Decision making is a key activity, perhaps the most important activity, in the practice of healthcare. Although physicians acquire a great deal of knowledge and specialised skills during their training and through their practice, it is in the exercise of clinical judgement and its application to individual patients that the outstanding physician is distinguished. This has become even more relevant as patients become increasingly welcomed as partners in a shared decision making process. This book translates the (...) research and theory from the science of decision making into clinically useful tools and principles that can be applied by clinicians in the field. It considers issues of patient goals, uncertainty, judgement, choice, development of new information, and family and social concerns in healthcare. It helps to demystify decision theory by emphasizing concepts and clinical cases over mathematics and computation. (shrink)

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

The authors developed this textbook in response to an increasing interest in ethics, and a growing number of courses on this topic that are now being offered in educational leadership programs. It is designed to fill a gap in instructional materials for teaching the ethics component of the knowledge base that has been established for the profession. The text has several purposes: First, it demonstrates the application of different ethical paradigms (the ethics of justice, care, critique, and the profession) through (...) discussion and analysis of real-life moral dilemmas that educational leaders face in their schools and communities. Second, it addresses some of the practical, pedagogical, and curricular issues related to the teaching of ethics for educational leaders. Third, it emphasizes the importance of ethics instruction from a variety of theoretical approaches. Finally, it provides a process that instructors might follow to develop their own ethics unit or course. * Part I provides an overview of why ethics is so important, especially for today's educational leaders, and describes a multiparadigm approach essential to practitioners as they grapple with ethical dilemmas. * Part II deals with the dilemmas themselves. Ethical dilemmas written by the authors' graduate students bring readers face-to-face with the kinds of dilemmas faced by practicing administrators in urban, suburban, and rural settings in an era full of complexities and contradictions. * Part III focuses on pedagogy and provides teaching notes for the instructor. The authors discuss the importance of self-reflection on the part of both instructors and students, and model how they thought through their own personal and professional ethical codes as well as reflected upon the critical incidents in their lives that shaped their teaching and frequently determined what they privileged in class. (shrink)

Prima facie, we make successful decisions as we act on and intervene in the world day-to-day. Epistemologists are often concerned with whether rationality is involved in such decision-making practices, and, if so, to what degree. Some, particularly in the post-structuralist tradition, argue that successful decision-making occurs via an existential leap into the unknown rather than via any determinant or criterion such as rationality. I call this view radical voluntarism (RV). Proponents of RV include those who subscribe (...) to a view they call Critical Complexity (CC). In this paper, I argue that CC presents a false dichotomy when it conceives of rationality in Cartesian – i.e. ideal and transcendental – terms, and then concludes that RV is the proper alternative. I then outline a pragmatist rationality informed by recent work in psychology on bounded rationality, ecological rationality, and specifically embodied rationality. Such a pragmatist rationality seems to be compatible with the tenets of post-structuralism, and can therefore replace RV in CC. (shrink)

This paper introduces a refined single-valued neutrosophic set (RSVNS) and presents a similarity measure of RSVNSs. Then a multicriteria decision-making method with RSVNS information is developed based on the similarity measure of RSVNSs. By the similarity measure between each alternative and the ideal solution (ideal alternative), all the alternatives can be ranked and the best one can be selected as well. Finally, an actual example on the selecting problems of construction projects demonstrates the application and effectiveness of the (...) proposed method. (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)

Marshall and colleagues (2024) contribute to the literature on autonomy and decision-making capacity by focusing on the case of individuals with opioid use disorder who refuse to remain in the hosp...

Decision-making Capacity matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that dmc matters because autonomy matters. And this is thought to justify dmc as a gatekeeper for autonomy – whereby autonomy concerns arise if but only if a patient has dmc. But appeals to autonomy invoke two distinct concerns: concern for authenticity – concern that a choice is consistent with an individual’s commitments; (...) and concern for sovereignty – concern that an individual exercises control over that which is hers to control. Here, I argue, neither concern can alone explain why dmc matters. Instead, dmc matters because it indicates a harmony between the two concerns – the demands of each concern are more likely to agree if a patient has dmc. This vindicates the standard story, but also makes clear that dmc is an inappropriate gatekeeper for autonomy. (shrink)

Decision-making capacity (DMC) plays an important role in clinical practice—determining, on the basis of a patient’s decisional abilities, whether they are entitled to make their own medical decisions or whether a surrogate must be secured to participate in decisions on their behalf. As a result, it’s critical that we get things right—that our conceptual framework be well-suited to the task of helping practitioners systematically sort through the relevant ethical considerations in a way that reliably and transparently delivers correct (...) verdicts about who should and should not have the authority to make their own medical decisions. Unfortunately, however, the standard approach to DMC does not get things right. It is of virtually no help in identifying and clarifying the relevant ethical considerations. And, embedded in the prevailing anti-paternalist paradigm, DMC assessments obfuscate and distort the underlying ethical justification for granting or withholding decisional authority. Here, we describe the core commitments of the standard approach to DMC and then highlight three problems with it. We then argue that these problems are significant enough that they call for more than merely tinkering and fine tuning—variations of the standard approach cannot adequately address them. Instead, we should ditch DMC. (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)

This article provides an overview of a number of research studies conducted within the field of parenthood and reproduction in a variety of Western cultures, including Slovakia and the countries of Eastern Europe. The main aim of this overview is to analyse two key indicators on Second Demographic Transition: delaying marriage and parenthood until later on in life and the growth in cohabitation as an alternative living arrangement and childbearing as part of that. The author points out that the majority (...) of parents opt to have a first child and this brings normative and emotional fulfilment. Most young people do not reject this, but simply postpone it until later on in life. The hypothesis is postulated that the decision on whether to have further children is to a larger extent rationally based and is more dependent on weighing up the incentives available from the state. The article emphasises, on the basis of a comparison of the results of various empirical studies, that the same patterns of reproductive behaviour can produce markedly different consequences and outcomes within various subgroups of the population. It is recommended that current research into parenthood and reproduction should be extended so that studies are conducted into similar groups within subpopulations across different countries—in contrast to the current prevailing research that is focused on single countries or in comparing different countries as a whole. It is also recommended that the scope of the research be extended to compare a number of different subpopulations with similar value and life-style configurations as opposed to the majority of the current narrowly-focused approaches that concentrate on examining the differences in reproductive behaviour patterns of a section of the population selected on the basis of education. (shrink)

This article argues that supported decision making is ideal for people with dynamic cognitive and functional impairments that place them at the margins of autonomy. First, we argue that guardianship and similar surrogate decision-making frameworks may be inappropriate for people with dynamic impairments. Second, we provide a conceptual foundation for supported decision making for individuals with dynamic impairments, which integrates the social model of disability with relational accounts of autonomy. Third, we propose a three-step (...) model that specifies the necessary conditions of supported decision making: identifying domains for support; identifying kinds of supports; and reaching a mutually acceptable and formal agreement. Finally, we identify a series of challenges for supported decision making, provide preliminary responses, and highlight avenues for future bioethics research. (shrink)

Decision-making assisted by algorithms developed by machine learning is increasingly determining our lives. Unfortunately, full opacity about the process is the norm. Would transparency contribute to restoring accountability for such systems as is often maintained? Several objections to full transparency are examined: the loss of privacy when datasets become public, the perverse effects of disclosure of the very algorithms themselves, the potential loss of companies’ competitive edge, and the limited gains in answerability to be expected since sophisticated algorithms (...) usually are inherently opaque. It is concluded that, at least presently, full transparency for oversight bodies alone is the only feasible option; extending it to the public at large is normally not advisable. Moreover, it is argued that algorithmic decisions preferably should become more understandable; to that effect, the models of machine learning to be employed should either be interpreted ex post or be interpretable by design ex ante. (shrink)

In this paper, we define projection and bidirectional projection measures between interval rough neutrosophic sets and prove their basic properties. Then two new multi attribute decision making strategies are proposed based on interval rough neutrosophic projection and bidirectional projection measures respectively. Then the proposed methods are applied for solving multi attribute decision making problems. Finally, a numerical example is solved to show the feasibility, applicability and effectiveness of the proposed strategies.

In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making (...) are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice. (shrink)

Decision-Making Capacity First published Tue Jan 15, 2008; substantive revision Fri Aug 14, 2020 In many Western jurisdictions the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own medical decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This question has to (...) do with what is commonly called “decisional capacity”, a central concept in health care law and ethics, and increasingly an independent topic of philosophical inquiry. -/- Decisional capacity can be defined as the ability of subjects to make their own medical decisions. Somewhat similar questions of capacity arise in other contexts, such as capacity to stand trial in a court of law and the ability to make decisions that relate to personal care and finances. However, the history behind the more general legal notions of capacity to stand trial and capacity to manage one’s life is different and operates somewhat differently in law (Roth, Meisel, & Litz 1977; Zapf & Roesch 2005). For the purposes of this discussion the notion of decisional capacity will be limited to medical contexts only; most notably, those where decisions to consent or to refuse treatment or participation in clinical research are concerned. (shrink)

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

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

Ethical decision-making descriptive theoretical models often conflict with each other and typically lack comprehensiveness. To address this deficiency, a revised EDM model is proposed that consolidates and attempts to bridge together the varying and sometimes directly conflicting propositions and perspectives that have been advanced. To do so, the paper is organized as follows. First, a review of the various theoretical models of EDM is provided. These models can generally be divided into rationalist-based ; and non-rationalist-based. Second, the proposed (...) model, called ‘Integrated Ethical Decision Making,’ is introduced in order to fill the gaps and bridge the current divide in EDM theory. The individual and situational factors as well as the process of the proposed model are then described. Third, the academic and managerial implications of the proposed model are discussed. Finally, the limitations of the proposed model are presented. (shrink)

The options in a decision problem generally have outcomes with common features. Putting aside the common features simplifies deliberations, but the simplification requires a philosophical justification that this book provides.

Shared decision-making has become a new focus of health policy. Though its core elements are largely agreed upon, there is little consensus regarding which outcomes to prioritize for policy-mandated shared decision-making.

In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, (...) different versions of SDM are explored, versions compatible with paternalism and patient choice as well as versions that go beyond these traditional decision making models. Whenever SDM is discussed or introduced it is of importance to be clear over which of these different versions are being pursued, since they connect to basic values and ideals of health care in different ways. It is further argued that we have reason to pursue versions of SDM involving, what is called, a high level dynamics in medical decision-making. This leaves four alternative models to choose between depending on how we balance between the values of patient best interest, patient autonomy, and an effective decision in terms of patient compliance or adherence: Shared Rational Deliberative Patient Choice, Shared Rational Deliberative Paternalism, Shared Rational Deliberative Joint Decision, and Professionally Driven Best Interest Compromise. In relation to these models it is argued that we ideally should use the Shared Rational Deliberative Joint Decision model. However, when the patient and professional fail to reach consensus we will have reason to pursue the Professionally Driven Best Interest Compromise model since this will best harmonise between the different values at stake: patient best interest, patient autonomy, patient adherence and a continued care relationship. (shrink)

Decision-making assisted by algorithms developed by machine learning is increasingly determining our lives. Unfortunately, full opacity about the process is the norm. Would transparency contribute to restoring accountability for such systems as is often maintained? Several objections to full transparency are examined: the loss of privacy when datasets become public, the perverse effects of disclosure of the very algorithms themselves, the potential loss of companies’ competitive edge, and the limited gains in answerability to be expected since sophisticated algorithms (...) usually are inherently opaque. It is concluded that, at least presently, full transparency for oversight bodies alone is the only feasible option; extending it to the public at large is normally not advisable. Moreover, it is argued that algorithmic decisions preferably should become more understandable; to that effect, the models of machine learning to be employed should either be interpreted ex post or be interpretable by design ex ante. (shrink)

A discussion of ethical decision-making literature is overdue. In this article, we summarize the current literature of ethical decision-making models used in mental health professions. Of 1,520 articles published between 2001 and 2020 that met initial search criteria, 38 articles were included. We report on the status of empirical evidence for the use of these models along with comparisons, limitations, and considerations. Ethical decision-making models were synthesized into eight core procedural components and presented based (...) on the composition of steps present in each model. This taxonomy provides practitioners, trainers, students, and supervisors relevant information regarding ethical decision-making models. (shrink)

Decision-making assisted by algorithms developed by machine learning is increasingly determining our lives. Unfortunately, full opacity about the process is the norm. Would transparency contribute to restoring accountability for such systems as is often maintained? Several objections to full transparency are examined: the loss of privacy when datasets become public, the perverse effects of disclosure of the very algorithms themselves (“gaming the system” in particular), the potential loss of companies’ competitive edge, and the limited gains in answerability to (...) be expected since sophisticated algorithms usually are inherently opaque. It is concluded that, at least presently, full transparency for oversight bodies alone is the only feasible option; extending it to the public at large is normally not advisable. Moreover, it is argued that algorithmic decisions preferably should become more understandable; to that effect, the models of machine learning to be employed should either be interpreted ex post or be interpretable by design ex ante. (shrink)

Across two studies the hypotheses were tested that stressful situations affect both leadership ethical acting and leaders' recognition of ethical dilemmas. In the studies, decision makers recruited from 3 sites of a Swedish multinational civil engineering company provided personal data on stressful situations, made ethical decisions, and answered to stress-outcome questions. Stressful situations were observed to have a greater impact on ethical acting than on the recognition of ethical dilemmas. This was particularly true for situations involving punishment and lack (...) of rewards. The results are important for the Corporate Social Responsibility (CSR) of an organization, especially with regard to the analysis of the Stressors influencing managerial work and its implications for ethical behavior. (shrink)

In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this (...) process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, ‘strategic substitute decision-making’, paralleled the MCA’s legal and ethical framework, whilst the second process, ‘relational substitute decision-making’, was markedly different from these statutory procedures. In this setting, ‘relational substitute decision-making’ underpinned everyday personal and social interventions connected with residents’ daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed. (shrink)

It has recently been proposed to incorporate the use of a “Patient Preference Predictor” (PPP) into the process of making treatment decisions for incapacitated patients. A PPP would predict which treatment option a given incapacitated patient would most likely prefer, based on the individual’s characteristics and information on what treatment preferences are correlated with these characteristics. Including a PPP in the shared decision-making process between clinicians and surrogates has the potential to better realize important ethical goals for (...) making treatment decisions for incapacitated patients. However, developing and implementing a PPP poses significant practical challenges. The present paper discusses these practical challenges and considers ways to address them. (shrink)

Regarding police procedures with alcohol-intoxicated witnesses, Swedish police officers have previously reported inconsistent and subjective decisions when interviewing these potentially vulnerable witnesses. Most officers have also highlighted the need for national policy guidelines aiding in conducting investigative interviews with intoxicated witnesses. The aims of the two studies presented here were to investigate whether police officers’ inconsistent interview decisions are attributable to a lack of research-based knowledge; their decision to interview, as well as their perceptions of the witnesses’ credibility could (...) be influenced by scientific research; and police officers decision-making and perceptions of witness credibility are biased by pre-existing social norms. In two separate randomized online experiments, police professionals and recruits watched a recorded fictive witness interview to which they were asked to rate the probability of interviewing the witness, the witness’ credibility, and to estimate the witness’ level of intoxication. Results showed that interview probability and perceived witness credibility were affected by witness intoxication level. While it cannot be stated definitely from the present research, these findings provided indications that police officers and recruits lacked research-based knowledge. Results also showed that interview probability, but not perceptions of credibility, was influenced by a research-based message. In line with research, interview probability for the most intoxicated witness increased after reading the message. Unexpectedly, neither interview probability nor witness credibility was affected by social norms. The current findings added to the legal psychology literature by showing that a breath alcohol concentration as low as.04% was enough for police officers and recruits to consider intoxicated witnesses less credible than sober witnesses. Findings also indicated that, despite the lower credibility assessment, police may have some understanding that these witnesses can be interviewed at low intoxication levels. However, this willingness to interview intoxicated witnesses ceased at a BrAC lower than the levels where research has found intoxicated witnesses as reliable as sober witnesses. Future directions for research and policy development as well as theoretical and practical implications of the present findings are discussed. (shrink)

Multinational corporations face a litany of challenges regarding ethical decision-making as they traverse new variables in each country they operate in. Presented here is a new approach to ethical decision-making research for multinational corporations with the inclusion of moral virtues, national culture, and a feedback mechanism. The new proposed model builds off of the existing work by Trevino’s Person-Situated Interactionist Model. Hofstede’s work on individual national culture characteristics is used to move the conversation forward by explaining (...) the relationships between individual moderators in Trevino’s model and the effect of national culture on them. The new proposed model recommends the inclusion of moral virtues, with honesty and integrity as examples, as individual moderators in the decision-making process based on previous work. It contributes to the literature by introducing moral virtues into traditional ethical decision-making process models and introduces a new variable with a feedback mechanism for future learning. The paper concludes with recommendations for the future direction of research for ethical decision-making models for multinational organizations. (shrink)

Decisions are made under uncertainty when there are distinct outcomes of a given action, and one is uncertain to which the act will lead. Decisions are made under indeterminacy when there are distinct outcomes of a given action, and it is indeterminate to which the act will lead. This paper develops a theory of (synchronic and diachronic) decision-making under indeterminacy that portrays the rational response to such situations as inconstant. Rational agents have to capriciously and randomly choose how (...) to resolve the indeterminacy relevant to a given choice-situation, but such capricious choices once made constrain how they will choose in the future. The account is illustrated by the case of self-interested action in situations where it is indeterminate whether you yourself will survive to benefit or suffer the consequences. The conclusion emphasizes some distinctive anti-hedging predictions of the account. (shrink)

Our research’s aim is to assess the effect of cultural factors on business ethical decision-making process in a Western cultural context and in a non-Western cultural context. Specifically, this study investigates ethical perceptions, religiosity, personal moral philosophies, corporate ethical values, gender, and ethical intentions of U.S. and Moroccan business managers. The findings demonstrate that significant differences do exist between the two countries in idealism and relativism. Moroccan managers tend to be more idealistic than the U.S. managers. There is (...) a strong positive relationship between religiosity and idealism. There were mixed findings in examining the correlates of religiosity and various components of ethical intentions. Moroccan managers were more homogenous in their corporate ethical values than were the U.S. managers. The results demonstrate that (in general) idealism is a good predictor of ethical intentions and behaviors. Additionally, managers from the two countries differed in the degree of relationship between perceptions and intentions in three of the four scenarios. This study’s results confirm other research findings that, in general, female business managers have higher ethical sensitivity in terms of their ethical judgment than their male counterparts. Managerial implications are also discussed. (shrink)

This paper reports on a study of ethical decision-making in a fair trade company. This can be seen to be a crucial arena for investigation since fair trade firms not only have a specific ethical mission in terms of helping growers out of poverty, but they tend to be perceived as (and are often marketed on the basis of) having an "ethical" image. Eschewing a straightforward test of extant ethical decision models, we adopt Thompson''s proposal for a (...) more contextualist understanding rooted in ethnographic data. Our findings suggest that the fair trade mission of the firm is experienced as an over-riding ethical claim, which is often invoked to justify potentially ethically questionable decisions. Moreover, decision precedents emerge which can mean that the decision process is bypassed or hurried through. Finally we provide evidence that the significance of these precedents, and indeed, even moral intensity itself, could be actively shaped and constructed by organization members to support different, even shifting, conceptions of what is a morally acceptable decision for a fair trade company to make. (shrink)

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

In this study, we propose a new approach based on fuzzy TODIM (Portuguese acronym for interactive and multicriteria decision-making) for decision-making problems in uncertain environments. Our method incorporates group utility and individual regret, which are often ignored in traditional multicriteria decision-making (MCDM) methods. To enhance the analysis and application of fuzzy sets in decision-making processes, we introduce novel entropy and distance measures for q-rung picture fuzzy sets. These measures include an entropy measure (...) based on the sine function and a distance measure derived from the Jensen-Shannon divergence. In our methodology, incorporating the sine function into the entropy measure stands out as a distinctive decision, grounded in a profound understanding of the inherent characteristics of fuzzy sets. Utilizing the sine function proves especially advantageous when handling fuzzy sets that exhibit cyclical variations or fluctuations in their membership degrees. We effectively weight the criteria for an improved evaluation by using this new entropy measure. The introduced distance measure finds application in the TODIM approach, allowing the execution of TODIM method steps within a fuzzy environment until the determination of one alternative’s dominance over another—an advancement beyond traditional approaches. We apply our enhanced fuzzy TODIM method to a real-life construction project management problem from the literature and compare the results with those in the literature and obtained from other MCDM methods. Our proposed measures are robust, as demonstrated by the sensitivity analysis that varied the weights of group utility and individual regret, with the results visualized in a 3D sensitivity plot. The findings demonstrate the superiority of our method in providing a more comprehensive evaluation of alternatives, making it a useful tool for decision-makers facing complex and uncertain decision-making problems. (shrink)

PREVIOUS WORK Theoretical discussion of the interval measurement of utility based upon theories of decision making under conditions of risk has been voluminous and will not be reviewed here. Those interested will find extensive ...

Automated decision making for sentencing is the use of a software algorithm to analyse a convicted offender’s case and deliver a sentence. This chapter reviews the moral arguments for and against employing automated decision making for sentencing and finds that its use is in principle morally permissible. Specifically, it argues that well-designed automated decision making for sentencing will better approximate the just sentence than human sentencers. Moreover, it dismisses common concerns about transparency, privacy and (...) bias as unpersuasive or inapplicable. The chapter also notes that moral disagreement about theories of just sentencing are plausibly resolved by applying the principle of maximising expected moral choiceworthiness, and that automated decision making is better suited to the resulting ensemble model. Finally, the chapter considers the challenge posed by penal populism. The dispiriting conclusion is that although it is in theory morally desirable to use automated decision-making for criminal sentencing, it may well be the case that we ought not to try. (shrink)

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

This paper discusses the philosophical argument and the application of the Triple Font Theory for moral evaluation of human acts and attempts to integrate the conceptual components of major moral theories into a systematic internally consistent decision-making model that is theoretically driven. The paper incorporates concepts such as formal and material cooperation and the Principle of Double Effect into the theoretical framework. It also advances the thesis that virtue theory ought to be included in any adequate justification of (...) morality and the need to integrate or coordinate notions of virtue into various act-oriented or principles-based ethics. The TFT offers a comprehensive and practical approach to ethical decision-making and is a useful alternative embedded in traditional wisdom. This paper provides a more general framework of the TFT than traditionally presented. Practical judgment is shown to play a constitute role in providing a guide for right action and is the “glue” that integrates the various components of the TFT. (shrink)

Poor ethical decision–making costs industry billions of dollars a year and damages the images of corporations. Thus, by answering the question ‘Why do individuals behave as they do when confronted with ethical issues?’ ethical theory can provide businesses with a means to create a more ethical climate and a more successful operation. This study tested the Ethical Decision–Making Model with accountability (Beu & Buckley 2001), which uses theory that suggests that ethical behavior is influenced by the (...) individual, the issue, social relationships (accountability), and the organization in which the employee is embedded (Brass, Butterfield & Skaggs 1988; Frink & Klimoski 1998). The results showed that individuals’ thought processes (cognitive moral development), personalities (locus of control, hostility and aggression, Machiavellianism), and gender influence how they respond to ethical dilemmas, as well as the salience of the moral issue (moral intensity) and the environmental context (work/school). (shrink)

In response to the lack of empirical studies examining the internal disclosure behavior in the Chinese context, this study tested a whistleblowing -decision-making process among employees in the Chinese banking industry. For would-be whistleblowers, positive affect and organizational ethical culture were hypothesized to enhance the expected efficacy of their whistleblowing intention, by providing collective norms concerning legitimate, management-sanctioned behavior. Questionnaire surveys were collected from 364 employees in 10 banks in the Hangzhou City, China. By and large, the findings (...) supported the hypotheses. Issues of whistleblowing in the Chinese context and implications were discussed. (shrink)

Poor ethical decision–making costs industry billions of dollars a year and damages the images of corporations. Thus, by answering the question ‘Why do individuals behave as they do when confronted with ethical issues?’ ethical theory can provide businesses with a means to create a more ethical climate and a more successful operation. This study tested the Ethical Decision–Making Model with accountability (Beu & Buckley 2001), which uses theory that suggests that ethical behavior is influenced by the (...) individual, the issue, social relationships (accountability), and the organization in which the employee is embedded (Brass, Butterfield & Skaggs 1988; Frink & Klimoski 1998). The results showed that individuals’ thought processes (cognitive moral development), personalities (locus of control, hostility and aggression, Machiavellianism), and gender influence how they respond to ethical dilemmas, as well as the salience of the moral issue (moral intensity) and the environmental context (work/school). (shrink)