Genetic testing seems to hold out hope for the cure of a number of debilitating conditions. At the same time, many people fear the information that genetic testing can make available. In this commentary, I argue that as of now, the nature of the information revealed in such tests should lead to cautious views about the value of genetic testing. Moreover, I suggest that our overall views about such testing should account for the fact that individuals place different sorts of (...) value on the possession of their own genetic information. As a result, we should largely defer to personal preference in thinking about the propriety of genetic testing. (shrink)

It’s certainly wrong for employers to accept applications from only white people. Universities that open admissions to only white people surely act wrongly. But do people who date, or consider dating, only white people do something wrong? Many people say that racialized attraction is just a matter of personal preference. Against this view, it will be argued that it often constitutes wrongful discrimination.

In healthcare ethics there is a discussion regarding whether autonomy of personal preferences, what sometimes is referred to as authenticity, is necessary for autonomous decision-making. It has been argued that patients’ decisions that lack sufficient authenticity could be deemed as non-autonomous and be justifiably overruled by healthcare staff. The present paper discusses this issue in relation certain psychiatric disorders. It takes its starting point in recent qualitative studies of the experiences and thoughts of patients’ with anorexia nervosa where (...) issues related to authenticity seem particularly relevant. The paper examines different interpretations of authenticity relevant for autonomy and concludes that the concept, as it has been elaborated in recent debate, is highly problematic to use as a criterion for autonomous decision-making in healthcare. (shrink)

In contrast to most Western countries, routine offer of prenatal screening is considered problematic in the Netherlands. The main argument against offering it to every pregnant woman is that women would be brought into a moral dilemma when deciding whether to use screening or not. This paper explores whether the active offer of a prenatal screening test indeed confronts women with a moral dilemma. A qualitative study was developed, based on a randomised controlled trial that aimed to assess the decision-making (...) process of women when confronted with a test offer. A sample of 59 women was interviewed about the different factors balanced in decision-making. Participants felt themselves caught between a need for knowledge and their unwillingness to take on responsibility. Conflict was reported between wishes, preferences and ethical views regarding parenthood; however, women did not seem to be caught in a choice between two or more ethical principles. Participants balanced the interests of the family against that of the fetus in line with their values and their personal circumstances. Therefore, we conclude that they are not so much faced with an ethical dilemma as conflicting interests. We propose that caregivers should provide the opportunity for the woman to discuss her wishes and doubts to facilitate her decision. This approach would help women to assess the meaning of testing within their parental duties towards their unborn child and their current offspring. (shrink)

Background Physician-assisted suicide is a controversial issue and has sometimes raised emotion-laden reactions. Against this backdrop, we have analyzed how Swedish physicians are reasoning about physician-assisted suicide if it were to be legalized. Methods and participants We conducted a cross-sectional study and analyzed 819 randomly selected physicians’ responses from general practitioners, geriatricians, internists, oncologists, psychiatrists, surgeons, and all palliativists. Apart from the main questions about their attitude toward physician-assisted suicide, we also asked what would happen with the respondents’ own trust (...) in healthcare if physician-assisted suicide were legalized. Response options were that trust would decrease, not be influenced, or would increase. Results We identified a strong statistical association between on the one hand those whose own trust would increase and who were pro physician-assisted suicide, and on the other hand those who were against physician-assisted suicide and whose own trust would decrease [relative risk: 16.7 (95% confidence interval: 10.2–27.2)]. Among those whose own trust would not be influenced (n = 456), 60% were pro pysician-assisted suicide, 16% were against, and 24% were undecided. Of those whose trust would increase or not be influenced, a large majority supported autonomy-based arguments, whereas those whose trust would decrease supported non-maleficence-based arguments. Conclusion Analyzing the answers after having divided respondents into those whose own trust in healthcare would decrease or increase and not be influenced brings about interesting results such as how the three groups prioritize arguments for and against physician-assisted suicide. This way of analyzing the data seems to be a promising strategy when identifying value-impregnated factual claims. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even (...) if such a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Ruth Jonathan; Persons and their Preferences, Journal of Philosophy of Education, Volume 31, Issue 1, 16 December 2002, Pages 143–179, https://doi.org/10.1111/1.

The present study investigated relations between personality and values on the one hand and compensation preferences on the other. We hypothesized that HEXACO Honesty-Humility and self-transcendence versus self-enhancement values predict preference for higher relative compensation level and that HEXACO Openness to Experience and openness to change versus conservation values predict preference for compensation variability. Furthermore, we expected perceived utility of money and risk aversion to mediate the respective relations. The hypotheses were tested using a sample of 2,210 employees from (...) a large international organization. The results provided support for the direct and mediated relations between personality and values on the one hand and preferences for compensation variability and level on the other. (shrink)

Let’s say that an act requires Person-Affecting Justification if and only if some alternative would have been better for someone. So, Lucifer breaking Xavier’s back requires Person-Affecting Justification because the alternative would have been better for Xavier. But the story continues: While Lucifer evades justice, Xavier moves on and founds a school for gifted children. Xavier’s deepest values become identified with the school and its community. When authorities catch Lucifer, he claims no Person-Affecting Justification is needed: because the attack set (...) Xavier on his life’s path, it’s no longer true that the alternative would have been better by the standard of what Xavier now values most. An unappealingly paternalistic way to hold Lucifer to account is to discount Xavier’s preferences as merely adaptive. Instead, I propose understanding the persons of Person-Affecting Justification to be not persons but person stages. This allows us to hold Lucifer to account without having to discount Xavier’s actual preferences, and has interesting implications for compensatory justice, including making sense of reparations for historical wrongs. (shrink)

As persons, beings with a capacity for autonomy, we face a certain practical task in living out our lives. At any given period we find ourselves with many desires or preferences, yet we have limited resources, and so we cannot satisfy them all. Our limited resources include insufficient economic means, of course; few of us have either the funds or the material provisions to obtain or pursue all that we might like. More significantly, though, we are limited to a (...) single life and one of finite duration. We also age, and pursuits that were possible at earlier points within a life may become impossible at later stages; we thus encounter not only an ultimate time limit but episodic limits as well. Because we must live our lives with limited resources—material and temporal—we are pressed to choose among and to order our preferences. Without some selection and ordering, few if any of them would be satisfied, and we would be unable to live lives that are recognizably good at all. Moreover, we would be unable to function well as the autonomous beings that we are. Our practical task then is to form a coherent, stable, and attractive ordering of aims—to develop a conception of our good. (shrink)

If one can get the targets of one's current wants only by acquiring new wants (as in the Prisoner's Dilemma), is it rational to do so? Arguably not. For this could justify adopting unsatisfiable wants, violating the rational duty to maximize one's utility. Further, why cause a want's target if one will not then want it? And people "are" their wants. So if these change, people will not survive to enjoy their wants' targets. I reply that one rationally need not (...) advance one's future wants, only current ones. Furthermore, rational choice seeks not utility (the co-obtaining of a want and its target), but satisfaction (the eventual obtaining of what is now wanted) -- otherwise, it would be irrational to care now about what happens after one dies. Finally, persons survive "rational" changes of values. Thus reflection on the rational revision of values illuminates the conditions on personal identity and the bases and aims of rational choice. (shrink)

The study examines a model proposing relationships between personal values, positive (i.e., benefits) and negative (i.e., threats) appraisal of immigrants, and social contact. Based on a values-attitudes-behavior paradigm, the study extends previous work on personal values and attitudes to immigrants by examining not only negative but also positive appraisal and their connection with social contact with immigrants. Using a representative sample of 1,600 adults in the majority population in Israel, results showed that higher preference for anxiety-avoidance values (self-enhancement (...) and conservation) was related to higher levels of perceived threat and lower levels of benefit, while higher preference for anxiety-free values (self-transcendence and openness to change) was related to higher levels of perceived benefits and lower levels of threat. Greater opportunities for contact and perceived benefits and lower levels of threats were related to more social contact. The model showed good fit across the total sample, and across four diverse immigrant groups in Israel (diaspora immigrants from the Former Soviet Union, Ethiopia and Western countries, and asylum seekers). In line with a Stereotype Content Model, which suggests that group-specific stereotypes are related to social structural characteristics of the group, associations between variables differed by group. Results strengthen a theoretical conceptualization that posits an indirect relationship between personal value preferences and behavior through group appraisal. They highlight the importance of comprehensive conceptualizations including both positive and negative appraisal of immigrants, which take into account the way different groups may be appraised by the majority population. (shrink)

The Institute of Medicine's report, the American Medical Association's project, the Open Society Institute's and the initiative sponsored by the Robert Wood Johnson Foundation have focused attention on improving the care of dying patients. These efforts include advance care planning and the use of written advance directives. Although previous studies have provided quantitative descriptions of patient preferences for life-sustaining treatment, including those documented in written ADs, to our knowledge open-ended written preferences have not been studied. Studies of these (...) open-ended preferences could highlight issues with respect to quality end-of-life care. The purpose of this study was to explore the open-ended proxy, health, and personal care preferences of people with HIV as expressed in a written AD form. (shrink)

Except in extraordinary circumstances, patients' clinical care should reflect their preferences. Incapacitated patients cannot report their preferences. This is a problem. Extant solutions to the problem are inadequate: surrogates are unreliable, and advance directives are uncommon. In response, some authors have suggested developing algorithmic "patient preference predictors" (PPPs) to inform care for incapacitated patients. In a recent paper, Earp et al. propose a new twist on PPPs. Earp et al. suggest we personalize PPPs using modern machine learning (ML) (...) techniques. In this paper, I argue that, contrary to Earp et al.'s claim, personalized patient preference predictors are neither technically feasible nor ethically desirable. (shrink)

Individual choices are commonly taken to manifest personal preferences. The present study investigated whether social and statistical cues influence young children's inferences about the generalizability of preferences. Preschoolers were exposed to either 1 or 2 demonstrators’ selections of objects. The selected objects constituted 18%, 50%, or 100% of all available objects. We found that children took a single demonstrator's choices as indicative only of his or her personal preference. However, when 2 demonstrators made the same selection, (...) then children inferred that it generalized to other agents of the same kind as the original demonstrator's, but not to agents of a different kind. Lastly, only when both demonstrators blatantly violated random selection (i.e., in the 18% condition) did children generalize the preference even to an agent of a different kind. Thus, from a young age, social and statistical cues inform children's naïve sociology. (shrink)

This article explored the role of personality disposition and value preference as predictors of social well-being in the context of ecological setting. Ecological contexts like rural and urban are critical, particularly in a developing country like India, because they represent significant disparities and variations in the lived experiences of the people. The participants ( n = 360) from the age range of 15–65 years (M = 33.50, SD = 11.99) were drawn from two ecological settings, that is, rural (Gorakhpur Region, (...) Eastern Uttar Pradesh, India) and urban (National Capital Region of Delhi, India) and from both the genders. They completed the measures of social well-being, value preference and personality dispositions. The results showed that the different facets of social well-being were differentially related to the aspects of personality and value preference. Ecological setting had significant influence on the measures of personality disposition, value preference and social well-being. Regression analysis showed that except neuroticism, all other factors of personality had consistent positive contribution as the predictors of social well-being. It was also observed that social value and growth factors of value preference had significant contribution, whereas personal value and protection—factors of value preference—had negative contribution as the predictors of social well-being. (shrink)

One of the reasons for adopting hyperbolic discounting is to explain preference reversals. Another is that this value structure suggests an elegant theory of the will. I examine the capacity of the theory to solve Newcomb's problem. In addition, I compare Ainslie's account with other procedural theories of choice that seem at least equally capable of accommodating reversals of preference.

In this article, I argue that the state has a prima facie obligation to help its citizens satisfy their autonomous preferences. I argue that this obligation is grounded in the state's obligation to respect its citizens as persons, and that part of what is involved in respecting someone as a person is helping her satisfy her autonomous preferences. I argue that that which makes preferences autonomous is also that which makes them, and not their non-autonomous counterparts, worthy (...) of respect. In addition, I reject other views of what makes preferences worthy of respect, in particular Ronald Dworkin's view that only preferences for one's own enjoyment of some goods or opportunities deserve political consideration. Finally, I consider the state's obligation towards immoral autonomous preferences, and I argue that the state's prima facie obligation to promote the satisfaction of autonomous preferences is quite strong. (shrink)

In this preliminary study, the authors extend Swanson's concept of normative myopia (the propensity of executives to downplay or ignore the values at stake in their decision making) by using it as a point of reference for studying executives' preference for high pay dispersion. Specifically, the authors designed a survey to examine hypothesized relationships among myopia, personality, and executives' preference for highly stratified organizational pay structures. Data from 133 executive respondents suggest that myopic executives tend to prefer top-heavy compensation systems. (...) In addition, the findings point to an inverse relationship between the personality factor Agreeableness and normative myopia, with the former offsetting the latter. The authors reject the alternative hypothesis that gender influences both agreeableness and myopia and conclude with some implications for business and society, including Swanson's proposition that normative myopia at the top contributes to a neglectful form of corporate social performance. (shrink)

Background Immense volumes of personal health information are required to realize the anticipated benefits of artificial intelligence in clinical medicine. To maintain public trust in medical research, consent policies must evolve to reflect contemporary patient preferences. Methods Patients were invited to complete a 27-item survey focusing on: broad versus specific consent; opt-in versus opt-out approaches; comfort level sharing with different recipients; attitudes towards commercialization; and options to track PHI use and study results. Results 222 participants were included in (...) the analysis; 83% were comfortable sharing PHI with researchers at their own hospital, although younger patients were more uncomfortable than older patients. While 56% of patients preferred broad consent, 38% preferred specific consent; 6% preferred not sharing at all. The majority of patients preferred to be asked for permission before entry into a contact pool. Again, this trend was more pronounced for younger patients. Approximately half of patients were uncomfortable sharing PHI with commercial enterprises. Most patients preferred to track PHI usage, with the highest proportion once again reported by the youngest patients. A majority of patients also wished to be notified regarding study results. Conclusions While most patients were willing to share their PHI with researchers within their own institution, many preferred a transparent and reciprocal consent process. These data also suggest a generational shift, wherein younger patients preferred more specific consent options. Modernizing consent policies to reflect increased autonomy is crucial in fostering sustained public engagement with medical research. (shrink)

Philosophers working on time-biases assume that people are hedonically biased toward the future. A hedonically future-biased agent prefers pleasurable experiences to be future instead of past, and painful experiences to be past instead of future. Philosophers further predict that this bias is strong enough to apply to unequal payoffs: people often prefer less pleasurable future experiences to more pleasurable past ones, and more painful past experiences to less painful future ones. In addition, philosophers have predicted that future-bias is restricted to (...) first-person preferences, and that people’s third-person preferences are time-neutral. Philosophers disagree vigorously about the normative status of these preferences—i.e., they disagree about whether first-person future-bias is rationally permissible. Time-neutralists, for example, have appealed to the predicted asymmetry between first- and third-person preferences to argue for the rational impermissibility of future-bias. We empirically tested these predictions, and found that while people do prefer more past pain to less future pain, they do not prefer less future pleasure to more past pleasure. This was so in both first and third-person conditions. This suggests that future-bias is typically non-absolute, and is more easily outweighed in the case of positive events. We connect this result to the normative debate over future-bias. (shrink)

In the age where AI is showing increasing potential to solve problems in unprecedented ways, it becomes tempting to see it as the solution for every problem, resulting in a focus on the means (i.e....

England and Wales are moving toward a model of ‘opt out’ for use of personal confidential data in health research. Existing research does not make clear how acceptable this move is to the public. While people are typically supportive of health research, when asked to describe the ideal level of control there is a marked lack of consensus over the preferred model of consent. This study sought to investigate a relatively unexplored difference between the consent model that people prefer (...) and that which they are willing to accept. It also sought to explore any reasons for such acceptance. (shrink)

Background Rapid ethical access to personal health information to support research is extremely important during pandemics, yet little is known regarding patient preferences for consent during such crises. This follow-up study sought to ascertain whether there were differences in consent preferences between pre-pandemic times compared to during Wave 1 of the COVID-19 global pandemic, and to better understand the reasons behind these preferences. Methods A total of 183 patients in the pandemic cohort completed the survey via (...) email, and responses were compared to the distinct pre-pandemic cohort ; all were patients of a large Canadian cancer center. The survey covered broad versus study-specific consent; opt-in versus opt-out contact approach; levels of comfort sharing with different recipients; perceptions of commercialization; and options to track use of information and be notified of results. Four focus groups were subsequently conducted to elucidate reasons motivating dominant preferences. Results Patients in the pandemic cohort were significantly more comfortable with sharing all information and biological samples, sharing information with the health care institution, sharing information with researchers at other hospitals, sharing PHI provincially, nationally and internationally compared to the pre-pandemic cohort. Discomfort with sharing information with commercial companies remained unchanged between the two cohorts. Significantly more pandemic cohort patients expressed a wish to track use of PHI, and to be notified of results. Thematic analysis uncovered that transparency was strongly desired on outside PHI use, particularly when commercialization was involved. Conclusions In pandemic times, patients were more comfortable sharing information with all parties, except with commercial entities, where levels of discomfort remained unchanged. Focus groups identified that the ability to track and receive results of studies using one’s PHI is an important way to reduce discomfort and increase trust. These findings meaningfully inform wider discussions on the use of personal health information for research during global crises. (shrink)

Both economists and psychologists are interested in understanding decision making under uncertainty. Yet, they rely on different concepts to analyse human behaviour: economists use economic preference parameters rooted in utility theory, while psychologists use personality traits to describe responses to uncertain situations. Using a large sample of university students, this study examines and contrasts five economic preference parameters and six psychological personality traits that are commonly used to study individuals’ attitudes towards uncertainty. A novelty of this paper is including both (...) the economic concept of ambiguity aversion as well as the personality trait of ambiguity intolerance. We find that standard economic preference measures based on incentivized choice tasks seem to capture rather different characteristics than psychological personality traits. In contrast, economic preference measures obtained from self-assessment questions appear more related to personality traits, especially ambiguity intolerance. (shrink)

This paper describes the design and evaluation of a personality for the robotic user interface “iCat”. An application was developed that helps users find a TV-programme that fits their interests. Two experiments were conducted to investigate what personality users prefer for the robotic TV-assistant, what level of control they prefer, and how personality and the level of control relate to each other. The first experiment demonstrated that it is possible to create convincing personalities of the TV-assistant by applying various social (...) cues. The results of the second experiment showed that an extravert and agreeable TV-assistant was preferred over a more introvert and formal one. Overall, the most preferred combination was an extravert and friendly personality with low user control. Additionally, it was found that perceived level of control was influenced by the robot’s personality. This suggests that the robot’s personality can be used as a means to increase the amount of control that users perceive. (shrink)

The idea of personalized nutrition is to give tailored dietary advice based on personal health-related data, i.e. phenotoype, genotype, or lifestyle. PN may be seen as part of a general trend towards personalised health care and currently various types of business models are already offering such services in the market. This paper explores ethical issues of PN by examining how PN services within the contextual environment of four future scenarios about health and nutrition in Europe might affect aspects of (...) social justice according to Martha Nussbaum’s capability approach. The scenarios have been created by a mixed group of stakeholders and experts in three consecutive workshops. This resulted in the definition of four future scenarios within a scenario space consisting of two variables: the ‘logic of health care systems’ and ‘conception of health’. Within each scenario, PN is likely to play a more or less important role in improving health by influencing food consumption patterns in society. Nussbaum’s capability approach implies a concept of social justice as a function of a minimum standard of human dignity. This denotes an account for equality in terms of a minimum of entitlements. However, also the ability of achieving individual objectives is essential for social justice. Personalisation advice in health and food consumption patterns, as aimed for by PN, is therefore acceptable provided a minimum of entitlements is guaranteed to all members of a society, and at the same time freedom concerning personal preferences is respected. Potential variation of how different people might benefit from PN should therefore be consistent with the minimum required as defined by the list of capabilities. (shrink)

The future of medicine will be predictive, preventive, personalized, and participatory. Recent technological advancements bolster the realization of this vision, particularly through innovations in...

Healthcare systems contribute considerably to worldwide carbon emissions and therefore reinforce the negative health impacts of climate change. Significant attempts to reduce emissions have been made on the macro level of politics and on the institutional level. Less attention has been paid so far to decisions that take place at the micro level of immediate doctor–patient contact. Current bioethical debates discuss potential tensions between ‘Green Healthcare’ and an orientation towards ethical principles such as promoting patient welfare or respect for patient (...) autonomy. The article addresses this debate from a different angle starting from the premise that at least some patients might have a preference to reduce carbon outputs that are often deeply rooted in their personal value system. Taking different accounts of patient autonomy as a starting point, the article analyses whether such preferences must be respected as being part of patient autonomy. The analysis comes to a positive conclusion but highlights that certain factors such as misinterpretation, lack of understanding or pressure must be carefully considered. In addition, a patient’s climate-related preference does not per se justify the choice of treatment but must be integrated into shared decision-making and reconciled with the healthcare professional’s expert judgement on the intervention being a legitimate and promising way for reaching certain treatment goals. As a recommendation, empirical research on stakeholders’ attitudes, knowledge and practice regarding ecological sustainability in clinical decision-making is needed together with further ethical analyses. (shrink)

Can teams and other collectivities have preferences of their own, preferences that are not in some way reducible to the personal preferences of their members? In short, are collective preferences possible? In everyday life people speak easily of what we prefer, where what is at issue seems to be a collective preference. This is suggested by the acceptability of such remarks as ‘My ideal walk would be . . . along rougher and less well-marked paths (...) than we prefer as a family’. One can imagine, indeed, that each member of a given family prefers something other than what the family prefers. What, then, do the collective preferences of everyday understanding amount to? (shrink)