differentiation might help to clarify the relationship between affect and intuition and we derive a very general hypothesis as to when intuition will lead to good decisions and when it will go astray. (shrink)

The rapidly increasing role of automation throughout the economy, culture and our personal lives has generated a large literature on the risks of algorithmic decision-making, particularly in high-stakes legal settings. Algorithmic tools are charged with bias, shrouded in secrecy, and frequently difficult to interpret. However, these criticisms have tended to focus on particular implementations, specific predictive techniques, and the idiosyncrasies of the American legal-regulatory regime. They do not address the more fundamental unease about the prospect that we might (...) one day replace judges with algorithms, no matter how fair, transparent, and intelligible they become. The aim of this paper is to propose an account of the source of that unease, and to evaluate its plausibility. I trace foundational unease with algorithmic decision-making in the law to the powerful intuition that there is a basic moral and legal difference between showing that something is true of many people just like you and showing that it is true of you. Human judgment attends to the exception; automation insists on blindly applying the rule. I show how this intuitive thought is connected to both epistemological arguments about the value of statistical evidence, as well as to court-centered conceptions of the rule of law. Unease with algorithmic decision-making in the law thus draws on an intuitive principle that underpins a disparate range of views in legal philosophy. This suggests the principle is deeply ingrained. Nonetheless, I argue that the powerful intuition is not as decisive as it may seem, and indeed runs into significant epistemological and normative challenges. At an epistemological level, I show how concerns about statistical evidence's ability to track the truth can be resolved by adopting a probabilistic, rather than modal, conception of truth-tracking. At a normative level, commitment to highly individualized decision-making co-exists with equally ingrained and competing principles, such as consistent application of law. This suggests that the “rule of law” may not identify a discrete set of institutional arrangements, as proponents of a court-centric conception would have it, but rather a more loosely defined set of values that could potentially be operationalized in multiple ways, including through some level of algorithmic adjudication. Although the prospect of replacing judges with algorithms is indeed unsettling, it does not necessarily entail unreasonable verdicts or an attack on the rule of law. (shrink)

A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on (...) the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions. (shrink)

This article will be concerned with the phenomenon of vitality, which emerged as one of the main findings in a larger grounded theory study about life and death decisions in hospitals' neonatal units. Definite signs showing the new-born infant's energy and vigour contributed to the clinician's judgements about life expectancy and the continuation or termination of medical treatment. In this paper we will discuss the normative importance of vitality as a diagnostic cue and will argue that vitality, as a sign (...) perceived by doctors and nurses, has moral significance and represents a legitimate contribution to clinical decision-making in difficult cases where the child's life is at stake. We will argue that these clinical intuitions can be justified on a moral basis but only with certain qualifications that accounts for a certain objectivity and intersubjective reliability in the therapeutic judgements. (shrink)

Neither in theory nor in practice does there exist a single model of decision making. It is very difficult to identify a model, or models, which would be most useful during and after a disaster. Within the disaster timeframe (a difficult and complex situation), specific moral dilemmas arise. All the decision making theories tend to be associated with different assumptions about human nature, the quality of the decisions made and the manner in which they are made. (...) Different assumptions may result in different tools being used and subsequently different consequences. The paper will provide a general introduction to the ethical decision making model, and will suggest two ways in which decisions in ethics might be made. The paper will try to deepen the discussion, and suggest answers to questions such as which type of ethical decision making is better in a specific situation such as a disaster? Is there any need to use a different decision making model (from an ethical point of view) in a disaster than in another event? Nonetheless, the article does not provide explicit solutions to these questions, since providing them would require further investigation than is the aim of this paper. (shrink)

Kahneman's theory of two systems assumes that human decision making in Economy is based on two cognitive systems, one that is automatic, intuitive and mostly unconscious, and one that is reflexive, rational and fully conscious. The authors consider Kahneman’s approach incomplete and limited in accounting for the creativity of embodied agents grasping the opportunities afforded by physical and social environments. This limitation leads us to argue for the existence of a third system in decision making (...) in Economy, the creative intuition based on direct perception of affordances, addressing not only the dispositions and goals of agents but also the social and environmental responsibility of corporations and governments. The authors argue that the third decision-making system the authors propose implies a concept of intuition that is different from the type of association process discussed by Morewedge and Kahneman [2] and gives an example of the third system operation, the Bolsa Família in Brazil, and finding new options for the funding of similar programs. (shrink)

Shoot From The Hip - Professional Intuition In Decision-Making -/- Why do eighty percent of decision-makers say that they use intuition often or very often in their decision-making? What is intuition? How does it function? How can we achieve becoming more intuitive? How can we apply it in understanding the world and making more ethical decisions?

Terrence Ackerman has suggested that we ought to view general bioethical principles as generalizations which summarize our previous bioethical decisions rather than as moral rules. He would have us derive our ethical views instead principally from the facts of the cases in question and our intuitions about them. The proposal is attractive because of its similarity to medical decision-making, but it fails because it allows for no higher order standard of reference against which conflicting ethical intuitions may be (...) judged. CiteULike Connotea Del.icio.us What's this? (shrink)

This introduction just aims to be a fast foreword to the special topic now turned into an e-book. The Editorial "Decision-Making Experiments under a Philosophical Analysis: Human Choice as a Challenge for Neuroscience" alongside with my opinion article "Neurophilosophical considerations on decision making: Pushing-up the frontiers without disregarding their foundations" play the real role of considering in more details the articles and the whole purpose of this e-book. What I must highlight in this foreword is that (...) our intention with such a project was to deepen into the very foundations of our current paradigms in decision neuroscience and to philosophically moot its foundations and repercussions. Normal Science (a term coined by Philosopher Thomas Kuhn) works under a research consensus among a scientific community: A shared paradigm, consolidated methods, widespread convictions. Pragmatically, winning formulas must be kept, although, not at any cost. What differentiates a gifted and revolutionary scientist from a more bureaucratic colleague is the capacity and willingness of constantly reevaluating, depurating and refining his/her own paradigm. That is best strategy to avoid that a paradigm itself would gradually come under challenge. In my view, some achievements, in this sense, were brought about in our project. The e-book will be inspiring and informative for both neuroscientists that are concerned with the very foundations of their works and for philosophers that are not blind to empirical evidence. Kant once said: “Thoughts without content are empty, intuitions without concepts are blind”. Paraphrasing Kant we could say: Philosophy without science is empty, science without philosophy is blind. (shrink)

The relationship between intuition and ethical decision-making has been researched extensively during the past two decades. This study aimed at exploring empirically observable associations between intuition and the moral intensity of ethical decision-making processes. A scenario-based quantitative approach was used to collect data from 157 practising professional spirit mediums. It was found that only collective universal intuition had a significant positive association with the moral intensity of ethical decision-making processes. Personal experience intuition and collective (...) archetype intuition were not significantly associated with moral intensity. This may explain why previous studies were unable to gauge the effects of intuition on ethical decision-making. The results suggest that a pure mind can improve one’s ability to make decisions. Thus, decision-makers would benefit by being more attuned to their sense of morality. (shrink)

ABSTRACT Research examining ethical decision-making has focused on how people engage in EDM, leading many researchers to focus on sensemaking models of EDM. Although the merits of a sensemaking approach with respect to EDM are evident in the literature, less is known about the specific cognitive processes by which sensemaking impacts EDM. This study examines the impact of three late-cycle cognitive processes – idea generation, evaluation, and revision – as well as the timing of these processes on EDM. (...) Results indicate that information gathering early on is critical to EDM; a finding which supports an active sensemaking model over an intuitive one. (shrink)

New and experienced psychotherapists alike can find themselves overwhelmed by an ethical quandary where there doesn't seem to be an easy solution. This book presents positive ethics as a means to overcome such ethical challenges. The positive approach focuses on not just avoiding negative consequences, but reaching the best possible outcomes for both the psychotherapist and the client. The authors outline a clear decision-making process that is based on three practical strategies: the ethics acculturation model to help therapists (...) incorporate personal ethics into their professional roles, the quality enhancement model for dealing with high-risk patients who are potentially harmful, and ethical choice-making strategies to make the most ethical decision in a situation where two ethical principles conflict. Throughout the decision-making process, psychotherapists are encouraged to follow four basic guidelines: Focus on overarching ethical principles Consider intuitive, emotional, and other nonrational factors Accept that some problems have elusive solutions Solicit input from colleagues and consultation groups Numerous vignettes illustrate how to apply positive ethics to many different ethical challenges that psychotherapists will likely encounter in practice. (shrink)

Should the assessment of decision‐making capacity (DMC) be risk sensitive, that is, should the threshold for DMC vary with risk? The debate over this question is now nearly five decades old. To many, the idea that DMC assessments should be risk sensitive is intuitive and commonsense. To others, the idea is paternalistic or incoherent, or both; they argue that the riskiness of a given decision should increase the epistemic scrutiny in the evaluation of DMC, not increase (...) the threshold for DMC. We respond to the critics’ main concerns by providing a comprehensive account of how risk‐sensitive DMC is coherent, avoids paternalism, and best fulfills the epistemic goal of DMC evaluations. (shrink)

It is widely accepted in psychology and cognitive science that there are two “systems” in the mind: one system is characterized as quick, intuitive, perceptive, and perhaps more primitive, while the other is described as slower, more deliberative, and responsible for our higher-order cognition. I use the term “reflectivism” to capture the view that conscious reflection—in the “System 2” sense—is a necessary feature of good moral judgment and decision-making. This is not to suggest that System 2 must (...) operate alone in forming our moral decisions, but that it plays a normatively ineliminable role. In this paper, I discuss arguments that have been offered in defense of reflectivism. These arguments fit into two broad categories; let us think of them as two sides of a coin. On the first side are arguments about the efficaciousness of conscious reasoning—for example, without conscious deliberation we will make bad moral judgments and decisions. On the other side of the coin are arguments about the centrality of conscious deliberation to normative actions—for example, without conscious deliberation we are no more agential than animals or automatons. Despite their attractiveness, I argue that these arguments do not successfully establish that reflection is a necessary component of good moral judgment and decision-making. If I am right, the idea that good moral judgment and decision-making can result from entirely automatic and subconscious processes gains traction. My goal in this paper is to show that reflectivism fails to include the full range of cases of moral decision-making and that a theory of automaticity may do a better job. I briefly discuss at the end of the paper how an account of successful automatic moral judgment and decision-making might begin to take shape. (shrink)

Background Advance healthcare decision-making presumes that a prior treatment preference expressed with sufficient mental capacity (“T1 preference”) should trump a contrary preference expressed after significant cognitive decline (“T2 preference”). This assumption is much debated in normative bioethics, but little is known about lay judgments in this domain. This study investigated participants’ judgments about which preference should be followed, and whether these judgments differed depending on a first-person (deciding for one’s future self) versus third-person (deciding for a friend or (...) stranger) perspective. -/- Methods A vignette-based survey was conducted (N = 1445 US Americans; gender-balanced sample), in a 3 (relationship: self, best friend, stranger) × 2 (T1 preference: treat, do not treat) × 2 (T2 contrary preference: ambiguous, unambiguous) design. -/- Results Participants were more likely to defer to the incapacitated T2 preference of a third-party, while being more likely to insist on following their own T1 capacitated preference. Further, participants were more likely to conclude that others with substantial cognitive decline were still their “true selves,” which correlated with increased deference to their T2 preferences. -/- Conclusions These findings add to the growing evidence that lay intuitions concerning the ethical entitlement to have decisions respected are not only a function of cognition, as would be expected under many traditional bioethical accounts, but also depend on the relationship of the decision to the decision-maker’s true self. (shrink)

During goals of care conversations, palliative care clinicians help patients and families determine priorities of care and align medical care with those priorities. The style and methods of communicating with families and negotiating a care plan can range from paternalistic to entirely patient driven. In this paper, we describe a case in which the palliative care clinician approached decision-making using a paradigm that is intuitive to many clinicians and which seems conceptually sound, but which has not been (...) fully explored in the bioethics literature. This paradigm, termed maternalism, allows the clinician to direct decision-making within a relationship such that best interests and autonomy are mutually reinforced, thus reflecting relational autonomy as opposed to individual autonomy. We explore whether this method is appropriate in this case and explain how it captures significant ethical features of the case that might be missed by other approaches. (shrink)

This book focuses on the very nature and function of intuitive thought. It presents an up-to-date scientific model on how the non-conscious and intuitive thought processes work in human beings. The model is based on mainstream theorizing on intuition, as well as qualitative meta-analysis of the empirical data available in the research literature. It combines recent work in the fields of philosophy of mind, cognitive psychology and positive psychology. While systematic research in intuition is relatively new, there is (...) an abundance of positions advocating more or less imaginative ideas of what intuition is about, ranging from quantum mechanical phenomena to new age ideologies. Research in the past few decades, in particular by proponents of the dual processing theory of thought such as Daniel Kahneman and Jonathan Evans, offers powerful tools to address and evaluate the question of intuition without the need to resort to spiritual entities. Within the framework of the dual processing theory, backed up by findings in positive psychology, intuition turns out to be the capacity to carry out complex cognitive operations within a specific domain of operations familiar to the agent. (shrink)

ABSTRACT School psychologists are frequently confronted with ethically challenging situations arising from the need to balance multiple parties’ competing interests and the challenge of serving as both student advocate and school employee. Use of a systematic decision-making model has been recommended as a way of improving the quality of school psychologists’ ethical decisions. In the present study, school psychology practitioners were randomly assigned to one of two conditions: a Critical Evaluative condition, requiring the use of a problem-solving approach (...) to resolve an ethical dilemma, or an Intuitive condition, which entailed generating a solution based solely on intuition and professional experience/judgment. Use of a formal decision-making model did not result in higher caliber ethical resolutions. Participants’ age and number of years in the field were significantly correlated with raters’ judgments that solutions considered the consequences of a chosen course of action. Most participants reported that they did not utilize an ethical decision-making model during the course of their practice, relying instead on consultation with peers/colleagues and their own professional experience. Implications of these findings are discussed in the context of school psychology practice. (shrink)

Three studies test eight hypotheses about (1) how judgment differs between people who ascribe greater vs. less moral relevance to choices, (2) how moral judgment is subject to task constraints that shift evaluative focus (to moral rules vs. to consequences), and (3) how differences in the propensity to rely on intuitive reactions affect judgment. In Study 1, judgments were affected by rated agreement with moral rules proscribing harm, whether the dilemma under consideration made moral rules versus consequences of choice (...) salient, and by thinking styles (intuitive vs. deliberative). In Studies 2 and 3, participants evaluated policy decisions to knowingly do harm to a resource to mitigate greater harm or to merely allow the greater harm to happen. When evaluated in isolation, approval for decisions to harm was affected by endorsement of moral rules and by thinking style. When both choices were evaluated simultaneously, total harm -- but not the do/allow distinction -- influenced rated approval. These studies suggest that moral rules play an important, but context-sensitive role in moral cognition, and offer an account of when emotional reactions to perceived moral violations receive less weight than consideration of costs and benefits in moral judgment and decision making. (shrink)

In this paper I argue that the rationality of law and legal decision making would be enhanced by a systematic attempt to recognize and respond to the implications of empirical uncertainty for policy making and decision making. Admission of uncertainty about the accuracy of facts and the validity of assumptions relied on to make inferences of fact is commonly avoided in law because it raises the spectre of paralysis of the capacity to decide issues authoritatively. (...) The roots of this short-sighted view are found in primitive mechanical models of relationships in the empirical and social world – those of objective causality and determinism. Insofar as it is believed that if we had sufficient data a clear and unequivocal answer would be available to each question, admission of uncertainty is seen as a sign of insufficiency, incompetence, impotence, and is avoided whenever a decision that must be seen to be based on valid reasons, cannot be avoided. Avoidance of some decisions, duplicity in others, is the result. -/- Decision-making must be restructured to recognize the provisional and context-bound validity and relevance of the models we use to conceptualize and order our understanding of phenomena, and to utilize this awareness as an instrument in the production of legal policies and decisions that will be authoritative precisely because they are honestly accurate and socially responsible. The paper makes a start on such a re-structuring of the legal process by exploring the implications of the observation that if law is to be “just”: 1) legal policy must be based on accurate information and rationally related to social goals; and 2) decisions applying policy to individual fact situations must be based on assumptions that are both relevant and accurate. -/- Reasons for determinations of fact must be given, otherwise the presumption that the trier of fact is “reasonable” is an unconditional licence to use private modes of logic and theories of social and natural science. What is not disclosed cannot be challenged on grounds of invalidity or irrelevance. Use of “objective validity” as a standard to evaluate conclusions made by the trier of fact in contentious cases would only serve to beg all important questions by concealing: 1) fundamental normative conflict, and 2) the limited nature and applicability of many validity claims. -/- Our use of the phrases “undue risk,” “public interest,” “reasonable,” and “necessary,” reflects the weight we choose to give conflicting social values and goals when we must make decisions in relative ignorance of all the consequences. “Objective criteria” are of limited utility in legal decision-making because their social meaning is derivative. Policy generation in the absence of any coherent conceptual-normative framework, use of vague terminology in legislation stating policy, and the absence of rational means to distinguish between individual cases to which decision-makers are required by law to apply policy, make it inevitable that many legal “decisions” made in the guise of determinations of objective fact, are charades, an arbitrary, capricious, intuitive, subjective (and thus private) use of public decision-making power. -/- Law must alter its aspirations and recognize that rational decision-making is a process that can occur only within parameters set by present knowledge and societal preference structures. Only by working with the constraints imposed by these parameters is it possible to achieve “just” decisions. Where no rational basis for differentiating cases exists, “individualized justice” must be avoided and public policy articulated in law applied uniformly to all cases in a class. The terms “reasonable” and “necessary,” used to describe policy and its consequences for specific cases, must be understood to represent provisional societal assessments, attempts to implement societal preference structures in the face of limited knowledge. Heightened awareness of the limited nature of our knowledge can only result in legal policies that have a more explicit normative basis. (shrink)

The aim of this article is to explore the complex forms of knowledge involved in diagnostic and interventional decision making by comparing the processes in medicine and nursing, including nurse practitioners. Many authors assert that the practice of clinical decision making involves the application of theoretical knowledge (acquired in the classroom and textbooks) as well as research evidence, upon concrete particular cases. This approach draws on various universal principles and algorithms to facilitate the task. On the (...) other hand, others argue that this involves an intuitive form of judgement that is difficult to teach, one that is acquired principally through experience. In an exploration of these issues, this article consists of three sections. A clarification of terms commonly used when discussing decision making is provided in the first section. In the second section, an epistemological analysis of decision making is presented by examining several perspectives and comparing them for their use in the nursing and medical literature. Bunge's epistemological framework for decision making (based on scientific realism) is explored for its fit with the aims of medicine and nursing. The final section presents a discussion of knowledge utilization and decision making as it relates to the implications for the education and ongoing development of nurse practitioners. It is concluded that Donald Schön's conception of reflective practice best characterizes the skilful conduct of clinical decision making. (shrink)

Introduction It is increasingly considered important that people make an autonomous and informed decision concerning colorectal cancer screening. However, the realisation of autonomy within the concept of informed decision-making might be interpreted too narrowly. Additionally, relatively little is known about what the eligible population believes to be a 'good' screening decision. Therefore, we aimed to explore how the concepts of autonomous and informed decision-making relate to how the eligible CRC screening population makes their (...) class='Hi'>decision and when they believe to have made a 'good' screening decision. Methods We conducted 27 semi-structured interviews with the eligible CRC screening population. The general topics discussed concerned how people made their CRC screening decision, how they experienced making this decision and when they considered they had made a 'good' decision. Results Most interviewees viewed a 'good' CRC screening decision as one based on both reasoning and feeling/intuition, and that is made freely. However, many CRC screening non-participants experienced a certain social pressure to participate. All CRC screening non-participants viewed making an informed decision as essential. This appeared to be the case to a lesser extent for CRC screening participants. For most, experiences and values were involved in their decision-making. Conclusion Our sample of the eligible CRC screening population viewed aspects related to the concepts of autonomous and informed decision-making as important for making a 'good' CRC screening decision. However, in particular the existence of a social norm may be affecting a true autonomous decision-making process. Additionally, the present concept of informed decision-making with its strong emphasis on making a fully informed and well-considered decision does not appear to be entirely reflective of the process in practice. More efforts could be made to attune to the diverse values and factors that are involved in deciding about CRC screening participation. (shrink)

Proper linear models are those in which predictor variables are given weights such that the resulting linear composite optimally predicts some criterion of interest; examples of proper linear models are standard regression analysis, discriminant function analysis, and ridge regression analysis. Research summarized in P. Meehl's book on clinical vs statistical prediction and research stimulated in part by that book indicate that when a numerical criterion variable is to be predicted from numerical predictor variables, proper linear models outperform clinical intuition. Improper (...) linear models are those in which the weights of the predictor variables are obtained by some nonoptimal method. The present article presents evidence that even such improper linear models are superior to clinical intuition when predicting a numerical criterion from numerical predictors. In fact, unit weighting is quite robust for making such predictions. The application of unit weights to decide what bullet the Denver Police Department should use is described; some technical, psychological, and ethical resistances to using linear models in making social decisions are considered; and arguments that could weaken these resistances are presented. (shrink)

Logic programs under answer set semantics have become popular as a knowledge representation formalism in Artificial Intelligence. In this paper we investigate the possibility of using answer sets for qualitative decision making. Our approach is based on an extension of the formalism, called logic programs with ordered disjunction (LPODs). These programs contain a new connective called ordered disjunction. The new connective allows us to represent alternative, ranked options for problem solutions in the heads of rules: A × B (...) intuitively means: if possible A, but if A is not possible then at least B. The semantics of logic programs with ordered disjunction is based on a preference relation on answer sets. We show that LPODs can serve as a basis for qualitative decision making. (shrink)

While decision making scholarship in management has specifically addressed the objectivist assumptions within the rational choice model, a similar move within business ethics has only begun to occur. Business ethics scholarship remains primarily based on rational choice assumptions. In this article, we examine the managerial decision making literature in order to illustrate equivocality within the rational choice model. We identify four key assumptions in the decision making literature and illustrate how these assumptions affect (...) class='Hi'>decision making theory, research, and practice within the purview of business ethics. Given the breadth of disciplines and approaches within management decision making scholarship, a content analysis of management decision making scholarship produces a greater range of assumptions with finer granularity than similar scholarship within business ethics. By identifying the core assumptions within decision making scholarship, we start a conversation about why, how, and to what effect we make assumptions about decision making in business ethics theory, research, and practice. Examining the range of possible assumptions underlying current scholarship will hopefully clarify the conversation and provide a platform for future business ethics research. (shrink)

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

Organizations have become essential institutions that facilitate the vital coordination and cooperation necessary to create value across societies. Recent research within moral psychology and behavioral ethics indicates that emotions play a pivotal role in promoting ethical decision making. The theory developed here maintains that most organizations retain norms that disfavor the experience and expression of many strong emotions while at work. This dynamic inhibits individual’s ability to generate moral intuitions and reason about ethical issues they encounter. This occurs (...) as individuals utilize specific emotion regulation mechanisms that stifle the experience and expression of emotion in organizational decision making. Over time, individuals fail to register emotion within organizational decision processes, which increases the prevalence of amoral decision making. Organizational emotion norms also influence the chronic accessibility of specific moral foundations that effect the contents of both moral intuitions that do occur, as well as deliberate reasoning that generates moral judgments. (shrink)

Whereas classic work in judgment and decision making has focused on the deviation of intuition from rationality, more recent research has focused on the performance of intuition in real-world environments. Borrowing from both approaches, we investigate to which extent competing models of intuitive probabilistic decision making overlap with choices according to the axioms of probability theory and how accurate those models can be expected to perform in real-world environments. Specifically, we assessed to which extent heuristics, (...) models implementing weighted additive information integration (WADD), and the parallel constraint satisfaction (PCS) network model approximate the Bayesian solution and how often they lead to correct decisions in a probabilistic decision task. PCS and WADD outperform simple heuristics on both criteria with an approximation of 88.8% and a performance of 73.7%. Results are discussed in the light of selection of intuitive processes by reinforcement learning. (shrink)

This paper presents methods and challenges attendant on the use of protocol analysis to develop a model of heuristic processing applied to research ethics. Participants are exposed to ethically complex scenarios and asked to verbalize their thoughts as they formulate a requested decision. The model identifies functional parts of the decision-making task: interpretation, retrieval, judgment and editing and seeks to reliably code participant verbalizations to those tasks as well as to a set of cognitive tools generally useful (...) in such work. Important difficulties in the reliability and external validity of measurement are evaluated and a small set of illustrative data is used in support of that discussion. Results indicate that both intuitive emotional but also more deliberative cognition is present which is consistent with work in related literatures in expertise and in neuropsychology. Finally, the theoretical and practical potential of the approach is elaborated, particularly through links to a framing in Aristotelian ethics. (shrink)

This paper presents methods and challenges attendant on the use of protocol analysis to develop a model of heuristic processing applied to research ethics. Participants are exposed to ethically complex scenarios and asked to verbalize their thoughts as they formulate a requested decision. The model identifies functional parts of the decision-making task: interpretation, retrieval, judgment and editing and seeks to reliably code participant verbalizations to those tasks as well as to a set of cognitive tools generally useful (...) in such work. Important difficulties in the reliability and external validity of measurement are evaluated and a small set of illustrative data is used in support of that discussion. Results indicate that both intuitive emotional but also more deliberative cognition is present which is consistent with work in related literatures in expertise and in neuropsychology. Finally, the theoretical and practical potential of the approach is elaborated, particularly through links to a framing in Aristotelian ethics. (shrink)

It is by now a well-supported hypothesis in cognitive neuroscience that there exists a functional network for the moral appraisal of situations. However, there is a surprising disagreement amongst researchers about the significance of this network for moral actions, decisions, and behavior. Some researchers suggest that we should uncover those ethics [that are built into our brains ], identify them, and live more fully by them, while others claim that we should often do the opposite, viewing the cognitive neuroscience of (...) morality more like a science of pathology. To analyze and evaluate the disagreement, this paper will investigate some of its possible sources. These may include theoretical confusions about levels of explanation in cognitive science, or different senses of ‘morality’ that researchers are looking to explain. Other causes of the debate may come from empirical assumptions about how possible or preferable it is to separate intuitive moral appraisal from moral decisions. Although we will tentatively favor the ‘Set Aside’ approach, the questions outlined here are open areas of ongoing research, and this paper will be confined to outlining the position space of the debate rather than definitively resolving it. (shrink)