In a context of imperfect risk protection, households may protect against the impact of a health shock by employing various financial and non-financial coping mechanisms, such as foregoing or reducing needed medical care, labor substitution, consumption reduction, borrowing money, dissaving, and selling assets. However, leveraging certain coping mechanisms may reduce future productivity, potentially trapping households in chronic or persistent poverty. Resources and risk are not necessarily shared equitably within a household; the ability and willingness of the household to (...) leverage coping mechanisms, or the choice of coping mechanism may depend on the social protection policy context, household socioeconomic status, and type of intrahousehold risk sharing. Vietnam has been making policy changes aimed towards achieving Universal Health Coverage for the past several decades, culminating in a 2015 change mandating universal insurance coverage. This can potentially influence both providers in making decisions around service delivery and households around financing care. This research aims to contribute to the literature exploring the relationships among direct and indirect health care costs, potentially maladaptive coping mechanisms, and household living standards, within the particular health financing and social protection environment in Vietnam. (shrink)

This thesis contains three studies which provide theoretical analysis and empirical evidence on the decision-making of farm households under shocks and imperfect markets in Vietnam. The first study attempts to investigate the effects of the 2007-08 global food crisis on the investment, saving and consumption decisions of household producers by using the panel data of the Vietnam Household Living Standard Survey (VHLSS), covering 2006 and 2008. The results show that the high food prices had a positive (...) effect on only fixed asset investments in the period of the crisis. When the price shocks are incorporated in the financial conditions, the findings reveal that the effects of household incomes, loans obtained and land sizes matter. The second study uses the Vietnam Access to Resources Household Survey (VARHS) of 2010 to assess the determinants of chemical fertiliser adoption for rice cultivation, and effects on productivity and household welfare. The analysis implements both nonparametric (propensity score matching) and parametric (instrumental variables) approaches. The findings show determinants affecting decision of adoption differ from those affecting decision of adoption intensity. The results show unsurprisingly positive impact on outcomes, but focus on advantage of using parametric approach to estimate these impacts. The third study employs a sub-sample from the 2008 VHLSS that is restricted to rural areas and to children from 10 to 14 years old to explore the relationship between farmland and the employment of children on their family’s farm. The hypothesis is tested in three models (the Tobit, Heckit and double-hurdle models), in which the dependent variables are examined for two stages of decision-making, including the probability of participation and the extent of participation. Empirical evidence supports the hypothesis that child labour increases in land-rich households and decreases in land-poor households. (shrink)

Although social scientists have identified diverse behavioral patterns among children from dissimilarly structured families, marketing scholars have progressed little in relating family structure to consumption-related decisions. In particular, the roles played by members of single-mother families—which may include live-in grandparents, mother’s unmarried partner, and step-father with or without step-sibling(s)—may affect children’s influence on consumption-related decisions. For example, to offset a parental authority dynamic introduced by a new stepfather, the work-related constraints imposed on a breadwinning mother, or the imposition of adult-level (...) household responsibilities on children, single-mother families may attend more to their children’s product preferences. -/- Without a profile that includes socio-economic, behavioral, and psychological aspects, efficient and socially responsible marketing to single-mother households is compromised. Relative to dual-parent families, single-mother families tend to have fewer resources and less buying power, children who consume more materialistic and compulsively, and children who more strongly influence decision making for both own-use and family-use products. Timely research would ensure that these and other tendencies now differentiate single-mother from dual-parent families in ways that marketers should address. Hence, our threefold goal is (1) to consolidate and highlight gaps in existing theory applied to studying children’s influence on consumption-related decision making in single-mother families, and (2) to propose a hybrid framework that merges two theories conducive to such research, and (3) to identify promising research propositions for future research. (shrink)

This research is concerned with understanding the factors behind the trade-off between child labor and child schooling, given the well-documented links between the two. It examines parents' behavior in their decision-making on their children's schooling or practicing child labor. Depending on qualitative research methods including 28 semi-structured interviews and two focus group discussions conducted in the rural areas of Bangladesh in 2020, this study reveals the following: subsistence needs compel households, particularly the ultra-poor and the female-headed, to trade (...) off child labor with schooling; due to higher demand of labor, parents engage their children into work instead of schooling; parents of labor-intensive occupations tend to trade off child labor with schooling; sexual division of labor remains obvious; finally, credit constraints and cultural beliefs have negative impacts on parental decision-making on child schooling. Interventions aiming to reduce child labor and increase schooling in these rural areas must remain mindful of the socio-economic and cultural needs. (shrink)

Food prices are a daily concern in many households’ decision-making, especially when people want to have healthier diets. Employing Bayesian Mindsponge Framework (BMF) analytics on a dataset of 710 Indonesian citizens, we found that people from wealthier households are less likely to have concerns about food prices. However, the degree of health considerations in food consumption was found to moderate against the above association. In other words, people of higher income-based social classes may worry more about food prices (...) if they care more about the health impacts of their food choices. These findings provide more insights for policymakers on the psychological aspects of promoting the balance between finance and health in food consumption. (shrink)

The purpose of the paper is to consider genesis and approaches to forming a security culture of tourism and hospitality enterprises that are superstructures of economic, industrial, professional, household, ecological, psychological and social security. In the research, apart from general scientific methods, we used the collection and analysis of primary information obtained from the survey of 220 respondents. Three areas that have a decisive influence on the security of tourism and hospitality enterprises have been identified: organizational culture, decision- (...) class='Hi'>making responsibility, and competitiveness. The decision-making methods for different leadership styles were identified. There were conceptualized connection and strength of correlation between types of strategic decisions, leadership styles and organizational culture of tourism and hospitality enterprises. It has been proposed the factors’ configuration relevant to the security of tourism and hospitality enterprises, which focuses on the economic security formation as a function of organizational culture, responsibility for decision making and competitiveness. The styles of leadership and decision-making styles have been revealed, which determine the effectiveness of economic security of tourism and hospitality enterprises. (shrink)

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)

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)

Introduction: Interdisciplinary, transdisciplinary and action research of a city in lockdown. As we write this chapter, most cities across the world are subject to a similar set of measures due to the spread of COVID-19 coronavirus, which is now a global pandemic. Independent of city size, location, or history, an observer would note that almost all cities have now ground to a halt, with their citizens being confined to their private dwellings, social and public gatherings being almost entirely forbidden, and (...) commercial areas being nearly devoid of visitors. Striking as these apparent similarities are, closer scrutiny would reveal important differences between cities and within cities – differences that can be highly relevant to consider when scholars are assessing the responses of cities to this pandemic or trying to predict the consequences of those responses. For example, the public health systems in some cities are better prepared than in others for coping with the increasing number of patients in life threatening conditions. Multigenerational households, which are associated with a greater risk for elderly members, are not equally common in all cities. Tourist destinations have taken a more severe economic hit from the lockdown than those cities which are economically less dependent upon this particular source of income. Communal celebrations in one city will result in a higher number of contagions and perhaps even deaths in this situation, whereas that same social fabric generally does contribute to a population’s health. The pandemic has also had unprecedented effects on differences and inequalities within cities. In cities in the United States, neighborhoods primarily inhabited by African Americans have been disproportionately affected by COVID-19 due to living and health conditions, yet also due to the fact they disproportionately perform vital jobs. Parks and green spaces are crowded, while city centers like Amsterdam’s Red Light District have suddenly lost the bustle of tourism, providing opportunities for citizens to reoccupy scarce public spaces and reclaim ownership. Clearly, such differences between cities are in many cases only discernible to the eye of an expert, possessing the necessary background knowledge to interpret the perceptible local changes caused by the global pandemic. Typically, drawing upon his or her disciplinary training, the expert also knows how to further probe the impact of the pandemic in an appropriate way. However, compared to the usual application of expertise, this crisis situation might, in an unusual way, test even experts. For the pandemic has created a unique situation, imposing unfamiliar constraints on the health, economic, social, and other conditions of cities, constraints that interact in sometimes unexpected ways with each other. Such interactions in turn force experts to collaborate across the boundaries commonly associated with disciplines, their concepts, theories, methods, and assumptions (Klein, 1996). These brief observations of how a virus pandemic can have differential impacts upon various cities, and what this exceptional situation might mean for the application of city methods, allow us to draw a few consequences for the current context of this chapter on interdisciplinary and transdisciplinary research. First, whenever we are investigating a complex and dynamic phenomenon it is by no means easy to determine which disciplinary perspectives are required to do justice to it. Indeed, the choice of useful disciplines can only be made after an initial overview of the situation and a preliminary selection of what appear to be the most important features of the situation. Relevance is key in guiding this selection process and scholars must remain open to the possibility that they may need to revise their earlier assessments of what is relevant and what is not. Second, if scholars from different disciplines were to study different features of a city in isolation, their ‘multidisciplinary’ account would miss important dynamic and complex interactions, such as those between a city’s demographics and geographical situation, its governance and economy. In other words, it is the integration of the perspectives of different disciplines that is crucial, as only then are such interactions taken into account. Indeed, this integration between disciplinary perspectives is what distinguishes an interdisciplinary from a multidisciplinary account. Thirdly, in addition to checking the relevance of disciplines and aiming for their integration, the outcome of interdisciplinary and transdisciplinary research has typically limited generalizability. Since a city is sensitive to a multitude of internal and external dynamical factors, in ways that partly rest upon its socio-cultural history, its investigation will often have the nature of a case study rather than be capable of leading to law-like insights (Krohn, 2010; Menken & Keestra, 2016). As can be seen from these three characteristics of ascertaining the relevance of different disciplinary contributions, the challenge of their integration, and the limited generalizability of their results owing to the specificity of interdisciplinary (ID) and transdisciplinary (TD) research, such research into ‘real world problems’ is clearly distinct from most monodisciplinary research. A consequence of this distinction is the absence of a general ID/TD methodology that can guide specific case studies. By contrast, the collaboration implied in such research requires researchers – and stakeholders, if they are involved – to reflect upon their potential contribution and the implicit assumptions associated with that. We will elaborate on this in the next section. Next, we offer several typologies of integration that urban scholars could employ for their research projects, after which we will offer a few brief analyses of initial collaborations of urban research. Finally, we discuss in more detail the process of the interdisciplinary research project. This will include a brief reflection upon the decision-making process that is implied in such projects. In sum, we aim to provide some guidance in conducting an ID/TD project, albeit not in the form of a definite methodology. (shrink)

There is wide consensus among bioethicists about the importance of autonomy when determining whether or not a patient has the right to refuse life-saving treatment (LST). In this context, autonomy has typically been understood in terms of the patient’s ability to make an informed decision. According to the traditional view, decision-making capacity (DMC) is seen as both necessary and sufficient for the right to refuse LST. Recently, this view has been challenged by those who think that considerations (...) of authenticity and putative counterexamples should lead us to revise the traditional account. In this paper, we respond to these revisionist arguments, and we defend the traditional view according to which we have autonomy-based reasons to respect a patient’s decision to refuse LST if and only if she has DMC. (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)

Algorithm Decision Making (ADM) systems designed to augment or automate human decision-making have the potential to produce better decisions while also freeing up human time and attention for other pursuits. For this potential to be realised, however, algorithmic decisions must be sufficiently aligned with human goals and interests. We take a Principal-Agent (P-A) approach to the questions of ADM alignment and trust. In a broad sense, ADM is beneficial if and only if human principals can trust (...) algorithmic agents to act faithfully on their behalf. This mirrors the challenge of facilitating P-A relationships among humans, but the peculiar nature of human-machine interaction also raises unique issues. The problem of asymmetric information is omnipresent but takes a different form in the context of ADM. Although the decision-making machinery of an algorithmic agent can in principle be laid bare for all to see, the sheer complexity of ADM systems based on deep learning models prevents straightforward monitoring. We draw on literature from economics and political science to argue that the problem of trust in ADM systems should be addressed at the level of institutions. Although the dyadic relationship between human principals and algorithmic agents is our ultimate concern, cooperation at this level must rest against an institutional environment which allows humans to effectively evaluate and choose among algorithmic alternatives. (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)

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)

Abstract: The military establishment plays an important role in society, not only because it is pivotal in securing the state from external and internal threats but also because the conduct of soldiers affect the fortunes of the state both fiscally and morally. Early in their career, soldiers are trained to be irreproachable in their loyalty, unquestioning in their obedience and unthinking in their pursuit of military objective. This, however changes as they move up into command positions and are required to (...) decide on objectives as well as give orders for others to obey. For many officers, this is usually a difficult transition to make even though Staff School training is supposed to enable them to make this transition. This paper is based on an attempt to introduce philosophical dialogue to student officers of a military academy to help them make this difficult transition. It discusses the use of philosophical dialogue in facilitating officers’ understanding of important issues in the military, including military decision making. It highlights the procedure, difficulties and dangers of facilitating philosophical dialogue between soldiers especially as it relates to the corporate unity and command structure of the military. The paper also reflects on the efficacy and desirability of involving soldiers in a dialogue process. Keywords: Decision making, Military training, MDMP (Military Decision Making Process), Philosophical Dialogue, Resumen: La institución militar y juega un papel importante en la sociedad, no sólo porque es una base crucial para la seguridad del estado frente a amenazas internas y externas sino porque la conducta de los soldados afecta al destino del estado tan física como moralmente. Al comienzo de sus carreras, los soldados son entrenados en el desarrollo de una lealtad indubitable, evitando el cuestionamiento y la crítica para incentivar el desarrollo de los objetivos militares. Esta situación cambia cuando asciende a posiciones superiores, donde se requiere que decidan sobre la consecución de ciertos objetivos y que den órdenes a otros. Para muchos oficiales, esto supone una difícil transición a pesar de que la escuela de oficiales se supone que los capacita para realizar esta transición. Este artículo pretende explicar cómo introducir el diálogo filosófico a los estudiantes que se preparan para ser oficiales en la academia militar, actividad que les ayudará a desenvolver esta complicada transición. El trabajo discute el uso del diálogo filosófico para facilitar a los oficiales la comprensión de los asuntos militares importantes, lo cual abarca la toma de decisión militar. Subrayará, el procedimiento, las dificultades y los peligros de facilitar un diálogo filosófico entre los soldados, particularmente cuando se dirige a la unidad militar y a la estructura de órdenes delejército. Además, esta investigación reflexiona sobre la eficacia y deseabilidad de incorporar a los soldados en un proceso dialógico. Palabras clave: Toma de decisión, entrenamiento militar, Proceso de toma de decisión militar (PTDM), diálogo filosófico. (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)

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

This article is about the information relevant to decision-making capacity in refusal of life-prolonging medical treatment cases. We examine the degree to which the phenomenology of the options available to the agent—what the relevant states of affairs will feel like for them—forms part of the capacity-relevant information in the law of England and Wales, and how this informational basis varies across adolescent and adult medical treatment cases. We identify an important doctrinal phenomenon. In the leading authorities, the courts (...) appear to count the first-personal phenomenology of the available options among the information that adolescents seeking to refuse life-prolonging treatment must understand and appreciate in order to possess capacity; adults are not held to this (higher) standard. We evaluate this differential treatment in light of philosophical work on transformative choice—decisions involving options whose sensory character, and effect on our values and preferences, are grasped only through experience itself. (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)

This theoretical paper explores the application of Hegelian inferentialism combined with contemporary quantitative methods to enhance decision-making in healthcare leadership. It proposes a novel conceptual framework that integrates Hegel’s inferentialism with Bayesian analysis and epistemic justice indices to offer a new approach for understanding complex decision processes in healthcare settings. The paper develops theoretical constructs such as the Decision Quality Index (DQI) and the Epistemic Justice Quotient (EJQ), which aim to quantitatively assess leadership effectiveness and ethical (...) considerations in decision-making processes. The discussion includes mathematical proofs for these proposed indices and examines the potential practical implications of this integrated approach, emphasizing its theoretical potential to improve healthcare leadership through more inclusive and evidence-based practices. This work provides a conceptual foundation for future empirical research in healthcare leadership and decision-making. (shrink)

In this paper, we define correlation coefficient measure between any two rough neutrosophic sets. We also prove some of its basic properties.. We develop a new multiple attribute group decision making method based on the proposed correlation coefficient measure. An illustrative example of medical diagnosis is solved to demonstrate the applicability and effecriveness of the proposed method.

According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, (...) this paper argues that standard accounts of SDM actually undermine patient autonomy. It also provides an overview of the obligations generated by the principle of respect for relational autonomy that have not been captured in standard accounts of SDM and which are necessary to ensure consistency between clinical practice and respect for patient autonomy. (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)

Albert Jonsen and Stephen Toulmin have argued that the best way to resolve complex “moral” issues in clinical settings is to focus on the details of specific cases. This approach to medical decision-making, labeled ‘casuistry’, has met with much criticism in recent years. In response to this criticism, Carson Strong has attempted to salvage much of Jonsen’s and Toulmin’s version of casuistry. He concludes that much of their analysis, including Jonsen’s further elaboration about the casuistic methodology, is on (...) the mark. In this essay, the details of Jonsen’s and Toulmin’s version of casuistry and the major criticisms against their approach to clinical decision-making are explicated. Furthermore, it is argued that Strong’s salvage efforts fail to deflect these criticisms. The upshot of this analysis, which includes a few additional criticisms, is that Jonsen’s and Toulmin’s version of casuistry is not an appropriate framework from which to resolve complex “moral” issues in clinical settings. (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)

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)

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)

In this paper, multi attribute decision making problem based on grey relational analysis in neutrosophic cubic set environment is investigated. In the decision making situation, the attribute weights are considered as single valued neutrosophic sets. The neutrosophic weights are converted into crisp weights. Both positve and negative GRA coefficients, and weighted GRA coefficients are determined. Hamming distances for weighted GRA coefficients and standard (ideal) GRA coefficients are determined. The relative closeness coefficients are derived in order to (...) rank the alternatives. The relative closeness coefficients are designed in ascending order. Finally, a numerical example is solved to demonstrate the applicability of the proposed approach. (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)

Abstract: This paper defends a constraint that any satisfactory decision theory must satisfy. I show how this constraint is violated by all of the decision theories that have been endorsed in the literature that are designed to deal with cases in which opinions or values are represented by a set of functions rather than a single one. Such a decision theory is necessary to account for the existence of what Ruth Chang has called “parity” (as well as (...) for cases in which agents have incomplete preferences or imprecise credences). The problem with the all of the decision theories that have been defended to account for parity is that they are committed to a claim I call unanimity: when all of the functions in the set agree that an agent ought to do A, then an agent ought to do A. A decision theory committed to unanimity violates the constraint I defend in this paper. Thus, if parity exists, a new approach to decision theory is necessary. (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)

This essay investigates, via the concepts of the philosophy of orientation, Annie Duke’s decision-making theory in "Thinking in Bets" and scrutinizes as to what extent one can universalize the 'orientation skill' of decision-making with regard to our everyday and professional life.

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 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 study aimed to identify the reality of decision-making in the local NGOs in Gaza Strip. In order to achieve the objectives of the study and to test its hypotheses, the analytical descriptive method was used, relying on the questionnaire as a main tool for data collection. The study society was one of the decision makers in the local NGOs in Gaza Strip. The study population reached 78 local NGOs in Gaza Strip. A Census Method of the (...) possible study community was adopted, and the use of the Statistical Package for Social Sciences (SPSS) was mainly based on the analysis and analysis of the data obtained through the survey tool. The study reached a set of results, the most important of which are: NGOs follow a decision-making mechanism. NGOs examine the problems and causes of the organization. Organizations are less concerned with stakeholder participation. Make decision. The main recommendations of the study are: To promote systematic methods of decision-making in NGOs in Gaza Strip: Local NGOs in Gaza Strip should continue to develop their competencies in order to make sound and correct decisions and encourage them to follow the scientific methodologies in the mechanism of taking Decisions. (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)

The stakes associated with an algorithmic decision are often said to play a role in determining whether the decision engenders a right to an explanation. More specifically, “high stakes” decisions are often said to engender such a right to explanation whereas “low stakes” or “non-high” stakes decisions do not. While the overall gist of these ideas is clear enough, the details are lacking. In this paper, we aim to provide these details through a detailed investigation of what we (...) will call the “Simple Stakes Thesis”. The Simple Stakes Thesis, as it will turn out, is too simple. For even if the stakes associated with a specific one-off decision are low—and hence does not engender a right to an explanation—such decisions may nevertheless form part of a high stakes pattern or aggregate of decisions. In such cases, we argue, even a low stakes decision may engender a right to explanation. Not only does this show that the right to explanation is more demanding than so far recognized. It also shows that the stakes thesis is significantly harder to apply in practice. (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 volume presents research that integrates decision making and creativity within the social contexts in which these processes occur. The volume is an essential addition to and expansion of recent approaches to decision making. Such approaches attempt to incorporate more of the psychological and socio-cultural context in which human decision making takes place. The authors come from different disciplines and also belong to a broad spectrum of research traditions. They present innovative chapters dealing with (...) both theoretical and empirical aspects of decision making in different personal and organizational contexts. All chapters are written from the perspective that human decision making is inherently social and more or less creative. The volume addresses fundamental questions about the nature of human decision making as it occurs in different social contexts. Thereby, it becomes essential reading for researchers in decision making and for advanced students in psychology, management science, informatics, and related disciplines. (shrink)

Psychopathy, which is characterized by a constellation of antisocial behavioral traits, may be subdivided on the basis of etiology: “primary” (low-anxious) psychopathy is viewed as a direct consequence of some core intrinsic deficit, whereas “secondary” (high-anxious) psychopathy is viewed as an indirect consequence of environmental factors or other psychopathology. Theories on the neurobiology of psychopathy have targeted dysfunction within ventromedial prefrontal cortex (vmPFC) as a putative mechanism, yet the relationship between vmPFC function and psychopathy subtype has not been fully explored. (...) In this study, we administered two laboratory decision-making tasks (the Ultimatum Game and the Dictator Game) to a group of prisoners (n=47) to determine whether the different subtypes of psychopathy (primary vs. secondary) are associated with characteristic patterns of economic decision-making, and furthermore, whether either subtype exhibits similar performance to patients with vmPFC lesions. Comparing primary psychopaths (n=6) to secondary psychopaths (n=6) and non-psychopaths (n=22), we found that primary psychopathy was associated with significantly lower acceptance rates of unfair Ultimatum offers and lower offer amounts in the Dictator Game. Moreover, primary psychopaths were quantitatively similar to vmPFC lesion patients in their response patterns. These results support the purported connection between psychopathy and vmPFC dysfunction, bolster the distinction between primary and secondary psychopathy, and demonstrate the utility of laboratory economic decision-making tests in differentiating clinical subgroups. (shrink)

This paper inaugurates a discussion about the phenomenology of union decision-making. Phenomenology provides a new lens that may enable us to gain penetrating insights into how unions function in the fractious world of human resources management. The present paper is preliminary to any fieldwork that may be undertaken. Its main purposes are to identify theory that could be the foundation of further practical work, relate recent work in the phenomenology of management to union practices and to propose directions (...) of enquiry. The relevant theory is that of Edmund Husserl who provides us with a practical method of enquiry into the real world of human resource practice. Husserl’s work has already been applied in relation to local government functioning and some of the findings there appear relevant to the present enquiry. In particular, the nature and role of plebiscites. (shrink)

I identify an undertheorized problem with decisions we make with the aid of algorithms: the problem of inauthenticity. When we make decisions with the aid of algorithms, we can make ones that go against our commitments and values in a normatively important way. In this paper, I present a framework for algorithm-aided decision-making that can lead to inauthenticity. I then construct a taxonomy of the features of the decision environment that make such outcomes likely, and I discuss (...) three possible solutions to the problem. (shrink)

Research on human decision making is at the present time undergoing rapid changes. From previously being much focused on models and approaches with an origin in economy, much of the present day research finds its inspiration from disciplinary approaches concerned with incorporating more of the context that the decision making takes place in. This context includes psychological aspects of the decision maker and social-cultural aspects of the situation he or she acts in. All human (...) class='Hi'>decision making occurs in dynamically changing contexts. One factor contributing to this is that human beings or groups in many situations act as entrepreneurs trying to improve the situation for themselves or their organization. Given that this is the case, it is of increasing interest for both researchers and practitioners interested in the social aspects of decision making to consider the relation between creativity and decision making. (shrink)

This text provides an introduction to the topic of rational decision making as well as a brief overview of the most common biases in judgment and decision making. "Decision Making" is relatively short (300 pages) and richly illustrated with approximately 100 figures. It is suitable for both self-study and as the basis for an upper-division undergraduate course in judgment and decision making. The book is written to be accessible to anybody with minimum (...) knowledge of mathematics (high-school level algebra and some elementary notions of set theory and probability, which are reviewed in the book). At the end of each chapter there is a collection of exercises that are grouped according to that chapter’s sections. Complete and detailed answers for each exercise are given in the last section of each chapter. The book contains a total of 121 fully solved exercises. (shrink)

Advanced AI systems are rapidly making their way into medical research and practice, and, arguably, it is only a matter of time before they will surpass human practitioners in terms of accuracy, reliability, and knowledge. If this is true, practitioners will have a prima facie epistemic and professional obligation to align their medical verdicts with those of advanced AI systems. However, in light of their complexity, these AI systems will often function as black boxes: the details of their contents, (...) calculations, and procedures cannot be meaningfully understood by human practitioners. When AI systems reach this level of complexity, we can also speak of black-box medicine. In this paper, we want to argue that black-box medicine conflicts with core ideals of patient-centered medicine. In particular, we claim, black-box medicine is not conducive for supporting informed decision-making based on shared information, shared deliberation, and shared mind between practitioner and patient. (shrink)

Management decision-making is a daily task that managers of various levels solve in every organization. Degree of difficulty of this process depends on the scope of authority, responsibility level, manager’s position in organizational hierarchy; on the changes in the environment, unpredictability of which causes emergence of significant amounts of alternatives. For this reason, managers do not rely only on intuition or personal experience (which limited with selective perception, cognitive ability, ability to withstand stress and/or the presence of bias), (...) but use tools (methods) that have stood the test of time and practice; are based at the analysis of a significant amount of primary and secondary information; involve team-building to find the optimal option or to generate ideas. A significant amount of research papers are devoted to such methods, however, the author forms a synergetic approach which contains a detailed analysis of their correlation with the key factors of the competitiveness of enterprise, such as organizational culture and leadership. Existing decision-making practices, problems and style of management at the tourism enterprises are revealed from conducted survey (the first half of 2014) in tourism firms of Dnepropetrovsk and Zaporizhzhia regions of Ukraine, in which 729 tourism managers took part. The most popular decision-making practices in tourism branch were specified, among them are modeling and monitoring of previous results. The study proved the hypothesis of the author concerning strong connection of decision-making management and type of organizational culture. Moreover, 63% of managers were dissatisfied with low attention to organizational culture at their companies. The basis for future research and the synergetic matrix for decision-making management were worked out in the article which give preconditions for further studies and improvements in tourism management of Ukrainian enterprises. (shrink)

With the rise and public accessibility of AI-enabled decision-support systems, individuals outsource increasingly more of their decisions, even those that carry ethical dimensions. Considering this trend, scholars have highlighted that uncritical deference to these systems would be problematic and consequently called for investigations of the impact of pertinent technology on humans’ ethical decision-making. To this end, this article conducts a systematic review of existing scholarship and derives an integrated framework that demonstrates how intelligent decision-support systems (IDSSs) (...) shape humans’ ethical decision-making. In particular, we identify resulting consequences on an individual level (i.e., deliberation enhancement, motivation enhancement, autonomy enhancement and action enhancement) and on a societal level (i.e., moral deskilling, restricted moral progress and moral responsibility gaps). We carve out two distinct methods/operation types (i.e., processoriented and outcome-oriented navigation) that decision-support systems can deploy and postulate that these determine to what extent the previously stated consequences materialize. Overall, this study holds important theoretical and practical implications by establishing clarity in the conceptions, underlying mechanisms and (directions of) influences that can be expected when using particular IDSSs for ethical decisions. (shrink)

This book is concerned with helping you improve your approach to decision-making. The author examines judgement in a selection of managerial contexts and provides important understanding that can help you make better leadership decisions. The book also pinpoints the in-house politics of organisational decision-making. Drawing on the very latest research, it introduces practical techniques that show you how to analyse and develop your own decision-making style. It will help you to deliver sharp and insightful (...) analyses of your business and develop effective solutions. In addition, it presents simple checklists that will give you vital insights throughout the decision-making process. Students and practitioners of leadership, management, and allied fields will find this book useful in order to understand and implement useful methods. (shrink)

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

Stephanie Collins’ Group Duties offers interesting new arguments and brings together numerous interconnected issues that have hitherto been treated separately. My critical commentary focuses on two particularly original and central claims of the book: (1) Only groups that are united under a group-level decision-making procedure can bear duties. (2) Attributions of duties to other groups should be understood as attributions of “coordination duties” to each member of the group, duties to take steps responsive to the others with a (...) view to the group’s φ-ing or express willingness to do so. In support of the first claim, Collins argues that only groups that can make decisions can bear duties, and that the ability to make decisions requires the relevant sort of decision-making procedure. I suggest that both parts of this argument remain in need of further support. I furthermore argue that Collins’ account of coordination duties gets certain kinds of cases wrong, and suggest that attributions of duties to groups without decision-making procedures are more plausibly understood as attributing shared duties. (shrink)