Decision-making competence reflects individual differences in the susceptibility to decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate mechanisms that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth (...) class='Hi'>decision-making competence (Y-DMC) and one such mechanism, the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when expected value favors those options and (b) avoiding risky options when expected value favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions. (shrink)

Rational decision making depends on what one believes, what one desires, and what one knows. In conventional decision models, beliefs are represented by probabilities and desires are represented by utilities. Software agents are knowledgeable entities capable of managing their own set of beliefs and desires, and they can decide upon the next operation to execute autonomously. They are also interactive entities capable of filtering communications and managing dialogues. Knowledgeability includes representing knowledge about the external world, reasoning with (...) it, and sharing it. Interactions include negotiations to perform tasks in cooperative, coordinative, and competitive ways. In this paper we focus on decision-making mechanisms for agent-based systems on the basis of agent interaction. We identify possible interaction scenarios and define mechanisms for decision making in uncertain environments. It is believed that software agents will become the underlying technology that offers the capability of distribution of competence, control, and information for the next generation of ubiquitous, distributed, and heterogeneous information systems. (shrink)

This paper presents a new decision theory for modelling choice under risk. The new theory is a two-parameter generalization of expected utility theory. The proposed theory assumes that a decision maker: behaves as if maximizing expected utility; but may experience disappointment when the utility of a lottery’s outcome falls short of the expected utility of the lottery; and may have a preference for gambling. The proposed theory can rationalize the fourfold pattern of risk attitudes; the common (...) ratio effect and the reverse thereof ; the Allais paradox in classical common consequence problems and the reverse Allais paradox—in common consequence problems with an even split of a probability mass; violations of the betweenness axiom; switching behavior in the Samuelson’s example; violations of ordinal, upper and lower cumulative independence ; and preference reversals between valuations and choice. In application to insurance, the theory can rationalize full insurance with an actuarially unfair premium and aversion to probabilistic insurance. In application to optimal portfolio investment, the theory can rationalize the equity premium puzzle. (shrink)

Many studies have highlighted a substantial "bureaucracy domination" in procedures relating to migrants’ access to territory. This form of domination is marked by highly discretionary and arbitrary practices, enacted by the administrative authorities of the state. Only minor attention, however, has been devoted to the arbitrariness of judicial decisions and to the judicial role in general in the numerous proceedings that increasingly affect the path of migrants. This path is the main object of this paper. The study focuses on Italian (...) case law in expulsion and detention proceedings of irregular third country national citizens and asylum seekers and presents qualitative empirical research on decisions issued by the competent national authorities. The results have been analysed using a selection of theoretical tools, all referable to the general concept of the rule of law. The judicial decisions on pre-removal detention proceedings in two case studies are examined: the jurisprudence on detention of irregular migrants, in different offices of the Justice of the Peace in Italy; and the case law on detention of asylum seekers in the Ordinary Tribunal of Rome. The assumption underlying the research is that various conceptions of the rule of law may have different explanatory power when it comes to explaining the empirical results. To verify this hypothesis, the study proposes an overview of the main rule of law doctrines in the Western tradition of political and legal thought and applies the method of historical-conceptual analysis. As a result, the explanatory power of six theoretical models of the rule of law was verified against the data with the view to highlight the virtues and vices of the respective explanatory frameworks. This article reaches a two-fold conclusion. First, as far as the explanatory frameworks are concerned: the results of the two case studies cannot be fully explained by any of the models considered in this study. This fact alone casts doubts on the explanatory power of these theories and calls for further research on judicial decision-making more generally. Secondly, a key finding of the study regarding the notions of discretion and arbitrariness is that the judicial approach which assures the highest protection of rights is also the one that is most easily influenced by arbitrariness. The author argues that this paradox can be easily dissolved by paying attention to the plural dimensions of arbitrariness. If we consider arbitrariness from a legal point of view, i.e. as an illegal decision, it is unsurprising that the authority that most uses its discretionary powers is also the one most at risk of abusing these discretionary powers and hence of exercising arbitrary power. However, if we consider arbitrariness from the point of view of philosophical-political theory, i.e. as a form of domination characterised by the absence of sufficient justification, it is unsurprising that the judicial approach which assures the highest protection of rights is also the one that takes its own role as guarantor of these rights and of the constitutional democratic legal order as such most seriously. This judicial approach thus most often risks exercising its power in criticisable ways, as compared to an authority much more in line with the requirements of law enforcement agencies. Keywords: migration, discretion, justice, arbitrariness, civil rights, Rechtsstaat, expulsion, mixed constitution. (shrink)

In many real-world gambles, a non-trivial amount of time passes before the uncertainty is resolved but after a choice is made. An individual may have a preference between gambles with identical probability distributions over final outcomes if they differ in the timing of resolution of uncertainty. In this domain, utility consists not only of the consumption of outcomes, but also the psychological utility induced by an unresolved gamble. We term this utility anxiety. Since a reflective (...) class='Hi'>decision maker may want to include anxiety explicitly in analysis of unresolved lotteries, a multiple-outcome model for evaluating lotteries with delayed resolution of uncertainty is developed. The result is a rank-dependent utility representation (e.g., Quiggin, 1982), in which period weighting functions are related iteratively. Substitution rules are proposed for evaluating compound temporal lotteries. The representation is appealing for a number of reasons. First, probability weights can be interpreted as the cognitive attention allocated to certain outcomes. Second, the model disaggregates strength of preference from temporal risk aversion and thus provides some insight into the old debate about the relationship between von Neumann–Morgenstern utility functions and strength of preference value functions. (shrink)

This paper reports the results of an experiment designed to uncover the stochastic structure of individual preferences over lotteries. Unlike previous experiments, which have presented subjects with pair-wise choices between lotteries, our design allowed subjects to choose between two lotteries or (virtually) any convex combination of the two lotteries. We interpret the mixtures of lotteries chosen by subjects as a measure of the stochastic structure of choice. We test between two alternative interpretations of stochastic choice: the random utility interpretation (...) and the deterministic preferences interpretation. The main findings of the experiment are that the typical subject prefers mixtures of lotteries rather than the extremes of a linear lottery choice set. The distribution of choices does not change between a first and second asking of the same question. We argue that this provides support for the deterministic preferences interpretation over the random utility interpretation of stochastic choice. As a subsidiary result, we find a small proportion of subjects make choices that violate transitivity, but the level of intransitive choice falls significantly over time. (shrink)

The application of artificial intelligence (AI) to judicial decision-making has already begun in many jurisdictions around the world. While AI seems to promise greater fairness, access to justice, and legal certainty, issues of discrimination and transparency have emerged and put liberal democratic principles under pressure, most notably in the context of bail decisions. Despite this, there has been no systematic analysis of the risks to liberal democratic values from implementing AI into judicial decision-making. This article sets out to (...) fill this void by identifying and engaging with challenges arising from artificial judicial decision-making, focusing on three pillars of liberal democracy, namely equal treatment of citizens, transparency, and judicial independence. Methodologically, the work takes a comparative perspective between human and artificial decision-making, using the former as a normative benchmark to evaluate the latter. -/- The chapter first argues that AI that would improve on equal treatment of citizens has already been developed, but not yet adopted. Second, while the lack of transparency in AI decision-making poses severe risks which ought to be addressed, AI can also increase the transparency of options and trade-offs that policy makers face when considering the consequences of artificial judicial decision-making. Such transparency of options offers tremendous benefits from a democratic perspective. Third, the overall shift of power from human intuition to advanced AI may threaten judicial independence, and with it the separation of powers. While improvements regarding discrimination and transparency are available or on the horizon, it remains unclear how judicial independence can be protected, especially with the potential development of advanced artificial judicial intelligence (AAJI). Working out the political and legal infrastructure to reap the fruits of artificial judicial intelligence in a safe and stable manner should become a priority of future research in this area. (shrink)

Victor and Cullen (1987, 1988) developed a typology of ethical climates based upon the level of moral development of the work group (egoism, benevolence and principled a la Kohlberg, 1981) and the locus of analysis utilized in reaching decisions (individual, local, cosmopolitan). Building on this typology, data were obtained from a high technology company for the purpose of empirically extending the examination of the number of ethical climates that exist and portraying the relationship between ethical climates and the ethical dimension (...) of decisions.When faced with decisions posing various types of ethical dilemmas, most respondents indicated they would take the ethical path. The one exception involved bribery where respondents were about equally likely to make or withhold payment. One climate guided by laws/professional codes accounted for over half of the respondents. Several climates accounted for less than ten percent of the respondents. (shrink)

Motivated by the analysis of a general optimal portfolio selection problem, which encompasses as special cases an optimal consumption and an optimal debt-arrangement problem, we are concerned with the questions of how a personality trait like risk-perception can be formalized and whether the two objectives of utility-maximization and risk-minimization can be both achieved simultaneously. We address these questions by developing an axiomatic foundation of preferences for which utility-maximization is equivalent to minimizing a utility-based shortfall risk measure. (...) Our axiomatization hinges on a novel axiom in decision theory, namely the risk-perception axiom. (shrink)

The idea that there is a fundamental difference in value between persons and things, and that respecting this difference is an important moral requirement, has strong intuitive appeal. Kantian ethics is unique in placing this requirement at the center of a moral system and in explicating the conditions for complying with it. Unlike challenges to Kantian ethics that focus on tragic cases that pit respect for one person against respect for another, this paper focuses on the question of how (...) we can respect the value distinction between persons and things under conditions of uncertainty. After exploring why decision making under uncertainty is a neglected topic among Kantians and demonstrating how uncertainty challenges our ability to comply with this norm, we propose a notion of morally insignificant risk within a framework that allows agents to navigate real-world decisions involving material benefit and some risk to dignity without violating the Kantian’s core commitments. We conclude by exploring some of the challenges facing this approach. (shrink)

This paper focuses on the comparison of individual and group decision-making, in a stochastic inter-temporal problem in two decision environments, namely risk and ambiguity. Using a consumption/saving laboratory experiment, we investigate behaviour in four treatments: individual choice under risk; group choice under risk; individual choice under ambiguity and group choice under ambiguity. Comparing decisions within and between decision environments, we find an anti-symmetric pattern. While individuals are choosing on average closer to the theoretical optimal (...) predictions, compared to groups in the risk treatments, groups tend to deviate less under ambiguity. Within decision environments, individuals deviate more when they choose under ambiguity, while groups are better planners under ambiguity rather than under risk. Our results extend the often observed pattern of individuals behaving more optimally under risk, to its dynamic dimension. (shrink)

Men often make riskier decisions than women across a wide range of real-life behaviors. Whether this sex difference is accentuated, diminished, or stable under stressful conditions is, however, contested in the scientific literature. A critical blind spot lies amid this contestation: Most studies use standardized, laboratory-based, cognitive measures of decision making rather than complex real-life social simulation tasks to assess risk-related behavior. To address this blind spot, we investigated the effects of acute psychosocial stress on risk (...) class='Hi'>decision making in men and women using a standardized cognitive measure and a novel task that simulated a real-life social situation. Participants were exposed to either an acute psychosocial stressor or an equivalent control condition. Stressor-exposed participants were further characterized as high- or low-cortisol responders. Results confirmed that the experimental manipulation was effective. On the IGT, participants characterized as low-cortisol responders made significantly riskier decisions than those characterized as high-cortisol responders. Similarly, in the online chatroom, participants characterized as low-cortisol responders were, relative to those in the Non-Stress group, significantly more likely to make risky decisions. Together, these results suggest that at lower levels of cortisol both men and women tend to make riskier decisions in both economic and social spheres. (shrink)

In the present contribution I attempt to refute a recent challenge raised by Michael Otsuka against prioritarianism, according to which the priority view is objectionable since it rejects the moral permissibility of choosing in accordance with rational self-interest – understood as maximization of expected utility – in one-person cases involving other-regarding decision-making under risk. I claim that Otsuka’s argument is bound to make an illegitimate move, which is either to assume implausibly that individuals are generally risk-neutral (...) or to assume implausibly that the decision-maker in his cases can have accurate information on the attitudes towards risk held by the individual on behalf of whom the decision is taken. I argue, pace Otsuka, that acting in accordance with rational self-interest in cases characterized by these types of epistemic constraints requires that we adopt a view on other-regarding decision-making that takes into account general empirical facts about human nature and that prioritarianism does not conflict with this latter view. (shrink)

Research on the cognitive abilities involved in decision making has shown that, under objective risk conditions (i.e., when explicit information about possible outcomes and risks is available), superior decisions are especially predicted by executive functions and exact number processing skills, also referred to as objective numeracy. So far, decision-making research has mainly focused on exact number processing skills, such as performing calculations or transformations of symbolic numbers. There is evidence that such exact numeric skills are based on (...) approximate number processing (ANP) skills, which enable quick and accurate processing of non-symbolic numbers (e.g. Chen and Li, 2014). Very few studies, however, have investigated ANP skills in the context of risky decision making and have analyzed direct associations among the aforementioned sub functions. Possible interactions between the closely related skills have not been considered. The current study (N = 128) examines interactions of ANP skills with executive functions and objective numeracy, in predicting risky choice behavior. ANP skills are represented by the accuracy in a dot-comparison task. Decision making is measured by two versions of the Game of Dice Task (GDT), which place different emphases on the reflection of potential risks. The results show two-way as well as three-way interactions between the measures of ANP skills, executive functions, and objective numeracy in predicting risky decisions in both GDT versions. The riskiest decisions were most frequently made in case of low scores in all of the three competencies, while good performance in any one of them resulted in significant reductions of disadvantageous decisions. The findings indicate that high ANP skills can positively affect choice behavior in individuals who have weaknesses in reflectively attributed skills, namely executive functions and objective numeracy. Potential compensatory effects and mechanisms of ANP in decision making are discussed. (shrink)

The aim of the paper is to propose a preferences representation model under risk where risk perception can be past experience dependent. A first step consists in considering a one period decision problem where individual preferences are no more defined only on decisions but on pairs (decision, past experience). The obtained criterion is used in the construction of a dynamic choice model under risk. The paper ends with an illustrative example concerning insurance demand. It (...) appears that our model allows to explain modifications in the insurance demand behavior over time observed on the insurance markets for catastrophic risk and difficult to justify with standard models. (shrink)

Social norms play an essential role in human interactions and the development of the evolution of human history. Extensive studies corroborate that compliance with social norms typically requires a punishment threat as almost always specific individuals have self-interests that tempt them to violate the norm. Neural imaging studies demonstrate that lateral orbitofrontal cortex and right dorsolateral prefrontal cortex (rDLPFC) are activated when individuals decide to increase social norm compliance when punishment is possible. Moreover, rDLPFC is affirmed to be involved (...) in social norm compliance with or without external punishment threats in a series of transcranial direct current stimulation (tDCS) research. However, these neuroscience studies are based on the ultimatum game in which the decision-making power between the proposer and the responder is unequal, and no studies support the causal relationship between rDLPFC and voluntary cooperative norms compliance among the equal decision-making power of subjects. Whether modulating the excitability of rDLPFC, which plays a role in norm compliance, alters the extent of compliance with voluntary cooperative norms under equal decision-making power and how norms from different types with asymmetric endowment influence compliance remain unknown. The present study aimed to provide evidence of a direct link between the neural and behavioral results through the application of tDCS over rDLPFC on compliance with voluntary cooperative norms under equal decision-making power. Results verified that activating rDLPFC altered voluntary cooperative norms compliance of all our participants and significant effect over different initial endowments was observed. The role of norm.own and norm.other in compliance was changed in the anodal treatment. Findings validate that enhancing the excitability of the rDLPFC using tDCS leads to high compliance in voluntary cooperation and this effect is specific to equal decision-making power rather than unequal decision-making power. (shrink)

Emotions influence human decisions under risk and uncertainty, even when they are unrelated to the decisions, i.e. incidental to them. Empirical findings are mixed regarding the directions and sizes of the effects of discrete emotions such as fear, anger, or happiness. According to the Appraisal-Tendency Framework (ATF), appraisals of certainty and control determine why same-valence emotions can differentially alter preferences for risky and uncertain options. Building upon this framework of emotion-specific appraisals, we conducted a systematic review and meta-analysis of (...) 28 experimental studies on the effects of discrete incidental emotions on decision-making under risk and uncertainty. We evaluated potential moderators at the task and study levels. We find emotion-specific, moderately heterogeneous effects partially in line with the expectations of the ATF. The framing and financial consequences of choices, the type of choices, and the presence of other participants during the task do not moderate the effect. Our meta-analytic results support the differential influence of discrete, incidental emotions on decision-making under risk and uncertainty depending on appraisals other than valence. We discuss limited sample sizes and heterogeneity as reasons for the absence of significant moderators and encourage experimental investigations of individual differences in the susceptibility to incidental affective influences. (shrink)

:A good deal of contemporary moral nonconsequentialism assumes that agents have perfect knowledge about the various features and consequences of their options. This assumption is unrealistic. More often than not, moral agents can only assess with a certain degree of probability the factual circumstances that are morally relevant for their decision making. My aim in this essay is to discuss the problem of moral decisions under risk from the point of view of nonconsequentialism. Basically, I analyze how (...) objective moral principles can be transformed into subjective, decisional prescriptions, and argue that the standard nonconsequentialist approach to moral decision making, which focuses on probability thresholds, is wrong. In accordance with the fundamental postulates of nonconsequentialism, I seek to solve the problem of risk in moral choice by proposing a theory about the marginal moral value of various options. Actions can vary along various dimensions, and each of these dimensions can offer a different moral value function. Nonconsequentialist marginalism can level the playing field with consequentialism. Whereas consequentialism can simply borrow the notion of expected utility from economics, nonconsequentialism must introduce the notion of expectational obligation to formulate a general principle of moral choice under risk. I finally suggest that further empirical work is needed to delineate the shape of various moral value functions that are critical for applying the general principle of moral decision making under risk to well-known cases. View HTML Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.DECISIONAL NONCONSEQUENTIALISM AND THE RISK SENSITIVITY OF OBLIGATIONVolume 32, Issue 2Horacio Spector DOI: https://doi.org/10.1017/S0265052516000121Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. DECISIONAL NONCONSEQUENTIALISM AND THE RISK SENSITIVITY OF OBLIGATIONVolume 32, Issue 2Horacio Spector DOI: https://doi.org/10.1017/S0265052516000121Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. DECISIONAL NONCONSEQUENTIALISM AND THE RISK SENSITIVITY OF OBLIGATIONVolume 32, Issue 2Horacio Spector DOI: https://doi.org/10.1017/S0265052516000121Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation Request permission. (shrink)

Investigation of neural and cognitive processes underlying individual variation in moral preferences is underway, with notable similarities emerging between moral- and risk-based decision-making. Here we specifically assessed moral distributive justice preferences and non-moral financial gambling preferences in the same individuals, and report an association between these seemingly disparate forms of decision-making. Moreover, we find this association between distributive justice and risky decision-making exists primarily when the latter is assessed with the Iowa Gambling Task. (...) These findings are consistent with neuroimaging studies of brain function during moral and risky decision-making. This research also constitutes the first replication of a novel experimental measure of distributive justice decision-making, for which individual variation in performance was found. Further examination of decision-making processes across different contexts may lead to an improved understanding of the factors affecting moral behaviour. (shrink)

Virtual enterprise is a dynamic alliance of businesses, in which multiple members undertake joint research, development, manufacturing, operation, etc. The complexity of the relationship between business members, coupled with many new technologies or methods applied in the alliance operation, leads to more uncertain factors and difficulties in the operation and risk management of the virtual enterprise. The distributed decision-making model is a fast and effective decision-making model, in which dispersed intellectual resources and information resources are dynamically (...) integrated through virtual organization forms and operating mechanisms, and the dynamic reorganization, result evaluation, and synthesis of the decision-making system are realized by certain control rules. On the basis of summarizing and analyzing previous research works, this paper expounded the research status and significance of the risk control of virtual enterprise; elaborated the development background, current status, and future challenges of distributed decision-making model; introduced the related works of decision-making variable calculation and constraint determination; constructed a risk control model for virtual enterprise based on distributed decision-making model; analyzed the multiobjective model and interval programming model of risk control; established a risk control approach for virtual enterprise based on distributed decision-making model; performed the optimal allocation of risk control funds and the selective optimization of backup allies; and finally conducted a case analysis. The study results show that, in view of the diversity of relationships between alliance businesses and the complexity of the distribution of cooperative areas, the distributed decision-making model can more reasonably describe the relationship between alliance members and accurately control the risks of virtual enterprise from multiple angles, which can effectively manage the risks of virtual enterprise. The study results of this paper provide a reference for further research on the risk control of virtual enterprise based on distributed decision-making model. (shrink)

The rapidly increasing role of automation throughout the economy, culture and our personal lives has generated a large literature on the risks of algorithmic decision-making, particularly in high-stakes legal settings. Algorithmic tools are charged with bias, shrouded in secrecy, and frequently difficult to interpret. However, these criticisms have tended to focus on particular implementations, specific predictive techniques, and the idiosyncrasies of the American legal-regulatory regime. They do not address the more fundamental unease about the prospect that we might (...) one day replace judges with algorithms, no matter how fair, transparent, and intelligible they become. The aim of this paper is to propose an account of the source of that unease, and to evaluate its plausibility. I trace foundational unease with algorithmic decision-making in the law to the powerful intuition that there is a basic moral and legal difference between showing that something is true of many people just like you and showing that it is true of you. Human judgment attends to the exception; automation insists on blindly applying the rule. I show how this intuitive thought is connected to both epistemological arguments about the value of statistical evidence, as well as to court-centered conceptions of the rule of law. Unease with algorithmic decision-making in the law thus draws on an intuitive principle that underpins a disparate range of views in legal philosophy. This suggests the principle is deeply ingrained. Nonetheless, I argue that the powerful intuition is not as decisive as it may seem, and indeed runs into significant epistemological and normative challenges. At an epistemological level, I show how concerns about statistical evidence's ability to track the truth can be resolved by adopting a probabilistic, rather than modal, conception of truth-tracking. At a normative level, commitment to highly individualized decision-making co-exists with equally ingrained and competing principles, such as consistent application of law. This suggests that the “rule of law” may not identify a discrete set of institutional arrangements, as proponents of a court-centric conception would have it, but rather a more loosely defined set of values that could potentially be operationalized in multiple ways, including through some level of algorithmic adjudication. Although the prospect of replacing judges with algorithms is indeed unsettling, it does not necessarily entail unreasonable verdicts or an attack on the rule of law. (shrink)

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

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

Expected value maximization gives plausible guidance for moral decision‐making under uncertainty in many situations. But it has unappetizing implications in ‘Pascalian’ situations involving tiny probabilities of extreme outcomes. This paper shows, first, that under realistic levels of ‘background uncertainty’ about sources of value independent of one's present choice, a widely accepted and apparently innocuous principle—stochastic dominance—requires that prospects be ranked by the expected value of their consequences in most ordinary choice situations. But second, this implication does not hold when (...) differences in expected value are driven by tiny probabilities of extreme outcomes. Stochastic dominance therefore lets us draw a surprisingly principled line between ‘ordinary’ and ‘Pascalian’ situations, providing a powerful justification for de facto expected value maximization in the former context while permitting deviations in the latter. Drawing this distinction is incompatible with an in‐principle commitment to maximizing expected value, but does not require too much departure from decision‐theoretic orthodoxy: it is compatible, for instance, with the view that moral agents must maximize the expectation of a utility function that is an increasing function of moral value. (shrink)

Modern scholarship on decision behavior dates from the late 1940s. But that scholarship has been preoccupied with two ideas that are much older. One is the notion of expected utility, first articulated in the scholarly literature by Daniel Bernoulli in 1738. In its simplest form, the expected utility concept applies to monetary gambles. Imagine you are asked to choose between two gifts, either gamble G, which you would then play and get either $9 or nothing, or else (...) a simple, direct payment of $3. As shown in the decision tree in figure 10.1, you receive gamble G's $9 payoff if the toss of a fair die yields one or two pips, but you receive nothing otherwise. (In decision trees, choice points are represented by square nodes, chance points by circular nodes.) The expected value or expectation of a gamble is the sum of its payoffs, each weighted (i.e., multiplied) by its probability. Thus, the expected value of G is EV(G) = (1/3)($9) + (2/3)($0) = $3, the same as the direct payment. So, if you generally make decisions like this one so as to maximize expected value, you would be indifferent between the present options. However, if you are like most people, you are not indifferent. Instead, you are risk‐averse, preferring the guaranteed $3. Why? (shrink)

Decisions about continuing or terminating a pregnancy touch on profound, individualized questions about bodily integrity, reproductive autonomy, deeply held values regarding one's capacity for parenthood, and, in the case of a high-risk pregnancy, the risks one is willing to take to have a baby. So far as possible, reproductive decisions are made between a patient, in some cases her partner, and her medical provider. However, this standard framework cannot be applied if the patient lacks decision-making capacity. In this (...) essay, we discuss one such case that came before our clinical ethics team. We describe the challenges of respecting a patient's reproductive preferences when the patient cannot share what those preferences are, and we argue that decisions regarding reproductive health care should not be treated with exceptionalism. Rather, they should proceed under the normal processes of surrogate decision-making, including the application of substituted judgment. This approach enables us to take the patient's values into account when considering the questions implicated in reproductive health care, just as we do for other kinds of health care decisions in which a patient's deeply held values are salient. (shrink)

Insurers draw on sophisticated models for the probability distributions over losses associated with catastrophic events that are required to price insurance policies. But prevailing pricing methods don’t factor in the ambiguity around model-based projections that derive from the relative paucity of data about extreme events. I argue however that most current theories of decision making under ambiguity only partially support a solution to the challenge that insurance decision makers face and propose an alternative approach that allows (...) for decision making that is responsive to both the evidential situation of the insurance decision maker and their attitude to ambiguity. (shrink)

Self-driving vehicles will need to make decisions that carry ethical dimensions and manufacturers have (the responsibility) to pre-determine this underlying, deliberate decision-making process. With the rise of self-driving vehicles, scholars have simultaneously started investigating what ethical theories should guide machine behavior, but have not concluded as to which theory should be preferred and adopted. We aim to address this matter by providing a holistic and analytical review of the autonomous driving ethics literature. Based on this review, (...) we summarize the social, moral/legal, and functional advantages and disadvantages of applying particular (traditional) ethical theories to the decision-making of self-driving vehicles. Furthermore, we derive an integrated model that shows how each identified ethical theory could be technically implemented and guide the decision-making of self-driving vehicles. Overall, this article aims to set the groundwork for reflected, successful integration of ethical behavior within self-driving vehicles and deduce an updated research agenda. (shrink)

Over the past two decades, gamblers have begun taking mathematics into account more seriously than ever before. While probability theory is the only rigorous theory modeling the uncertainty, even though in idealized conditions, numerical probabilities are viewed not only as mere mathematical information, but also as a decision-making criterion, especially in gambling. This book presents the mathematics underlying the major games of chance and provides a precise account of the odds associated with all gaming events. It begins (...) by explaining in simple terms the meaning of the concept of probability for the layman and goes on to become an enlightening journey through the mathematics of chance, randomness and risk. It then continues with the basics of discrete probability, combinatorics and counting arguments for those interested in the supporting mathematics. These mathematic sections may be skipped by readers who do not have a minimal background in mathematics; these readers can skip directly to the Guide to Numerical Results to pick the odds and recommendations they need for the desired gaming situation. Doing so is possible due to the organization of that chapter, in which the results are listed at the end of each section, mostly in the form of tables. The chapter titled The Mathematics of Games of Chance presents these games not only as a good application field for probability theory, but also in terms of human actions where probability-based strategies can be tried to achieve favorable results. Through suggestive examples, the reader can see what are the experiments, events and probability fields in games of chance and how probability calculus works there. The main portion of this work is a collection of probability results for each type of game. Each game s section is packed with formulas and tables. Each section also contains a description of the game, a classification of the gaming events and the applicable probability calculations. The primary goal of this work is to allow the reader to quickly find the odds for a specific gaming situation, in order to improve his or her betting/gaming decisions. Every type of gaming event is tabulated in a logical, consistent and comprehensive manner. The complete methodology and complete or partial calculations are shown to teach players how to calculate probability for any situation, for every stage of the game for any game. Here, readers can find the real odds, returned by precise mathematical formulas and not by partial simulations that most software uses. Collections of odds are presented, as well as strategic recommendations based on those odds, where necessary, for each type of gaming situation. The book contains much new and original material that has not been published previously and provides great coverage of probabilities for the following games of chance: Dice, Slots, Roulette, Baccarat, Blackjack, Texas Hold em Poker, Lottery and Sport Bets. Most of games of chance are predisposed to probability-based decisions. This is why the approach is not an exclusively statistical one, but analytical: every gaming event is taken as an individual applied probability problem to solve. A special chapter defines the probability-based strategy and mathematically shows why such strategy is theoretically optimal.". (shrink)

In decision making under risk manifold individual differences are involved. To investigate their effect – specifically the effects of executive functions, memory, impulsivity, and consideration for future consequences − 130 healthy older adults were assessed through cognitive tests, self-report tools, and decisional tasks (the Game of Dice Task and the Balloon Analogue Risk-Taking Task). From a Latent Profile Analysis, three profiles characterised by differences in decisional performances emerged. “Impulsive and present-focused” individuals, notable for high levels of impulsivity (...) and consideration for immediate consequences, and “Cautious” individuals, characterised by having impulsivity scores below average, presented decisional performances characterised by lower incomes and a higher number of risky choices compared to “Impulsive and cognitively functional” individuals, signified by the highest levels of impulsivity and cognitive functioning. Findings outlined how different configurations of individual differences can affect older adults’ decisions and implications can follow for deepening the decisional mechanisms in older adults. (shrink)

In his classic book “the Foundations of Statistics” Savage developed a formal system of rational decision making. The system is based on (i) a set of possible states of the world, (ii) a set of consequences, (iii) a set of acts, which are functions from states to consequences, and (iv) a preference relation over the acts, which represents the preferences of an idealized rational agent. The goal and the culmination of the enterprise is a representation theorem: Any preference relation (...) that satisfies certain arguably acceptable postulates determines a (finitely additive) probability distribution over the states and a utility assignment to the consequences, such that the preferences among acts are determined by their expected utilities. Additional problematic assumptions are however required in Savage's proofs. First, there is a Boolean algebra of events (sets of states) which determines the richness of the set of acts. The probabilities are assigned to members of this algebra. Savage's proof requires that this be a σ-algebra (i.e., closed under infinite countable unions and intersections), which makes for an extremely rich preference relation. On Savage's view we should not require subjective probabilities to be σ-additive. He therefore finds the insistence on a σ-algebra peculiar and is unhappy with it. But he sees no way of avoiding it. Second, the assignment of utilities requires the constant act assumption: for every consequence there is a constant act, which produces that consequence in every state. This assumption is known to be highly counterintuitive. The present work contains two mathematical results. The first, and the more difficult one, shows that the σ-algebra assumption can be dropped. The second states that, as long as utilities are assigned to finite gambles only, the constant act assumption can be replaced by the more plausible and much weaker assumption that there are at least two non-equivalent constant acts. The second result also employs a novel way of deriving utilities in Savage-style systems -- without appealing to von Neumann-Morgenstern lotteries. The paper discusses the notion of “idealized agent" that underlies Savage's approach, and argues that the simplified system, which is adequate for all the actual purposes for which the system is designed, involves a more realistic notion of an idealized agent. (shrink)

With the rise and public accessibility of AI-enabled decision-support systems, individuals outsource increasingly more of their decisions, even those that carry ethical dimensions. Considering this trend, scholars have highlighted that uncritical deference to these systems would be problematic and consequently called for investigations of the impact of pertinent technology on humans’ ethical decision-making. To this end, this article conducts a systematic review of existing scholarship and derives an integrated framework that demonstrates how intelligent decision-support systems (...) (IDSSs) shape humans’ ethical decision-making. In particular, we identify resulting consequences on an individual level (i.e., deliberation enhancement, motivation enhancement, autonomy enhancement and action enhancement) and on a societal level (i.e., moral deskilling, restricted moral progress and moral responsibility gaps). We carve out two distinct methods/operation types (i.e., processoriented and outcome-oriented navigation) that decision-support systems can deploy and postulate that these determine to what extent the previously stated consequences materialize. Overall, this study holds important theoretical and practical implications by establishing clarity in the conceptions, underlying mechanisms and (directions of) influences that can be expected when using particular IDSSs for ethical decisions. (shrink)

In his paper, ‘Patients, doctors and risk attitudes’, Makins argues that doctors, when choosing a treatment for their patient, need to follow their risk profile.1 He presents a pair of fictitious diseases facing a patient who either has ‘exemplitis’, which requires no treatment or ‘caseopathy’, which is severe and disabling and for which there is a treatment with unpleasant side effects. The doctor needs to decide whether the patient should pursue the unpleasant treatment, just in case he (...) has caseopathy. Makins believes that rational-choice theory is a productive way to approach this problem. This theory frames all decisions as gambles. Each possible gamble (eg, not to pursue treatment) leads, probabilistically, to a set of outcomes (life with no disease and no side effects, but also, possibly, life with a disabling disease, since no treatment is taken). Utilities of these outcomes and probabilities that they will happen are combined to yield a number—expected utility. One is supposed to gamble—to make a choice—in a way that maximises this expected utility. Makins takes this framework for granted and is focused on an additional complication, the patient’s risk preference. He believes that, in his hypothetical example, even if expected utility were exactly the same, withholding treatment …. (shrink)

This paper investigates the behavior of contestants in the game show “Quiz Taxi” when faced with the decision whether to bet the winnings they have acquired on a final “double or nothing” question. The decision in this natural experiment is made by groups of two or three persons. This setup enables the decision-making process to be studied with regard to group and communication characteristics. The contestants show fairly risk averse behavior. There is also a (...) significant heterogeneity in attitude to risk. In particular, all-female groups are much less likely to go for the risky option. Furthermore, decision-making behavior appears to vary across differently composed groups and prior performance. The study also documents the importance of discussions: The propensity to gamble increases with discussion length, and the correlation between communication content and the final choice is strong, indicating that time and subjective context are important features of decisions made under risk. (shrink)

This paper critically explores the ethical dimensions of Behavioral Public Policy (BPP), a domain grounded in the understanding that human rationality is bounded and that this limitation often leads to behaviors deemed irrational. By applying the behavioral lens, which posits that people operate under bounded rationality, BPP aims to craft interventions that safeguard individuals against their biases. However, this approach raises significant ethical concerns, both in the scientific underpinnings of BPP and its application through policy interventions. Accordingly, this paper (...) examines two distinct ethical dimensions of BPP, both as a scientific discipline and through its intervention methodologies. The analysis of the first dimension argues that, viewing bounded rationality as only instrumental in decision-making processes, risks oversimplifying ethical complexities. Such simplification may ignore the moral and value-based rationalities underlying decisions, potentially misattributing instances of immorality and akrasia (the failure to act according to one's judgment) to mere deficiencies in rational thinking. Secondly, the paper examines the impact of BPP on moral behavior and character development, addressing ethical concerns like the evidentiary basis of BPP research, the bounded rationality of choice architects themselves, and the morality of behavior changes induced by policy. Overall, this article provides a much-needed examination of the moral considerations associated with behavioral strategies in public policy and its epistemological foundations, contributing to a more comprehensive understanding of their ethical implications . (shrink)

It is important to have an adequate model of uncertainty, since decisions must be made before the uncertainty can be resolved. For instance, flood defenses must be designed before we know the future distribution of flood events. It is standardly assumed that probability theory offers the best model of uncertain information. I think there are reasons to be sceptical of this claim. I criticise some arguments for the claim that probability theory is the only adequate model of uncertainty. In particular (...) I critique Dutch book arguments, representation theorems, and accuracy based arguments. Then I put forward my preferred model: imprecise probabilities. These are sets of probability measures. I offer several motivations for this model of uncertain belief, and suggest a number of interpretations of the framework. I also defend the model against some criticisms, including the so-called problem of dilation. I apply this framework to decision problems in the abstract. I discuss some decision rules from the literature including Levi’s E-admissibility and the more permissive rule favoured by Walley, among others. I then point towards some applications to climate decisions. My conclusions are largely negative: decision making under such severe uncertainty is inevitably difficult. I finish with a case study of scientific uncertainty. Climate modellers attempt to offer probabilistic forecasts of future climate change. There is reason to be sceptical that the model probabilities offered really do reflect the chances of future climate change, at least at regional scales and long lead times. Indeed, scientific uncertainty is multi-dimensional, and difficult to quantify. I argue that probability theory is not an adequate representation of the kinds of severe uncertainty that arise in some areas in science. I claim that this requires that we look for a better framework for modelling uncertainty. (shrink)

Multi-level institutional designs with distributed power and authority arrangements among federal, state, regional, and local government agencies could lead to the emergence of differential patterns of socioeconomic and infrastructure development pathways in complex social–ecological systems. Both exogenous drivers and endogenous processes in social–ecological systems can lead to changes in the number of “basins of attraction,” changes in the positions of the basins within the state space, and changes in the positions of the thresholds between basins. In an effort to (...) advance the theory and practice of the governance of policy systems, this study addresses a narrower empirical question: how do intergovernmental institutional rules set by federal, state, and regional government agencies generate and sustain basins of attraction in funding infrastructure projects? A pattern-oriented, agent-based model (ABM) of an intergovernmental network has been developed to simulate real-world transportation policy implementation processes across the federal, the state of Vermont, regional, and local governments for prioritizing transportation projects. The ABM simulates baseline and alternative intergovernmental institutional rule structures and assesses their impacts on financial investment flows. The ABM was calibrated with data from multiple focus groups, individual interviews, and analysis of federal, state, and regional scale transportation projects and programs. The results from experimental simulations are presented to test system-wide effects of alternative multi-level institutional designs, in particular different power and authority arrangements between state and regional governments, on the emergence of roadway project prioritization patterns and funding allocations across regions and towns. (shrink)

The commodity market plays a vital role in boosting the economy. Investors make decisions based on market knowledge and ignore cognitive biases. These cognitive biases or judgment errors have a significant effect on investment decisions. Therefore, this study aimed to investigate the effect of emotional intelligence on decision-making. In addition, optimism bias and risk perception are the intervening variables between emotional intelligence and decision-making. So, this study contributes to the body of knowledge by examining the mediating role (...) of optimism bias and risk perception. The data were collected from the respondents of the commodity market and the 370 questionnaires were distributed among the investors, of which 337 respondents gave their feedback. The convenience base sampling technique is used due to the easy access of respondents, time factor, and cost factor. Data entered into the SPSS Statistics Version 26 and PROCESS macro model 6 were used for serial mediation. AMOS was used for the validity and model-fit analysis. The results of this study aligned with the literature that there is a significant effect of emotional intelligence on decision-making. It also observed that optimism bias has a positive effect on decision-making. The finding of this study will be helpful for the brokers, the government, and especially the investors. This study also proposed that future studies on the stock exchange and real estate market comparative analysis can be conducted. (shrink)

People often face preferential decisions under risk. To further our understanding of the cognitive processes underlying these preferential choices, two prominent cognitive models, decision field theory (DFT; Busemeyer & Townsend, 1993) and the proportional difference model (PD; González‐Vallejo, 2002), were rigorously tested against each other. In two consecutive experiments, the participants repeatedly had to choose between monetary gambles. The first experiment provided the reference to estimate the models’ free parameters. From these estimations, new gamble pairs were (...) generated for the second experiment such that the two models made maximally divergent predictions. In the first experiment, both models explained the data equally well. However, in the second generalization experiment, the participants’ choices were much closer to the predictions of DFT. The results indicate that the stochastic process assumed by DFT, in which evidence in favor of or against each option accumulates over time, described people’s choice behavior better than the trade‐offs between proportional differences assumed by PD. (shrink)

The paper applies to approval voting, under which the voter casts a ballot by casting one vote for each of k candidates, wherek=;1,2, ? , m-1 and there are m candidates. I assume (following Brams and Fishburn) that each of the voter's 2=;-2 strategies is equally likely to be chosen. Election-outcome types include: the m-way tie;(m-1) -way ties with the runner-up trailing by 1,2,?,m votes; (m-2)-way ties, and so on. The frequency distribution of outcome types varies only with (...) m and n and is necessary to the calculation of the expected utilities of successive ballots cast, in the same election, by a voter under a variant of approval voting. This variant allows the voter to cast several complete ballots provided that he pays the respective prices, which could reasonably be based on the expected utilities. The paper describes a shortcut method of calculating the distribution of outcome types when m=;4 andn rises to levels that make straightforward calculation computationally infeasible. The shortcut involves the combining of an outcome type, instead of each member of that type, with each of the 14 strategies available to the incremental voter. In going fromn-1 to n, for n=3, the number of outcome types increases by a factor of (n+3)/n whereas, the number of combinations of strategies increases by a factor of 14. (shrink)

Personal values have long been associated with individual decision behavior. The role played by personal values in decision making within an organization is less clear. Past research has found that managers tend to respond to ethical dilemmas situationally. This study examines the relationship between personal values and the ethical dimension of decision making using Partial Least Squares (PLS) analysis. The study examines personal values as they relate to five types of ethical dilemmas. We found a significant (...) positive contribution of altruistic values to ethical decision making and a significant negative contribution of self-enhancement values to ethical decision making. (shrink)

German legislation demands that decisions about the treatment of mentally incompetent patients require an ‘informed consent’. If this was not given by the patient him-/herself before he/she became incompetent, it has to be sought by the physician from a guardian, who has to be formally legitimized before. Additionally this surrogate has to seek the permission of a Court of Guardianship (Vormundschaftsgericht), if he/she intends to consent to interventions, which pose significant risks to the health or the life of the person (...) under his/her care. This includes ‘end-of-life decisions’. Deviations from this procedure are only allowed in acute emergencies or cases of ‘medical futility’. On the basis of epidemiological and demographical data it can be shown that the vast majority of surrogate decisions on incompetent patients in Germany is not covered by legally valid consent. Moreover, the data suggests that if consent were to be requested according to the legal regulations, both the legal and medical system could realistically never cope with the practical consequences of this. Additionally, empiric research has revealed serious deficits concerning medical ‘end of life-decisions’ and practical performance in palliative care. As a consequence a multidisciplinary discussion has developed in Germany about the reform of present legislation with respect to key-issues like• the assessment of mental competence• the options for exercising patient self-determination via advance directives and durable powers of attorney• the improvement of palliative care facilities,• the clarification of formal procedures for surrogate decision-making in health care and towards the end of life• and the possibilities and their limitations of controlling these decision-making processes ‘externally’ (e.g., by Guardianship Courts or committees).The authors discuss those proposals, which clearly dominate the present debate: They all aim to comply with the scientific basis of German law, jurisdiction and the European traditions of philosophy of health care and bioethics. (shrink)

In this paper we investigated how justifications for price increases are associated with risky decision making and emotional responses. Across two studies with paired lottery choices and sequential decisions, we found that participants presented with a justification for price increases based on increasing demand decided to invest in a comparatively riskier asset more often than participants presented with a justification for price increases based on increasing tax or those presented with no justification at all. (...) We also found that participants presented with justifications for price increases based on increasing demand also reported more arousal displayed higher galvanic skin response than people in the other two justification conditions. Together, these studies provide evidence that the sole increasing demand underlying a price increase of a risky asset can influence the decision to buy it and suggests that emotional activation is involved in such a decision process. (shrink)

In 2004 prenatal risk assessment was implemented as a routine offer to all pregnant women in Denmark. It was argued that primarily the new programme would give all pregnant women an informed choice about whether to undergo prenatal testing. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, we call into question the assumption underlying the new guidelines that more choice and more objective information is a (...) source of empowerment and control. We focus on one couple's experience of PRA. This case makes it evident how supposed choices in the context of PRA may not be experienced as such. Rather, they are experienced as complicated processes of meaning-making in the relational space between the clinical setting, professional authority and the social life of the couples. PRA users are reluctant to make choices and abandon health professionals as authoritative experts in the face of complex risk knowledge. When assumptions about autonomy and self-determination are inscribed into the social practice of PRA, authority is transferred to the couple undergoing PRA and a new configuration of responsibility evolves between the couple and their relationship to the foetus. It is argued that al-though the new programme of prenatal testing in Denmark presents itself in opposition to quasi-eugenic and paternalistic forms of governing couples' decisions it represents another form of government that works through the notion of choice. An ethics of a shared responsibility of PRA and its outcome would be more in agreement with how decisions are actually made. (shrink)

Current environmental problems and technological risks are a challenge for a new institutional arrangement of the value spheres of Science, Politics and Morality. Distinguished authors from different European countries and America provide a cross-disciplinary perspective on the problems of political decision making under the conditions of scientific uncertainty. cases from biotechnology and the environmental sciences are discussed. The papers collected for this volume address the following themes: (i) controversies about risks and political decision making; (ii) concepts of science (...) for policy; (iii) the use of social science in the policy making process; (iv) ethical problems with developments in science and technology; (v) public and state interests in the development and control of technology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:IRBs Under the MicroscopeJonathan D. Moreno (bio)The spring and summer of 1998 were seasons in the sun for institutional review board (IRB) aficionados. Rarely have the arcana of the local human subjects review panels been treated to so much attention in both the executive and the legislative branches of government, not only at the federal but also at the state level. And it looks as if the attention will (...) continue for some time. The spate of interest is due to a series of coincidences: a powerful House of Representatives subcommittee held hearings after its chairman learned about the IRB system during a previous session on research in underdeveloped communities; the Department of Health and Human Services’s Inspector General (DHHS-IG) released a report on IRBs; the National Institutes of Health (NIH) Office of Extramural Research completed a report on clinical trial monitoring; the National Bioethics Advisory Commission (NBAC) readied a report on research involving persons with mental disorders; the states of Maryland and New York completed studies of research with subjects who lack decision-making capacity; and advocacy groups protested a psychiatric research project involving inner city children.Underlying these proximate causes for the IRB blitz is a growing realization that the already considerable clinical trial enterprise will expand significantly over the next few years. Congress is talking about giving the politically popular NIH half again the budget it currently receives, which in turn will stimulate more commercially supported research. The director of the National Cancer Institute is considering a five-fold increase in the number of subjects enrolled in oncology studies over the next several years. Phase I cancer studies are among the most ethically sensitive, so IRBs will have more work cut out for them if this goal is reached. Adding to the rush of interest in IRBs are the government’s recent apology to the survivors of the syphilis study in Tuskegee, continuing congressional dissatisfaction with the way the Pentagon handled its vaccine distribution during the Gulf War, and the controversy about AZT trials in developing countries.On the HillCongressman Christopher Shays, the moderate Connecticut Republican who has developed an interest in human research issues, convened hearings on human [End Page 329] subjects research and the IRB system on 11 June 1998. Shays chairs the House Government Reform/Human Resources Subcommittee. The committee’s ranking minority member is Edolphus Towns of Brooklyn, NY, who shares Shays’s interest in this area.The immediate rationale for the hearings was the release that day of the DHHS-IG report, Institutional Review Boards: A Time for Reform. The subtitle was changed from A System in Jeopardy apparently after some people in DHHS expressed reservations about its seemingly alarmist tone, but the IG staffers who testified before Shays’s subcommittee insisted that they stood behind the message that the IRB system is in trouble if considerable reforms are not undertaken. Among the factors in the research environment cited as support for the bleak forecast: managed care, commercialization, multi-site trials, high IRB workloads, minimal IRB oversight of approved studies, conflicts of interest, insufficient training of IRB members and investigators, and lack of IRB self-studies (DHHS-IG 1998).As is normally the case for congressional oversight hearings, the first panel of witnesses consisted of executive branch officials, including Eric Meslin, Executive Director of the National Bioethics Advisory Commission, and Gary Ellis, Director of the Office for Protection from Research Risks (OPRR). Shays pressed Ellis on the extent to which OPRR conducts on-site investigations of complaints about abuse of human subjects. Admitting that on-site investigations are rare, Ellis suggested that the agency is inadequately staffed to follow up on complaints as quickly as it might wish. The members of Congress who were present at the hearings generally expressed concern about the DHHS-IG’s findings.The second panel that day, which Shays was unable to attend, set a different tone. Four of the panelists—Paul Appelbaum of the University of Massachusetts at Worcester, Robert Levine of Yale University, Angela Bowen of the Western IRB (a private clinical trials review firm), and I—were invited as authorities on the current condition of the IRB system. Bert Spilker... (shrink)

The COVID-19 pandemic is putting the NHS under unprecedented pressure, requiring clinicians to make uncomfortable decisions they would not ordinarily face. These decisions revolve primarily around intensive care and whether a patient should undergo invasive ventilation. Certain vulnerable populations have featured in the media as falling victim to an increasingly utilitarian response to the pandemic—primarily those of advanced years or with serious existing health conditions. Another vulnerable population potentially at risk is those who lack the capacity to make (...) their own care decisions. Owing to the pandemic, there are increased practical and normative challenges to following the requirements of the Mental Capacity Act 2005. Both capacity assessments and best interests decisions may prove more difficult in the current situation. This may create a more paternalistic situation in decisions about the care of the cognitively impaired which is at risk of taking on a utilitarian focus. We look to these issues and consider whether there is a risk of patients who lack capacity to make their own care decisions being short-changed. (shrink)

Supported decision-making has been promoted at a policy level and within international human rights treaties as a way of ensuring that people with disabilities enjoy the right to legal capacity on an equal basis with others. However, little is known about the practical issues associated with implementing supported decision-making, particularly in the context of dementia. This study aimed to understand the experiences of people with dementia and their family members with respect to (...) decision-making and their views on supported decision-making. Thirty-six interviews were undertaken with fifty-seven participants across three states in Australia. Interpretative Phenomenological Analysis was used as the methodological approach, with relational autonomy as a theoretical perspective. We identified two overarching themes relating to participants’ experiences with decision-making: “the person in relationship over time” and “maintaining involvement.” Participant views on the practical issues associated with supported decision-making are addressed under the themes of “facilitating decision-making,” “supported decision-making arrangements,” “constraints on decision-making,” and “safeguarding decision-making.” While participants endorsed the principles of supported decision-making as part of their overarching strategy of “maintaining involvement” in decision-making, they recognized that progressive cognitive impairment meant that there was an inevitable transition toward greater involvement of, and reliance upon, others in decision-making. Social and contextual “constraints on decision-making” also impacted on the ability of people with dementia to maintain involvement. These themes inform our proposal for a “spectrum approach” to decision-making involvement among people living with dementia, along with recommendations for policy and practice to assist in the implementation of supported decision-making within this population. (shrink)