The response mode bias, in which subjects exhibit different risk attitudes when assessing certainty equivalents versus indifference probabilities, is a well-known phenomenon in the assessment of utility functions. In this empirical study, we develop and apply a cardinal measure of risk attitudes to analyze not only the existence, but also the strength of this phenomenon. Since probability levels involved in decision problems are already known to have a strong impact on behavior, we use this approach to study the impact (...) of probabilities on the extent of the response mode bias. We find that the direction in which probabilities influence measured risk aversion is the opposite in the certainty equivalence (CE) method versus in the probability equivalence (PE) method. Utilizing the CE elicitation approach leads to an increase of risk seeking for gambles involving high probabilities. For the PE method, subjects tend to behave risk averse with gambles of high probabilities. This behavior is reversed in the gain domain. This “tailwhip” effect is consistently replicated in several experiments, involving both loss and gain domains of lotteries. (shrink)

Utilities of health states are often estimated to support public decisions in health care. People’s preferences may be imprecise, for lack of actual trade-off experience. We show how to elicit the utilities accounting for imprecision, discover the main drivers of imprecision, and compare several approaches to modelling health state utility data in the fuzzy setting. We extended the time trade-off questionnaire, to elicit utilities of states defined in the EQ-5D-3L descriptive system in184 respondents. Our study demonstrates that respondents are (...) capable of assessing their own imprecision and rigorous mathematical modelling is possible. The imprecision is larger than as inferred from the standard TTO method and is larger than estimation error, even in our smallish sample. Non-trading in TTO often results from imprecision, rather than lexicographic preferences for longevity over quality. People are especially imprecise in assessing the impact of usual activities on utility; also, the internal inconsistency of a health state increases the imprecision. Fuzzy least squares method seems best suited to assign disutilities to individual dimensions, while separately modelling the location of utility and amount of imprecision seems best to produce value sets. If crisp parameters are estimated, accounting for imprecision changes the results little. (shrink)

Elicitation methods in decision-making under risk allow us to infer the utilities of outcomes as well as the probability weights from the observed preferences of an individual. An optimally efficient elicitation method is proposed, which takes the inevitable distortion of preferences by random errors into account and minimizes the effect of such errors on the inferred utility and probability weighting functions. Under mild assumptions, the optimally efficient method for eliciting utilities and probability weights is the following three-stage (...) procedure. First, a probability is elicited whose subjective weight is one half. Second, the utility function is elicited through the midpoint chaining certainty equivalent method using the probability elicited at the first stage. Finally, the probability weighting function is elicited through the probability equivalent method. (shrink)

Designing a mechanism that provides a direct incentive for an individual to report her utility function over several alternatives is a difficult task. A framework for such mechanism design is the following: an individual (a decision maker) is faced with an optimization problem (e.g., maximization of expected utility), and a mechanism designer observes the decision maker’s action. The mechanism does reveal the individual’s utility truthfully if the mechanism designer, having observed the decision maker’s action, infers the decision (...) maker’s utilities over several alternatives. This paper studies an example of such a mechanism and discusses its application to the problem of optimal social choice. Under certain simplifying assumptions about individuals’ utility functions and about how voters choose their voting strategies, this mechanism selects the alternative that maximizes Harsanyi’s social utility function and is Pareto-efficient. (shrink)

Since utilities and probabilities jointly determine choices, event-dependent utilities complicate the elicitation of subjective event probabilities. However, for the usual purpose of obtaining the information embodied in agent beliefs, it is sufficient to elicit objective probabilities, i.e., probabilities obtained by updating a known common prior with that agent’s further information. Bayesians who play a Nash equilibrium of a certain insurance game before they obtain relevant information will afterward act regarding lottery ticket payments as if they had event-independent risk-neutral (...) class='Hi'>utility and a known common prior. Proper scoring rules paid in lottery tickets can then elicit objective probabilities. (shrink)

Risk attitude is known to be a key determinant of various economic and financial choices. Behavioral studies that aim to evaluate the role of risk attitudes in contexts of this type, therefore, require tools for measuring individual risk tolerance. Recent developments in decision theory provide such tools. However, the methods available can be time consuming. As a result, some practitioners might have an incentive to prefer “fast and frugal” methods to clean but more costly methods. In this article, we focus (...) on a tractable procedure initially proposed by Holt and Laury (2002) to elicit risk attitude. We generalize this method to measure utility and risk aversion as follows. First, we allow measurement of probabilistic risk attitude through violations of expected utility due to probability weighting. Second, we use the outcome scale rather than the probability scale in the menu of choices. Third, we compare sure payoffs with lotteries instead of comparing non-degenerate lotteries. A within-subject experimental study illustrates the gains in tractability and bias minimization that can result from such an extension. (shrink)

This paper examines recent developments in U.K. utility regulation from a business ethics perspective. The regulatory framework that facilitated privatisation of the utility companies has foundations based upon free market principles involving a transfer from regulation to competitive markets wherever possible. Where competition is not feasible, continuing economic regulation is relied upon, designed to mirror the competitive market to induce, through comparative competition and the price capping mechanism, incentives for greater efficiency. The New Labour Government, having fundamentally reviewed (...) this framework when it came to office, has surprisingly endorsed its basic tenets. However, it wishes to superimpose social responsibility regulations designed to achieve social policy rather than economic objectives. This interventionist approach is in itself in conflict with the free market inspired regulatory framework but additionally, the imposition of social policy objectives creates fundamental ambiguities within the framework for the key stakeholders. The paper concludes that the Government''s policy, by eliciting stakeholder confusion and perverse behaviour, could be counter-productive but that ethical theories and frameworks can contribute to thinking in this vital area of the economy. (shrink)

This article is concerned with the representation of preferences which do not satisfy the ordinary axioms for state-independent utilities. After suggesting reasons for not being satisfied with solutions involving state-dependent utilities, an alternative representation shall be proposed involving state-independent utilities and a situation-dependent factor. The latter captures the interdependencies between states and consequences. Two sets of axioms are proposed, each permitting the derivation of subjective probabilities, state-independent utilities, and a situation-dependent factor, and each operating in a different framework. The first (...) framework involves the concept of a decision situation—consisting of a set of states, a set of consequences and a preference relation on acts; the probabilities, utilities and situation-dependent factor are elicited by referring to other, appropriate decision situations. The second framework, which is technically related, operates in a fixed decision situation; particular “subsituations” are employed in the derivation of the representation. Possible interpretations of the situation-dependent factor and the notion of situation are discussed. (shrink)

We develop an algorithm that can be used to approximate a decisionmaker’s beliefs for a class of preference structures that includes, among others, α-maximin expected utility preferences, Choquet expected utility preferences, and, more generally, constant additive preferences. For both exact and statistical approximation, we demonstrate convergence in an appropriate sense to the true belief structure.

Several axiom systems for preference among acts lead to a unique probability and a state-independent utility such that acts are ranked according to their expected utilities. These axioms have been used as a foundation for Bayesian decision theory and subjective probability calculus. In this article we note that the uniqueness of the probability is relative to the choice of whatcounts as a constant outcome. Although it is sometimes clear what should be considered constant, in many cases there are several (...) possible choices. Each choice can lead to a different "unique" probability and utility. By focusing attention on statedependent utilities, we determine conditions under which a truly unique probability and utility can be determined from an agent's expressed preferences among acts. Suppose that an agent's preference can be represented in terms of a probability P and a utility U.That is, the agent prefers one act to another iff the expected utility of that act is higher than that of the other. There are many other equivalent representations in terms of probabilities Q, which are mutually absolutely continuous with P, and state-dependent utilities V, which differ from U by possibly different positive affine transformations in each state of nature. We describe an example in which there are two different but equivalent state-independent utility representations for the same preference structure. They differ in which acts count as constants. The acts involve receiving different amounts of one or the other of two currencies, and the states are different exchange rates between the currencies. It is easy to see how it would not be possible for constant amounts of both currencies to have simultaneously constant values across the differentstates. Savage (1954, sec. 5.5) discovered a situation in which two seemingly equivalent preference structures are represented by different pairs of probability and utility. He attributed the phenomenon to the construction of a "small world." We show that the small world problem is just another example of two different, but equivalent, representations treating different actsas constants. Finally, we prove a theorem (similar to one of Karni 1985) that shows how to elicit a unique state-dependent utility and does not assume that there are prizes with constant value. To do this, we define a new hypothetical kind of act in which both the prize to be awarded and the state of nature are determined by an auxiliary experiment. (shrink)

Aristotle’s views on the choiceworthiness of friends might seem both internally inconsistent and objectionably instrumentalizing. On the one hand, Aristotle maintains that perfect friends or virtue friends are choiceworthy and lovable for their own sake, and not merely for the sake of further ends. On the other hand, in Nicomachean Ethics IX.9, Aristotle appears somehow to account for the choiceworthiness of such friends by reference to their utility as sources of a virtuous agent’s robust self-awareness. I examine Aristotle’s views (...) on the utility and choiceworthiness of friends, and offer a novel reading of Nicomachean Ethics IX.9. On this reading, Aristotle accepts a version of instrumental conditionalism about final value, that is, the thesis that goods (including friends) can be choiceworthy for their own sake (i.e., possess final or end value) at least partly on account of their instrumental properties. In articulating what sort of instrumental conditionalism it is reasonable to attribute to Aristotle, I argue that Aristotle appeals to the utility of perfect friends as part of a broadly material causal account of why such friends are choiceworthy for their own sake. On this reading, perfect friends are not choiceworthy for the sake of their utility in eliciting self-awareness; rather, their choiceworthiness for their own sake is (at least partly) realized in, or constituted by, their conduciveness to the virtuous agent’s self-awareness. This reading, I argue, frees Aristotle from the charge of inconsistency: Aristotle can appeal to the conduciveness of perfect friends to the virtuous agent’s self-awareness as a way of explaining why such friends are choiceworthy for their own sake. (shrink)

In comparing different risk elicitation methods under the assumptions of expected utility theory, previous studies have found significant differences in the elicited risk attitudes. This paper extends this line of research to consider cumulative prospect theory by comparing risk attitudes and probability weightings determined using two elicitation methods: the method by Tanaka et al. :557–571, 2010; TCN method) and the method by Wakker and Deneffe :1131–1150, 1996; WD method). We demonstrate that the two methods reveal significantly different (...) mean values for the measured risk attitudes. Participants are classified on average as moderately risk-averse using the TCN method, whereas the same individuals are classified as nearly risk-neutral using the WD method. Moreover, we find that on average, participants overweight low probabilities and underweight high probabilities to a greater extent with the WD method than with the TCN method. Therefore, the different elicitation methods, that both consider probability weighting, can lead to different measured values of risk attitude and probability weighting. (shrink)

For more than a half-century, evidence scholars have been exploring whether the criminal standard of proof can be grounded in decision theory. Such grounding would require the emergence of a social consensus about the utilities to be assigned to the four outcomes at trial. Significant disagreement remains, even among legal scholars, about the relative desirability of those outcomes and even about the formalisms for manipulating their respective utilities. We attempt to diagnose the principal reasons for this dissensus and to suggest (...) ways in which a broadly shared evaluation might be forged, both with respect to the appropriate equations for defining the standard of proof and with respect to the appropriate utilities to associate with the various trial outcomes. Where consensus cannot be forged, we hold that remaining differences can probably be finessed. We also suggest ways to elicit the utilities of individuals on these matters so as to avoid the usual flaws of such surveys. Along the way, we note a). the disproportionate role that the Blackstone ratio of errors continues to play in appraisals of the utilities of trial outcomes (despite its unintelligibility in the context of utilities) and b). the persisting belief -for which there is no theoretical basis-that every plausible assignment of utilities will inevitably result in a very high standard of proof. Finally, we examine some of the technical features associated with a proposed rank ordering of the utilities of trial outcomes. (shrink)

Discrete choice experiments (DCE) are often used to elicit preferences, for instance, in health preference research. However, DCEs only provide binary responses, whilst real-life choices are made with varying degrees of conviction. We aimed to verify whether eliciting self-reported convictions on a 0–100 scale adds meaningful information to the binary choice. Eighty three respondents stated their preferences for health states using DCE and the time trade-off method (TTO). In TTO, utility ranges were also elicited to account for preference imprecision. (...) We verified the properties of the conviction across three areas: (1) response to various choice task modifications (e.g. dominance, increase in complexity, distance from the status quo) and association with rationality violations (e.g. intransitivity); (2) association with test–retest results; (3) relation to the utility difference and imprecision estimated in TTO. Regarding (1), conviction increased in choice tasks with lower complexity, larger relative attractiveness, and lower distance to the status quo. Regarding (2), choices made with above-median conviction were sustained in 90% of the cases, compared to 68% for below-median conviction. Regarding (3), the conviction increases with utility difference and it decreases with utility imprecision; overconfidence seems to prevail: non-zero conviction is reported even for identical utilities. Self-reported conviction in DCE is associated in an intuitive way with the observed choices. It may, therefore, be useful in explaining or predicting behaviour or bridging the gap between the results of various elicitation tasks. (shrink)

The majority consensus in the empirical literature is that probability weighting functions are typically inverse-S shaped, that is, people tend to overweight small and underweight large probabilities. A separate stream of literature has reported event-splitting effects and shown that they can explain violations of expected utility. This leads to the questions whether the observed shape of weighting functions is a mere consequence of the coalesced presentation and, more generally, whether preference elicitation should rely on presenting lotteries in a (...) canonical split form instead of the commonly used coalesced form. We analyze data from a binary choice experiment where all lottery pairs are presented in both split and coalesced forms. Our results show that the presentation in a split form leads to a better fit of expected utility theory and to probability weighting functions that are closer to linear. We thus provide some evidence that the extent of probability weighting is not an ingrained feature, but rather a result of processing difficulties. (shrink)

Most economists and some philosophers distinguish individual utilities from interpersonal social values. Even if challenges to that conceptual distinction can be met, further philosophically interesting questions arise. I pursue three in this paper, using, as context for the discussion, health economics and its attempt to discern empirically a social welfare function to help guide rationing decisions. (1) To discern these utilities and values in a manner that is morally appropriate if they are to influence rationing decisions, who should be queried? (...) To discern individual health state utilities, persons in precisely those states should be asked (generically, patients), but for social values, representatives of the general public should be. (2) To discern social values, what should representatives of the public be asked? They should be asked person trade-off (PTO) questions that encompass their own self-interest, not PTO questions that focus only on others. (3) What must public representatives understand before they respond to such questions? Despite the philosophically complex problem of patient adaptation, they should understand (among other things) the health state utilities elicited from actual patients with the conditions at issue. (shrink)

Most economists and some philosophers distinguish individual utilities from interpersonal social values. Even if challenges to that conceptual distinction can be met, further philosophically interesting questions arise. I pursue three in this paper, using, as context for the discussion, health economics and its attempt to discern empirically a social welfare function to help guide rationing decisions. (1) To discern these utilities and values in a manner that is morally appropriate if they are to influence rationing decisions, who should be queried? (...) To discern individual health state utilities, persons in precisely those states should be asked (generically, "patients"), but for social values, representatives of the general public should be. (2) To discern social values, what should representatives of the public be asked? They should be asked "person trade-off" (PTO) questions that encompass their own self-interest, not PTO questions that focus only on others. (3) What must public representatives understand before they respond to such questions? Despite the philosophically complex problem of patient adaptation, they should understand (among other things) the health state utilities elicited from actual patients with the conditions at issue. (shrink)

Numerous studies have convincingly shown that prospect theory can better describe risky choice behavior than the classical expected utility model because it makes the plausible assumption that risk aversion is driven not only by the degree of sensitivity toward outcomes, but also by the degree of sensitivity toward probabilities. This article presents the results of an experiment aimed at testing whether agents become more sensitive toward probabilities over time when they repeatedly face similar decisions, receive feedback on the consequences (...) of their decisions, and are given ample incentives to reflect on their decisions, as predicted by Plott’s Discovered Preference Hypothesis (DPH). The results of a laboratory experiment with N = 62 participants support this hypothesis. The elicited subjective probability weighting function converges significantly toward linearity when respondents are asked to make repeated choices and are given direct feedback after each choice. Such convergence to linearity is absent in an experimental treatment where respondents are asked to make repeated choices but do not experience the resolution of risk directly after each choice, as predicted by the DPH. (shrink)

Utility functions often lack additive separability, presenting an obstacle for decision theoretic axiomatizations. We address this challenge by providing a representation theorem for utility functions of quasi-separable preferences of the form $$u(x,y,z)=f(x,z) + g(y,z)$$ on subsets of topological product spaces. These functions are additively separable only when holding z fixed but are cardinally comparable for different values of z. We then generalize the result to spaces with more than three dimensions and provide applications to belief elicitation, inequity (...) aversion, intertemporal choice, and rank-dependent utility. (shrink)

In this article, we elicit both individuals’ and couples’ preferences assuming prospect theory (PT) as a general theoretical framework for decision under risk. Our experimental method, based on certainty equivalents, allows to infer measurements of utility and probability weighting at the individual level and at the couple level. Our main results are twofold. First, risk attitude for couples is compatible with PT and incorporates deviations from expected utility similar to those found in individual decision making. Second, couples’ attitudes (...) towards risk are found to be consistent with a mix of individual attitudes, women being more influent on couples’ preferences at low probability levels. (shrink)

It is known that, on average, people adapt their choice of memory strategy to the subjective utility of interaction. What is not known is whether an individual's choices are boundedly optimal. Two experiments are reported that test the hypothesis that an individual's decisions about the distribution of remembering between internal and external resources are boundedly optimal where optimality is defined relative to experience, cognitive constraints, and reward. The theory makes predictions that are tested against data, not fitted to it. (...) The experiments use a no-choice/choice utility learning paradigm where the no-choice phase is used to elicit a profile of each participant's performance across the strategy space and the choice phase is used to test predicted choices within this space. They show that the majority of individuals select strategies that are boundedly optimal. Further, individual differences in what people choose to do are successfully predicted by the analysis. Two issues are discussed: the performance of the minority of participants who did not find boundedly optimal adaptations, and the possibility that individuals anticipate what, with practice, will become a bounded optimal strategy, rather than what is boundedly optimal during training. (shrink)

Whereas many others have scrutinized the Allais paradox from a theoretical angle, we study the paradox from an historical perspective and link our findings to a suggestion as to how decision theory could make use of it today. We emphasize that Allais proposed the paradox asa normative argument, concerned with ‘the rational man’ and not the ‘real man’, to use his words. Moreover, and more subtly, we argue that Allais had an unusual sense of the normative, being concerned not so (...) much with therationality of choicesas with therationality of the agent as a person. These two claims are buttressed by a detailed investigation – the first of its kind – of the 1952 Paris conference on risk, which set the context for the invention of the paradox, and a detailed reconstruction – also the first of its kind – of Allais’s specific normative argument from his numerous but allusive writings. The paper contrasts these interpretations of what the paradox historically represented, with how it generally came to function within decision theory from the late 1970s onwards: that is, as an empirical refutation of the expected utility hypothesis, and more specifically of the condition of von Neumann–Morgenstern independence that underlies that hypothesis. While not denying that this use of the paradox was fruitful in many ways, we propose another use that turns out also to be compatible with an experimental perspective. Following Allais’s hints on ‘the experimental definition of rationality’, this new use consists inletting the experiment itself speak of the rationality or otherwise of the subjects. In the 1970s, a short sequence of papers inspired by Allais implemented original ways of eliciting the reasons guiding the subjects’ choices, and claimed to be able to draw relevant normative consequences from this information. We end by reviewing this forgotten experimental avenue not simply historically, but with a view to recommending it for possible use by decision theorists today. (shrink)

We compare two different elicitation methods for measuring risk attitudes on a sample of French farmers. We consider the lottery tasks initially proposed by Holt and Laury (Econ Rev 92:1644–1655, 2002) and by Eckel and Grossman (Evol Hum Behav 23:281–295, 2002; J Econ Behav Org 68:1–7, 2008). The main empirical result from this within-subject study is that risk preference measures are affected by the type of mechanism used. We first show that this risk preference instability can be related to (...) non-expected utility preferences of farmers. Using a risk-taking psychometric questionnaire, we then demonstrate that risk preferences of farmers are context-dependent. This may be another explanation of the observed risk preference instability. (shrink)

In this article, ambiguity attitude is measured through the maximum price a decision maker is willing to pay to know the probability of an event. Two problems are examined in which the decision maker faces an act: in one case, buying information implies playing a lottery, while, in the other case, buying information gives also the option to avoid playing the lottery. In both decision settings, relying on the Choquet expected utility model, we study how the decision maker’s risk (...) and ambiguity attitudes affect the reservation price for ambiguity resolution. These effects are analyzed for different levels of ambiguity of the act. Operating instructions for the elicitation of the reservation price for ambiguity resolution in an experimental setting are provided at the end of the article. (shrink)

This paper (first published under the same title in Journal of Mathematical Economics, 29, 1998, p. 331-361) is a sequel to "Consistent Bayesian Aggregation", Journal of Economic Theory, 66, 1995, p. 313-351, by the same author. Both papers examine mathematically whether the the following assumptions are compatible: the individuals and the group both form their preferences according to Subjective Expected Utility (SEU) theory, and the preferences of the group satisfy the Pareto principle with respect to those of the individuals. (...) While the 1995 paper explored these assumptions in the axiomatic context of Savage's (1954-1972) SEU theory, the present paper explores them in the context of Anscombe and Aumann's (1963) alternative SEU theory. We first show that the problematic assumptions become compatible when the Anscombe-Aumann utility functions are state-dependent and no subjective probabilities are elicited. Then we show that the problematic assumptions become incompatible when the Anscombe-Aumann utility functions are state-dependent, like before, but subjective probabilities are elicited using a relevant technical scheme. This last result reinstates the impossibilities proved by the 1995 paper, and thus shows them to be robust with respect to the choice of the SEU axiomatic framework. The technical scheme used for the elicitation of subjective probabilities is that of Karni, Schmeidler and Vind (1983). (shrink)

Gene–environment covariance is the phenomenon whereby genetic differences bias variation in developmental environment, and is particularly problematic for assigning genetic and environmental causation in a heritability analysis. The interpretation of these cases has differed amongst biologists and philosophers, leading some to reject the utility of heritability estimates altogether. This paper examines the factors that influence causal reasoning when G–E covariance is present, leading to interpretive disagreement between scholars. It argues that the causal intuitions elicited are influenced by concepts of (...) agency and blame-worthiness, and are intimately tied with the conceptual understanding of the phenotype under investigation. By considering a phenotype-specific approach, I provide an account as to why causal ascriptions can differ depending on the interpreter. Phenotypes like intelligence, which have been the primary focus of this debate, are more likely to spark disagreement for the interpretation of G–E covariance cases because the concept and ideas about its ‘normal development’ relatively ill-defined and are a subject of debate. I contend that philosophical disagreement about causal attributions in G–E covariance cases are in essence disagreements regarding how a phenotype should be defined and understood. This moves the debate from one of an ontological flavour concerning objective causal claims, to one concerning the conceptual, normative and semantic dependencies. (shrink)

This essay argues that an alternative conception of time to that underlying the ideology of productivism and growth is not only possible, but desirable. The creation of this time requires what I refer to as the practice of refusal via taking time: the self-determined arrangement of the nexus of time, action and utility that begins with the a-synchronous insertion of unproductive time into the synchronous horizontal time of productivism. The essay is divided into three sections. The first offers the (...) reader a discussion of Jacques Rancière’s notion of time as a social and political medium that partitions and distributes actions and utility. The subsequent section of the essay elaborates in aesthetic terms an account of unproductive time that is indifferent to the time of productivism. In the final section, I discuss examples that show how taking time to do ‘nothing’ can elicit an emancipatory politics that seeks to liberate us from the hegemony of productivism. I conclude that political theory should attend to time as a political medium and to the possibilities of its occupation, and that picturing the taking of time in terms of stopping the force of productivism’s normalized horizontal time by entering the unproductive time of reverie and aesthetic experience, provides a promising perspective from which to apprehend a time for thriftless refusals, deliberate dis-identifications, and the forging of cooperation among people(s) and with nature. (shrink)

Because the number of organs available for transplantation does not meet the needs of potential recipients, some have proposed that a potentially effective way to increase registration is to offer a self‐benefit incentive that grants a 'preferred status' or some degree of prioritization to those who register as potential donors, in case they might need organs. This proposal has elicited an ethical debate on the appropriateness of such a benefit in the context of a life‐saving medical procedure. In this paper (...) we review arguments and ethical concerns raised by scholars, and studies of views of members of the public regarding the prioritization incentive system. We also report on our study of the views of those involved in organ transplant and of other medical professionals in Israel, as over half a decade ago Israel implemented a prioritization incentive system. Bioethicists propose that key stakeholders' views can provide additional arguments and perspectives on controversial issues. Proponents justify the prioritization incentive drawing mainly on arguments related to its potential effectiveness, reciprocity and fairness. Opponents point to the fact that registering is not binding and not an actual donation, and raise concerns regarding equity, autonomy and gaming the system. Ethical concerns raised by the practitioners in the study were examined in light of scholars' arguments and actual registration and donation data. Practitioners involved in transplantation raised ethical concerns corresponding to those raised by scholars as well as additional concerns. They also challenged proponents' assumptions regarding the utility of the incentive system from their own experience and argued that proponents obscure the meaning of reciprocity. (shrink)

The objective of this work is to categorize the available fly ashes in different parts of the world into distinct groups based on its compositional attributes. Kohonen's self-organizing feature map and radial basis function networks are applied in a cascading fashion for the classification of fly ashes in terms of its chemical parameters. The basic procedure of the methodology consists of three stages: apply self-organizing neural net to ascertain possible number of groups, delineate them and identify the group sensitive attributes; (...) find mean values of sensitive attributes of the elicited groups and augment them as start-up prototypes in k-means algorithm and find the refined centroids of these groups; incorporate the centroids in a two layer radial basis function network and fine-tune the delineated groups and develop an indexing equation using the weights of the stabilized network. Further, to demonstrate the utility of this classification scheme, the so formed groups were correlated with their performance in High Volume Fly Ash Concrete System [HVFAC]. The categorization was found to be excellent and compares well with Canadian Standard Association's [CSA A 3000] classification scheme. (shrink)

Advance care planning (ACP) is a process that seeks to elicit patients’ goals, values, and preferences for future medical care. While most commonly employed in adult patients, pediatric ACP is becoming a standard of practice for adolescent and young adult patients with potentially life-limiting illnesses. The majority of research has focused on patients and their families; little attention has been paid to the perspectives of healthcare providers (HCPs) regarding their perspectives on the process and its potential benefits and limitations. Focus (...) groups were conducted with 15 physicians as part of a larger study of adolescent and young adult ACP in hematopoietic stem cell transplant (HSCT) patients. This study identified two categories important to the utility of ACP in pediatric HSCT patients; (1) the temporal context of ACP and decision making and (2) the limitations of pediatric ACP, with subcategories identified as (a) embodied and witnessed knowing, (b) the impact of clinical cascades—when the treatment of one organ system creates complications in another system that needs to be treated—and a creation of a “new normal” following complications of illness and its treatment in the pediatric intensive care unit (PICU), (c) the balancing of adolescents’ autonomy with their capacity to make informed medical decisions, and (d) the epistemological frames that differ between HCP and patients and their families. These findings support ACP in adolescent and young adult HSCT patients, with a number of implications for practice as this process becomes more common. (shrink)

This paper reports an experimental comparison of attitudes toward time and toward money in experience-based decisions. Preferences were elicited under rank-dependent utility for prospects with two or three consequences expressed either in time or in monetary units. Probabilities were unknown but learned through sampling. More specifically, time and money were compared under two conditions. In a first experiment, both consequences and probabilities of prospects were unknown and learned through sequential sampling. In a second experiment, the possible consequences were revealed (...) after the sampling. A real incentive system was implemented for both time and money. The heterogeneity of preferences was assessed for time and for money through individual and mixed modeling estimations. We observe that the nature of consequences (time or money) modifies probability weighting in terms of elevation and sensitivity. Subjects exhibit more optimism and less sensitivity to probability changes when deciding about time than about money. Revealing the consequences impacts the shape of the utility function and leaves probability weighting unchanged. We also observe that the real incentives have no effect except for the reduction in decision errors. This effect is stronger for money than for time. (shrink)

In this late modern era within which the basic values of life have been reordered (driven by globalisation, the corporate agenda and mass communication technologies), the individual has effectively been reduced to a mere abstraction. It might be argued that the rational, moral and humanistic concept of freedom has, to a great extent, been compromised by a consequent crisis within the intelligentsia. These groups, in particular the gatekeepers of a classical liberal approach to legal scholarship, are caught between the twin (...) evils of increased unreflective populism and pragmatism evident within many law schools and modern legal institutions. Although a contested term, defenders of the ‘socio-legal’ tradition, who place the humanities at the heart of legal research and education, are obliged to restate with increased determination the utility of the liberal arts and literature to the law profession and wider legal community. In a normative environment, law and narrative are inextricably linked and narrative poetry is not only invaluable to explaining the origins and location of the legal tradition, but also elicits a mode of understanding which transcends the boundaries of narrowlydefined legal hermeneutics—which often only addresses issues of an operational nature. French novelist Flaubert claimed “chaque notaire porte en soi les débris d’un poète” (Flaubert in Madame bovary (trans: Wall, G.), Penguin Classics, London, 1960: 269), paraphrased by American civil rights lawyer, Clarence Darrow, as “inside every lawyer is the wreck of a poet” (Lukas in Big trouble: a murder in a small western town sets off a struggle for the soul of America, Simon & Schuster, New York, 1997: 323). In an age of disenchantment, this paper explores the poetic form as an important medium within which to understand the nature and function of law in a society of differentiated individuals. (shrink)

Most of the existing literature on social preferences either tests whether certain characteristics of the social context influence individual decisions, or tries to estimate parameters of social preference functions describing such behavior at the level of the entire population. In the present paper, we are concerned with measuring parameters of social preference functions at the individual level. We draw upon concepts developed for eliciting other types of utility functions, in particular the literature on decision making under incomplete information. Our (...) method derives parameters of social preference functions from indifference statements about the distribution of payoffs a group. We apply our method in a controlled social preference experiment to establish the external validity of estimated parameters. Our results show the expected relationships to some external factors and also a strong correspondence between parameter estimates and factors that, according to the subjects’ own descriptions, influenced their behavior. We also find that some concepts discussed in the literature on social preferences, in particular envy toward players receiving a larger payoff, have very diverse and complex effects at the individual level. (shrink)

The Cry family of Bacillus thuringiensis insecticidal and nematicidal proteins constitutes a valuable source of environmentally benign compounds for the control of insect pests and disease agents. An understanding of Cry toxin resistance at a molecular level will be critical to the long‐term utility of this technology; it may also shed light on basic mechanisms used by other bacterial toxins that target specific organisms or cell types. Selection and cross‐resistance studies have confirmed that genetic adaptation can elicit varying patterns (...) of Cry toxin resistance, which has been associated with deficient protoxin activation by host proteases, and defective Cry toxin‐binding cell surface molecules, such as cadherins, aminopeptidases and glycolipids. Recent work also suggests Cry toxin resistance may be induced in invertebrates as an active immune response. The use of model invertebrates, such as Caenorhabditis elegans and Drosophila melanogaster, as well as advances in insect genomics, are likely to accelerate efforts to clone Cry toxin resistance genes and come to a detailed and broad understanding of Cry toxin resistance. BioEssays 27:614–624, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

Prospect Theory (PT) is widely regarded as the most promising descriptive model for decision making under uncertainty. Various tests have corroborated the validity of the characteristic fourfold pattern of risk attitudes implied by the combination of probability weighting and value transformation. But is it also safe to assume stable PT preferences at the individual level? This is not only an empirical but also a conceptual question. Measuring the stability of preferences in a multi-parameter decision model such as PT is far (...) more complex than evaluating single-parameter models such as Expected Utility Theory under the assumption of constant relative risk aversion. There exist considerable interdependencies among parameters such that allegedly diverging parameter combinations could in fact produce very similar preference structures. In this paper, we provide a theoretic framework for measuring the (temporal) stability of PT parameters. To illustrate our methodology, we further apply our approach to 86 subjects for whom we elicit PT parameters twice, with a time lag of 1 month. While documenting remarkable stability of parameter estimates at the aggregate level, we find that a third of the subjects show significant instability across sessions. (shrink)

The psychiatric interview plays a critical role in clinical assessment and therapy. Problems with assessment reliability and validity that were apparent in nosological and diagnostic discrepancies plagued the field of psychiatry historically. Technical approaches including structured interviews were developed to address these problems. Although these approaches decreased diagnostic variance, they focused narrowly on eliciting signs and symptoms conforming to previously agreed diagnostic categories, necessarily restricting the range and richness of experiences and narratives that are elicited. This restriction inhibits the (...) class='Hi'>utility of assessment in furthering the interpersonal rapport and exploration that is essential to the task of therapy. The author reviews critiques of technical approaches to psychiatric assessment and highlights critical, often unexamined, epistemological assumptions and questions. In light of these critiques, he proposes a phenomenological approach to psychiatric assessment focused on narratives that situate particular experiences in the broader life context. In this approach the assessor functions as a participant observer, relying on the same empathic skills that inform effective therapy. It is argued that without over turning the advances in assessment reliability gained through technical approaches to the psychiatric interview, a phenomenological approach can illuminate, enrich, and broaden psychiatric assessment, increasing its effectiveness in psychopathological understanding and in therapy. (shrink)

Haunted People Syndrome denotes individuals who recurrently report various “supernatural” encounters in everyday settings ostensibly due to heightened somatic-sensory sensitivities to dis-ease states, which are contextualized by paranormal beliefs and reinforced by perceptual contagion effects. This view helps to explain why these anomalous experiences often appear to be idioms of stress or trauma. We tested the validity and practical utility of the HP-S concept in an empirical study of an active and reportedly intense ghostly episode that was a clinical (...) referral. The case centered on the life story of the primary percipient, a retired female healthcare worker. Secondary percipients included her husband and adult daughter, all of whom reported an array of benign and threatening anomalies across five successive residences. Guided by prior research, we administered the family online measures of transliminality, sensory-processing sensitivity, paranormal belief, locus of control, desirability for control, and a standardized checklist of haunt-type phenomena. The primary percipient also completed a measure of adverse childhood events and supplied an event diary of her anomalous experiences. We found reasonably consistent support for HP-S from a set of quantitative observations that compared five proposed syndrome features against the family members’ psychometric profiles and the structure and contents of their anomalous experiences. Specifically, the reported anomalies both correlated with the family’s scores on transliminality and paranormal belief, as well as elicited attributions and reaction patterns aligned with threat detection. There was also some evidence of perceptual congruency among the family members’ anomalous experiences. Putative psi cannot be ruled out, but we conclude that the family’s ordeal fundamentally involved the symptoms and manifestations of thin mental boundary functioning in the face of unfavorable circumstances or overstimulating environments and subsequently acerbated by poor emotion regulation, histrionic and catastrophizing reactions, and active confirmation biases. (shrink)

Experimental results in Ultimatum, Trust and Social Dilemma games have been interpreted as showing that individuals are, by and large, not driven by selfish motives. But we do not need experiments to know that. In our view, what the experiments show is that the typical economic auxiliary hypothesis of non-tuism should not be generalized to other contexts. Indeed, we know that when the experimental situation is framed as a market interaction, participants will be more inclined to keep more money, share (...) less, and disregard other participants’ welfare [Hoffman et al., 1994]. When the same game is framed as a fair division one, participants overall show a much greater concern for the other parties’ interests. The data thus indicate that the context of an interaction is of paramount importance in eliciting different motives. The challenge then is to model utility functions that are general enough to subsume a variety of motives and specific enough to allow for meaningful, interesting predictions to be made. For the sake of simplicity (and brevity), in what follows we will concentrate upon the results of experiments that show what appears to be individuals’ disposition to behave in a fair manner in a variety of circumstances [Camerer, 2003]., though what we are saying can be easily applied to other research areas. Such experimental results have been variously interpreted, each interpretation being accompanied by a specific utility function. We shall consider three such functions and the underlying interpretations that support them, and assess each one on the basis of what they claim to be able to explain and predict. (shrink)

The medical concept of prognosis is analysed into its basic constituents: patient data, medical intervention, outcome, utilities and probabilities; and sources of utility and probability values are discussed. Prognosis cannot be divorced from contemplated medical action, nor from action to be taken by the patient in response to prognostication. Regrettably, the usual decision-theoretic approach ignores this latter aspect. Elicitation of utilities, decision contemplation and prognostic counselling interweave, diagnostics playing a subsidiary role in decision-oriented clinical practice. At times the (...) doctor has grounds for withholding information. As this is known to the patient, prognostic counselling becomes a conflict-prone and rationality-thwarting activity. The meaning of standard phrases such as prognosis of a disease, the prognosis of this patient, the prognosis is unknown, is examined. (shrink)

We propose a task for eliciting attitudes toward risk that is close to real-world risky decisions which typically involve gains and losses. The task consists of accepting or rejecting gambles that provide a gain with probability p\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$p$$\end{document} and a loss with probability 1-p\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$1-p$$\end{document}. We employ finite mixture models to uncover heterogeneity in risk preferences and find that behavior is heterogeneous, with one half (...) of the subjects behaving as expected utility maximizers, for the others, reference-dependent models perform better than those where subjects derive utility from final outcomes, models with sign-dependent decision weights perform better than those without, and there is no evidence for loss aversion. The procedure is sufficiently simple so that it can be easily used in field or lab experiments where risk elicitation is not the main experiment. (shrink)

In his magnum opus, David Hume asserts that a person is “nothing but a bundle or collection of different perceptions, which succeed each other with an inconceivable rapidity, and are in a perpetual flux and movement.” (Treatise 252) Hume is clearly proud of his bold thesis, as is borne out by his categorical arguments and analyses on the self. Contributions like this will, in his opinion, help establish a new science of human nature, “which will not be inferior in certainty, (...) and will be much superior in utility to any other of human comprehension.” (Treatise xix) Unfortunately for Hume, the bundle theory of the self subsequently elicits substantial criticism and hostility from numerous critics, both philosophical and non-philosophical. As confident as the young Scot is about the merits of his theory when he first proposes it, the sharp critical responses to his thought on the self ultimately compel him to withdraw his controversial views from public scrutiny. The irony is that the author of the bundle theory of the self himself acknowledges that his account of the self is seriously defective. In his appendix to the Treatise, Hume decries the labyrinth that his views on the self have driven him into. Five years in the making, Hume's Labyrinth: A Search for the Self explores in detail both Hume's views on the self and his critical reservations on an account of the self that would subsequently become highly influential in the philosophy of mind. -/- Central to Hume's Labyrinth is the suggestion that a careful analysis of the appendix to the Treatise throws an invaluable light on a number of elements fundamental to Hume's views on the self, not least of which is the role of Berkeley s views on language. While Hume often acknowledges the significance of Berkeley's philosophy in the Treatise, the argument here is that Berkeley's account of terms is the foundation of Hume's philosophy of the mind, with its contentious bundle theory of the self. And when this influence is assayed a new dimension of Hume's views on the self emerges. For now it appears that the bundle theory of the self is nothing but a heuristic device adopted by Hume to help further philosophical investigations into the mind. In short, it turns out that Hume is a pragmatist, intent on presenting an account of the self that researchers interested in the problems of human nature will find useful. (shrink)

A popular form of cause marketing (CM) that has recently emerged is one requiring the consumer to perform a prescribed behavior—such as providing a product review or uploading a picture on social media alongside a hashtag—to trigger a donation from the firm to the charitable cause. While this approach may be engaging, its effectiveness in eliciting positive consumer responses toward the brand remains uncertain when compared to conventional forms of CM. The current research uses a moral self-signaling framework to examine (...) the role of effort in CM on consumer attitudes toward the brand, consumer choice, and purchase and participation intentions. Five studies reveal that consumers who are concerned about their moral self-image prefer effort-based CM over no-effort CM. This effect emerges because consumers anticipate greater moral self-signaling utility from effort-based CM than from no-effort CM. However, this effect only occurs for CM campaigns where the consumer’s effort is private. Despite the prevalence of CM campaigns requiring public performance of effort (e.g., selfie campaigns), consumers seeking to reinforce their moral self-image view such campaigns unfavorably. Important implications of effort-based CM for firms, non-profits, and consumers are discussed. (shrink)

When assessing the cost effectiveness of health care programmes, health economists typically presume that distant events should be given less weight than present events. This article examines the moral reasonableness of arguments advanced for positive discounting in cost-effectiveness analysis both from an intergenerational and an intrapersonal perspective and assesses if arguments are equally applicable to health and monetary outcomes. The article concludes that behavioral effects related to time preferences give little or no reason for why society at large should favour (...) the present over the future when making intergenerational choices regarding health. The strongest argument for discounting stems from the combined argument of diminishing marginal utility in the presence of growth. However, this hinges on the assumption of actual growth in the relevant good. Moreover, current modern democracy may be insufficiently sensitive to the concerns of future generations. The second part of the article categorises preference failures (which justify paternalistic responses) into two distinct groups, myopic and acratic. The existence of these types of preference failures makes elicited time preferences of little normative relevance when making decisions regarding the social discount rate, even in an intrapersonal context. As with intergenerational discounting, the combined arguments of growth and diminishing marginal utility offer the strongest arguments for discounting in the intrapersonal context. However, there is no prima facie reason to assume that this argument should apply equally to health and monetary values. To be sure, selecting an approach towards discounting health is a complex matter. However, the life-or-death implications of any approach require that the discussion not be downplayed to merely a technical matter for economists to settle. (shrink)

Risk preferences of Australian academics are elicited by analyzing the aggregate distribution of their retirement funds across available investment options. Not more than 10 % of retirement funds are invested as if their owners maximize expected utility under the assumption of constant relative risk aversion with an empirically plausible level of risk aversion. An implausibly high level of risk aversion is required to rationalize any investment into bonds when stocks are available. Not more than 36.54 % of all investments (...) can be rationalized by a model of loss averse preferences. Moreover, the levels of loss aversion typically reported in the experimental studies imply overinvestment in bonds, which is not observed in the data. Up to 67.18 % of all investments can be rationalized by rank-dependent utility or Yaari’s dual model with empirically plausible parameters. A median Australian academic behaves as if maximizing rank-dependent utility with parameter γ∈[0.76,0.79]\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\gamma \in [0.76, 0.79]$$\end{document} in a Tversky and Kahneman probability weighting function. (shrink)

Animal behavior is the link between organisms and their environment and is critical for biological adaptation. Despite many studies demonstrating the sensitivity and utility of behavioral endpoints in bioassays assessing potential pollutant effects in aquatic ecosystems, behavioral toxicity testing has not, historically, been included routinely in assessments of aquatic toxicity and subsequent environmental policy formulation. The results of behavioral risk assessments may allow behavioral toxicologists to demonstrate that a chemical is not merely a potential hazard, but that it elicits (...) a functional change in an animal. In this regard, the behavioral toxicologist is on stronger ground than toxicologists recommending action based on isolated, non-functional changes such as acute or chronic mortality. Such sublethal pollutant effects should be of major interest and concern to individuals formulating environmental policies and water quality criteria because many more aquatic organisms encounter sublethal rather than acutely or chronically lethal concentrations of pollutants in nature. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 27.2 (2003) 428-435 [Access article in PDF] Agapic Friendship Sharon E. Sytsma ARISTOTLE CATEGORIZED FRIENDSHIP into three types: friendships of pleasure, friendships of utility, and complete (perfect or true) friendships (1156a5-10). 1 The thesis developed here is that Aristotle neglects an important kind of friendship. Various aspects of his theory of friendship have been challenged, but no one has charged that his categorization is incomplete. (...) 2 In what follows, an Aristotelian account of the friendship between James Steerforth and David Copperfield in Dickens' David Copperfield will be given, and then shown to be inadequate. Then a brief account of agapic love will be given and shown to be another basis of friendship—agapic friendship. Finally, the agapic nature of the two young men's friendship will be highlighted. I One might suppose that the friendship between David Copperfield and Steerforth is a mixed form of the three types of friendships identified by Aristotle. There can be no doubt that their friendship was pleasurable and useful to both. The two boys (and later young men) were appreciative of the other's pleasing appearance. David frequently comments on the pleasure attending any kind remark issuing from Steerforth on his own behalf. He admits his pleasure in being "cherished as a kind of plaything in my room," indicating his awareness of Steerforth's pleasure in being with him. Steerforth took great pleasure in David's imaginative and talented storytelling, which David eagerly [End Page 428] used as a "cementing" force in their relationship. Surely, Steerforth also took pleasure in the respect and admiration of his doting schoolmate.Also undeniable is that both friends found each other to be useful. David treasured the gift of Steerforth's protection. Being favored by Steerforth automatically elicited the admiration and envy of the other schoolboys. "No one dared to annoy one whom [Steerforth] honored with his countenance." Steerforth, on his part, found David's storytelling to be a useful antidote to his insomnia.However, David's love for Steerforth went beyond any self-interested concern. David loved Steerforth for his friend's own sake. He stayed up late and rose early to recount and embellish tales, not because he was motivated by self-interest or fear, but only because he "admired and loved him." David perceived Steerforth to be considerate and generous, and he mistook his friend's self-confidence as evidence of nobility of character.These perceptions were hardly objective. David's good nature, generous-mindedness, and youthful naiveté kept him from recognizing the faults in his friend's character, even in the face of ample evidence. Steerforth's cruel streak should have been obvious to David since he witnessed Steerforth allowing another student, the hapless Traddles, to take the blame when Steerforth laughed in church, and his ruthless exposure of Mr. Mell's secret shame of having a mother living on charity in an almshouse. He heard Steerforth's story about how he had "accidentally" thrown a hammer into Rosa Dartle's face. David's uneasiness on these occasions was overcome by his natural generosity of spirit and sense of gratitude. When shocked by a cold and arrogant insult against Little Em'ly's fiancé, Ham, David responds with full confidence: [You may] try to hide your sympathies in jest from me, but I know better. When I see how perfectly you understand them and how exquisitely you can enter into happiness like this plain fisherman's, or humour a love like my old nurse's, I know that there is not a joy or sorrow, not an emotion, of such people, that can be indifferent to you. And I admire and love you for it, Steerforth, twenty times the more! So even though David has an inflated sense of Steerforth's virtue, his thinking of Steerforth as virtuous was integral to their relationship, and that in itself would support thinking of the friendship as based on the good.Given Steerforth's defects of character, one might easily be led to the conclusion that Steerforth loved David only for the pleasure and [End Page 429] benefits of his... (shrink)

Photo by Karl Raymund Catabas on Unsplash “After Buddha was dead, they still showed his shadow in a cave for centuries – a tremendous, gruesome shadow. God is dead; but given the way people are, there may still for millennia be caves in which they show his shadow. – And we – we must still defeat his shadow as well!” – Friedrich Nietzsche[1] INTRODUCTION Friedrich Nietzsche famously declared that “God is dead!”[2] but lamented that his contemporaries remained living in the (...) shadow of God. For Nietzsche, the morality of his time was still based in the Christian tradition, even though faith in God was waning. Bioethics lives under a similar shadow: the shadow of Enlightenment Era-rationalism. Bioethics curricula focus on principles derived from Kantian deontology and utilitarianism. The allure of maintaining a moral framework that provides a rational method that can be handily applied to any situation remains strong. The principlist approach advanced by Tom Beauchamp and James Childress is taught to nearly all medical students in the United States,[3] and is essentially the canonical ethical framework of bioethics. In this model, the principle of autonomy is Kantian in nature, and the principles of beneficence and non-maleficence are utilitarian in nature.[4] Moreover, the presented framework is an approach that, when applied rationally to any healthcare scenario, will yield an outcome “considered moral.”[5] This reflects a faulty conception of philosophy that plagues much of bioethics, wherein the only contribution of philosophy pertinent to bioethics is moral philosophy elucidated by European thinkers in the Enlightenment Era. The landscape of moral philosophy has evolved significantly from the 18th century. However, the bioethical world has not kept up with the philosophical world, remaining instead in the shadow of antiquated moral thinking. Also lacking in bioethics are other disciplines of philosophy, such as philosophy of language, existentialism, and aesthetics, which are often given no consideration at all. The inclusion of both modern moral philosophy and other philosophical fields is necessary if bioethics is to survive its transition into modernity. l. The Shadow of Enlightenment Enlightenment Era philosophers such as Immanuel Kant argued that one need only employ reason to obtain knowledge; emotion bore no relevance when determining ethical behavior. Kant’s moral theories thus privileged a duty to act according to moral imperatives over feelings. Other Enlightenment Era philosophers such as John Locke developed systems that attempted to quantify human goods and human ills. This quantification potentially reduces human welfare and suffering to utility. Today, in the world of philosophy, such a “neutral analysis,” as Cora Diamond noted, is “dead or moribund.”[6] Bernard Williams remarked that such moral philosophy is “empty and boring,”[7] and G. E. M. Anscombe stated that it “no longer generally survives.”[8] And yet, just as the atheists in Nietzsche’s world dwelt in the moral code of a dead God, bioethicists still pursue a unified moral system that takes an input, applies some moral rules, and generates a moral outcome, like the four principles approach that Beauchamp and Childress laid out.[9] Some detractors of principlism take issue with their approach for not being unified enough and want to replace it with a procedural framework that is even more systematic and complicated. They argue that the resulting moral framework would be a “comprehensive decision procedure for arriving at answers”[10] that retains the “impartiality that is an essential part of morality.”[11] The shadow of rationalist morality has caused bioethical decision making to become detached and rigid when bioethics should concern itself with the humans whose lives it affects. A rational, divorced-from-emotion way of thinking ultimately fails to yield satisfactory results when decisions are made by and for emotional beings. Dr. Paul Farmer, among others, championed the idea that bioethics should be de-philosophized, as philosophy, cold and calculated, fails to adequately respond to the realities of those worst off.[12] Instead, Dr. Farmer emphasized the inclusion of the social sciences, like sociology and anthropology, in bioethics. Undoubtedly, Dr. Farmer was on the right track; bioethics should certainly engage directly with the people whom its decisions involve. If the narrow band of moral philosophy currently found in bioethics – that of stringent rationalism – were all that philosophy had to offer, I, too, would advocate for a de-philosophization. Ludwig Wittgenstein notes that to attempt to capture the complexity of moral thinking in a manner that employs reason alone and casts aside emotion is a “hopeless task,” like reconstructing a sharp image “from a blurred one.”[13] Unfortunately, bioethics is mired in the remnants of this hopeless task. To Dr. Farmer, the dominant moral framework was too restrictive and was unresponsive to the social and humanitarian needs of those whom bioethics is meant to help. As such, he wished to free bioethics from the shadow of a morality derived from rationalist thinkers. ll. Beyond Rationalism Like Nietzsche, who tried to resolve Europe’s post-religion vacuum by providing his society with a new way to live, Dr. Farmer wanted to replace the rationalist philosophy upon which bioethics was built with a “resocialization” of the field.[14] I agree with Dr. Farmer’s call for resocialization, as well as his denouncement of philosophy as it exists in bioethics. Evaluating risks and benefits along a predetermined array of moral principles is far too rigid and impersonal to guide what are often the most important decisions one will make. For Dr. Farmer, the most needed change was restoring the social element of bioethics. However, in advocating for this resocialization, Dr. Farmer casts philosophy as the antithesis of social science, noting that “few would regard philosophy … as a socializing discipline.”[15] I disagree. Rationalist moral philosophy may be lacking in socializing force, but there are other fields of philosophy that are responsive to our social reality. Rather than de-philosophizing bioethics, it makes more sense to replace the antisocial philosophies predominant in bioethics with prosocial philosophies better suited to it. Of course, the contribution of philosophy to bioethics is more than moral theories from the Enlightenment Era. There are more recent philosophical contributions from outside the field of moral philosophy that have roused bioethical interest. Jennifer Blumenthal-Barby, et al., argue for philosophy’s continued place in bioethics, citing Derek Parfit’s “non-identity problem,” which altered the landscape of reproductive ethics, and David Chalmers’ contributions to philosophy of consciousness, which have implications for the moral status of brain organoids.[16] Still, these are narrow applications of philosophy to highly specialized areas of bioethics, which not all bioethicists are inclined to delve into. Philosophy in bioethics should not be confined to niche applications in specialist fields but should influence all bioethical thought. Fortunately, there remains untapped a wealth of philosophical disciplines that pertains to exactly this. Philosophy of language investigates the nature of meaning and understanding in communication, which is a necessary social action. Successfully deciphering and conveying moral values in discourse is a bioethicist’s bread and butter, as is resolving disagreements and reaching agreements. Indeed, it is often the case that miscommunication lies at the root of an impasse between a doctor and a patient. An understanding of the nature of the disagreement would help resolve the conflict, as different types of disagreements require different interventions for resolution. For instance, a “substantive disagreement,”[17] in which two parties use the same terms in the same ways and have a fundamental disagreement on which outcome is more desirable, can be resolved only if one party yields to the other. On the other hand, a “merely verbal dispute,”[18] in which two parties use the same terms to represent entirely different concepts and values, requires standardization of terminological usage for its resolution. As such, no one can overstate the moral importance of successful communication in bioethics, and an exploration of language itself would prove invaluable to a bioethicist’s training. Existentialism is another subset of philosophy that acknowledges the social nature of human existence, noting that one’s being in the universe is concomitant with the existence of others sharing the same universe.[19] Thus, there is the recognition that whatever existence is, it is not complete without the existence of others. With this as a starting point, existentialists examined how to live meaningfully with others in this world. Since ethics crucially involves others, it is no surprise that existentialists pondered how to live moral lives. Existentialist conceptions of morality did not revolve around acting in accordance with a set of rules, but rather, recognized individual freedom in choosing how to act and emphasized acting authentically. In this vein, bioethicists should commit to doing what is right rather than committing to applying a set of principles. Existentialism, while part of the broader bioethics literature, is less common throughout bioethics curricula and deserves more prominence. Martin Heidegger, for instance, emphasized the difference between two types of thinking: “calculative thinking” and “meditative thinking.” Heidegger characterizes calculative thinking as a computation, wherein from some given starting conditions “definite results”[20] are determined, and contrasts this with meditative thinking, which he describes as “thinking which contemplates the meaning which reigns in everything that is.”[21] Heidegger was critical of the pervasiveness of calculative thinking, seeing it as the “ground of thoughtlessness,”[22] in which we only relate to the world in a meaningless, mechanical way. This is the emphasized type of thinking in rationalist conceptions of morality popular in bioethics; from a set of starting conditions, a series of rules are applied, and a moral outcome is calculated. Such a technique, however, discounts the personal meaning individuals place on the aspects of their lives relevant to their decision making, as well as the meaning in committing to doing what is right. Under calculative thinking, such a commitment is reduced to rote rule-following. A turn to meditative thinking would ensure that bioethical decisions comport with living meaningful lives. Even aesthetics, a discipline devoted to examining beauty and taste,[23] has a place in bioethics. Just as the viewing of a painting, the listening of a song, or the reading of a book elicits an effective response, hearing a patient’s story leaves an emotional imprint. The recounting of a traumatic moment imparts sadness, and a joyous occasion begets joy in the listener as well. As acknowledged in the field of everyday aesthetics, these aesthetic experiences often spur us to act:[24] The unsightly appearance of a polluted riverbank drives us to remove the trash; the presence of sorrow in one’s life drives us to ameliorate it. To be mindful of aesthetic experiences and allow them to affect us emotionally is paramount to the motivation of a bioethicist to serve the patient, not out of an obligation to a job description, but out of a desire to truly avail the patient of their anguish. For example, the new field of narrative medicine utilizes critical reading and literary techniques to train clinicians and bioethicists in emotional understanding and listening skills that stress the social aspects of medicine beyond rational analysis and decision making. CONCLUSION Dr. Farmer is absolutely correct; bioethics is in dire need of resocialization. It should not be the case that the justification for a moral action is essentially that “the rules say so,” or that simply by teaching such rules to medical students, the very act of making bioethical decisions that diverge from those determined by principles can be seen as an act of “bad faith … hubris or, worse, malpractice.”[25] As bioethicists are coming to realize, the rationalist philosophical traditions that bioethics was founded upon are past their expiry, and the time for change is now. Indeed, as Dr. Farmer urges, “socializing disciplines” like anthropology, history, political economy, and sociology are necessary to humanize the field of bioethics.[26] So too, however, can philosophy be a socializing discipline, if we know where to look. Bioethics should evolve. Its new goal should be to focus on meaningful human relationships, and to phase out rigid, impersonal modes of moral thinking. The limited sampling of unsatisfying moral theories from hundreds of years ago leaves many bioethics students cold, and it is easy to see why bioethicists are ready to part ways with philosophy. I believe this is a move in the wrong direction; there is a place for philosophy in the future of bioethics. Just as bioethics needs a resocialization, it is also needs of a re-philosophization. These enrichments complement one another. There is more to bioethics than mechanically determining the right course of action in a healthcare setting. Bioethics engages with the most ancient of philosophical questions: questions of what makes human existence meaningful, what makes us who we are, how we want to relate to others, how and why we feel, what our place in the world is, how we can communicate what we think, and why our moral intuitions are so compelling. We would be remiss if we did not begin to investigate additional contributions to morality from a wider range of philosophies that try to provide answers to such questions, as they offer a richness to moral thinking that cannot be gleaned from traditional bioethical approaches alone. - [1] Friedrich Wilhelm Nietzsche, The Gay Science: With a Prelude in German Rhymes and an Appendix of Songs, ed. Bernard Williams, Josefine Nauckhoff, and Adrian Del Caro, Cambridge Texts in the History of Philosophy, 109. [2] Nietzsche, 120. [3] Daniel C O’Brien, “Medical Ethics as Taught and as Practiced: Principlism, Narrative Ethics, and the Case of Living Donor Liver Transplantation,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 47, no. 1 : 97, https://doi.org/10.1093/jmp/jhab039. [4] K. D. Clouser and B. Gert, “A Critique of Principlism,” Journal of Medicine and Philosophy 15, no. 2 : 219–36, https://doi.org/10.1093/jmp/15.2.219. [5] O’Brien, “Medical Ethics as Taught and as Practiced,” 97. [6] Cora Diamond, “Having a Rough Story about What Moral Philosophy Is,” New Literary History 15, no. 1 : 168, https://doi.org/10.2307/468998. [7] Bernard Williams, Morality: An Introduction to Ethics, Canto ed, xvii. [8] G. E. M. Anscombe, “Modern Moral Philosophy,” Philosophy 33, no. 124 : 1, https://doi.org/10.1017/S0031819100037943. [9] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 7th ed, 13. [10] Clouser and Gert, 233. [11] Clouser and Gert, “A Critique of Principlism,” 235. [12] Paul Farmer and Nicole Gastineau Campos, “Rethinking Medical Ethics: A View from Below,” Developing World Bioethics 4, no. 1 : 17–41, https://doi.org/10.1111/j.1471-8731.2004.00065.x. [13] Ludwig Wittgenstein, Philosophical Investigations, ed. Joachim Schulte, trans. P. M. S. Hacker, 4th edition, 40. [14] Farmer and Campos, “Rethinking Medical Ethics,” 20. [15] Farmer and Campos, 20. [16] Jennifer Blumenthal-Barby et al., “The Place of Philosophy in Bioethics Today,” The American Journal of Bioethics: AJOB, June 30, 2021, 3–5, https://doi.org/10.1080/15265161.2021.1940355. [17] Brendan Balcerak Jackson, “Verbal Disputes and Substantiveness,” Erkenntnis 79, no. S1 : 31–54, https://doi.org/10.1007/s10670-013-9444-5. [18] C. S. I. Jenkins, “Merely Verbal Disputes,” Erkenntnis 79, no. 1 : 11–30, https://doi.org/10.1007/s10670-013-9443-6. [19] Steven Crowell, “Existentialism,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Summer 2020, https://plato.stanford.edu/archives/sum2020/entries/existentialism/; Anita Avramides, “Other Minds,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Winter 2020, https://plato.stanford.edu/archives/win2020/entries/other-minds/. [20] Martin Heidegger, Discourse on Thinking, Harper Torchbooks, 46. [21] Heidegger, 46. [22] Heidegger, 45. [23] Nick Zangwill, “Aesthetic Judgment,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Winter 2021, https://plato.stanford.edu/archives/win2021/entries/aesthetic-judgment/. [24] Yuriko Saito, “Aesthetics of the Everyday,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Spring 2021, https://plato.stanford.edu/archives/spr2021/entries/aesthetics-of-everyday/. [25] O’Brien, “Medical Ethics as Taught and as Practiced,” 112. [26] Farmer and Campos, “Rethinking Medical Ethics,” 20. (shrink)

I reconsider Bleichrodt, Pinto Prades and Wakker’s 2001 paper about eliciting utility measures from stated preference surveys. That paper pioneers a method that is now widely used in behavioural economics to correct individuals’ ‘biases’ and to recover their ‘true preferences’. However, BPW propose this method as way of dealing with inconsistent responses to stated preference surveys, in contrast to more recent applications which aim to help individuals to avoid supposed mistakes in their private choices. I argue that the concepts (...) of true preference and bias are empirically ungrounded, but that BPW’s approach can be interpreted as not invoking those concepts. By ‘regularising’ preferences revealed in actual choice, this approach constructs measures of individual welfare that are broadly aligned with actual preferences and consistent with normative standards of rationality that are appropriate for public decision-making. Public decision-makers’ normative judgements are made explicit, rather than being disguised as apparently empirical claims about true preferences. (shrink)