Ethicists, regulators and researchers have struggled with the question of whether incidental findings in genomics studies should be disclosed to participants. In the ethical debate, a general consensus is that disclosed information should benefit participants. However, there is no agreement that genetic information will benefit participants, rather it may cause problems such as anxiety. One could get past this disagreement about disclosure of incidental findings by letting participants express their preferences in the consent form. We argue that this freedom of (...) choice is problematic. In transferring the decision to participants, it is assumed that participants will understand what they decide about and that they will express what they truly want. However, psychological findings about people's reaction to probabilities and risk have been shown to involve both cognitive and emotional challenges. People change their attitude to risk depending on what is at stake. Their mood affects judgments and choices, and they over- and underestimate probabilities depending on whether they are low or high. Moreover, different framing of the options can steer people to a specific choice. Although it seems attractive to let participants express their preferences to incidental findings in the consent form, it is uncertain if this choice enables people to express what they truly prefer. In order to better understand the participants' preferences, we argue that future empirical work needs to confront the participant with the complexity of the uncertainty and the trade-offs that are connected with the uncertain predictive value of genetic risk information. (shrink)

In 2004, prenatal risk assessment (PRA) was implemented as a routine offer in Denmark, in order to give all pregnant women an informed choice about whether to undergo prenatal testing. PRA is a non-invasive intervention performed in the first trimester of pregnancy and measures the risk of a fetus having Down's syndrome or other chromosomal disorders. The risk figure provides the basis for action, i.e. the decision about whether or not to undergo invasive fetal testing via (...) the maternal route (amniocentesis or chorionic villus sampling), which, however, involves the risk of inducing a miscarriage. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, this paper investigates how ideals such as autonomy and non-directiveness are practised in processes of decision-making. We view such ideals as forming social practice rather than neutral instruments to reach a certain goal. Focusing on one couple's trajectory through the clinical practices of PRA and the process through which a decision is reached, we call into question the assumption that more choice and more objective information is a source of empowerment and control. We make evident how decisions are made through a complicated process of meaning-making, which emerges through the relationship between professionals, the clinical setting and the social life of the couples. In the face of complex risk knowledge, PRA users are reluctant to make choices and seek to re-install authority in the health professionals. However, when assumptions about autonomy and self-determination are inscribed into the social practice of PRA, authority is transferred to the couple undergoing PRA and a new configuration of responsibility evolves between the couple and their relationship to the fetus. It is argued that PRA performs a form of government that works not through compulsion or persuasion but through choice. An ethic of a shared responsibility for PRA and its outcome between pregnant women and health professionals would be more in agreement with how decisions are actually made. (shrink)

How can it be rational to work on a new theory that does not yet meet the standards for good or acceptable theories? If diversity of approaches is a condition for scientific progress, how can a scientific community achieve such progress when each member does what it is rational to do, namely work on the best theory? These two methodological problems, the problem of pursuit and the problem of diversity, can be solved by taking into account the cognitive risk (...) that is involved in theory choice. I compare this solution to other proposals, in particular T. S. Kuhn's and P. Kitcher's view that the two problems demonstrate the epistemic significance of the scientific community. (shrink)

This paper describes the results of a field experiment involving 400 employees from ten financial institutions operating within the Shenzhen Special Economic Zone of the Peoples Republic of China. It was found that, when faced with an agency-based problem, employees indicated they would be less inclined to advise management of the existence of unethical work practices. Younger employees without supervisory experience displayed significant risk aversion. Traditional Chinese values associated with Confucian work dynamism, were shown to be poor predictors (...) of moral choice response. A parsimonious regression model was developed that provides evidence that the universal trait Masculinity/Femininity (Human-heartedness) acted to offset the negative influence of the agency problem. On the other hand, an operatives level of education attainment exerted a negative influence on moral response scores. (shrink)

This paper describes the results of a field experiment involving 400 employees from ten financial institutions operating within the Shenzhen Special Economic Zone of the People's Republic of China. It was found that, when faced with an agency-based problem, employees indicated they would be less inclined to advise management of the existence of unethical work practices. Younger employees without supervisory experience displayed significant risk aversion. Traditional Chinese values associated with Confucian work dynamism, were shown to be poor predictors (...) of moral choice response. A parsimonious regression model was developed that provides evidence that the universal trait Masculinity/Femininity acted to offset the negative influence of the agency problem. On the other hand, an operative's level of education attainment exerted a negative influence on moral response scores. (shrink)

Abstract Most discussions of risk are developed in broadly consequentialist terms, focusing on the outcomes of risks as such. This paper will provide an alternative account of risk from a virtue ethical perspective, shifting the focus to the decision to take the risk. Making ethical decisions about risk is, we will argue, not fundamentally about the actual chain of events that the decision sets in process, but about the reasonableness of the decision to take the (...) class='Hi'>risk in the first place. A virtue ethical account of risk is needed because the notion of the ‘reasonableness’ of the decision to take the risk is affected by the complexity of the moral status of particular instances of risk-taking and the risk-taker’s responsiveness to these contextual features. The very idea of ‘reasonable risk’ welcomes judgments about the nature of the risk itself, raises questions about complicity, culpability and responsibility, while at its heart, involves a judgement about the justification of risk which unavoidably focuses our attention on the character of the individuals involved in risk making decisions. Keywords: Risk; ethics; morality; responsibility; virtue; choice; reasons . (shrink)

The Argument from Inductive Risk (AIR) is taken to show that values are inevitably involved in making judgements or forming beliefs. After reviewing this conclusion, I pose cases which are prima facie counterexamples: the unreflective application of conventions, use of black-boxed instruments, reliance on opaque algorithms, and unskilled observation reports. These cases are counterexamples to the AIR posed in ethical terms as a matter of personal values. Nevertheless, it need not be understood in those terms. The values which load (...) a theory choice may be those of institutions or past actors. This means that the challenge of responsibly handling inductive risk is not merely an ethical issue, but is also social, political, and historical. (shrink)

Deontological theories face difficulties in accounting for situations involving risk; the most natural ways of extending deontological principles to such situations have unpalatable consequences. In extending ethical principles to decision under risk, theorists often assume the risk must be incorporated into the theory by means of a function from the product of probability assignments to certain values. Deontologists should reject this assumption; essentially different actions are available to the agent when she cannot know that a certain (...) act is in her power, so we cannot simply understand her choice situation as a “risk-weighted” version of choice under certainty. (shrink)

Describes and evaluates a number of existing criticisms of the formal theory of rationality and subjective expected utility theory. The author argues that rationality is not a behavioural entity, but rather has to do with the relation between an agent's preferences and his or her behaviour.

Modeling risk in a prescriptively plausible way represents a major issue in decision theory. The benchmarking procedure, being based on the satisficing principle and providing a probabilistic interpretation of expected utility (EU) theory, is prescriptive. Because it is a target-based language, the benchmarking procedure can be applied naturally to finance. In finance, the centrality of risk is widely recognized, but the risk measures that are commonly used to assess risk are too poor as a decision making (...) tool. In this paper we propose a two-stage decision criterion of choice under risk that provides an application of benchmarking to finance through a risk measure. We will analyze some nonexpected utility theories, in particular lottery dependent utility, as potential frameworks for our criterion. (shrink)

This paper presents a personal view of the interaction between the analysis of choice under uncertainty and the analysis of production under uncertainty. Interest in the foundations of the theory of choice under uncertainty was stimulated by applications of expected utility theory such as the Sandmo model of production under uncertainty. This interest led to the development of generalized models including rank-dependent expected utility theory. In turn, the development of generalized expected utility models raised the question of whether (...) such models could be used in the analysis of applied problems such as those involving production under uncertainty. Finally, the revival of the state-contingent approach led to the recognition of a fundamental duality between choice problems and production problems. (shrink)

Many of the policy choices we face that have implications for the lives of future generations involve creating a risk that they will live lives that are significantly compromised. I argue that we can fruitfully make use of the resources of Scanlon’s contractualist account of moral reasoning to make sense of the intuitive idea that, in many cases, the objection to adopting a policy that puts the interest of future generations at risk is that doing so wrongs those (...) who will live in the further future. (shrink)

Objective: The objective of the current study was to maximise the amount of information children and adolescents understand about the risks and benefits associated with participation in a biomedical research study.Design: Participants were presented with one of six hypothetical research protocols describing how to fix a fractured thigh using either a “standard” cast or “new” pins procedure. Risks and benefits associated with each of the treatment options were manipulated so that for each one of the six protocols there was either (...) a correct or ambiguous choice.Participants and setting: Two hundred and fifty one children, ages 6–15 , and 237 adults were interviewed while waiting for a clinic appointment at the Hospital for Sick Children.Results: Using standardised procedures and questionnaires, it was determined that most participants, regardless of age group, were able to understand the basic purpose and procedures involved in the research, and most were able to choose the “correct” operation. The younger children, however, showed an overall preference for a cast operation, whereas the older participants were more likely to choose the pins.Conclusions: By creating age appropriate modules of information, children as young as six years can understand potentially difficult and complex concepts such as the risks and benefits associated with participation in biomedical research. It appears, however, that different criteria were used for treatment preference, regardless of associated risks; older participants tended to opt for mobility whereas younger participants stayed with the more familiar cast operation. (shrink)

It is frequently argued that home birth is morally irresponsible because it involves the taking of risks on behalf of the fetus. Against this position, I argue three things. First, the fact that home birth involves risks does not necessarily entail that choosing or attending one is morally unacceptable, irresponsible or wrong. Second, parents have a prima facia prerogative to decide on behalf of their fetuses and children whether risks should be taken. While this prima facia prerogative can be overridden, (...) reasonable and widely accepted criteria for doing so are not met in the case of home birth. Third, since the current attitudes and behaviours of physicians with regard to home birth constitute a de facto morally and socially unjustifiable overriding of an informed parental decision, physician autonomy should be restricted so as to preserve the autonomy of the medical consumer. (shrink)

From the viewpoint of the independence axiom of expected utility theory, an interesting empirical dynamic choice problem involves the presence of a “global risk,” that is, a chance of losing everything whichever safe or risky option is chosen. In this experimental study, participants have to allocate real money between a safe and a risky project. Treatment variable is the particular decision stage at which a global risk is resolved: (i) before the investment decision; (ii) after the investment (...) decision, but before the resolution of the decision risk; (iii) after the resolution of the decision risk. The baseline treatment is without global risk. Our goal is to investigate the isolation effect and the principle of timing independence under the different timing options of the global risk. In addition, we examine the role played by anticipated and experienced emotions in the choice problem. Main findings are a violation of the isolation effect, and support for the principle of timing independence. Although behavior across the different global risk cases shows similarities, we observe clear differences in people’s affective responses. This may be responsible for the conflicting results observed in earlier experiments. Dependent on the timing of the global risk different combinations of anticipated and experienced emotions influence decision making. (shrink)

There are many risks involved in genetic engineering. The release of genetically altered organisms in the environment can increase human suffering, decrease animal welfare, and lead to ecological disasters. The containment of biotechnological material in laboratories and industrial plants contributes to the risk of accidental release, especially if the handling and storage are inadequate. The purely political dangers include intensified economic inequality, the possibility of large-scale eugenic programs, and totalitarian control over human lives. How should the acceptability of these (...) risks be determined? We argue that the assessment should be left to those who can be harmed by the decisions in question. Economic risks are acceptable, if they are condoned by the corporations and governments who take them. The risks imposed on laboratory personnel by the containment of dangerous materials ought to be evaluated by the laboratory personnel themselves. All other risks are more or less universal, and should therefore be assessed as democratically as possible. If risk-taking is based on the choices of those who can be harmed by the consequences, then, even if the undesired outcome is realized, the risk is acceptable, because it is embedded in their own system of ethical and epistemic values. (shrink)

It is frequently argued that home birth is morally irresponsible because it involves the taking of risks on behalf of the fetus. Against this position, I argue three things. First, the fact that home birth involves risks does not necessarily entail that choosing or attending one is morally unacceptable, irresponsible or wrong. Second, parents have a prima facia prerogative to decide on behalf of their fetuses and children whether risks should be taken. While this prima facia prerogative can be overridden, (...) reasonable and widely accepted criteria for doing so are not met in the case of home birth. Third, since the current attitudes and behaviours of physicians with regard to home birth constitute a de facto morally and socially unjustifiable overriding of an informed parental decision, physician autonomy should be restricted so as to preserve the autonomy of the medical consumer. (shrink)

If payoffs are tickets for binary lotteries, which involve only two money prizes, then rationality requires expected value maximization in tickets. This payoff scheme was increasingly used to induce risk neutrality in experiments. The experiment presented here involved lottery choice and evaluation tasks. One subject group was paid in binary lottery tickets, another directly in money. Significantly greater deviations from risk neutral behavior are observed with binary lottery payoffs. This discrepancy increases when subjects have easy access to (...) the alternatives' expected values and mean absolute deviations. Behavioral regularities are observed at least as often as with direct money payoffs. (shrink)

Athletes who wish to compete in spite of high risk of injury can prove a challenge for sports doctors. Overriding an athlete's choices could be considered to be unnecessarily overbearing or paternalistic. However simply accepting all risk-taking as the voluntary choice of an individual fails to acknowledge the context of high-level sport and the circumstances in which an athlete may be being coerced or in some other way be making a less than voluntary choice. Restricting the (...) voluntary choices of an athlete may still be possible but under very limited circumstances. This article explores the ways a sports doctor might respond in ensuring a choice is indeed voluntary and, if so, under what circumstances limits might be placed. Responding to such risk-taking by, for example, limiting the actions of an athlete or assisting them to compete, involves attempting to balance the athlete's aims against some set of ideals of good health or medical ends. (shrink)

The shift to companionate marriage in South Asia and elsewhere is widely read as a move from ‘tradition’ to ‘modernity’ resulting in an expansion of individual agency, especially for women. This paper critically examines the narratives of urban middle-class women in Sri Lanka spanning three generations to illustrate that rather than indicating a radical shift in the way they negotiated between individual desires and social norms, the emphasis on ‘choice’ signals a shift in the narrative devices used in the (...) presentation of the ‘self’. The paper illustrates how young women's narratives about marriage appear to suggest ‘modernity’ as inevitable—that its processes are reconstituting the person who, less constrained by ‘tradition’ and collective expectations, is now experiencing greater freedom in the domain of marriage. However, it also shows how urban middle-class families in Sri Lanka have collectively invested in the narrative of choice through which ‘a choosing person’ is consciously created as a mark of the family's modernity and progress. Rather than signalling freedom, these narratives about choice reveal how women are often burdened with the risks and responsibility of agency. The paper illustrates that the ‘choosing person’ is produced through narratives that emphasise agency as a responsibility that must be exercised with caution because women are expected by and obligated to their families to make the ‘right’ choices. Hence, a closer look at the individualised ‘choosing person’ reveals a less unitary, relational self with permeable boundaries embedded within and accountable to family and kinship. (shrink)

I focus my discussion on the well-known Ellsberg paradox. I find good normative reasons for incorporating non-precise belief, as represented by sets of probabilities, in an Ellsberg decision model. This amounts to forgoing the completeness axiom of expected utility theory. Provided that probability sets are interpreted as genuinely indeterminate belief, such a model can moreover make the “Ellsberg choices” rationally permissible. Without some further element to the story, however, the model does not explain how an agent may come to have (...) unique preferences for each of the Ellsberg options. Levi holds that the extra element amounts to innocuous secondary “risk” or security considerations that are used to break ties when more than one option is rationally permissible. While I think a lexical choice rule of this kind is very plausible, I argue that it involves a greater break with xpected utility theory than mere violation of the ordering axiom. (shrink)

In contrast to Di Nucci’s characterisation, my argument is not a technoapocalyptic one. The view I put forward is that systems like IBM’s Watson for Oncology create both risks and opportunities from the perspective of shared decision-making. In this response, I address the issues that Di Nucci raises and highlight the importance of bioethicists engaging critically with these developing technologies.

In this short response to Gray’s article Capacity and Decision Making we double down on our argument that risk-relativity is a nonsense. Risk relativity is the claim that we should set a higher standard of competence for a person to make a risky choice than to make a safe choice. Gray’s response largely involves calling attention to the complexities, ramifications and multiple value implications of decision-making, but we do not deny any of this. Using the notion (...) of quality of care mentioned by Gray, we construct an argument that might be used to support risk relativity. But it is no more persuasive than the arguments put forward by risk-relativists. (shrink)

In 2004 prenatal risk assessment was implemented as a routine offer to all pregnant women in Denmark. It was argued that primarily the new programme would give all pregnant women an informed choice about whether to undergo prenatal testing. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, we call into question the assumption underlying the new guidelines that more choice and more objective information is a (...) source of empowerment and control. We focus on one couple's experience of PRA. This case makes it evident how supposed choices in the context of PRA may not be experienced as such. Rather, they are experienced as complicated processes of meaning-making in the relational space between the clinical setting, professional authority and the social life of the couples. PRA users are reluctant to make choices and abandon health professionals as authoritative experts in the face of complex risk knowledge. When assumptions about autonomy and self-determination are inscribed into the social practice of PRA, authority is transferred to the couple undergoing PRA and a new configuration of responsibility evolves between the couple and their relationship to the foetus. It is argued that al-though the new programme of prenatal testing in Denmark presents itself in opposition to quasi-eugenic and paternalistic forms of governing couples' decisions it represents another form of government that works through the notion of choice. An ethics of a shared responsibility of PRA and its outcome would be more in agreement with how decisions are actually made. (shrink)

Recently proposed models of risky choice imply systematic violations of transitivity of preference. This study explored whether people show the predicted intransitivity of the two models proposed to account for the certainty effect in Allais paradoxes. In order to distinguish “true” violations from those produced by “error,” a model was fit in which each choice can have a different error rate and each person can have a different pattern of preferences that need not be transitive. Error rate for (...) a choice is estimated from preference reversals between repeated presentations of the same choice. Results showed that few people repeated intransitive patterns. We can retain the hypothesis that all participants were transitive. (shrink)

The regulation of innovation reflects a specific imaginary of the role of governance that makes it external to the field it governs. It is argued that this decision and rule-based view of regulation is insufficient to deal with the inescapable uncertainties that are produced by innovation. In particular, relying on risk-based knowledge as the basis of regulation fails to deal sufficiently both with the problem that innovation ensures the future will not resemble the past, and with the problem that (...) the social priorities that underlie innovation often remain unquestioned. Recently, rights-based frameworks have been defended as principle-based approaches to innovation governance that address the gaps which trouble an understanding of regulation as guided by risk-based decision procedures. An alternative view of governance is defended, based on a concept of care drawn from feminist ethics and other traditions. Care aims, not at justifying punctual decisions, but at transforming institutions and practices, with the goal of creating specific institutional ‘virtues’, and requires the broad and deep participation of publics in shaping innovation. In this way, governance is made internal to innovation. (shrink)

Background: The Albanian medical system and Albanian health legislation have adopted a paternalistic position with regard to individual decision making. This reflects the practices of a not-so-remote past when state-run facilities and a totalitarian philosophy of medical care were politically imposed. Because of this history, advance directives concerning treatment refusal and do-not-resuscitate decisions are still extremely uncommon in Albania. Medical teams cannot abstain from intervening even when the patient explicitly and repeatedly solicits therapeutic abstinence. The Albanian law on health care (...) has no provisions regarding limits or withdrawal of treatment. This restricts the individual's healthcare choices.DiscussionThe question of 'medically futile' interventions and pointless life-prolonging treatment has been discussed by several authors. Dutch physicians call such interventions 'medisch zinloos' (senseless), and the Netherlands, as one of the first states to legislate on end-of-life situations, actually regulates such issues through appropriate laws. In contrast, leaving an 'advance directive' is not a viable option for Albanian ailing individuals of advanced age. Verbal requests are provided during periods of mental competence, but unfortunately such instructions are rarely taken seriously, and none of them has ever been upheld in a legal or other official forum.SummaryEnd-of-life decisions, treatment refusal and do-not-resuscitate policies are hazardous options in Albania, from the legal point of view. Complying with them involves significant risk on the part of the physician. Culturally, the application of such instructions is influenced from a mixture of religious beliefs, death coping-behaviors and an immense confusion concerning the role of proxies as decision-makers. Nevertheless, Albanian tradition is familiar with the notion of 'amanet', a sort of living will that mainly deals the property and inheritance issues. Such living wills, verbally transmitted, may in certain cases include advance directives regarding end-of-life decisions of the patient including refusal or termination of futile medical treatments. Since these living wills are never formally and legally validated, their application is impossible and treatment refusal remains still non practicable. Tricks to avoid institutional treatment under desperate conditions are used, aiming to provide legal coverage for medical teams and relatives that in extreme situations comply with the advice of withholding senseless treatment. (shrink)

Open theists have generally affirmed that God exercises general sovereignty, seeking to achieve an overall providential goal related to our freely choosing to love Him, though the path to that goal is uncertain. This understanding of God's relationship to the world has the implication that God risks failure in achieving His purpose, since His success ultimately depends upon our free choices. In this paper, I first outline some concerns about the risks involved in God's exercising general sovereignty, and then explain (...) how an alternative ‘hopeful’ view alleviates these concerns. I conclude that the hopeful view is a promising alternative that deserves further exploration. (shrink)

In this paper I present an argument in favour of a parental duty to use preimplantation genetic diagnosis (PGD). I argue that if embryos created in vitro were able to decide for themselves in a rational manner, they would sometimes choose PGD as a method of selection. Couples, therefore, should respect their hypothetical choices on a principle similar to that of patient autonomy. My thesis shows that no matter which moral doctrine couples subscribe to, they ought to conduct the PGD (...) procedure in the situations when it is impossible to implant all of the created embryos and if there is a significant risk for giving birth to a child with a serious condition. (shrink)

How can one knowingly choose against one's best judgment? This is both a traditional philosophical puzzle and a realistic problem in our everyday life. This dissertation is an exposition and examination of a recent work, by George Ainslie, with regard to its innovative explanation as well as rational solution of such a problem. With the help of the new Ainsliean model, I have also sought to offer some analysis of a number of issues that I believe are important to the (...) understanding of the nature of practical rationality. ;The central question for Ainslie's approach to the dynamic problem of preference change is how to justify the "bundling" idea underlying his solution of the problem by adopting a "personal rule." The bundling idea is a belief in the relation between a series of similar choices as each predicting the direction of all the later choices. Being able to think in terms of this bundling idea is a powerful means of abstaining from defection, though it requires considerable cognitive effort. I try to defend the plausibility of such a personal-rule approach. But Ainslie's own account falls short of showing the ultimate necessity of the bundling idea, viz., why the collapse of the whole sequence of choices would necessarily follow from one defection. My argument hinges on demonstrating that neither a causal consideration about the links between similar choices, nor a prudential consideration about the possible risk involved in certain actions is sufficient for understanding the necessity: we need a normative perspective instead. ;This leads to my analysis of the conditions under which a normative solution can be justified. The analysis also delineates the type of dynamic choice situations Ainslie's approach may adequately fit, or have the greatest advantage. Some underlying hypothesis about the status and role of cognition in desire and higher-level motivation is carefully discussed; and the cognitive, deliberative, and affective aspects of the adoption of a rule is explored. During my discussions, I also compare Ainslie's approach with other theories in the domain of practical reasoning, such as that of Donald Davidson's, Jon Elster's, Michael Bratman's, Edward McClennen's, and David Gauthier's, in terms of their explanatory power, or their scope of application, limits, and complementarity. ;Ainslie's motivational model of mind has apparent as well as potential implications for a group of interesting philosophical issues. They include the nature of willpower, the nature of practical rationality as well as moral rules, personal identity, autonomy, and the existentialist theme on self-creation. My conclusion is that the clarification of the metaphysical underpinnings of the Ainsliean model can help to shed some light on these issues. (shrink)

In public debate over agricultural biotechnology, at issue hasbeen its self-proclaimed aim of further industrializingagriculture. Using languages of ’risk‘, critics and proponentshave engaged in an implicit ethics debate on the direction oftechnoscientific development. Critics have challenged thebiotechnological R&D agenda for attributing socio-agronomicproblems to genetic deficiencies, while perpetuating the hazardsof intensive monoculture. They diagnosed ominous links betweentechnological dependency and tangible harm from biotechnologyproducts.In response to scientific and public concerns, theEuropean Community enacted precautionary legislation for theintentional release of genetically modified organisms. (...) Inits implementation, choices for managing and investigatingbiotechnological risk involve an implicit environmental ethics.Yet the official policy language downplays the inherent valuejudgments, by portraying risk regulation as a matter of’objective‘ science.In parallel with safety regulation, thestate has devised an official bioethics that judges where to’draw the line‘ in applying biotechnological knowledge, as ifthe science itself were value-free. Bioethics may also judge howto ’balance‘ risks and benefits, as if their definition were notan issue. This form of ethics serves to compensate for theunacknowledged value-choices and institutional commitmentsalready embedded in R&D priorities.Thus the state separates’risk‘ and ’ethics‘, while assigning both realms to specialists.The risk/ethics boundary encourages public deference to theexpert assessments of both safety regulators and professionalethicists. Biotechnology embodies a contentious model of controlover nature and society, yet this issue becomes displaced andfragmented into various administrative controls. At stake arethe prospects for democratizing the problem-definitions thatguide R&D priorities. (shrink)

Prenatal screening, consisting of maternal serum screening and nuchal translucency screening, is on the verge of expansion, both by being offered to more pregnant women and by screening for more conditions. The Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists have each recently recommended that screening be extended to all pregnant women regardless of age, disease history, or risk status. This screening is commonly justified by appeal to the value of autonomy, or (...) women's choice. In this paper, I critically examine the value of autonomy in the context of prenatal screening to determine whether it justifies the routine offer of screening and the expansion of screening services. I argue that in the vast majority of cases the option of prenatal screening does not promote or protect women's autonomy. Both a narrow conception of choice as informed consent and a broad conception of choice as relational reveal difficulties in achieving adequate standards of free informed choice. While there are reasons to worry that women's autonomy is not being protected or promoted within the limited scope of current practice, we should hesitate before normalizing it as part of standard prenatal care for all. (shrink)

Maps provide us with an easily recognizable version of the new demarcation problem: On the one hand, we are all familiar with graphics and maps that unacceptably distort our perceptions without being technically inaccurate or fictive; indeed there are whole websites groups devoted to curating such images for fun. On the other hand, there are multiple unavoidably value-laden choices that must be made in the production of any map. Producing a map requires choosing everything from the colors and thicknesses of (...) the lines, the scale, the projection system, the categories and parameters represented, and much more. There is no neutral default for any of these choices, and all of them shape what information the map communicates. All the visual choices involved in producing a map enable some information to be conveyed at the cost of hiding or distorting other information, as map makers themselves routinely acknowledge and discuss. Hence there are no straightforward answers to questions about the line between distortion and legitimate representational choices. I explore three distinctive kinds of epistemic risks in map-making that generate special versions of the demarcation problem, which I dub aesthetic risk, categorization risk, and simplification risk. I argue that in each case, even good maps – maps that are accurate and epistemically valuable – have the potential to mislead us. I end by looking at maps that offer special epistemic benefits by making clear their own lack of value-neutrality while still being accurate and epistemically fecund. (shrink)

Originally published in 1968. This is a critical study of the concept of 'rule' featuring in law, ethics and much philosophical analysis which the author uses to investigate the concept of 'rationality'. The author indicates in what manner the modes of reasoning involved in reliance upon rules are unique and in what fashion they provide an alternative both to the modes of logico-mathematical reasoning and to the modes of scientific reasoning. This prepares the groundwork for a methodology meeting the requirements (...) of the fields using rules such as law and ethics which could be significant for communications theory and the use of computers in normative fields. Other substantive issues related to the mainstream of legal philosophy are discussed - theories of interpretation, the notion of purpose and the requirements of principled decision-making. The book utilizes examples drawn from English and American legal decisions to suggest how the positions of legal positivism and of natural law are equally artificial and misleading. (shrink)

Tattoos are widely regarded as morally neutral, and the decision to have them as carrying no ethical implications. The aim of this paper is to question this assumption. I argue that decisions to have tattoos involve risks that are not merely prudential—they are normative. The argument starts with a thesis that the power we presently have over our lives is constrained by the need to respect our future selves. If we make a discretionary choice that disregards our future interests (...) and preferences, then, under certain circumstances, we can be morally to blame. I argue that certain decisions to get tattoos fit this description. Therefore, getting some tattoos makes us blameworthy. (shrink)

The problem of how to make optimal choices in the face of risk arises in both economics/decision theory and also evolutionary biology; in the former, ‘optimal’ means utility maximizing, while in the latter it means fitness maximizing. This article explores the links, thematic and formal, between the economic and evolutionary theories of optimal choice in risky situations, with particular reference to the relationship between utility and fitness. It is argued that the link is strongest between evolution and ‘nonexpected’ (...) utility theory, rather than traditional expected utility theory. (shrink)

The ways in which the decisions we make for others differ from the ones we make for ourselves has received much attention in the literature, although less is known about their relationship to our p...

The standard economic choice model assumes that the decision maker chooses from sets of alternatives. In contrast, we analyze a choice model in which the decision maker encounters the alternatives in the form of a list. We present two axioms similar in nature to the classical axioms of choice from sets. We show that they characterize all the choice functions from lists that involve the choice of either the first or the last optimal alternative in (...) the list according to some preference relation. We then relate choice functions from lists to the classical notions of choice correspondences and random choice functions. (shrink)

Addressing himself not only to an academic but to a generally educated public, Lamont introduces the perennial debate between determinism and freedom of choice with liberal and lively quotes from both sides down through history. He proceeds to argue with passionate conviction that both objective contingency and necessity exist as correlative cosmic ultimates, and that the world must therefore be viewed as essentially pluralistic. Moving from a consideration of contingency to the notion of potentiality, Lamont analyzes freedom of (...) class='Hi'>choice as the actualization of one of a plurality of genuinely open alternatives which are made possible by contingency and potentiality. Following Hartshorne, he argues that the relation of universal to particular, of determinable to determinate, is one of indeterminate or contingent or potential to determinate or actual; on this ground he finds contingency or freedom inherent in the very act of rational deliberation. Moreover, scientific theories of probability are interpreted as confirming the existence of this sort of objective contingency. Determinism on the other hand, he maintains, not only rules out universals altogether but denies the dynamic character of time, undercuts the notion of ethical responsibility, and defies common sense and ordinary use of language. The book is highly readable--and highly provocative. A fair example of its provocative character is provided in the mileage Lamont gets out of his crucial chapter which seeks to establish the existence of objective contingency as a cosmic ultimate which "demolishes the case for a completely determined universe". On the one hand, contingency is taken to be "simply the opposite of determinism or necessity, meaning that an event, object, or state of affairs either may or may not be". On this interpretation it is not difficult to see why Lamont feels that "freedom of choice is obviously an impossibility unless contingency objectively exists in Nature". On the other hand, it turns out that what it means to say that a contingent event "may or may not be" is perhaps not after all so clearly incompatible with determinism. Thus contingency "does not imply that any event is causeless" but only that it is possible for causally determined factors to impinge on other factors--themselves in turn causally but independently determined. In the long run this seems to involve an act of faith that "the infinitely diverse world of Nature radiates from different centers... that if there ever was a beginning to the universe, which is most doubtful, it would have been beginnings, that is, a multitude of first causes all popping at once". Moreover, it is not wholly clear just how this sort of contingency--which seems to be non-teleological and by definition must operate from outside the causal sequence--is supposed to make possible or even provide a parallel to the exercise of free choice. To a believer in freedom, Lamont's account of contingency seems to offer a meager foundation for so important a theory.--R. D. (shrink)

The environmentally friendly or ‘sustainable’ products have been launched in various markets in response to the growing concerns for the environmental deterioration and the alarming effects of climate change in past years. However, the uptake of green products does not seem to fully reflect the self-claimed pro-environmental concerns and attitudes. Consumers who profess to be environmentally conscious and believe they could help slow down environmental deterioration do not necessarily purchase eco-friendly products. This discrepancy between behaviour and attitude has been termed (...) as ‘intention-behaviour gap’ or ‘green gap’. This study aims at exploring the green gap in the purchases of high-involvement products such as skincare products. Focus groups and thematic analysis were conducted. It was found that environmental concern was virtually non-existent in making purchase decisions with regard to skincare products because the perceived product effectiveness is found to be the key determinant of the choice of skincare products. Other factors such as weak social norm, weak perceived consumer effectiveness, and a sense of powerlessness facing the environment degradation, to some degree, attribute to the consumers’ justification of their non-green consumption practices. Implications for closing the gap have been drawn for marketing practitioners and policy makers. Directions for future research are also provided. (shrink)

In the context of computational social choice, we study voting methods that assign a set of winners to each profile of voter preferences. A voting method satisfies the property of positive involvement (PI) if for any election in which a candidate x would be among the winners, adding another voter to the election who ranks x first does not cause x to lose. Surprisingly, a number of standard voting methods violate this natural property. In this paper, we investigate different (...) ways of measuring the extent to which a voting method violates PI, using computer simulations. We consider the probability (under different probability models for preferences) of PI violations in randomly drawn profiles vs. profile-coalition pairs (involving coalitions of different sizes). We argue that in order to choose between a voting method that satisfies PI and one that does not, we should consider the probability of PI violation conditional on the voting methods choosing different winners. We should also relativize the probability of PI violation to what we call voter potency, the probability that a voter causes a candidate to lose. Although absolute frequencies of PI violations may be low, after this conditioning and relativization, we see that under certain voting methods that violate PI, much of a voter's potency is turned against them - in particular, against their desire to see their favorite candidate elected. (shrink)

Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some (...) members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC. (shrink)

Trustful interaction serves the interests of those involved. Thus, one could reason that trust itself may be analyzed as part of rational, goaloriented action. In contrast, common sense tells us that trust is an emotion and is, therefore, independent of rational deliberation to some extent. I will argue that we are right in trusting our common sense. My argument is conceptual in nature, referring to the common distinction between trust and pure reliance. An emotional attitude may be understood as some (...) general pattern in the way the world or some part of the world is perceived by an individual. Trust may be characterized by such a pattern. I shall focus on two central features of a trusting attitude. First, trust involves a participant attitude (Strawson) toward the person being trusted. Second, a situation of trust is perceived by a trusting person as one in which shared values or norms motivate both his own actions as well as those of the person being trusted. As an emotional attitude, trust is, to some extent, independent of objective information. It determines what a trusting person will believe and how various outcomes are evaluated. Hence, trust is quite different from rational belief and the problem with trust is not adequately met in minimizing risk by supplying extensive information or some mechanism of sanctioning. Trust is an attitude that enables us to cope with risk in a certain way. If we want to promote trustful interaction, we must form our institutions in ways that allow individuals to experience their interest and values as shared and, thus, to develop a trusting attitude. (shrink)

The primary responsibility of the US Food and Drug Administration is to protect public health by ensuring the safety of the food supply. To that end, it sometimes conducts risk assessments of novel food products, such as genetically modified food. The FDA describes its regulatory review of GM food as a purely scientific activity, untainted by any normative considerations. This paper provides evidence that the regulatory agency is not justified in making that claim. It is argued that the FDA’s (...) policy stance on GM food is shaped by neoliberal considerations. The agency’s review of a genetically engineered animal, the AquAdvantage salmon, is used as a case study to track the influence of neoliberalism on its regulatory review protocol. After that, an epistemic argument justifying public engagement in the risk assessment of new GM food is outlined. It is because risk evaluations involve normative judgments, in a democracy, layperson representatives of informal epistemic communities that could be affected by a new GM food should have the opportunity to decide the ethical, political or other normative questions that arise during the regulatory review of that entity. (shrink)

Since its inception, donor conception practices have been a reproductive choice for the infertile. Past and current practices have the potential to cause significant and lifelong harm to the offspring through loss of kinship, heritage, identity, and family health history, and possibly through introducing physical problems. Legislation and regulation in Australia that specifies that the welfare of the child born as a consequence of donor conception is paramount may therefore be in conflict with the outcomes. Altering the paradigm to (...) a child-centric model, however, impinges on reproductive choice and rights of adults involved in the process. With some lobby groups pushing for increased reproductive choice while others emphasise offspring rights there is a dichotomy of interests that society and legislators need to address. Concepts pertaining to a shift toward a child-centric paradigm are discussed. (shrink)