In this paper I argue that the rationality of law and legal decision making would be enhanced by a systematic attempt to recognize and respond to the implications of empirical uncertainty for policy making and decision making. Admission of uncertainty about the accuracy of facts and the validity of assumptions relied on to make inferences of fact is commonly avoided in law because it raises the spectre of paralysis of the capacity to decide issues (...) authoritatively. The roots of this short-sighted view are found in primitive mechanical models of relationships in the empirical and social world – those of objective causality and determinism. Insofar as it is believed that if we had sufficient data a clear and unequivocal answer would be available to each question, admission of uncertainty is seen as a sign of insufficiency, incompetence, impotence, and is avoided whenever a decision that must be seen to be based on valid reasons, cannot be avoided. Avoidance of some decisions, duplicity in others, is the result. -/- Decision-making must be restructured to recognize the provisional and context-bound validity and relevance of the models we use to conceptualize and order our understanding of phenomena, and to utilize this awareness as an instrument in the production of legal policies and decisions that will be authoritative precisely because they are honestly accurate and socially responsible. The paper makes a start on such a re-structuring of the legal process by exploring the implications of the observation that if law is to be “just”: 1) legal policy must be based on accurate information and rationally related to social goals; and 2) decisions applying policy to individual fact situations must be based on assumptions that are both relevant and accurate. -/- Reasons for determinations of fact must be given, otherwise the presumption that the trier of fact is “reasonable” is an unconditional licence to use private modes of logic and theories of social and natural science. What is not disclosed cannot be challenged on grounds of invalidity or irrelevance. Use of “objective validity” as a standard to evaluate conclusions made by the trier of fact in contentious cases would only serve to beg all important questions by concealing: 1) fundamental normative conflict, and 2) the limited nature and applicability of many validity claims. -/- Our use of the phrases “undue risk,” “public interest,” “reasonable,” and “necessary,” reflects the weight we choose to give conflicting social values and goals when we must make decisions in relative ignorance of all the consequences. “Objective criteria” are of limited utility in legal decision-making because their social meaning is derivative. Policy generation in the absence of any coherent conceptual-normative framework, use of vague terminology in legislation stating policy, and the absence of rational means to distinguish between individual cases to which decision-makers are required by law to apply policy, make it inevitable that many legal “decisions” made in the guise of determinations of objective fact, are charades, an arbitrary, capricious, intuitive, subjective (and thus private) use of public decision-making power. -/- Law must alter its aspirations and recognize that rational decision-making is a process that can occur only within parameters set by present knowledge and societal preference structures. Only by working with the constraints imposed by these parameters is it possible to achieve “just” decisions. Where no rational basis for differentiating cases exists, “individualized justice” must be avoided and public policy articulated in law applied uniformly to all cases in a class. The terms “reasonable” and “necessary,” used to describe policy and its consequences for specific cases, must be understood to represent provisional societal assessments, attempts to implement societal preference structures in the face of limited knowledge. Heightened awareness of the limited nature of our knowledge can only result in legal policies that have a more explicit normative basis. (shrink)

Higher courts sometimes assess the constitutionality of law by working through a concrete case, other times by reasoning about the underlying question in a more abstract way. Prior research has found that the degree of concreteness or abstraction with which an issue is formulated can influence people's prescriptive views: For instance, people often endorse punishment for concrete misdeeds that they would oppose if the circumstances were described abstractly. We sought to understand whether the so-called ‘abstract/concrete paradox’ also jeopardizes the consistency (...) of judicial reasoning. In a series of experiments, both lay and professional judges sometimes reached opposite conclusions when reasoning about concrete cases versus the underlying issues formulated in abstract terms. This effect emerged whether participants reasoned with broad principles, such as human dignity, or narrow rules, and was largest among individuals high in trait empathy. Finally, to understand whether people reflectively endorse the discrepancy between abstract and concrete resolutions, we examined their reactions when evaluating both, either simultaneously or sequentially. These approaches revealed no single pattern across lay and expert populations, or exploratory and confirmatory studies. Taken together, our studies suggest that empathic concern plays a greater role in guiding the judicial resolution of concrete cases than in illuminating judges' professed standards—which may result in concrete decisions in violation of their own abstract principles. (shrink)

It is well known that experts’ opinion and testimony take on a decisive weight in judicial fact-finding, raising issues and perplexities that have long been under scholarly scrutiny. In this paper I argue that expert’s opinions have a much wider impact on legal decision-making. In particular, they may generate a problem that I will call ‘the opacity of law’. A legal text, such as a statute or regulation, becomes opaque if a legal authority is not (...) able to grasp its full linguistic content but is nevertheless in a position to use it, thanks to an expert’ opinion, in legal decision-making. When this occurs, not only do experts contribute to fact-finding but also to determining the content of the law. In the paper I analyse the linguistic and cognitive sources of this phenomenon, its characteristics and troublesome consequences, and the different kinds of opacity that may affect legal decision-making. (shrink)

Reasoning by jurors concerning whether an accused person should be convicted of committing a crime is a kind of casual inference. Jurors need to decide whether the evidence in the case was caused by the accused’s criminal action or by some other cause. This paper compares two computational models of casual inference: explanatory coherence and Bayesian networks. Both models can be applied to legal episodes such as the von Bu¨low trials. There are psychological and computational reasons for preferring the (...) explanatory coherence account of legal inference. (shrink)

Chance inevitably plays a role in law but it is not often that we consciously try to import an element of randomness into a legal process. Random Justice: On Lotteries and Legal Decision-Making explores the potential for the use of lotteries in social, and particularly legal, decision-making contexts. Utilizing a variety of disciplines and materials, Neil Duxbury considers in detail the history, advantages, and drawbacks of deciding issues of social significance by lot and (...) argues that the value of the lottery as a legal decision-making device has generally been underestimated. The very fact that there exists widespread resistance to the use of lotteries for legal decision-making purposes betrays a commonly held belief that legal processes are generally more important than are legal outcomes. Where, owing to the existence of indeterminacy, the process of reasoning is likely to be excessively protracted and the reasons provided strongly contestable, the most cost-efficient and impartial decision-making strategy may well be recourse to lot. Aversion to this strategy, while generally understandable, is not necessarily rational. Yet in law, as Professor Duxbury demonstrates, reason is generally valued more highly than is rationality. The lottery is often conceived to be a decision-making device that operates in isolation. Yet lotteries can frequently and profitably be incorporated into other decision-frameworks. The book concludes by controversially considering how lotteries might be so incorporated and also advances the thesis that it may sometimes be sensible to require that adjudication takes place in the shadow of a lottery. (shrink)

Purpose. The study seeks to clarify the preconditions for moral and legal decision-making based on the identification of axiological foundations that correlate with the moral perceptions of good and evil and psychological phenomena such as emotions. Theoretical basis of the study is to apply comparative, axiological, systemic methods. This methodological approach allows us to analyze and disclose the essence of the process of moral and legal decision-making on the basis of certain axiological prerequisites and (...) enables to substantiate the connection between the axiological and psychological aspects of taking moral and legal decisions. Originality of the work is to broaden the perceptions of the processes and mechanisms for making moral and legal decisions, which are based on the axiological dimension, in particular on the system of reference individual and social values. The study shows that every necessary moral and legal decision taken by a person is futurologically balanced in the emotional sense, rationally reasoned and morally perceptible in the context of man’s beliefs about good and evil, and realized with necessity in the personal system of reference values that determines the style and manner of individual and social behaviour in the context of material and spiritual values and is an axiological foundation for making all types of moral and legal decisions. Conclusions. Moral and legal decision-making is a social process that is connected with such a social essence of a person as rationality, which gives an opportunity to act axiologically. A person makes moral and legal decisions in a complex way, based on the unity of the moral, axiological and psychological aspects of his worldview, which are grounded on the system of reference values. (shrink)

Courts frequently engage in the weighing of competing values; perhaps most obviously, such balancing constitutes an integral aspect of proportionality analysis in many states’ constitutional law. However, such balancing raises a difficult theoretical question: What does it mean that one value “outweighs” another in any particular case? If the values at issue are incommensurable — as they often will be — such balancing may appear to break down. As Justice Scalia has stated, balancing in the presence of incommensurable values “is (...) more like judging whether a particular line is longer than a particular rock is heavy.” It may appear that if a judge is asked in a particular case to decide, for example, whether a state interest is sufficiently strong to justify the limitation of a constitutional right, he will be forced to a) either abandon the notion of a genuine plurality of values, or b) make an arbitrary decision. This article argues that neither of these options need be accepted and that rational choice is indeed possible in the presence of incommensurable values. Specifically, it contends that the Nash bargaining solution provides a means, at least in certain circumstances, of rationally understanding and undertaking the weighing of distinct and mutually irreducible values which adjudication frequently requires. The Nash framework can both elucidate proportionality analysis by providing a social choice-based framework for understanding the structure of proportionality analysis and also justify proportionality analysis by demonstrating that the weighing of competing values is not necessarily mere judicial hand-waving. (shrink)

In his essay ‘Ethical Consistency’, Bernard Williams famously introduced the concept of a moral remainder, which points to the phenomenon of an in itself defensible decision that may nonetheless re...

Law 49/2018, of August 14, created the Portuguese legal regime of the assisted decision-making (capacity), thus eliminating the legal institutes of interdiction and disqualification, provided for in the Civil Code (CC). The aim of this legal regime was to embed a new vision of disability based on a model of rights, that grants people with disabilities an independent and autonomous life and reflects the acceptance of the International Convention on the Rights of Persons with Disabilities (...) (CRPD) guidelines. This paper intends to discuss the ‘new’ Portuguese legal system regarding the legal capacity of persons with disabilities and its role in valuing the expression of the real will of people with disabilities. (shrink)

U.S. researchers and scholars often point to two legal factors as significant obstacles to the inclusion of pregnant women in clinical research: the Department of Health and Human Services’ regulatory limitations specific to pregnant women's research participation and the fear of liability for potential harm to children born following a pregnant woman's research participation. This article offers a more nuanced view of the potential legal complexities that can impede research with pregnant women than has previously been reflected in (...) the literature. It reveals new insights into the role of legal professionals throughout the research pathway, from product conception to market, and it highlights a variety of legal factors influencing decision-making that may slow or halt research involving pregnant women. Our conclusion is that closing the evidence gap created by the underrepresentation and exclusion of pregnant women in research will require targeted attention to the role of legal professionals and the legal factors that influence their decisions. (shrink)

Health care decision making for patients without decisional capacity is ethically and legally challenging. Advance directives (living wills) have proved to be of limited usefulness in clinical practice. Therefore, academic attention should focus more on substitute decision making by the next of kin. In this article, we comparatively analyse the legal approaches to substitute medical decision making in England and Germany. Based on the current ethico-legal discourse in both countries, three aspects of (...) substitute decision making will be highlighted: (1) Should there be a legally predefined order of relatives who serve as health care proxies? (2) What should be the respective roles and decisional powers of patient-appointed versus court-appointed substitute decision-makers? (3) Which criteria should be determined by law to guide substitute decision-makers? (shrink)

Formal models of argumentation have been investigated in several areas, from multi-agent systems and artificial intelligence (AI) to decision making, philosophy and law. In artificial intelligence, logic-based models have been the standard for the representation of argumentative reasoning. More recently, the standard logic-based models have been shown equivalent to standard connectionist models. This has created a new line of research where (i) neural networks can be used as a parallel computational model for argumentation and (ii) neural networks can (...) be used to combine argumentation, quantitative reasoning and statistical learning. At the same time, non-standard logic models of argumentation started to emerge. In this paper, we propose a connectionist cognitive model of argumentation that accounts for both standard and non-standard forms of argumentation. The model is shown to be an adequate framework for dealing with standard and non-standard argumentation, including joint-attacks, argument support, ordered attacks, disjunctive attacks, meta-level attacks, self-defeating attacks, argument accrual and uncertainty. We show that the neural cognitive approach offers an adequate way of modelling all of these different aspects of argumentation. We have applied the framework to the modelling of a public prosecution charging decision as part of a real legal decision making case study containing many of the above aspects of argumentation. The results show that the model can be a useful tool in the analysis of legal decision making, including the analysis of what-if questions and the analysis of alternative conclusions. The approach opens up two new perspectives in the short-term: the use of neural networks for computing prevailing arguments efficiently through the propagation in parallel of neuronal activations, and the use of the same networks to evolve the structure of the argumentation network through learning (e.g. to learn the strength of arguments from data). (shrink)

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

This “Legal Briefing” column covers recent legal developments involving patient decision aids. This topic has been the subject of recent articles in JCE. It is included in the 2010 Patient Protection and Affordable Care Act. And it has received significant attention in the biomedical literature, including a new book, a thematic issue of Health Affairs, and a recent article in the New England Journal of Medicine. Moreover, physicians and health systems across the United States are increasingly integrating (...) decision aids into their clinical practice. Both federal and state laws play a significant role in promoting this expanded use. On the other hand, concerns about liability could stymie development and implementation. We categorize legal developments concerning patient decision aids into the following five sections:1. Development of decision aids2. Effectiveness of decision aids3. Federal regulation of decision aids4. State regulation of decision aids5. Legal concerns regarding decision aids. (shrink)

This paper addresses the black-box problem in artificial intelligence (AI), and the related problem of explainability of AI in the legal context. We argue, first, that the black box problem is, in fact, a superficial one as it results from an overlap of four different – albeit interconnected – issues: the opacity problem, the strangeness problem, the unpredictability problem, and the justification problem. Thus, we propose a framework for discussing both the black box problem and the explainability of AI. (...) We argue further that contrary to often defended claims the opacity issue is not a genuine problem. We also dismiss the justification problem. Further, we describe the tensions involved in the strangeness and unpredictability problems and suggest some ways to alleviate them. (shrink)

In recent years, a growing body of work has emerged in legal theory that focuses on the relationship between law and virtue. Part of this virtue jurisprudence literature deals with the role of virtue in adjudication and judicial decision-making, with leading authors claiming that virtue plays a central explanatory and normative role. This article engages with this literature on virtue in adjudication, and connects it with a contemporary phenomenon that poses a risk for courts and judges, namely (...) the politicisation of judiciaries. In particular, the question emerges whether virtue jurisprudence is able to provide practical guidance to judges and courts in order to help them avert such politicisation. I sketch the outlines of two contrasting answers to this question, by exploring two alternative approaches to understanding the politicisation of judiciaries from within a broadly virtue-ethical framework. On the first approach, it appears that judges may help prevent politicisation, by becoming more attentive to the tragic character of particular cases and by deciding as civic friends. However, on the other approach, which builds on Alasdair MacIntyre’s critique of modern moral discourse, politicisation appears to be intractable, and the practical recommendations following from the first perspective may even aggravate it. (shrink)

Legal processes very often require judges and jurors to make determinations as to what mental states other individuals were in at a particular point in time, i.e., what they intended, believed, con...

The two grand theories of judging – legal realism and legal formalism - have their differences set around the importance of legal rules. For formalists, judging is a rule-bound activity. In its more extreme versions, a judge is seen as an operator of a giant syllogism machine. Legal realists, in contrast, argue that legal rules, at least formal legal rules, do not determine outcomes of cases. Legal realism has been misunderstood almost everywhere outside (...) its birthplace – the United States. Continental legal theory, for one, views legal realism as practical, down-to-earth, hard-nosed school of thought which is opposed to the more “scientific” theories. The purpose of this article is two-fold. First, to show what legal realists really stood for - that contrary to the popular myth, they did not maintain that formal legal rules do not matter at all; that most of them considered legal rules to be important, only many of those rules are informal rules. Second, contrary to the popular understanding in Continental legal theory, legal realism by its nature was not an antiscientific theory of judging - in fact, it was either a first scientific theory of judging or at least its prototype. (shrink)

Background Abortion is one of the most common gynaecological procedures. It is related to personal, social, and economic reasons under a legal term that is recognised as a common sexual and reproductive right in most of countries. However, making the decision to abort is complex, because it is politicised and is often framed in public discourse related to moral or ethical issues beyond women’s experiences. Therefore, it is subject to medical criteria, religious evaluations, and sociological analysis. Purpouse (...) The aim of this synthesis of qualitative studies was to synthesise the decision-making experiences of women who legally aborted. Research design and method The Noblit and Hare’s interpretive meta‐ethnography was conducted, and it was written in accordance with the eMERGe meta‐ethnography reporting guidance. Ten studies met the research objective and inclusion criteria, after a comprehensive systematic search strategy in five databases. Findings The metaphor “The wrestling between why and what will happen next” and three themes emerged from the data analysis: (1) Forces that incite the arm wrestling; (2) Facing social stigma; and (3) Defeated by a greater rival. The metaphor provided interpretive experiences of the moral conflict experienced by women who decided to have an abortion and emerged from the confrontation of the reasons why they decided to abort and the social repercussions that making the decision entails. The result of the struggle was loneliness and vulnerability. Conclusion The lines of action impact policy makers, the media, and health professionals. Actions should focus on the de-stigmatisation and normalisation of abortion, the use of appropriate language, and the training and sensitisation of health professionals. (shrink)

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

Families frequently act as substitute decisionmakers for their older members who suffer from diminished mental capacity to make and express their own medical choices. Substitute decisionmaking takes on particular ethical and legal urgency within the nursing home environment, especially when choices concern potential medical treatment near the end of the nursing home resident's life. This article examines current legal mechanisms in the United States that enable a family to make substitute medical decisions, the ethical underpinnings of those mechanisms, (...) and specific ethical and legal considerations implicated by their application to the nursing home setting. The article offers advice to nursing home professionals, including physicians, in working with families as substitute decisionmakers. (shrink)

The present article reviews the state of public debate and legal provisions concerning end‐of‐life decision‐making in Italy and offers an evaluation of the moral and legal issues involved. The article further examines the content of a recent law concerning informed consent and advance treatment directives, the main court pronouncements that formed the basis for the law, and developments in the public debate and important jurisprudential acts subsequent to its approval. The moral and legal grounds for (...) a positive evaluation of this law, which attests that the patient may withhold or withdraw from life‐prolonging treatment, will be offered with reference to liberal approaches and particularly to the frameworks of care and virtue ethics; but reasons will also be offered in order to consider not only the latter but also broader range of end‐of‐life treatment decisions as morally apt options. In this light, we argue in favour of a further development of the Italian legislation to encompass forms of assisted suicide and active euthanasia. (shrink)

Discussion of supported decision making has been dominated by legal scholars, philosophers, and advocates for persons with disabilities. Peterson et al.’s primary contribution is introducing...

The paper is concerned with the introduction of computerized systems into public administration. As a basis for the assessment of current systems, a brief history of such systems is offered. Not only are “legal information systems” discussed, but the access to factual information is also dealt with. Three generations of systems in public administration are indicated: The first generation emphasized use of data bases and computers for calculation, as well as “computer‐oriented legislation.” The second generation lifted the forms, which (...) structure the case work, onto the computer screens. And the third generation is being born from the current efforts to design integrated work stations, using knowledge based methods. On this background, a discussion of impact on legal decision‐making is offered, emphasizing the replacement of vague by strict criteria, and the re‐use of pre‐collected factual information. A final note addresses the problem of reviewing or supervising such systems. (shrink)

Introduction: Nurses who work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective: The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design: Data were analysed, codified (...) and triangulated using qualitative ethnographic content analysis. Participants and research context: This research is set in a large emergency department in the Midlands area of England. Data were collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies. Ethical considerations: Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results: The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations among the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion: The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion: The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen. (shrink)

We report on an interview-based study of decision-making capacity in two classes of patients suffering from depression. Developing a method of second-person hermeneutic phenomenology, we articulate the distinctive combination of temporal agility and temporal inability characteristic of the experience of severely depressed patients. We argue that a cluster of decision-specific temporal abilities is a critical element of decision-making capacity, and we show that loss of these abilities is a risk factor distinguishing severely depressed patients from (...) mildly/moderately depressed patients. We explore the legal and clinical consequences of this result. (shrink)

Past research showed that the ability to focus on one’s internal states positively correlates with the self-regulation of behavior in situations that are accompanied by somatic and/or physiological changes, such as emotions, physical workload, and decision-making. The analysis of moral oriented decision-making can be the first step for better understanding the legal reasoning carried on by the main players in the field, as lawyers are. For this reason, this study investigated the influence of the (...) class='Hi'>decision context and interoceptive manipulation on the moral decision-making process in the legal field gathering the responses of two groups of lawyers. A total of 20 lawyers were randomly divided into an experimental group, which was explicitly required to focus the attention on its interoceptive correlates, and a control group, which only received the general instruction to perform the task. Both groups underwent a modified version of the Ultimatum Game, where are presented three different moral conditions and three different offers. Results highlighted a significant increase of Acceptance Rate in those offers that should be considered more equal than fair or unfair ones, associated with a general increase of Reaction Times in the equal offers. Furthermore, the interoceptive manipulation oriented the Lawyers toward a more self-centered decision. This study shows how individual, situational, contextual, and interoceptive factors may influence the moral decision-making of lawyers. Future research in the so-called Neurolaw field is needed to replicate and expand current findings. (shrink)

The United Nations Convention on the Rights of Persons with Disabilities urges and requires changes to how signatories discharge their duties to people with intellectual disabilities, in the direction of their greater recognition as legal persons with expanded decision-making rights. Australian jurisdictions are currently undertaking inquiries and pilot projects that explore how these imperatives should be implemented. One of the important changes advocated is to move from guardianship models to supported or assisted models of decision-making. (...) A driving force behind these developments is a strong allegiance to the social model of disability, in the formulation of the Convention, in inquiries and pilot projects, in implementation and in the related academic literature. Many of these instances suffer from confusing and misleading statements and conceptual misinterpretations of certain elements such as legal capacity, decision-making capacity, and support for decision-making. This paper analyses some of these confusions and their possible negative implications for supported decision-making instruments and those whose interests these instruments would serve, and advises a more incremental development of existing guardianship regimes. This provides a more realistic balance between neglecting the real limits of those with mental disabilities and thereby ignoring their identity and particularity, and continuing to bring them equally and fully into society. (shrink)

People with cognitive impairments often have difficulties formulating, understanding, or articulating decisions that others judge reasonable. The frequent response shifts decision-making authority to substitutes through advance directives of the person or guardianship orders from a court. The Convention on the Rights of People with Disabilities defends supported decision-making as an alternative to such forms of supplanted decision-making. But supported decision-making raises both metaphysical questions—what is required for a decision to be the (...) person’s own?—and epistemological questions: how do we know what persons judge to be their good, when they have difficulty conceptualizing and articulating? It raises practical questions, too, such as protection against risks of exploitation. This article uses a non-discrimination account of legal personhood drawn from the CRPD to explore how common features of decisions employed by people without cognitive disabilities are important in supported decision-making too. These features include prostheses, guardrails, relationships, and social contexts. (shrink)

The author singles out various conceptions of rationality used in practical legal discourse: formal and substantive rationality, instrumental goal‐ and means‐rationality, communicative rationality. Practical rationality is expressed in decisions justified by epistemic and axiological premises according to the rules of justificatory reasoning. Five levels of analysis of this justification are identified. Rules, principles and evaluations are used as justifying arguments and their characteristics determine the dimensions of rationality of decision depending on the features of rules, various conceptions of (...) principles, and kinds of relativisation of evaluations. The dimensions of legal rationality depend mainly on three singled out conceptions of rationality, i.e., formal rationality dealing with the deep structure of justification, instrumentally oriented rationality as content of justifiability, and communicative rationality linked with the pragmatics of human interaction. Legitimacy, according to the presented analysis, appears as a subclass of external justification dealing with axiological premisses in terms of instrumental rationality and/or communicative rationality. (shrink)

Unrepresented patients are some of the most vulnerable patients encountered in the healthcare system today. One of the challenges associated with healthcare for unrepresented patients is the lack of a standardized legal approach to decision making for this highly vulnerable population. Current statutory approaches vary widely without best practices or consensus guidelines. In 2016, Colorado passed a medical proxy law that established a process for the appointment of an independent physician to serve as a temporary proxy (...) class='Hi'>decision maker for an unrepresented patient. Although this approach helps to identify a decision maker when no proxy is available, the appropriate standards for decision making remain uncertain. A peer-to-peer session at the Clinical Ethics Unconference in 2022 approached this conundrum with a focus on the best interests standard and the appropriate use of patients’ context in decision making. (shrink)

During the COVID-19 pandemic, global healthcare systems faced unprecedented challenges, with a lack of resources and suboptimal patient care emerging as primary concerns. Our research, using a comprehensive 24-item electronic questionnaire, “Reflections on the Provision of Healthcare during the COVID-19 Pandemic,” delved into the experiences of 938 physicians across the Czech Republic. Over fifty per cent observed a “lower standard of care” compared to pre-pandemic levels. A division arose among physicians regarding a decision’s medical, ethical, or legal basis, (...) with a notable gender disparity: male doctors leaned towards medical perspectives, whereas females accented the ethical perspective. Decision-making concerning health care limitations required agreement among the physicians on duty, interdisciplinary teams, or shift supervisors. Physicians reported varying degrees of patient or family participation in health care decisions. Variables such as age, pre-existing health conditions, and life expectancy influenced care decisions. Surprisingly, half of the physicians faced refusals of patients’ transportation to better-equipped facilities due to resource constraints. One-third of physicians never discuss the decision about care limitation and other options with patients or their families. As a result, almost fifty per cent of the physicians rarely or never imparted information about care limitations to patients. The survey shed light on the profound ethical dilemmas hospital physicians face across different types of healthcare facilities during the pandemic. It uncovered the need for open dialogue and scholarly debate on resource allocation and strengthening the role of patients and their families in care decisions in future healthcare crises. (shrink)

This paper explores management attitudes towards ethical issues in an attempt to shed some light on the determinants of ethical issue intensity in the context of business. A sample of business executives in Mauritius was surveyed in order to establish their ethical perceptions when exposed to potentially questionable business practices. The findings demonstrated the significant influence of factors associated with moral deliberations on strategies for ethical decision–making as compared with the impact of company policy and legal requirements. (...) Participants revealed that, irrespective of codes of conduct, personal ethics predominate when it comes to making ethical choices. Some view the behaviour of management as a key determinant of ethical conduct. This trend differs from predictions in the literature. To date, research conducted in the developed world shows that employee perception of ethics of their superiors is a stronger predictor of behaviour than employees’ personal ethical beliefs. This article focuses on Mauritius as an emerging economy, and looks at potential strategies for ethical decision–making, where business people do not necessarily operate under a specific code of conduct. (shrink)

This article will explore some previously unrecognised legal and ethical issues associated with informal care-giving and criminal justice in the context of end of life decision-making. It was prompted by a recent case in Leeds Crown Court, which raises important issues for the people who care for their loved ones at home and for the criminal justice system more generally. Government figures estimate that over 5.2 million Britons are responsible for the care of relatives or loved ones. (...) In order to evaluate some of the ways in which they might find themselves exposed to unexpected criminal liability we have characterised this group as untrained carers who assume responsibility. (shrink)

This book clarifies the meaning of the most important and pervasive concepts and tools in bioethical argumentation and assesses the methodological suitability of the main methods for clinical decision-making and argumentation. The first part of the book is devoted to the most developed or promising approaches regarding bioethical argumentation, namely those based on principles, values and human rights. The authors then continue to deal with the contributions and shortcomings of these approaches and suggest further developments by means of (...) substantive and procedural elements and concepts from practical philosophy, normative systems theory, theory of action, human rights and legal argumentation. Furthermore, new models of biomedical and health care decision-making, which overcome the aforementioned criticism and stress the relevance of the argumentative responsibility, are included. (shrink)

Self-driving vehicles (SDVs) will need to make decisions that carry ethical dimensions and are of normative significance. For example, by choosing a specific trajectory, they determine how risks are distributed among traffic participants. Accordingly, policymakers, standardization organizations and scholars have conceptualized what (shall) constitute(s) ethical decision-making for SDVs. Eventually, these conceptualizations must be converted into specific system requirements to ensure proper technical implementation. Therefore, this article aims to translate critical requirements recently formulated in scholarly work, existing standards, regulatory (...) drafts and guidelines into an explicit five-step ethical decision model for SDVs during hazardous situations. This model states a precise sequence of steps, indicates the guiding ethical principles that inform each step and points out a list of terms that demand further investigation and technical specification. By integrating ethical, legal and engineering considerations, we aim to contribute to the scholarly debate on computational ethics (particularly in autonomous driving) while offering practitioners in the automotive sector a decision-making process for SDVs that is technically viable, legally permissible, ethically grounded and adaptable to societal values. In the future, assessing the actual impact, effectiveness and admissibility of implementing the here sketched theories, terms and the overall decision process requires an empirical evaluation and testing of the overall decision-making model. (shrink)

This paper will examine the effects of gender, age, work experience, academic status and legality on certain ethical decisions. Six scenarios representing ethical dilemmas were presented to both undergraduate and MBA students in an attempt to determine if various demographic factors influenced ethical decision making. While some past studies have suggested that gender has an important effect on ethical decision making, this study does not completely support this conclusion and suggests that age and/or length of work (...) experience should be included in any study of ethical decision making.The legality of the decisions was determined and compared to the reason given by the students for their decisions. In some cases the choice made by a majority of the students was not the one that was supported by the legal authorities which suggests that there may be conflicts between the ethical system of the respondents and the behavior expected of them by society. (shrink)

Asylum legal aid lawyers are under continuous public scrutiny. On the one hand, these lawyers are portrayed as being solely motivated by profit. On the other hand, they are depicted as leftist activists frustrating the legal system. When assisting their asylum seeking clients under the state's legal aid scheme, lawyers need to balance the client's interest, the public interest in the administration of justice and their own interest in profit or survival. The current book examines this balancing (...) act and explores the role of the institutional context. It does so by studying the decision making of asylum legal aid lawyers in the Netherlands and England in respect of two ethical issues: 'time vs. money' and 'hopeless cases'. This empirical research into lawyers' professional ethics in practice will appeal to scholars engaged in lawyers' ethics, policy makers and those involved in the regulation of the legal profession. Dissertation. [Subject: Politics, Human Rights Law, International Law]. (shrink)

Making decisions is an important component of everyday living, and issues surrounding autonomy and self-determination are crucial for persons with intellectual disabilities. Adults with intellectual disabilities are characterized by the limitations in their intellectual functioning and in their adaptive behavior, which compromises three skill types, and this starts before the age of 18. Though persons with intellectual disabilities are characterized by having these limitations, they are thought to face significant decisionmaking challenges due to their disability. Moving away from this (...) generalization, Article 12 of the United Nations Convention on the Rights of Persons with Disabilities addresses this issue of decision-making for persons with disabilities, recognizing the right to legal capacity. (shrink)