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)

Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We (...) report on the difficult task of operationalizing the principles of beneficence, non-maleficence and patient autonomy, and describe how we selected suitable input parameters that we extracted from a training dataset of clinical cases. The first performance results are promising, but an algorithmic approach to ethics also comes with several weaknesses and limitations. Should one really entrust the sensitive domain of clinical ethics to machine intelligence? (shrink)

In order to strengthen RI in the private sector, it is imperative to understand how companies organise this process, where it takes place, and what considerations and motivations are central in the innovation process. In this chapter, the questions of whether and where normative considerations play a role in the innovation process, and whether dimensions of RI are present in the innovation process, are addressed. In order answer these research questions, a theoretical framework is developed based on Jones’s theory of (...) ethical decision making and Cooper’s stagegate model of innovation management. In order to answer the research questions, a specific case of innovations that contribute to public health is explored, namely, that of food companies that participate in a Front-of-Pack logo for healthier food. As the use of healthy food logos does not necessarily have a positive impact on sales and profits, it is expected that in the decision-making process, as part of their innovation process, companies make several trade-offs between economic, technical and moral factors. As the social-ethical values at stake in corporate innovation processes have remained to a large extent unexplored in research on innovation management, the aim of this chapter is to identify the motivations and barriers for companies embracing and continuing a FoP logo for healthier food, and to assess whether ethical considerations play a role in this innovation process. From the findings in this research, it will become clear that although the studied companies participated in a programme for healthy food and thus are responsive to the needs of society, and although the companies feel responsible for public health, ethical considerations do not play a central role in the operational innovation process. Instead, technical and economic considerations seem to prevail in the operational innovation process. Furthermore, none of the procedural dimensions of RI seems to be present at this level in the innovation trajectory. It is argued that this may be an indication that the ethical decision-making process for RI is not located at the level of the operational innovation process itself, but is something that might be located on a higher strategic level in the company. It is at this level that the moral decision is taken to adopt the FoP logo and to engage in the RI process. The findings cast a new light on the discourse on RI in general, and in the private sector in particular. (shrink)

This paper examines the relationship of ethical decision-making by individuals to corporate business ethics and organizational performance of three groups: SMEs, Outstanding SMEs and Large Enterprises, in order to provide a reference for Taiwanese entrepreneurs to practice better business ethics. The survey method involved random sampling of 132 enterprises within three groups. Some 524 out of 1320 questionnaires were valid. The survey results demonstrated that ethical decision-making by individuals, corporate business ethics and organizational performance (...) are highly related. In summary, then, high levels of organizational performance were directly attributable to high levels of applied corporate and individual ethics. Furthermore, there is a demonstrable tendency for Outstanding SMEs to reject ethically unsound practices such as padded expense accounts, tax evasion and misleading advertising. The measurement criteria used to assess organizational performance, however, did not include an objective evaluation of financial performance. (shrink)

One recent priority of the U.S. government is developing autonomous robotic systems. The U.S. Army has funded research to design a metric of evil to support military commanders with ethical decision-making and, in the future, allow robotic military systems to make autonomous ethical judgments. We use this particular project as a case study for efforts that seek to frame morality in quantitative terms. We report preliminary results from this research, describing the assumptions and limitations of a (...) program that assesses the relative evil of two courses of action. We compare this program to other attempts to simulate ethical decision-making, assess possibilities for overcoming the trade-off between input simplification and output reliability, and discuss the responsibilities of users and designers in implementing such programs. We conclude by discussing the implications that this project highlights for the successes and challenges of developing automated mechanisms for ethical decision making. (shrink)

Every day nurses are required to make ethical decisions in the course of caring for their patients. Ethics in Nursing Practice provides the background necessary to understand ethical decision making and its implications for patient care. The authors focus on the individual nurse’s responsibilities, as well as considering the wider issues affecting patients, colleagues and society as a whole. This third edition is fully updated, and takes into account recent changes in ICN position statements, WHO documents, (...) as well as addressing current issues in healthcare, such as providing for the health and care needs of refugees and asylum seekers, bioethics and the enforcement of nursing codes. (shrink)

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 personality traits of social work leaders are important factors influencing ethical decision-making in organisations. The lack of empirical evidence with regard to the relationship between personal authenticity and ethical decision-making in social work stimulated the present study. Two hundred thirty-eight leaders (81.9% female) from organisations working in various fields of social work were administrated with the Authenticity Scale, Managerial Ethical Profile, and conducted two free association tasks with the cue words authenticity and (...) self. Authenticity was positively correlated with ethical decision-making. In contrast, authenticity was not correlated with the tendency to make decisions in an effort to maximise economic profit for the organisation. The results of the present study have important practical implications for the social work sector. The positive correlation of authenticity with ethical decision-making indicates that positive reinforcement of authenticity in leaders could possibly lead to supporting ethical decision-making within an organisation. Therefore, supporting authenticity in leaders working in social work may also help foster quality services and prevent unethical behaviour. (shrink)

This paper discusses two approaches to climate ethics for practicalreflection and decision-making in concrete local climate changegovernance. After a brief review of the main conceptual frameworksin climate ethics research, we show that none of these leadingapproaches is sufficiently context specific and pluralistic to provideguidance appropriate for concrete local climate governance. Asalternatives, we present principlism as a methodology of midlevelprinciples and environmental pragmatism as an ethicalapproach. We argue that the two methodologies of principlismand pragmatism offer a new pluralistic framework (...) that allows realworldconditions and contexts to be properly integrated into ethicalanalysis and decision-making in climate governance. (shrink)

This paper attempts to delineate the interaction between trust, emotion, and ethical decision making. The authors first propose that trust can either incite an individual toward ethical decisions or drag him or her away from ethical decisions, depending on different situations. The authors then postulate that the feeling of guilt is central in understanding how trust affects the ethical decision making process. Several propositions based on these assumptions are introduced and implications for (...) practice discussed. (shrink)

While artificial intelligence (AI) is increasingly applied for decision-making processes, ethical decisions pose challenges for AI applications. Given that humans cannot always agree on the right thing to do, how would ethical decision-making by AI systems be perceived and how would responsibility be ascribed in human-AI collaboration? In this study, we investigate how the expert type (human vs. AI) and level of expert autonomy (adviser vs. decider) influence trust, perceived responsibility, and reliance. We find (...) that participants consider humans to be more morally trustworthy but less capable than their AI equivalent. This shows in participants’ reliance on AI: AI recommendations and decisions are accepted more often than the human expert’s. However, AI team experts are perceived to be less responsible than humans, while programmers and sellers of AI systems are deemed partially responsible instead. (shrink)

Resumen: Este artículo tiene como objetivo indagar si la mímesis ―o imitación― tal como la entiende René Girard (1923-2015), afecta el juicio ético ―o evaluación moral― de una acción que el ejecutivo realiza en la empresa. En la primera parte, se caracteriza el juicio ético de acuerdo con una revisión de la literatura de ética empresarial (2010-2020). En la segunda parte, se sintetiza cómo Girard explica la conformación de la sociedad a partir de la mímesis, una fuerza impulsora ambivalente que (...) se manifiesta en el deseo de ser como el otro y de diferenciarse del otro, el deseo de apropiarse de lo del otro y la rivalidad. En la tercera, se ilustran las ideas de Girard con ejemplos de la dinámica organizacional. En la cuarta y última parte, se realiza la discusión a fin de responder la pregunta de investigación. Se concluye que, si el sujeto decide no ejercer su capacidad de discernimiento, la mímesis ofrece elementos y oportunidades o bien para el autoengaño respecto de la moralidad y responsabilidad de una acción, o bien para la omisión del juicio ético individual. Abstract: This article aims to investigate whether mimesis ―or imitation― as understood by René Girard (1923-2015), affects the ethical judgment ―or moral evaluation― of an action that the executive performs in the company. First, this text offers a characterization of the ethical judgment according to the business ethics literature review (2010-2020). Second, this article provides a synthesis of Girard´s theory of mimetic desire. Girard conceived the mimesis as a main social driving force from which emerge both, the desire to be like the other and to differentiate from the other. This ambivalent and paradoxical force leads human beings to order and union, or to rivalry and revenge. Third, this inquiry illustrates Girard's ideas with examples of organizational dynamics. In the fourth and last part, the discussion leads to answering the research question. Study’s limitations are pointed out. This inquiry concludes that if the decision-making subject decides not to exercise his/her discernment and rather to remain in the mimesis' blindness, the executive will find elements and opportunities for self-deception or substitution of his/her own ethical judgment with others imitation. (shrink)

In the last few decades psychologists have gained a clearer picture of the notion of happiness and a more sophisticated account of its explanation. Their research has serious consequences for any ethic based on the maximization of happiness, especially John Stuart Mill’s classical eudaimonistic utilitarianism. In the most general terms, the research indicates that a congenital basis for homeostatic levels of happiness in populations, the hedonic treadmill effect, and other personality factors, contribute to maintain a satisfactory level of happiness over (...) the long run for a large percentage of any population, and relatively independently of the circumstances of the population. Consequently, although there are certainly ethical reasons to address the conditions of persons and populations, it is of marginal value to base such decisions on improvements in their levels of happiness. The happiness of others is not a sensible criterion for ethical decision-making. (shrink)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds (...) in philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

Some economists, notably Gary Becker, claim that economic analysis is applicable to any decision, ethical or otherwise. Ethical principles within Objectivist Ethics are based on long-range success— life being the measure of success. This paper examines these different approaches to decision-making. Decision theory and Rand's Benevolent Universe Premise form the basis for the analysis.

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)

It has been argued by disability advocates that supported decision-making must replace surrogate, or substituted, decision-making for people with cognitive disabilities. From a moral perspective surrogate decision-making it is said to be an indefensible form of paternalism. At the heart of this argument against surrogate decision-making is the belief that such paternalistic action expresses something fundamentally disrespectful about those upon whom it is imposed: that they are inferior, deficient or child-like in some (...) way. Contrary to this widespread belief, I will argue that surrogate decision-making sometimes expresses more respect for people with life-long, ‘severe’ or ‘profound’ cognitive disabilities than does the adoption of supported decision-making.. Specifically, I argue that in some cases supported decision-making can arguably express that people with severe or profound cognitive disabilities lack equal moral value. I also argue that supported decision-making for people with profound cognitive disabilities can arguably express that they lack complex and rich inner lives. If our aim is to ensure our behaviour and practices express respect for people with life-long ‘severe’ or ‘profound’ cognitive disabilities, then sometimes surrogate rather than supportive decision-making will be a better option. (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)

Utilitarianism, it has been said, is not sensitive to the distribution of welfare. In making risky decisions for others there are multiple sensitivities at work. I present examples of risky decision-making involving drug allocations, charitable giving, breast-cancer screening and C-sections. In each of these examples there is a different sensitivity at work that pulls away from the utilitarian prescription. Instances of saving fewer people at a greater risk to many is more complex because there are two distributional (...) sensitivities at work that pull in opposite directions from the utilitarian calculus. I discuss objections to these sensitivities and conclude with some reflections on the value of formal modelling in thinking about societal risk. (shrink)

Using artificial intelligence (AI) to make decisions in human resource management (HRM) raises questions of how fair employees perceive these decisions to be and whether they experience respectful treatment (i.e., interactional justice). In this experimental survey study with open-ended qualitative questions, we examine decision making in six HRM functions and manipulate the decision maker (AI or human) and decision valence (positive or negative) to determine their impact on individuals’ experiences of interactional justice, trust, dehumanization, and perceptions (...) of decision-maker role appropriate- ness. In terms of decision makers, the use of human decision makers over AIs generally resulted in better perceptions of respectful treatment. In terms of decision valence, people experiencing positive over negative decisions generally resulted in better perceptions of respectful treatment. In instances where these cases conflict, on some indicators people preferred positive AI decisions over negative human decisions. Qualitative responses show how people identify justice concerns with both AI and human decision making. We outline implications for theory, practice, and future research. (shrink)

Important decisions that impact humans lives, livelihoods, and the natural environment are increasingly being automated. Delegating tasks to so-called automated decision-making systems can improve efficiency and enable new solutions. However, these benefits are coupled with ethical challenges. For example, ADMS may produce discriminatory outcomes, violate individual privacy, and undermine human self-determination. New governance mechanisms are thus needed that help organisations design and deploy ADMS in ways that are ethical, while enabling society to reap the full economic (...) and social benefits of automation. In this article, we consider the feasibility and efficacy of ethics-based auditing as a governance mechanism that allows organisations to validate claims made about their ADMS. Building on previous work, we define EBA as a structured process whereby an entity’s present or past behaviour is assessed for consistency with relevant principles or norms. We then offer three contributions to the existing literature. First, we provide a theoretical explanation of how EBA can contribute to good governance by promoting procedural regularity and transparency. Second, we propose seven criteria for how to design and implement EBA procedures successfully. Third, we identify and discuss the conceptual, technical, social, economic, organisational, and institutional constraints associated with EBA. We conclude that EBA should be considered an integral component of multifaced approaches to managing the ethical risks posed by ADMS. (shrink)

In this chapter, it is argued that some animal shelters fulfill the conditions that make triage protocols necessary, namely, the operation with limited financial budgets, space, medical resources, and staff. It is suggested that requirements presented for triage in humans can be fruitfully applied to the context of animal shelters. The focus lies on the criteria of maximizing benefit, justice, medical criteria, life-span considerations, fair decision-making, patient will, re-evaluation of triage decisions and changes in the therapeutic goal, and (...) burden of triage and staff support. The establishment of triage protocols for shelters will make the decision-making process less arbitrary, fairer, and more transparent. Furthermore, it is argued that, in situations where disagreement persist among shelter staff, an external Ethics Board could be called in to help analyze and potentially resolve some of the remaining ethical issues. (shrink)

Computers are used to make decisions in an increasing number of domains. There is widespread agreement that some of these uses are ethically problematic. Far less clear is where ethical problems arise, and what might be done about them. This paper expands and defends the Ethical Gravity Thesis: ethical problems that arise at higher levels of analysis of an automated decision-making system are inherited by lower levels of analysis. Particular instantiations of systems can add new (...) problems, but not ameliorate more general ones. We defend this thesis by adapting Marr’s famous 1982 framework for understanding information-processing systems. We show how this framework allows one to situate ethical problems at the appropriate level of abstraction, which in turn can be used to target appropriate interventions. (shrink)

Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, (...) and Merleau-Ponty in order to identify and explain its implications for our current understanding of the principle of respect for patient autonomy and the norms of clinical decision making. (shrink)

When comparing alternative courses of action, modern military decision makers often must consider both the military effectiveness and the ethical consequences of the available alternatives. The basis, design, calibration, and performance of a principles-based computational model of ethical considerations in military decision making are reported in this article. The relative ethical violation (REV) model comparatively evaluates alternative military actions based upon the degree to which they violate contextually relevant ethical principles. It is based (...) on a set of specific ethical principles deemed by philosophers and ethicists to be relevant to military courses of action. A survey of expert and non-expert human decision makers regarding the relative ethical violation of alternative actions for a set of specially designed calibration scenarios was conducted to collect data that was used to calibrate the REV model. Perhaps unsurprisingly, the survey showed that people, even experts, disagreed greatly amongst themselves regarding the scenarios’ ethical considerations. Despite this disagreement, two significant results emerged. First, after calibration the REV model performed very well in terms of replicating the ethical assessments of human experts for the calibration scenarios. The REV model outperformed an earlier model that was based on tangible consequences rather than ethical principles, that earlier model performed comparably to human experts, the experts outperformed human non-experts, and the non-experts outperformed random selection of actions. All of these performance comparisons were measured quantitatively and confirmed with suitable statistical tests. Second, although humans tended to value some principles over others, none of the ethical principles involved—even the principle of not harming civilians—completely overshadowed all of the other principles. (shrink)

Three common ethical principles for establishing the limits of parental authority in pediatric treatment decision making are the harm principle, the principle of best interest, and the threshold view. This paper consider how these principles apply to a case of a premature neonate with multiple significant comorbidities whose mother wanted all possible treatments, and whose health care providers wondered whether it would be ethically permissible to allow him to die comfortably despite her wishes. Whether and how these (...) principles help to understand what was morally right for the child is questioned. The paper concludes that the principles were of some value in understanding the moral geography of the case, but that the case reveals common bioethical principles for medical decision making are problematically value-laden because they are inconsistent with the widespread moral value of medical vitalism. (shrink)

What process ought to guide decision making for pediatric patients? The prevailing view is that decision making should be informed and guided by the best interest of the child. A widely discussed structural model proposed by Buchanan and Brock focuses on parents as surrogate decision makers and examines best interests as guiding and/or intervention principles. Working from two recent articles by Ross on “constrained parental autonomy” in pediatric decision making (which is grounded in (...) the Buchanan and Brock model), I discuss (supportively) features of Ross’s effort visa-vis the best interest standard. I argue that any pediatric decision-making model that brackets or formally limits an engagement with the child patient assumes too much. Further, any model that under appreciates the place of parents and their autonomy, and the dynamic parent-child relationship, misses an opportunity to broaden the clinical encounter by considering questions of justice for the child (Rawls) and within a family (Ross). In this context, I focus on the child’s emerging and ongoing emotional and intellectual development and autonomy—their capabilities and identifying primary goods. (shrink)

Shared Decision Making (‘SDM’) is one of the most significant developments in Western health care practices in recent years. Whereas traditional models of care operate on the basis of the physician as the primary medical decision maker, SDM requires patients to be supported to consider options in order to achieve informed preferences by mutually sharing the best available evidence. According to its proponents, SDM is the right way to interpret the clinician-patient relationship because it fulfils the (...) class='Hi'>ethical imperative of respecting patient autonomy. However, there is no consensus about how decisions in SDM contexts relate to the principle of respect for autonomy. In response, I demonstrate that in order to make decisions about what treatment they will or will not receive, patients will be required to meet different conditions depending on the approach proponents of SDM take to understanding personal autonomy. Due to the fact that different conceptions of autonomy yield different obligations, I argue that if physicians and patients satisfied all the conditions described in standard accounts of SDM, then SDM would undermine patient autonomy. (shrink)

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

Any ethical inquiry into addiction research is faced with the preliminary challenge that the term “addiction” is itself a matter of scientific and ethical controversy. Accordingly, the chapter begins with a brief history of the term “addiction.” The chapter then turns to ethical issues surrounding consent and decision-making capacity viewed from the perspective of the current opioid epidemic. One concern is the neglect of the cyclical nature of addiction and the implications of this for the (...) validity of current psychometric instruments used to evaluate decision-making capacity in addiction. Another is the apparent discrepancy—possibly an ethical double standard—in the manner in which society and addiction researchers view the mental capacity and vulnerability of individuals who suffer from severe addiction. On the whole, the main ethical concern of the chapter is the puzzling lack of clinical research on decision-making capacity in research on addiction. (shrink)

In response to the Royal Society report’s claim that “the acceptability of geo­engineering will be determined as much by social, legal, and political issues as by scientific and technical factors” (Geoengineering the Climate: Science, Governance and Uncertainty [London: Royal Society, 2009], ix), a number of authors have suggested the key to this challenge is to engage the public in geoengineering decision-making. In effect, some have argued that inclusion of the public in geoengineering decision-making is necessary for (...) any geoengineering project to be morally permissible. Yet, while public engagement on geoengineering comes in various forms, the discussion in geoengineering governance and the ethics of geoengineering have too often conceptualized it exclusively in terms of public participation in decision-making, and supported it by various liberal democratic values. However, if the predominant understanding of public engagement on—or, the role of the public in—geoengineering decision-making is indeed only grounded on liberal democratic values, then its normative relevance could be challenged by and in other ethical-political traditions that do not share those values. In this paper, I shall explore these questions from a Confucian perspective. I argue that the liberal democratic values invoked in support of the normative importance of public participation are, at least, foreign to Confucian political philosophy. This presents a prima facie challenge to view public participation in geoengineering decision-making as a universal moral requirement, and invites us to reconsider the normative significance of this form of public engagement in Confucian societies. Yet, I contend that the role of the public remains normatively significant in geoengineering governance and the ethics of geoengineering from a Confucian perspective. Drawing from recent work on Confucian political philosophy, I illustrate the potential normative foundation for public engagement on geoengineering decision-making. (shrink)

Many artificial intelligence (AI) systems currently used for decision-making are opaque, i.e., the internal factors that determine their decisions are not fully known to people due to the systems’ computational complexity. In response to this problem, several researchers have argued that human decision-making is equally opaque and since simplifying, reason-giving explanations (rather than exhaustive causal accounts) of a decision are typically viewed as sufficient in the human case, the same should hold for algorithmic decision- (...) class='Hi'>making. Here, I contend that this argument overlooks that human decision-making is sometimes significantly more transparent and trustworthy than algorithmic decision-making. This is because when people explain their decisions by giving reasons for them, this frequently prompts those giving the reasons to govern or regulate themselves so as to think and act in ways that confirm their reason reports. AI explanation systems lack this self-regulative feature. Overlooking it when comparing algorithmic and human decision-making can result in underestimations of the transparency of human decision-making and in the development of explainable AI that may mislead people by activating generally warranted beliefs about the regulative dimension of reason-giving. (shrink)

Berger (forthcoming) states that moral intimacy is important in applying the best interests standard. But what he calls moral intimacy requires that someone has overcome epistemic burdens needed to represent the patient. We argue elsewhere that good surrogate decision-making is first and foremost a matter of overcoming epistemic burdens, or those obstacles that stand in the way of a surrogate decision-maker knowing what a patient wants and how to satisfy those preferences. Berger’s notion of moral intimacy depends (...) on epistemic intimacy: the fact that a surrogate's epistemic burdens with respect to the best interests of the incapacitated patient have been adequately surmounted, plus some other feature. Thus, where a particular patient-surrogate relationship fails to be morally intimate, what is lacking is either epistemic intimacy or this second feature. Furthermore, Berger uses the notion of moral intimacy as an explanans for the application of the best interests standard. We argue that the notions of epistemic intimacy and epistemic burdens not only help to explain the notion of moral intimacy, but also better explain the application of the best interests standard. Given the role of epistemic burdens and the epistemic intimacy that overcoming them enables, bioethicists and physicians should consider a surrogate’s epistemic standing relative to the patient’s best interests before pronouncing on the former’s ethical probity. (shrink)

We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.

For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts (...) to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. (shrink)

With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients “comparative risk information,” such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the “personal risk”), the risk reduction the treatment (...) provides, and any possible side effects. I explore this view and the theories of rationality that ground it, and I argue instead that comparative risk information can play a positive role in decision-making. The criticism of disclosing this sort of information to patients, I conclude, rests on a mistakenly narrow account of the goals of prevention and the nature of rational choice in medicine. (shrink)

This article will offer an alternative understanding of managerial decision-making drawing from Sartre’s Critique of Dialectical Reason rather than simply Being and Nothingness. I will begin with a brief explanation of Sartre’s account of freedom in Being and Nothingness. I will then show in the second section how Andrew West uses Sartre’s conception of radical freedom from Being and Nothingness for a managerial decision-making model. In the third section, I will explore a more robust account of (...) freedom from Sartre’s Critique of Dialectical Reason. I will attempt to show that freedom is not simply a matter of choosing (or not choosing) to perform an action, but entails external constraints—including other people. Finally, I will provide the implications of this account of freedom for managerial decision-making. I will show that it’s unreasonable to place full responsibility and/or blame on managers given their constraints. This does not absolve them from responsibility, but better accounts for the way in which we ought to hold them responsible. (shrink)

Many seem to think that AI-induced responsibility gaps are morally bad and therefore ought to be avoided. We argue, by contrast, that there is at least a pro tanto reason to welcome responsibility gaps. The central reason is that it can be bad for people to be responsible for wrongdoing. This, we argue, gives us one reason to prefer automated decision-making over human decision-making, especially in contexts where the risks of wrongdoing are high. While we are (...) not the first to suggest that responsibility gaps should sometimes be welcomed, our argument is novel. Others have argued that responsibility gaps should sometimes be welcomed because they can reduce or eliminate the psychological burdens caused by tragic moral choice-situations. By contrast, our argument explains why responsibility gaps should sometimes be welcomed even in the absence of tragic moral choice-situations, and even in the absence of psychological burdens. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and (...) data collection were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

The era of AI-based decision-making fast approaches, and anxiety is mounting about when, and why, we should keep “humans in the loop” (“HITL”). Thus far, commentary has focused primarily on two questions: whether, and when, keeping humans involved will improve the results of decision-making (making them safer or more accurate), and whether, and when, non-accuracy-related values—legitimacy, dignity, and so forth—are vindicated by the inclusion of humans in decision-making. Here, we take up a related (...) but distinct question, which has eluded the scholarship thus far: does it matter if humans appear to be in the loop of decision-making, independent from whether they actually are? In other words, what is stake in the disjunction between whether humans in fact have ultimate authority over decision-making versus whether humans merely seem, from the outside, to have such authority? Our argument proceeds in four parts. First, we build our formal model, enriching the HITL question to include not only whether humans are actually in the loop of decision-making, but also whether they appear to be so. Second, we describe situations in which the actuality and appearance of HITL align: those that seem to involve human judgment and actually do, and those that seem automated and actually are. Third, we explore instances of misalignment: situations in which systems that seem to involve human judgment actually do not, and situations in which systems that hold themselves out as automated actually rely on humans operating “behind the curtain.” Fourth, we examine the normative issues that result from HITL misalignment, arguing that it challenges individual decision-making about automated systems and complicates collective governance of automation. (shrink)

This article examines the complaint that arbitrary algorithmic decisions wrong those whom they affect. It makes three contributions. First, it provides an analysis of what arbitrariness means in this context. Second, it argues that arbitrariness is not of moral concern except when special circumstances apply. However, when the same algorithm or different algorithms based on the same data are used in multiple contexts, a person may be arbitrarily excluded from a broad range of opportunities. The third contribution is to explain (...) why this systemic exclusion is of moral concern and to offer a solution to address it. (shrink)

The studies of ethics had long been under-dealt although it is the kind of primary in sustaining a civility. It is hardly deniable that the concept of efficiency and productivity has hailed on the mindedness and interest of academic community. The narrative of ethics or social justice would be ridiculed as the kind of Greek juggle on philosophy or put to be on neglect for its lacking or default on the modern disciplinary frame in the academics. A cure, however, seems (...) not to be from a juggernaut of modern capitalistic civilization and its supportive paradigm of understanding so that alternative way for any more realistic solution can be made exploitative from the ethics or similar tools of motivation. Now we talk about noblesse oblige or benevolent capitalism as one important dose for the new paradigm of social promise or reformed capitalism. The ethics studies have increasingly made its way as focused in the discipline of business and public administration. Typically, it is profiled in combination of leadership studies, and the civility tends to accept this narrative, beyond the liberal competition and fairness school, as one of important element when we consider the concept of social justice. The modern professionals, for example, bar members, medical doctors, and many of licensees for their business operation, also clone to carry their responsibility under a specific ethical code. This would be the kind of safety code from the abusive or madly profit-driven capitalism. More importantly, I believe that a sheer understanding of ethics and social justice would be assets and equipment for the ruling class in the contemporary society. In this context, the paper would survey an ethical theory or decision making model, history of Korea as well as a recent episode involving the chief prosecutor of South Korea. Korean leadership, typically for the powerful cores or inner circle princelings, can be revisited in purview of ethics studies, such as Cooper‟s design and ethical decision making model. (shrink)

Current environmental problems and technological risks are a challenge for a new institutional arrangement of the value spheres of Science, Politics and Morality. Distinguished authors from different European countries and America provide a cross-disciplinary perspective on the problems of political decision making under the conditions of scientific uncertainty. cases from biotechnology and the environmental sciences are discussed. The papers collected for this volume address the following themes: (i) controversies about risks and political decision making; (ii) concepts (...) of science for policy; (iii) the use of social science in the policy making process; (iv) ethical problems with developments in science and technology; (v) public and state interests in the development and control of technology. (shrink)

The dominant approach to assessing decision-making capacity in medicine focuses on determining the extent to which individuals possess certain core cognitive abilities. Critics have argued that this model delivers the wrong verdict in certain cases where patient values that are the product of mental disorder or disordered affective states undermine decision-making without undermining cognition. I argue for a re-conceptualization of what it is to possess the capacity to make medical treatment decisions. It is, I argue, the (...) ability to track one’s own personal interests at least as well as most people can. Using this idea, I demonstrate that it is possible to craft a solution for the problem cases—one that neither alters existing criteria in dangerous ways (e.g. does not open the door to various kinds of abuse) nor violates widely accepted ethical constraints on decision-making assessment. (shrink)

In this chapter, we provide an overview of the ethical considerations relevant to the use of nudges in organ donation policy. We do not defend a position on the permissibility of nudging in this context, but instead aim to clearly outline the strongest arguments on the different sides of this issue that have been presented in the English-language scholarly bioethics literature. We also highlight the questions that are in need of further investigation. In part 1, we briefly discuss nudging (...) before considering proposals to use nudges to increase the number of registered organ donors, including opt-out donor registration systems and the use of “nudge statements.” In part 2, we discuss the use of nudges to influence the decision-making of family members in circumstances where they have a veto over the donation of their loved one’s organs. (shrink)

Qualitative evidence concerning the relationship between QoL and a wide range of disabilities suggests that subjective judgments regarding other people’s QoL are wrong more often than not and that such judgments by medical practitioners in particular can be biased. Guided by their desire to do good and avoid harm, surgeons often rely on "the eyeball test" to decide whether a patient will or will not benefit from surgery. But the eyeball test can easily harbor a range of implicit judgments and (...) biases against patients with disabilities, including erroneous assumptions about QoL. We critique the use of the "eyeball" test and offer suggestions to reduce bias and ensure that patients’ values are more consistently prioritized in surgical decision-making. (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 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)

Because an increasing number of patients have medical conditions that render them incompetent at making their own medical choices, more and more medical choices are now made by surrogates, often patient family members. However, many studies indicate that surrogates often do not discharge their responsibilities adequately, and in particular, do not choose in accordance with what those patients would have chosen for themselves, especially when it comes to end-of-life medical choices. This chapter argues that a significant part of the (...) explanation of such surrogate failure is that family surrogates are likely to undergo anticipatory grief when making end-of-life decisions. After clarifying both the emotional structure and object of grief, I propose that the pending death of a loved one induces an emotional conflict in surrogates between the care demanded by their responsibility as surrogates and the attachment surrogates feel toward their dying loved one, an attachment surrogates "resolve" in the direction of attachment rather than care. This hypothesis helps to explain both surrogates' general inability to exercise "substituted judgment" on behalf of their loved ones and a wide swath of the particular data regarding this inability (e.g., that surrogates more often err by choosing overtreatment). I conclude by considering possible clinical and philosophical responses to this hypothesis. (shrink)