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

First paper introducing probabilisitic decision theory methods to AI problem solving.

Normative ethical theories owe us an account of how to evaluate decisions under risk and uncertainty. Deontologists seem at a disadvantage here: our best decision theories seem tailor-made for consequentialism. For example, decision theory enjoins us to always perform our best option; deontology is more permissive. In this paper, we discuss and defend the idea that, when some pro-tanto wrongful act is all-things considered permissible, because it is a ‘lesser evil’, it is often merely permissible, by the lights of deontology. (...) We show that this raises new problems for deontological decision theory, and we show that to resolve them, we need to take a more innovative approach to morally evaluating decision-making under risk and uncertainty. (shrink)

In some decision problems adoption of an option furnishes evidence about the option's consequences. Rational decisions take account of that evidence, although it makes an option's adoption changes the option's expected utility.

It has often been noted that there is some tension between engaging in decision-making and believing that one’s choices might be predetermined. The possibility that our choices are predetermined forces us to consider, in our decisions, act-state pairs which are inconsistent, and hence to which we cannot assign sensible utilities. But the reasoning which justifies two-boxing in Newcomb’s problem also justifies associating a non-zero causal probability with these inconsistent act-state pairs. Put together these undefined utilities and non-zero probabilities entail that (...) expected utilities are undefined whenever it is a possibility that our choices are predetermined. There are three ways to solve the problem, but all of them suffer serious costs: always assume that, contrary to our evidence, the outcome of our present decision-making is not predetermined; give up the reasoning that justifies unconditional two-boxing in Newcomb’s problem; or allow epistemically impossible outcomes to contribute to expected utility, leading to the wrong results in a series of cases introduced by Ahmed :665–685, 2014a, Evidence, decision and causality, Cambridge University Press, Cambridge, 2014b). However they choose to respond, causal decision theorists cannot remain silent: the intuitive tension between decision-making and the possibility of predetermination can be made precise, and resolving it will require giving up something. Causal decision theorists have a predetermination problem. (shrink)

Decision Making Competence (DMC) reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804) completed an online DMC measure, using a subset of the original Adult-DMC battery (A-DMC; Bruine de Bruin, Parker, & Fischhoff, (...) 2007). Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits) across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC  expected benefits  risk-taking than the DMC  perceived risk  risk-taking path, especially for risk behaviors that may be considered more antisocial in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of the given behavior. (shrink)

Group decisions raise a number of substantial philosophical and methodological issues. We focus on the goal of the group decision exercise itself. We ask: What should be counted as a good group decision-making result? The right decision might not be accessible to, or please, any of the group members. Conversely, a popular decision can fail to be the correct decision. In this paper we discuss what it means for a decision to be "right" and what components are required in a (...) decision process to produce happy decision-makers. Importantly, we discuss how "right" decisions can produce happy decision-makers, or rather, the conditions under which happy decision-makers and right decisions coincide. In a large range of contexts, we argue for the adoption of formal consensus models to assist in the group decision-making process. In particular, we advocate the formal consensus convergence model of Lehrer and Wagner (1981), because a strong case can be made as to why the underlying algorithm produces a result that should make each of the experts in a group happy. Arguably, this model facilitates true consensus, where the group choice is effectively each person's individual choice. We analyse Lehrer and Wagner's algorithm for reaching consensus on group probabilities/utilities in the context of complex decision-making for conservation biology. While many conservation decisions are driven by a search for objective utility/probability distributions (regarding extinction risks of species and the like), other components of conservation management primarily concern the interests of stakeholders. We conclude with cautionary notes on mandating consensus in decision scenarios for which no fact of the matter exists. For such decision settings alternative types of social choice methods are more appropriate. (shrink)

When making decisions, people naturally face uncertainty about the potential consequences of their actions due in part to limits in their capacity to represent, evaluate or deliberate. Nonetheless, they aim to make the best decisions possible. In Decision Theory with a Human Face, Richard Bradley develops new theories of agency and rational decision-making, offering guidance on how 'real' agents who are aware of their bounds should represent the uncertainty they face, how they should revise their opinions as a result of (...) experience and how they should make decisions when lacking full awareness of, or precise opinions on relevant contingencies. He engages with the strengths and flaws of Bayesian reasoning, and presents clear and comprehensive explorations of key issues in decision theory, from belief and desire to semantics and learning. His book draws on philosophy, economics, decision science and psychology, and will appeal to readers in all of these disciplines. (shrink)

Decisions are central to engineering processes and hold them together. It is argued that better decisions will lead to better engineering. To achieve better decisions requires that they be understood in detail. A typical decision is broken down into its essential requirements and processes, thus displaying the components of its framework. The process leads to the identification of a number of concerns. The components are discussed and a set of issues where more work needs to be done is identified. There (...) are significant implications for both engineering practice and engineering education. © 2013 © 2013 Taylor & Francis. (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 competence reflects individual differences in the susceptibility to decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate mechanisms that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC) and one such mechanism, (...) the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when expected value favors those options and (b) avoiding risky options when expected value favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions. (shrink)

The article describes a framework that identifies event, organizational, and individual factors that threaten ethical decision making in organizations facing discrete crises or in an ongoing crisis environment. Nine propositions are stated that predict threats to ethical decision making during crisis. A comparison between predictions from our model and from Jones's (1991) model is made. Suggestions for research to test and refine the framework are proposed.

The stakes associated with an algorithmic decision are often said to play a role in determining whether the decision engenders a right to an explanation. More specifically, “high stakes” decisions are often said to engender such a right to explanation whereas “low stakes” or “non-high” stakes decisions do not. While the overall gist of these ideas is clear enough, the details are lacking. In this paper, we aim to provide these details through a detailed investigation of what we will call (...) the “Simple Stakes Thesis”. The Simple Stakes Thesis, as it will turn out, is too simple. For even if the stakes associated with a specific one-off decision are low—and hence does not engender a right to an explanation—such decisions may nevertheless form part of a high stakes pattern or aggregate of decisions. In such cases, we argue, even a low stakes decision may engender a right to explanation. Not only does this show that the right to explanation is more demanding than so far recognized. It also shows that the stakes thesis is significantly harder to apply in practice. (shrink)

This article examines how people with type 2 diabetes perceive autonomous decision making and which moral capacities they consider important in diabetes nurses' support of autonomous decision making. Fifteen older adults with type 2 diabetes were interviewed in a nurse-led unit. First, the data were analysed using the grounded theory method. The participants described a variety of decision-making processes in the nurse and family care-giver context. Later, descriptions of the decision-making processes were analysed using hermeneutic text interpretation. We suggest first- (...) and second-order moral capacities that nurses specializing in diabetes need to promote the autonomous decision making of their patients. We recommend nurses to engage in ongoing, interactive reflective practice to further develop these moral capacities. (shrink)

BackgroundHospitalized older adults frequently have impaired cognition and must rely on surrogates to make major medical decisions. Ethical standards for surrogate decision making are well delineated, but little is known about what factors surrogates actually consider when making decisions.ObjectivesTo determine factors surrogate decision makers consider when making major medical decisions for hospitalized older adults, and whether or not they adhere to established ethical standards.DesignSemi-structured interview study of the experience and process of decision making.SettingA public safety-net hospital and a tertiary referral (...) hospital in a large city in the Midwest United States.ParticipantsThe study included 35 surrogates with a recent decision-making experience for an inpatient aged 65 or older.MeasurementsThe key factors that surrogates considered when making decisions. Interview transcripts were coded and analyzed using the grounded theory method of qualitative analysis.ResultsSurrogates considered patient-centered factors and surrogate-centered factors. Patient-centered factors included: respecting the patient’s input, using past knowledge of the patient to infer the patient’s wishes, and consider ing what is in the patient’s best interests. Some surrogates expressed a desire for more information about the patient’s prior wishes. Surrogate-centered factors included: surrogate’s wishes as a guide, surrogate’s religious beliefs and/or spirituality, surrogate’s interests, and family consensus.ConclusionOur study indicates that surrogate decision making is more complex than the standard ethical models, which are limited to considerations of the patient’s autonomy and beneficence. Because surrogates also imagine what they would want under the circumstances and consider their own needs and preferences, models of surrogate decision making must account for these additional considerations. Surrogates’ desire for more information about patients’ preferences suggests a need for greater advance care planning. (shrink)

Motivations and decision-making styles that influence participation in biomedical research vary across study types, cultures, and countries. While there is a small amount of literature on informed consent in non-western cultures, few studies have examined how participants make the decision to join research. This study was designed to identify the factors motivating people to participate in biomedical research in a traditional Nigerian community, assess the degree to which participants involve others in the decision-making process, and examine issues of autonomy in (...) decision-making for research. A descriptive cross-sectional study was conducted with 100 adults (50 men, 50 women) in an urban Nigerian community who had participated in a biomedical research study. Subjects were interviewed using a survey instrument.Two-thirds of the respondents reported participating in the biomedical study to learn more about their illness, while 30% hoped to get some medical care. Over three-quarters (78%) of participants discussed the enrolment decision with someone else and 39% reported obtaining permission from a spouse or family member to participate in the study. Women were more than twice as likely as men to report obtaining permission from someone else before participating. More specifically, half of the female participants reported seeking permission from a spouse before enrolling. The findings suggest that informed consent in this community is understood and practised as a relational activity that involves others in the decision making process. Further studies are needed in non-Western countries concerning autonomy, decision-making, and motivation to participate in research studies. (shrink)

Decision making capacity (DMC) is a fundamental concept grounding the principle of respect for autonomy and the practice of obtaining informed consent. DMC must be determined and documented every time a patient undergoes a hospital procedure and for routine care when there is reason to believe decision making ability is compromised. In this paper we explore a path toward ethically informed development and implementation of a hospital policy related to DMC assessment. We begin with a review of the context of (...) DMC assessment before discussing some considerations relevant to policy creation by healthcare ethics committees. The discussion concludes in a presentation of a typology of capacity assessment policies, which draws upon a sampling of currently used hospital policies to illustrate relevant ethical considerations. (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)

In Decision Space: Multidimensional Utility Analysis, first published in 2001, Paul Weirich increases the power and versatility of utility analysis and in the process advances decision theory. Combining traditional and novel methods of option evaluation into one systematic method of analysis, multidimensional utility analysis is a valuable tool. It provides formulations of important decision principles, such as the principle to maximize expected utility; enriches decision theory in solving recalcitrant decision problems; and provides in particular for the cases in which an (...) expert must make a decision for a group of people. The multiple dimensions of this analysis create a decision space broad enough to accommodate all factors affecting an option's utility. The book will be of interest to advanced students and professionals working in the subject of decision theory, as well as to economists and other social scientists. (shrink)

:We address the question, in decision theory, of how the value of risky options should be assessed when they have no finite standard expected value, that is, where the sum of the probability-weighted payoffs is infinite or not well defined. We endorse, combine and extend the proposal of Easwaran to evaluate options on the basis of their weak expected value, and the proposal of Colyvan to rank options on the basis of their relative expected value.

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

This book defends the view that any adequate account of rational decision making must take a decision maker's beliefs about causal relations into account. The early chapters of the book introduce the non-specialist to the rudiments of expected utility theory. The major technical advance offered by the book is a 'representation theorem' that shows that both causal decision theory and its main rival, Richard Jeffrey's logic of decision, are both instances of a more general conditional decision theory. The book solves (...) a long-standing problem for Jeffrey's theory by showing for the first time how to obtain a unique utility and probability representation for preferences and judgements of comparative likelihood. The book also contains a major new discussion of what it means to suppose that some event occurs or that some proposition is true. The most complete and robust defence of causal decision theory available. (shrink)

Regional planning has been regarded as a design activity. Usually planners focus on physical design rather than on societal issues. Nowadays, mass communication, environmental issues and social awareness lead to often complex and conflicting needs and interests of the public in regional planning. This paper focuses on the regional planning as a group problem solving process from the view of information processing. It offers an analysis of the causes of conflicts in the group decision process, and defines the characteristics of (...) group decision process support systems. (shrink)

Despite being fairly powerful, finite non-deterministic matrices are unable to characterize some logics of formal inconsistency, such as those found between mbCcl and Cila. In order to overcome this limitation, we propose here restricted non-deterministic matrices (in short, RNmatrices), which are non-deterministic algebras together with a subset of the set of valuations. This allows us to characterize not only mbCcl and Cila (which is equivalent, up to language, to da Costa's logic C_1) but the whole hierarchy of da Costa's calculi (...) C_n. This produces a novel decision procedure for these logics. Moreover, we show that the RNmatrix semantics proposed here induces naturally a labelled tableau system for each C_n, which constitutes another decision procedure for these logics. This new semantics allows us to conceive da Costa's hierarchy of C-systems as a family of (non deterministically) (n+2)-valued logics, where n is the number of "inconsistently true" truth-values and 2 is the number of "classical" or "consistent" truth-values, for every C_n. (shrink)

Background: Independent decision-making is one of the basic rights of patients. However, in clinical practice, most older cancer patients’ treatment decisions are made by family members. Objective: This study attempted to analyze the treatment decision-making process and formation mechanism for older cancer patients within the special cultural context of Chinese medical practice. Method: A qualitative study was conducted. With the sample saturation principle, data collected by in-depth interviews with 17 family members and 12 patients were subjected to thematic analysis. Ethical (...) considerations: The study was approved by the ethics committees of Sun Yat-sen University. All participants provided verbal informed consent after being told their rights of confidentiality, anonymity, and voluntary participation. They had the right to refuse to answer questions and could withdraw at any time. Results: Three themes emerged: (1) complex process; (2) transformation of family decision-making power; and (3) individual compromise. Family members inevitably had different opinions during the long process of treatment decision-making for older cancer patients. The direction of this process could be regarded as an extension of the family power relationship. The patient usually compromised the decision to survive, which was made by family members. Conclusion: This study describes the treatment decision-making process of older cancer patients in the context of Chinese culture. The reasons underlying this process are related to the views on life and death and family values. An individual is a part of the family, which is often seen as the minimal interpersonal unit in Chinese society. It is significant that while emphasizing patient autonomy in the decision-making process, health professionals should also pay attention to the important roles of culture and family. (shrink)

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

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)

Decision-making capacity (DMC) is the gatekeeping element for a patient’s right to self-determination with regard to medical decisions. A DMC evaluation is not only conducted on descriptive grounds but is an inherently normative task including ethical reasoning. Therefore, it is dependent to a considerable extent on the values held by the clinicians involved in the DMC evaluation. Dealing with the question of how to reasonably support clinicians in arriving at a DMC judgment, a new tool is presented that fundamentally differs (...) from existing ones: the U-Doc. By putting greater emphasis on the judgmental process rather than on the measurement of mental abilities, the clinician as a decision-maker is brought into focus, rendering the tool more of an evaluation guide than a test instrument. In a qualitative study, the perceived benefits of and difficulties with the tool have been explored. The findings show on the one hand that the evaluation aid provides basic orientation, supports a holistic perspective on the patient, sensitizes for ethical considerations and personal biases, and helps to think through the decision, to argue, and to justify one’s judgment. On the other hand, the room for interpretation due to absent operationalisations, related ambiguities, and the confrontation with one’s own subjectivity may be experienced as unsettling. (shrink)

Los conceptos de voluntariedad y decisión trabajados en la Ética Nicomaquea de Aristóteles permiten pensar bajo qué condiciones se atribuye la responsabilidad de una acción a una persona. Como primera condición para ello tal acción no se puede efectuar de una manera involuntaria (akô), donde se actúe por ignorancia o coacción. De esta forma se hace evidente que la responsabilidad recae sólo en un caso voluntario (hekôn), donde éste implica un decisión entre dos o más opciones. Así, en (...) el presente texto se avalúa en qué consiste el concepto de decisión, siendo éste una deliberación que lleva a una determinación o juicio (Krisis), en donde solamente se delibera lo que se esté en poder de realizar. Por ello la decisión, que se da bajo una consideración voluntaria, fundamenta la acción y de esta manera ésta última se convierte en responsabilidad de la persona que decide. (shrink)

Previous studies have found that the proportions of people who endorsed utilitarian decisions varied across different variants of the trolley dilemma. In this paper, we explored whether moral choices were associated with beliefs about outcome probabilities in different moral dilemmas. Results of two experiments showed that participants’ perceptions of outcome probabilities were different between two dilemmas that were similar to the classical switch case and footbridge case. Participants’ judgments of the outcome probabilities were associated with their moral choices. The results (...) suggested that participants might not accept task instructions and thus did not perceive the outcomes in the dilemmas as certain. We argued that researchers who endorse descriptive tasks in moral reasoning research should be cautious about the findings and should take participants’ beliefs in the outcomes into account. (shrink)

My topic is how to make decisions when you possess foreknowledge of the consequences of your choice. Many have thought that these kinds of decisions pose a distinctive and novel problem for causal decision theory (CDT). My thesis is that foreknowledge poses no new problems for CDT. Some of the purported problems are not problems. Others are problems, but they are not problems for CDT. Rather, they are problems for our theories of subjunctive supposition. Others are problems, but they are (...) not new problems. They are old problems transposed into a new key. Nonetheless, decisions made with foreknowledge illustrate important lessons about the instrumental value of our choices. Once we've appreciated these lessons, we are left with a version of CDT which faces no novel threats from foreknowledge. (shrink)

There have been two major lines of research aimed at capturing resource-bounded players in game theory. The first, initiated by Rubinstein (), charges an agent for doing costly computation; the second, initiated by Neyman (), does not charge for computation, but limits the computation that agents can do, typically by modeling agents as finite automata. We review recent work on applying both approaches in the context of decision theory. For the first approach, we take the objects of choice in a (...) decision problem to be Turing machines, and charge players for the “complexity” of the Turing machine chosen (e.g., its running time). This approach can be used to explain well-known phenomena like first-impression-matters biases (i.e., people tend to put more weight on evidence they hear early on) and belief polarization (two people with different prior beliefs, hearing the same evidence, can end up with diametrically opposed conclusions) as the outcomes of quite rational decisions. For the second approach, we model people as finite automata, and provide a simple algorithm that, on a problem that captures a number of settings of interest, provably performs optimally as the number of states in the automaton increases. (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)

Background Prioritization decision-making arises when nurses encounter intricate situations that demand ethically challenging judgments about care. This phenomenon has rarely been studied in nursing homes. Prioritization decision-making may lead to instances where individuals in social and healthcare may not receive all services they need. Making prioritization decisions and awareness of their consequences can increase nurses’ workload. Aim To describe prioritization decision-making regarding unfinished nursing care in nursing homes. Research design A qualitative descriptive study conducted through individual theme interviews. Participants were (...) recruited through social media. The data was analyzed using inductive content analysis. Participants and research context Nurses ( n = 23) working in nursing homes for the elderly people in Finland. Data were collected between June 2022 and February 2023. Ethical considerations Finnish legislation does not mandate an ethical review or research permits, as the participants took part as private individuals. [ask authors to make reference here to informed consent process and anonymity] Findings Nurses stated that the need for prioritization decision-making arises from challenges associated with nurses’ engagement with person-centered care, the culture of the work community, the burden due to workload and challenges associated with the leadership. Prioritization decision-making was based on the interests of residents, striving for an efficient workflow and nurse’s personal interests. Nurses did not receive support for decision-making regarding unfinished care, and protocols for prioritization had not been established in their work communities. Prioritization decision-making and unfinished care were concealed and left unspoken. Conclusion Nursing leaders should address this hidden phenomenon, making it visible through discussions with nurses and by involving them in the development of protocols. The findings can be utilized for developing new approaches to support nurses and reduce their workload and for enhancing the quality and person-centeredness of nursing care in nursing homes. (shrink)

The timely feature article by van der Pijl et al 1 highlights not only the widespread frequency with which unconsented episiotomies and other procedures during labour are reported by women but also that there is hardly any discussion in the literature on the ethics of consent for procedures in labour. Those national and international bodies with responsibility for midwifery and obstetric practice need not only to recognise but also act to remedy this unacceptable situation. The studies quoted used the recollection (...) of women in reporting consent or lack of it and, although this is an entirely appropriate measure, it gives no insight into what, if any, informed decision-making the care providers carried out. Such information would be useful to determine how better practice might be achieved. A study into the practice of episiotomies by Dutch midwives and obstetricians is referred to and is not reassuring.2 They frequently expressed surprise that consent should be necessary and women were minimally involved in the decision for performing episiotomy. This and other examples quoted of lack of valid consent have a corrosive effect on the fundamental but fragile trust and necessary trustworthiness of the relationship between the person being cared for …. (shrink)

Evidential Decision Theory is a radical theory of rational decision-making. It recommends that instead of thinking about what your decisions *cause*, you should think about what they *reveal*. This Element explains in simple terms why thinking in this way makes a big difference, and argues that doing so makes for *better* decisions. An appendix gives an intuitive explanation of the measure-theoretic foundations of Evidential Decision Theory.

An agent's options in a decision problem are best understood as the decisions that the agent might make. Taking options this way eliminates the gap between an option's adoption and its execution.

The dispute in philosophical decision theory between causalists and evidentialists remains unsettled. Many are attracted to the causal view’s endorsement of a species of dominance reasoning, and to the intuitive verdicts it gets on a range of cases with the structure of the infamous Newcomb’s Problem. But it also faces a rising wave of purported counterexamples and theoretical challenges. In this paper I will describe a novel decision theory which saves what is appealing about the causal view while avoiding its (...) most worrying objections, and which promises to generalize to solve a set of related problems in other normative domains. (shrink)

Walter Benjamin’s writings are often read in terms of their emphasis on undecidability. This article focuses on Benjamin’s view of decision as a philosophic capacity to suspend recognizable myth. Myth is recognizable as closure. Myth becomes recognizable as myth when exceptions and extremes arise in relation to it. Without necessarily following the specific exception or extreme (which may itself be mythic), philosophy is a politics that is attuned to the capacity of an exception or extreme to perform the limit of (...) a specific mythic form. In elaborating philosophically impelled decision as a capacity to take exception to myth, the article compares Benjamin’s works with writings by Agamben, Schmitt, Hiller, Sorel, Derrida and others. At various points in the article, and especially towards the end, the discussion of the notion of philosophic decision includes consideration of ways in which aspects of Benjamin’s enmity to myth might themselves become mythic, unphilosophic. (shrink)