"ACT Administrative Appeals Tribunal Decisions." Ethos: Official Publication of the Law Society of the Australian Capital Territory, (200), pp. 42.

It is widely held that Bayesian decision theory is the final word on how a rational person should make decisions. However, Leonard Savage--the inventor of Bayesian decision theory--argued that it would be ridiculous to use his theory outside the kind of small world in which it is always possible to "look before you leap." If taken seriously, this view makes Bayesian decision theory inappropriate for the large worlds of scientific discovery and macroeconomic enterprise. When is it correct to use (...) Bayesian decision theory--and when does it need to be modified? Using a minimum of mathematics, Rational Decisions clearly explains the foundations of Bayesian decision theory and shows why Savage restricted the theory's application to small worlds. The book is a wide-ranging exploration of standard theories of choice and belief under risk and uncertainty. Ken Binmore discusses the various philosophical attitudes related to the nature of probability and offers resolutions to paradoxes believed to hinder further progress. In arguing that the Bayesian approach to knowledge is inadequate in a large world, Binmore proposes an extension to Bayesian decision theory--allowing the idea of a mixed strategy in game theory to be expanded to a larger set of what Binmore refers to as "muddled" strategies. Written by one of the world's leading game theorists, Rational Decisions is the touchstone for anyone needing a concise, accessible, and expert view on Bayesian decision making. (shrink)

Artificial intelligence (AI) has long been recognised as a challenge to responsibility. Much of this discourse has been framed around robots, such as autonomous weapons or self-driving cars, where we arguably lack control over a machine’s behaviour and therefore struggle to identify an agent that can be held accountable. However, most of today’s AI is based on machine-learning technology that does not act on its own, but rather serves as a decision-support tool, automatically analysing data to help human agents make (...) better decisions. I argue that decision-support tools pose a challenge to responsibility that goes beyond the familiar problem of finding someone to blame or punish for the behaviour of agent-like systems. Namely, they pose a problem for what we might call “decision ownership”: they make it difficult to identify human agents to whom we can attribute value-judgements that are reflected in decisions. Drawing on recent philosophical literature on responsibility and its various facets, I argue that this is primarily a problem of attributability rather than of accountability. This particular responsibility problem comes in different forms and degrees, most obviously when an AI provides direct recommendations for actions, but also, less obviously, when it provides mere descriptive information on the basis of which a decision is made. (shrink)

Ethical thought experiments such as the trolley dilemma have been investigated extensively in the past, showing that humans act in utilitarian ways, trying to cause as little overall damage as possible. These trolley dilemmas have gained renewed attention over the past few years, especially due to the necessity of implementing moral decisions in autonomous driving vehicles. We conducted a set of experiments in which participants experienced modified trolley dilemmas as drivers in virtual reality environments. Participants had to make (...) class='Hi'>decisions between driving in one of two lanes where different obstacles came into view. Eventually, the participants had to decide which of the objects they would crash into. Obstacles included a variety of human-like avatars of different ages and group sizes. Furthermore, the influence of sidewalks as potential safe harbors and a condition implicating self-sacrifice were tested. Results showed that participants, in general, decided in a utilitarian manner, sparing the highest number of avatars possible with a limited influence by the other variables. Derived from these findings, which are in line with the utilitarian approach in moral decision making, it will be argued for an obligatory ethics setting implemented in ADVs. (shrink)

How do you make decisions under ignorance? That is, how do you decide when you lack subjective probabilities for some of your options’ possible outcomes? One answer is that you follow the Laplace Rule: you assign an equal probability to each state of nature for which you lack a subjective probability (that is, you use the Principle of Indifference) and then you maximize expected utility. The most influential objection to the Laplace Rule is that it is sensitive to the (...) individuation of states of nature. This sensitivity is problematic because the individuation of states seems arbitrary. In this paper, however, I argue that this objection proves too much. I argue that all plausible rules for decisions under ignorance are sensitive to the individuation of states of nature. (shrink)

This paper is a study of the decisions that researchers take during the execution of a research plan: their researcher discretion. Flexible research methods are generally seen as undesirable, and many methodologists urge to eliminate these so-called ‘researcher degrees of freedom’ from the research practice. However, what this looks like in practice is unclear. Based on twelve months of ethnographic fieldwork in two end-of-life research groups in which we observed research practice, conducted interviews, and collected documents, we explore when (...) researchers are required to make decisions, and what these decisions entail.An abductive analysis of this data showed that researchers are constantly required to further interpret research plans, indicating that there is no clear division between planning and plan execution. This discretion emerges either when a research protocol is underdetermined or overdetermined, in which case they need to operationalise or adapt the plans respectively. In addition, we found that many of these instances of researcher discretion are exercised implicitly. Within the research groups it was occasionally not clear which topic merited an active decision, or which action could retroactively be categorised as one.Our ethnographic study of research practice suggests that researcher discretion is an integral and inevitable aspect of research practice, as many elements of a research protocol will either need to be further operationalised or adapted during its execution. Moreover, it may be difficult for researchers to identify their own discretion, limiting their effectivity in transparency. (shrink)

Medical decisions regarding end-of-life care have undergone significant changes in recent decades, driven by changes in both medicine and society. Catholic tradition in medical ethics offers clear guidance in many issues, and a moral framework accessible to those who do not share the same faith as well as to members of its faith community. In some areas, a Catholic perspective can be seen clearly and confidently, such as in teachings on the permissibility of suicide and euthanasia. In others, such (...) as withdrawal of nutrition and hydration, the Church does not yet speak with one voice and has not closed out the discussion. Yet, it is not in the teaching on individual issues that a Catholic moral tradition offers the most help and comfort, but in its account of what it means to lead a life in Christ, and to prepare for a Christian death. As in the problem of pain and suffering, it is the spiritual support more than the ethical guidance that helps both patients and physicians bear the unbearable and fathom the unfathomable. (shrink)

This paper sets out to explore the relation between social argumentation and inner debate by taking into account suggestions from argumentation studies and from social and discursive psychology. It develops Dascal’s claim that there are metonymical and structural relations between the two realms of debate by substantiating it with data taken from international migrants’ inner debates at moments of difficult decisions. The data are drawn from the experience of migrating mothers who have to decide whether to go back or (...) to remain in their host country. I show that others are present in migrants’ multivoiced decisions in two important senses: first, inner debates can be reconstructed as critical discussions. Second, the locus from analogy has the special function of allowing the comparison between the migrant’s experience and someone else’s experience. (shrink)

I critique Matthias Steup’s account of exercising direct voluntary control over coming to have doxastic attitudes via doxastic decisions. I show that the sort of agency Steup argues is exercised in doxastic decision-making is not sufficient for agents to exercise direct voluntary control over their doxastic attitudes. This counts against such putative decisions being the locus of direct control in doxastic agency. Finally, I briefly consider what, if any, consequences the failure of Steup’s theory of doxastic agency may (...) have for epistemic deontologism. (shrink)

In the traditional decision theories the role of forecasts is to a large extent swept under the carpet. I believe that a recognition of the connections between forecasts and decisions will be of benefit both for decision theory and for the art of forecasting.In this paper I have tried to analyse which factors, apart from the utilities of the outcomes of the decision alternatives, determine the value of a decision. I have outlined two answers to the question why a (...) decision which is made on the basis of a forecast is better than a decision which is based on a guess. Neither of these answers is universally valid. An assumption which is necessary for the first answer, i.e. Good's result, is that Bayes' rule is accepted as a correct and generally applicable decision principle. The second answer, which was given with the aid of probability intervals, departed from a more general decision principle, the maximin criterion for expected utilities, which was formulated in order to evade some of the criticism against Bayes' rule. However, the argument leading to the ansser is based on the assumption that the probability intervals associated with the states of nature represent certain knowledge. For this reason this answer is only approximatively valid.As a number of quotations in the section on “the weight of evidence” show, it is not sufficient to describe the knowledge about the states of nature by a single number, representing the (subjective) probability of the state, but something else has to be invoked which measures the amount of information on which a decision is based. Several authors have tried to characterize this mysterious quantity, which here was called the weight of evidence. However, there seems to be little agreement as to how this quantity should be measured. (shrink)

To guide treatment decisions for incompetent patients who have no advance directives, health care institutions should look to the preferences of their own communities of patients. That is the best way to ensure that incompetent patients' wishes will be followed.

As we increasingly delegate decision-making to algorithms, whether directly or indirectly, important questions emerge in circumstances where those decisions have direct consequences for individual rights and personal opportunities, as well as for the collective good. A key problem for policymakers is that the social implications of these new methods can only be grasped if there is an adequate comprehension of their general technical underpinnings. The discussion here focuses primarily on the case of enforcement decisions in the criminal justice (...) system, but draws on similar situations emerging from other algorithms utilised in controlling access to opportunities, to explain how machine learning works and, as a result, how decisions are made by modern intelligent algorithms or 'classifiers'. It examines the key aspects of the performance of classifiers, including how classifiers learn, the fact that they operate on the basis of correlation rather than causation, and that the term 'bias' in machine learning has a different meaning to common usage. An example of a real world 'classifier', the Harm Assessment Risk Tool (HART), is examined, through identification of its technical features: the classification method, the training data and the test data, the features and the labels, validation and performance measures. Four normative benchmarks are then considered by reference to HART: (a) prediction accuracy (b) fairness and equality before the law (c) transparency and accountability (d) informational privacy and freedom of expression, in order to demonstrate how its technical features have important normative dimensions that bear directly on the extent to which the system can be regarded as a viable and legitimate support for, or even alternative to, existing human decision-makers. (shrink)

OBJECTIVES: Life-sustaining treatment at the end of life gives rise to many ethical problems in Japan. Recent surveys of Japanese physicians suggested that they tend to treat terminally ill patients aggressively. We studied why Japanese physicians were reluctant to withhold or withdraw life-support from terminally ill patients and what affected their decisions. DESIGN AND PARTICIPANTS: A qualitative study design was employed, using a focus group interview with seven physicians, to gain an in-depth understanding of attitudes and rationales in Japan (...) regarding medical care at the end of life. RESULTS: Analysis revealed that physicians and patients' family members usually make decisions about life-sustaining treatment, while the patients' wishes are unavailable or not taken into account. Both physicians and family members tend to consider withholding or withdrawing life-sustaining treatment as abandonment or even killing. The strongest reason to start cardiopulmonary resuscitation- and to continue it until patients' family members arrive-seems to be the family members' desire to be at the bedside at the time of death. All physicians participating in our study regarded advance directives that provide information as to patients' wishes about life-sustaining treatment desirable. All expressed concern, however, that it would be difficult to forego or discontinue life-support based on a patient's advance directive, particularly when the patient's family opposed the directive. CONCLUSION: Our group interview suggested several possible barriers to death with dignity and the appropriate use of advance directives in Japan. Further qualitative and quantitative research in this regard is needed. (shrink)

Under the independence and competence assumptions of Condorcet’s classical jury model, the probability of a correct majority decision converges to certainty as the jury size increases, a seemingly unrealistic result. Using Bayesian networks, we argue that the model’s independence assumption requires that the state of the world (guilty or not guilty) is the latest common cause of all jurors’ votes. But often – arguably in all courtroom cases and in many expert panels – the latest such common cause is a (...) shared ‘body of evidence’ observed by the jurors. In the corresponding Bayesian network, the votes are direct descendants not of the state of the world, but of the body of evidence, which in turn is a direct descendant of the state of the world. We develop a model of jury decisions based on this Bayesian network. Our model permits the possibility of misleading evidence, even for a maximally competent observer, which cannot easily be accommodated in the classical model. We prove that (i) the probability of a correct majority verdict converges to the probability that the body of evidence is not misleading, a value typically below 1; (ii) depending on the required threshold of ‘no reasonable doubt’, it may be impossible, even in an arbitrarily large jury, to establish guilt of a defendant ‘beyond any reasonable doubt’. (shrink)

The use of AI algorithms in criminal trials has been the subject of very lively ethical and legal debates recently. While there are concerns over the lack of accuracy and the harmful biases that certain algorithms display, new algorithms seem more promising and might lead to more accurate legal decisions. Algorithms seem especially relevant for bail decisions, because such decisions involve statistical data to which human reasoners struggle to give adequate weight. While getting the right legal outcome (...) is a strong desideratum of criminal trials, advocates of the relational theory of procedural justice give us good reason to think that fairness and perceived fairness of legal procedures have a value that is independent from the outcome. According to this literature, one key aspect of fairness is trustworthiness. In this paper, I argue that using certain algorithms to assist bail decisions could increase three diferent aspects of judges’ trustworthiness: (1) actual trustworthiness, (2) rich trustworthiness, and (3) perceived trustworthiness. (shrink)

There has been a long history of discussion on the usefulness of formal methods in legal settings.1 Some of the recent debate has focussed on foundational issues in statistics, in particular, how the reference-class problem affects legal decisions based on certain types of statistical evidence.2 Here we examine aspects of this debate, stressing why the reference-class problem presents serious difficulties for the kinds of statistical inferences under consideration and the relevance of this for the use of statistics in the (...) courtroom. We also consider the relevance of foundational statistical issues in the broader context of.. (shrink)

DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge. Ethical competence can (...) be developed through experience, communication and education, and a supportive environment is necessary for maintaining a high ethical competence. The aim of the present study was to investigate how nurses and physicians in oncology and hematology care understand the concept of ethical competence in order to make, or be involved in, DNR decisions and how such skills can be learned and developed. A further aim was to investigate the role of guidelines in relation to the development of ethical competence in DNR decisions. Individual interviews were conducted with fifteen nurses and sixteen physicians. The interviews were analyzed using thematic content analysis. Physicians and nurses in the study reflected on their ethical competence in relation to DNR decisions, on what it should comprise and how it could be developed. The ethical competence described by the respondents related to the concepts being, doing and knowing. In order to make ethically sound DNR decisions in oncology and hematology care, physicians and nurses need to develop appropriate virtues, improve their knowledge of ethical theories and relevant clinical guidelines. Ethical competence also includes the ability to act upon ethical judgements. Continued ethical education and discussions for further development of a common ethical language and a good ethical working climate can improve ethical competence and help nurses and physicians cooperate better with regard to patients in relation to DNR decisions, in their efforts to act in the best interest of the patient. (shrink)

Is Bayesian decision theory a panacea for many of the problems in epistemology and the philosophy of science, or is it philosophical snake-oil? For years a debate had been waged amongst specialists regarding the import and legitimacy of this body of theory. Mark Kaplan had written the first accessible and non-technical book to address this controversy. Introducing a new variant on Bayesian decision theory the author offers a compelling case that, while no panacea, decision theory does in fact have the (...) most profound consequences for the way in which philosophers think about inquiry, criticism and rational belief. The new variant on Bayesian theory is presented in such a way that a non-specialist will be able to understand it. The book also offers new solutions to some classic paradoxes. It focuses on the intuitive motivations of the Bayesian approach to epistemology and addresses the philosophical worries to which it has given rise. (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)

Decisions about cardiopulmonary resuscitation may be based on medical prognosis, quality of life and patients' choices. Low survival rates indicate its overuse. Although the concept of medical futility has limitations, several strong predictors of non-survival have been identified and prognostic indices developed. Early results indicate that consideration of resuscitation in the elderly should be very selective, and support "opt-in" policies. In this minority of patients, quality of life is the principal issue. This is subjective and best assessed by the (...) individual in question. Patients' attitudes cannot be predicted reliably and surrogate decision-making is inadequate. Lay knowledge is poor. However, patients can use prognostic information to make rational choices. The majority welcome discussion of resuscitation and prefer this to be initiated by their doctors; many wish to decide for themselves. There is little evidence that this causes distress. The views of such patients, if competent, should be sought actively. (shrink)

Medical decisions concerning noncompetent patients that are most morally problematical are those that involve life and death choices. In making these choices for others, I urge that decision-makers carefully attend to the degree and history of a person's noncompetence, and distinguish four relevant categories of competence: partial, potential, lost and never possessed. Attending to these will help enable us to sort out when and how autonomous choice is possible and desirable and when and how to rely upon a judgment (...) of a patient's best interests instead. This conflict is explored with particular reference to the Quinlan, Fox and Saikewicz cases. I argue that respect for autonomy, wherever possible, has presumptive priority, and that it is more often possible than frequently supposed. On the other hand, the notion of autonomous choice itself is perverted when forced upon inappropriate cases, such as those presented by the never competent. Here it is not merely legitimate, but inescapable to use a best interest criterion that ignores autonomy in making treatment decisions. Specific cases in which these normally distinct guidelines for decision-making concur, conflict and need resolution are discussed. In the end it is often more important to determine who will choose than by what substantive criteria he or she will be guided. In considering this issue, I try to show that the substantive criteria have implications for who the proper decision-makers are in many problematical cases. (shrink)

This paper analyzes statistical decisions during the interim analyses of clinical trials. After some general remarks about the ethical and scientific demands of clinical trials, I introduce the notion of a hard-case clinical trial, explain the basic idea behind it, and provide a real example involving the interim analyses of zidovudine in asymptomatic HIV-infected patients. The example leads me to propose a decision analytic framework for handling ethical conflicts that might arise during the monitoring of hard-case clinical trials. I (...) use computer simulations to show how the framework can assist in reconciling certain ethical conflicts. The framework is partial, lacking the precision of a complete systematization of statistical monitoring procedures in practice. (shrink)

Although expected utility theory has proven a fruitful and elegant theory in the finite realm, attempts to generalize it to infinite values have resulted in many paradoxes. In this paper, we argue that the use of John Conway's surreal numbers shall provide a firm mathematical foundation for transfinite decision theory. To that end, we prove a surreal representation theorem and show that our surreal decision theory respects dominance reasoning even in the case of infinite values. We then bring our theory (...) to bear on one of the more venerable decision problems in the literature: Pascal's Wager. Analyzing the wager showcases our theory's virtues and advantages. To that end, we analyze two objections against the wager: Mixed Strategies and Many Gods. After formulating the two objections in the framework of surreal utilities and probabilities, our theory correctly predicts that (1) the pure Pascalian strategy beats all mixed strategies, and (2) what one should do in a Pascalian decision problem depends on what one's credence function is like. Our analysis therefore suggests that although Pascal's Wager is mathematically coherent, it does not deliver what it purports to, a rationally compelling argument that people should lead a religious life regardless of how confident they are in theism and its alternatives. (shrink)

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1873 edition. Excerpt:...but it does not follow that knowledge is not good. It is more needful that I should be a good Christian, than that I should be able to make good shoes. But this, too, is needful for one who is a shoemaker, and his Christianity is to show (...) itself in his earthly calling, and not to be an excuse for unskilfulness therein. And here, too, the case is similar. It is true that knowledge puffs up, that is, superficial knowledge, the appearance of knowledge, where its reality and solidity are wanting; while true knowledge, and earnest genuine research, makes a man humble and modest. For the more we learn, the more we perceive what we owe to others, and the more we know, the more we perceive how little we know. Heal research, moreover, is impossible without self-denial, devotion, and a feeling for truth which will not be ashamed to confess its errors to itself and others. To investigate is a moral labour, and not a mere exercise of the mind. True science cannot be separated from morality, and true morality has always a religious root, even when this is unconfessed. When we investigate, too, we owe our best discoveries to God; our best possessions are a gift from above. When Pythagoras had discovered his famous geometrical theorem concerning the squares of a right-angled triangle, he sacrificed a hecatomb to the gods. And Kepler concluded his famous work on the motion of the planets with hearty thanksgiving to God. The true disciples of science have ever been the pupils of that heavenly wisdom of which St. James says that it is " peaceable, gentle, easy to be entreated, without partiality, and without hypocrisy." And does not all knowledge, when we go deeply into it, lead is to God? What Bacon said of philosophy, that " a little inclineth mens minds... (shrink)

BackgroundChronic kidney disease is a significant cause of global deaths. Those who progress to end-stage kidney disease often commence dialysis as a life-extending treatment. For cognitively impaired patients, the decision as to whether they commence dialysis will fall to someone else. This scoping review was conducted to map existing literature pertaining to how decisions about dialysis are and should be made with, for, and on behalf of adult patients who lack decision-making capacity. In doing so, it forms the basis (...) of a larger body of work that is exploring how these decisions ought to be made.MethodsTo identify relevant papers, searches were conducted on Ovid MEDLINE(R), Embase, PsychINFO, The Cochrane Library, and Web of Science. Inclusion criteria were then applied, requiring that papers: report on empirical studies about how decisions about dialysis are made and/or discuss how decisions about dialysis should be made with, for, and on behalf of adult patients who lack decision-making capacity; be published from 1961 onwards; and be published in English. This resulted in 27 papers eligible for inclusion.ResultsOf note, the majority of papers originated in the United States. There was wide variation across the included papers. Extracted data were grouped under the following themes: involving various parties (patient involvement, family dominance, and wider communication); objectivity about care options (including difficulties with family detachment); cultural sensitivity; medical versus non-medical factors; managing nonadherent patients; and the role and prevalence of substituted judgement. The literature shows that there is inconsistency in the principles and processes surrounding decisions made about dialysis with, for, and on behalf of adult patients who lack decision-making capacity.ConclusionsThis scoping review demonstrates that there is significant variation in both the practice and theory of dialysis decision making with, for, and on behalf of cognitively impaired adult patients. Complexity arises in considering who should get a say, how influential their say should be in a decision, and what factors are most relevant to the decision. A lack of up-to-date literature exploring this issue is highlighted, with this scoping review providing a useful groundwork from which further research can be undertaken. (shrink)

Given the potential dangers of unethical decisions in the workplace, it has become increasingly important for managers to hire, and promote into leadership positions, those who are morally inclined. Behavioral ethics research has contributed to this effort by examining an array of individual difference variables that play a role in morality. However, past research has focused mostly on direct causal effects and not so much on the processes through which different factors, especially those that are morality based, decrease unethical (...) choices. The purpose of the current research is to examine the process, which includes both subconscious and conscious decision pathways, through which moral attentiveness curbs unethical decision making at the individual level. The findings of a study employing about 200 participants and a cheating task reveal that both accurate ethical prototypes and moral awareness of the situation decreased unethical decisions, and moral attentiveness was found to be positively related to both of these constructs. In addition, having accurate ethical prototypes was found to be a partial mediator between perceptual moral attentiveness and less cheating, while moral awareness was found to be a partial mediator between reflective moral attentiveness and less cheating. The theoretical and practical implications of these findings are discussed. (shrink)

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

Decision theory has at its core a set of mathematical theorems that connect rational preferences to functions with certain structural properties. The components of these theorems, as well as their bearing on questions surrounding rationality, can be interpreted in a variety of ways. Philosophy’s current interest in decision theory represents a convergence of two very different lines of thought, one concerned with the question of how one ought to act, and the other concerned with the question of what action consists (...) in and what it reveals about the actor’s mental states. As a result, the theory has come to have two different uses in philosophy, which we might call the normative use and the interpretive use. It also has a related use that is largely within the domain of psychology, the descriptive use. This essay examines the historical development of decision theory and its uses; the relationship between the norm of decision theory and the notion of rationality; and the interdependence of the uses of decision theory. (shrink)

Orthodox decision theory gives no advice to agents who hold two goods to be incommensurate in value because such agents will have incomplete preferences. According to standard treatments, rationality requires complete preferences, so such agents are irrational. Experience shows, however, that incomplete preferences are ubiquitous in ordinary life. In this paper, we aim to do two things: (1) show that there is a good case for revising decision theory so as to allow it to apply non-vacuously to agents with incomplete (...) preferences, and (2) to identify one substantive criterion that any such non-standard decision theory must obey. Our criterion, Competitiveness, is a weaker version of a dominance principle. Despite its modesty, Competitiveness is incompatible with prospectism, a recently developed decision theory for agents with incomplete preferences. We spend the final part of the paper showing why Competitiveness should be retained, and prospectism rejected. (shrink)

Background Concerns about decision making related to resuscitation have led to two important challenges in the courts resulting in new legal precedents for decision-making practice. Systematic research investigating the experiences of doctors involved in decisions about resuscitation in light of the recent changes in law remains lacking. Aim To analyse the practice of resuscitation decision making on hospital wards from the perspectives of doctors. Design The data presented in this paper were collected as part of a wider research study (...) of end-of-life care in an acute hospital setting. Data collection comprised ethnographic non-participant observation on two acute hospital wards and individual interviews with patients, relatives and healthcare professionals caring for patients thought to be approaching the end of life. Data were analysed using a constructivist grounded theory approach. Results Discussions and decision making about resuscitation present many challenges for those involved on acute medical wards. The data highlight the potential for multiple interpretations of legal precedents, creating misunderstandings that may impact patient care in less positive ways. Conclusions This paper provides unique insights into how doctors respond to the changing medico-legal culture and the subsequent effects on patient care. It demonstrates how the juridification of medical practice can occur. It highlights the potential benefit of a structure to support clinicians, patients and relatives in discussing and navigating decisions around care at the end of life in line with the patient’s wishes and preferences. Recommendations for future research are made and legal ramifications are discussed. (shrink)

Algorithms increasingly make managerial decisions that people used to make. Perceptions of algorithms, regardless of the algorithms' actual performance, can significantly influence their adoption, yet we do not fully understand how people perceive decisions made by algorithms as compared with decisions made by humans. To explore perceptions of algorithmic management, we conducted an online experiment using four managerial decisions that required either mechanical or human skills. We manipulated the decision-maker, and measured perceived fairness, trust, and emotional (...) response. With the mechanical tasks, algorithmic and human-made decisions were perceived as equally fair and trustworthy and evoked similar emotions; however, human managers' fairness and trustworthiness were attributed to the manager's authority, whereas algorithms' fairness and trustworthiness were attributed to their perceived efficiency and objectivity. Human decisions evoked some positive emotion due to the possibility of social recognition, whereas algorithmic decisions generated a more mixed response – algorithms were seen as helpful tools but also possible tracking mechanisms. With the human tasks, algorithmic decisions were perceived as less fair and trustworthy and evoked more negative emotion than human decisions. Algorithms' perceived lack of intuition and subjective judgment capabilities contributed to the lower fairness and trustworthiness judgments. Positive emotion from human decisions was attributed to social recognition, while negative emotion from algorithmic decisions was attributed to the dehumanizing experience of being evaluated by machines. This work reveals people's lay concepts of algorithmic versus human decisions in a management context and suggests that task characteristics matter in understanding people's experiences with algorithmic technologies. (shrink)

Although we make decisions all the time in our own personal lives and as scientists, there is still a surprising amount of ambiguity about what constitutes an optimal decision. We recently started to improve or fully outsource some of our decision-making to AI technologies that are built to provide recommendations or decision-making support. In a society that relies more and more on such support systems, it is also remarkably unclear how optimal decision-making could be further boosted. Although AI outputs (...) often successfully assist human decision-making processes, what has yet to find sufficient attention in the debate is an encompassing understanding of the conditions for optimal decision-making with and without AI. This chapter (i) critically investigates the understanding of and overall pursuit to make optimal decisions, and (ii) describes the discrepancy between human practice of decision-making and the so-called AI decision-making processes. The concept of decision-making is connected to concepts of agency and thus part of a normative framework. One result of this investigation is that while AI can provide some calculative assistance to find a defined optimum, it cannot make optimal decisions. (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)

This paper deals with the moral issues relevant to medical decisions to terminate the life of a human organism. The expression “termination of life” will be used to cover both (1) active intervention to bring about a state of an Organism that will cause its death, and (2) a failure to intervene in causal processes that will otherwise result in the death of an organism. I shall attempt to distinguish the different cases in which the decision to terminate life (...) is morally justified and to isolate the considerations that are morally relevant to such decisions. -/- Decisions to terminate life: some possibly relevant considerations -/- There are a number of considerations that different people think relevant to medical decisions to terminate life and that are taken into account in actual medical practice. The following questions capture, I hope, the main ones: 1. Can the Organism in question be characterized as a person? 2. If the Organism is not a person, is it at least a potential person; that is such as will develop into a person? 3. If the Organism is a person, does he or she desire his or her own death, and if so is that desire a rational one? 4. If the Organism is a potential person, will this potential person express a rational desire to die once it becomes capable of expressing such a desire? 5. What quality of life will this person enjoy 6. What quality of life will this potential person enjoy? 7. What is the cost of maintaining the life of this person? 8. What is the cost of allowing this potential person to become a person, and then of maintaining his or her life? 9. Are we dealing with an unconscious person whom it is technologically impossible to restore to consciousness? 10. Is the termination of life a matter of active intervention or only a matter of refraining from saving the life of the organism? 11. Are we dealing with the case of “direct” killing or only one of “indirect” killing? 12 Does it require “ extraordinary” or only “ordinary” means to keep the person alive? 13. Is the individual suffering from a fatal illness? There are two ways in which each of these considerations might be relevant to a decision to terminate life. First, it might bear upon the question of whether it is morally permissible to terminate life. Secondly, if termination of life is morally permissible it may be relevant to the question of whether there is any positive reason for terminating life. (shrink)

This paper argues that we need to look beyond Bayesian decision theory for an answer to the general problem of making rational decisions under uncertainty. The view that Bayesian decision theory is only genuinely valid in a small world was asserted very firmly by Leonard Savage [18] when laying down the principles of the theory in his path-breaking Foundations of Statistics. He makes the distinction between small and large worlds in a folksy way by quoting the proverbs ”Look before (...) you leap” and ”Cross that bridge when you come to it”. You are in a small world if it is feasible always to look before you leap. You are in a large world if there are some bridges that you cannot cross before you come to them. As Savage comments, when proverbs conflict, it is proverbially true that there is some truth in both—that they apply in different contexts. He then argues that some decision situations are best modeled in terms of a small world, but others are not. He explicitly rejects the idea that all worlds can be treated as small as both ”ridiculous” and ”preposterous”. The first half of his book is then devoted to a very successful development of the set of ideas now known as Bayesian decision theory for use in small worlds. The second half of the book is an attempt to develop a quite different set of ideas for use in large worlds, but this part of the book is usually said to be a failure by those who are aware of its existence.2 Frank Knight [15] draws a similar distinction between making decision under risk or uncertainty.3 The pioneering work of Gilboa and Schmeidler [7] on making.. (shrink)

Healthcare decisions evaluate treatment risks and benefits, using a shared decision-making process between patient and clinician. Healthcare workers (HCWs) offer treatments based on condition specific evidence and expert knowledge. The patient evaluates treatment choices from their individual perception of how helpful or harmful treatment might be. This is a “risk-taking” decision. Those in a disorder of consciousness (DOC) have unreliable or absent awareness. They cannot participate in the risk-taking decisional process outlined above. Instead, family members and HCWs evaluate the (...) options and determine how much risk is acceptable. We propose this is a distinctly different decisional process called “risk-making,” and that for those in a DOC it is influenced by multiple poorly understood factors. The different ways that decisions are made on their behalf may be negatively impacting their healthcare and creating a distributive justice need. A “risk-making” theory of DOC healthcare decision-making was developed via narrative literature review. It aims to explicate the realities of DOC decision-making practices, and surface rarely discussed assumptions and social factors possibly impacting DOC healthcare for discussion and future exploration. (shrink)

This chapter contains sections titled: An Ethical Framework for Treatment Decision‐making Futile Treatment Ordinary and Extraordinary Treatment Killing and Allowing to Die Treating Pain and the Doctrine of Double Effect Conclusion References Further reading.

Everywhere in the world, and in every period of human history, it has been common for energy decisions to be made in an ethically haphazard manner. With growing population pressure and increasing demand for energy, this approach is no longer viable. We believe that decision makers must include ethical considerations in energy decisions more routinely and systematically. To this end, we propose an applied ethics framework that accommodates principles from three classical ethical theories—virtue ethics, deontology, consequentialism, and two (...) Native American ethics (Lakota and Navajo)—all considered from the perspectives of the impacted communities. We illustrate this framework by evaluating five recent energy decisions: the Dakota Access Pipeline, the Navajo Nation’s possible transition from coal to solar, hydraulic fracturing in Pennsylvania, uranium mining in Virginia, and the construction of the Xiaolangdi Dam in China. An applied ethics framework is preferable to existing ethical analyses because it can serve to sharpen arguments for (un)ethical decisions and action. Rather than treat ethical reasoning as a matter of opinion, we argue that applying ethical principles in a universal and standardized way adds rigor to energy sector decisions by presenting a position available for objective scrutiny. Because our framework identifies which aspects of a targeted action (if any) must adjust to improve ethical merit, it can serve as a practical tool for improving decision-making as we enter a new era of energy transitions. (shrink)

Is it time to take a break from feminism? In this pathbreaking book, Janet Halley reassesses the place of feminism in the law and politics of sexuality. She argues that sexuality involves deeply contested and clashing realities and interests, and that feminism helps us understand only some of them. To see crucial dimensions of sexuality that feminism does not reveal--the interests of gays and lesbians to be sure, but also those of men, and of constituencies and values beyond the realm (...) of sex and gender--we might need to take a break from feminism. Halley also invites feminism to abandon its uncritical relationship to its own power. Feminists are, in many areas of social and political life, partners in governance. To govern responsibly, even on behalf of women, Halley urges, feminists should try taking a break from their own presuppositions. Halley offers a genealogy of various feminisms and of gay, queer, and trans theories as they split from each other in the United States during the 1980s and 1990s. All these incommensurate theories, she argues, enrich thinking on the left not despite their break from each other but because of it. She concludes by examining legal cases to show how taking a break from feminism can change your very perceptions of what's at stake in a decision and liberate you to decide it anew. (shrink)