This book is an accessible, research-based introduction to behavioral ethics. Often ethics education is incomplete because it ignores how and why people make moral decisions. But using exciting new research from fields such as behavioral psychology, cognitive science, and evolutionary biology, the study of behavioral ethics uncovers the common reasons why good people often screw up. Chapters coordinate with free online teaching resources from The University of Texas at Austin. Scientists have long studied the ways human beings make (...) decisions, but only recently have researchers begun to focus specifically on ethical decision making. Unlike philosophy and religion, which aim to tell people how to think and act about various moral issues, behavioral ethics research reveals the factors that influence how people really make moral decisions. Most people get into ethical trouble for doing obviously wrong things. Aristotle cannot help, but learning about behavioral ethics can. By supplementing traditional approaches to teaching ethics with a clear, accessible, detailed, and research-based introduction to behavioral ethics, beginners can quickly become familiar with the important elements of this new field. This book includes the bonus of being coordinated with Ethics Unwrapped-a free, online, educational resource featuring award-winning videos and teaching materials on a variety of behavioral ethics (and general ethics) topics. This book is a useful supplement for virtually every ethics course, and important in any course where incorporating practical ethics in an engaging manner is paramount. The content applies to every discipline-journalism, business ethics, medicine, legal ethics, and others-because its chief subject is the nature of moral decision making. Because the book is research-based yet accessibly written with interesting studies, it could be used in high schools, colleges, graduate schools, and industry. (shrink)

First responders to chemical, biological, radiological, or nuclear (CBRN) events face decisions having significant human consequences. Some operational decisions are supported by standard operating procedures, yet these may not suffice for ethical decisions. Responders will be forced to weigh their options, factoring-in contextual peculiarities; they will require guidance on how they can approach novel (indeed unique) ethical problems: they need strategies for “on the spot” ethical decision making. The primary aim of this paper is to examine (...) how first responders should approach on the spot ethical decision-making amid the stress and uncertainty of a CBRN event. Drawing on the long-term professional CBRN experience of one of the authors, this paper sets out a series of practical ethical dilemmas potentially arising in the context of a large-scale chemical incident. We propose a broadly consequentialist approach to on the spot ethical decision-making, but one which incorporates ethical values and rights as “side-constraints”. (shrink)

A link between biological and human sciences may be established, under the condition that we should admit the existence of reciprocal influences between them. The model for the regulation of agonistic antagonistic couples (MRAAC) is built from the study of biological systems and gives rise to specific types of control. This model can be helpful in decision processes in some human sciences such as management, economical and political strategies. The reason for such an opportunity lies in the fact that MRAAC (...) is a general and phenomenological model able to incorporate the whole of the agonistic antagonistic systems. This type of regulation might be related to the concept of the viability of a system (yet also valid for human science systems) and to a functional and structural pattern which is the basis for agonistic antagonistic networks. (shrink)

Some experts and advocates propose environmental biotechnologies such as genetic engineering, gene drive systems, and synthetic biology as potential solutions to accelerating rates of species loss. While these tools may offer hope for a seemingly intractable problem, they also present potential governance challenges for which innovative decision‐making systems are required. Two of the perennial governance challenges include, when are broader stakeholder groups involved in these decisions and who exactly should be involved? We propose the decision phases framework—which (...) includes research and development, regulatory review, and deployment, management, and monitoring—as a framework for identifying which stakeholders might be best suited for different phases throughout the innovation and deployment of emerging environmental biotechnologies for species protection. (shrink)

This paper is interested in the relationship between evolutionary thinking and moral behavior and commitments, ethics. There is a traditional way of forging or conceiving of the relationship. This is traditional evolutionary ethics, known as Social Darwinism. Many think that this position is morally pernicious, a redescription of the worst aspects of modern, laissez-faire capitalism in fancy biological language. It is argued that, in fact, there is much more to be said for Social Darwinism than many think. In respects, it (...) could be and was an enlightened position to take; but it flounders on the matter of justification. Universally, the appeal is to progress—evolution is progressive and, hence, morally we should aid its success. I argue, however, that this progressive nature of evolution is far from obvious and, hence, traditional social Darwinism fails. There is another way to do things. This is to argue that the search for justification is mistaken. Ethics just is. It is an adaptation for humans living socially and has exactly the same status as other adaptations, like hands and teeth and genitalia. As such, ethics is something with no standing beyond what it is. However, if we all thought that this was so, we would stop being moral. So part of the experience of ethics is that it is more than it is. We think that it has an objective referent. In short, ethics is an illusion put in place by our genes to make us good social cooperators. (shrink)

This paper is interested in the relationship between evolutionary thinking and moral behavior and commitments, ethics. There is a traditional way of forging or conceiving of the relationship. This is traditional evolutionary ethics, known as Social Darwinism. Many think that this position is morally pernicious, a redescription of the worst aspects of modern, laissez-faire capitalism in fancy biological language. It is argued that, in fact, there is much more to be said for Social Darwinism than many think. In respects, it (...) could be and was an enlightened position to take; but it flounders on the matter of justification. Universally, the appeal is to progress—evolution is progressive and, hence, morally we should aid its success. I argue, however, that this progressive nature of evolution is far from obvious and, hence, traditional social Darwinism fails. There is another way to do things. This is to argue that the search for justification is mistaken. Ethics just is. It is an adaptation for humans living socially and has exactly the same status as other adaptations, like hands and teeth and genitalia. As such, ethics is something with no standing beyond what it is. However, if we all thought that this was so, we would stop being moral. So part of the experience of ethics is that it is more than it is. We think that it has an objective referent. In short, ethics is an illusion put in place by our genes to make us good social cooperators. (shrink)

Approximately one in 10 children in foster care are medically complex and require intensive medical supervision, frequent hospitalization, and difficult medical decision making. Some of these children are in foster care because their parents cannot care for their medical needs; other parents are responsible for their child’s medical needs due to abuse or neglect. In either case, there can be uncertainty about the role that a child’s biological parents should play in making serious medical decisions. Here we (...) highlight some of the ethical challenges inherent in making these decisions for children in foster care, as seen through the lenses of a child welfare provider, an inpatient care physician, and a primary care pediatrician. (shrink)

Several attempts have been made previously to provide a biological grounding for cognitive architectures by relating their components to the computations of specific brain circuits. Often, the architecture's action selection system is identified with the basal ganglia. However, this identification overlooks one of the most important features of the basal ganglia—the existence of a direct and an indirect pathway that compete against each other. This characteristic has important consequences in decision-making tasks, which are brought to light by Parkinson's disease (...) as well as genetic differences in dopamine receptors. This paper shows that a standard model of action selection in a cognitive architecture cannot replicate any of these findings, details an alternative solution that reconciles action selection in the architecture with the physiology of the basal ganglia, and extends the domain of application of cognitive architectures. The implication of this solution for other architectures and existing models are discussed. (shrink)

This paper describes a cross-cultural research project on the relation between how people conceptualize nature and how they act in it. Mental models of nature differ dramatically among and within populations living in the same area and engaged in more or less the same activities. This has novel implications for environmental decision making and management, including dealing with commons problems. Our research also offers a distinct perspective on models of culture, and a unified approach to the study of culture (...) and cognition. We argue that cultural transmission and formation does not consist primarily in shared rules or norms, but in complex distributions of causally-connected representations across minds in interaction with the environment. The cultural stability and diversity of these representations often derives from rich, biologically-prepared mental mechanisms that limit variation to readily transmissible psychological forms. This framework addresses a series of methodological issues, such as the limitations of conceiving culture to be a well-defined system or bounded entity, an independent variable, or an internalized component of minds. (shrink)

Ethical decision making is of concern to researchers across all fields. However, researchers typically focus on the biases that may act to undermine ethical decision making. Taking a new approach, this study focused on identifying the most common compensatory strategies that counteract those biases. These strategies were identified using a series of interviews with university researchers in a variety of areas, including biological, physical, social, and health as well as scholarship and the performing arts. Interview transcripts were assessed (...) with two scoring procedures, an expert rating system and computer-assisted qualitative analysis. Although the expert rating system identified Understanding Guidelines, Recognition of Insufficient Information, and Recognizing Boundaries as the most frequently used compensatory strategies across fields, other strategies, Striving for Transparency, Value/norm Assessment, and Following Appropriate Role Models, were identified as most common by the computer-assisted qualitative analyses. Potential reasons for these findings and implications for training and practice are identified and discussed. (shrink)

We critically review themushrooming literature addressing the neuralmechanisms of moral cognition (NMMC), reachingthe following broad conclusions: (1) researchmainly focuses on three inter-relatedcategories: the moral emotions, moral socialcognition, and abstract moral reasoning. (2)Research varies in terms of whether it deploysecologically valid or experimentallysimplified conceptions of moral cognition. Themore ecologically valid the experimentalregime, the broader the brain areas involved.(3) Much of the research depends on simplifyingassumptions about the domain of moral reasoningthat are motivated by the need to makeexperimental progress. This is a (...) valuablebeginning, but as more is understood about theneural mechanisms of decision-making, morerealistic conceptions will need to replace thesimplified conceptions. (4) The neuralcorrelates of real-life moral cognition areunlikely to consist in anything remotely like a``moral module'' or a ``morality center.'' Moralrepresentations, deliberations and decisionsare probably highly distributed and notconfined to any particular brainsub-system. Discovering the basic neuralprinciples governing planning, judgment anddecision-making will require vastly more basicresearch in neuroscience, but correlatingactivity in certain brain regions withwell-defined psychological conditions helpsguide neural level research. Progress on socialphenomena will also require theoreticalinnovation in understanding the brain'sdistinctly biological form of computationthat is anchored by emotions, needs, drives,and the instinct for survival. (shrink)

This article presents a part of the results of an empirical study conducted at a Parisian hospital between 2011 and 2014. It aimed at understanding the women and couples’ motivations to terminate or not a pregnancy once a prenatal diagnosis has revealed a genetically related disease in the embryo or fetus. The article first presents the social and legal context of the study, the methodology used and the pathologies that were encountered. Then, it examines the results of the interviews conducted (...) with 5 women alone and 23 couples explaining their reasons for deciding to terminate or not the pregnancy. Finally, it explores the patients’ views about the doctor’s involvement in the decision-making process. The findings reveal the reasons they formulate when they ponder whether to terminate or not the pregnancy. It highlights the process of their deliberation, their hierarchisation of arguments and concerns. They also show how patients, though often consumed in sorrow, claim to be the legitimate decision-makers, especially women, in a social and legal context in which the rejection of eugenics is viewed as an undisputable principle. (shrink)

A recent interpretation of artificial intelligence (AI) (Floridi 2013, 2022) suggests that the implementation of AI demands the investigation of the binding conditions that make it possible to build and integrate artifacts into our lived world. Such artifacts can successfully interact with the world because our environment has been designed to be compatible with intelligent machines (such as robots). As the use of AI becomes ubiquitous in society, possibly leading to the formation of increasingly intelligent bio-technological unions, there will likely (...) be a coexistence of a plethora of micro-environments wrapped and tailored around humans and basic robots. The key element of this pervasive process will be the capacity to integrate biological realms in an infosphere suitable for the implementation of AI technologies. This process will require extensive datafication. This is because data is the basis of the logical-mathematical codes and models that drive and guide AI. This process will have huge consequences on workplaces, on workers, as well as on the decision-making processes required for the functioning of future societies. In this paper we will offer a comprehensive reflection on the moral and social implications of datafication as well as a set of considerations about its desirability, which will be informed by the following insights: (1) full protection of privacy may become structurally impossible, thus leading to undesirable forms of political and social control; (2) worker’s freedom may be reduced; (3) human creativity, imagination, and even divergence from AI logic might be channeled and possibly discouraged; (4) there will likely be a push towards efficiency and instrumental reason, which will become preeminent in production lines as well as in society. (shrink)

BackgroundSystems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology ; “big data” statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate (...) systems medicine knowledge and clinicians working to apply it.DiscussionThis article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through “big data” approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the “death computer,” to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their “quantified self.”SummaryThis paper examines possible ethical challenges that are likely to be raised as systems medicine to be translated into clinical medicine. These include the epistemological challenges for clinical decision-making, the use of scoring systems optimized by big data techniques and the risk that incidental and secondary findings will significantly increase. While some ethical implications remain still hypothetical we should use the opportunity to prospectively identify challenges to avoid making foreseeable mistakes when systems medicine inevitably arrives in routine care. (shrink)

An epistemological analysis of the decision, this book includes a critical analysis through the continuous reference to an interdisciplinary approach including a synthesis of philosophical approaches, biology and neuroscience.

Ethical decision making measures are widely applied as the principal dependent variable used in studies of research integrity. However, evidence bearing on the internal and external validity of these measures is not available. In this study, ethical decision making measures were administered to 102 graduate students in the biological, health, and social sciences, along with measures examining exposure to ethical breaches and the severity of punishments recommended. The ethical decision making measure was found to be related to (...) exposure to ethical events and the severity of punishments awarded. The implications of these findings for the application of ethical decision making measures are discussed. (shrink)

As an incapacitated patient is unable to make decisions regarding their care, physicians turn to next-of-kin when appointing a surrogate decision-maker in the absence of an advanced directive. With the increasing complexity of modern families, physicians are facing new ethical dilemmas when choosing the individual to make end-of-life decisions for their patients. Legal definitions and hierarchies are no longer adhering to the purpose of a surrogate-decision maker, which is to maintain a patient’s autonomy. Moral criteria for surrogates, which (...) emphasize the importance of making decisions that align with the patient’s desires and wishes and negate biological relationships over emotional connections, are becoming much more important. This paper explores a case study in which physicians must appoint a surrogate decision-maker for an incapacitated patient, forced to choose between a biological relationship and a strong emotional connection. (shrink)

There is considerable correspondence between theories and models used in biology and the social sciences. One type of model that is in use in both biology and the social sciences is the fitness landscape model. The properties of the fitness landscape model have been applied rather freely in the social domain. This is partly due to the versatility of the model, but it is also due to the difficulties of transferring a model to another domain. We will demonstrate (...) that in order to transfer the biological fitness landscape model to the social science it needs to be substantially modified. We argue that the syntactic structure of the model can remain unaltered, whilst the semantic dimension requires considerable modification in order to fit the specific phenomena in the social sciences. We will first discuss the origin as well as the basic properties of the model. Subsequently, we will demonstrate the considerations and modifications pertaining to such a transfer by showing how and why we altered the model to analyse collective decision-making processes. We will demonstrate that the properties of the target domain allow for a transfer of the syntactic structure but don’t tolerate the semantic transfer. (shrink)

Religious considerations in medical decision-making have enjoyed newfound attention in recent years, challenging the assumption that the domains of biological and spiritual flourishing can be cleanly separated in clinical practice. A surprising majority of patients desire their physicians to engage their religious and spiritual concerns, yet most never receive such attention, particularly in cases near the end of life where such attention seems most warranted.1–3 As physicians Aparna Sajja and Christina Puchalski recently wrote in the AMA Journal of Ethics (...) theme issue on ‘Religion and Spirituality in Healthcare Practice’, modern medical training is ‘falling short of preparing physicians to help patients with the metaphysical needs of their illness’.4 It would seem then that both patients and physicians might challenge the conclusions proffered by philosophers Jake Greenblum and Ryan Hubbard in ‘Responding to Religious Patients: Why Physicians Have No Business Doing Theology’, in which they claim that physicians ought not to engage religious reasoning for medical decisions. Their conclusion relies on two core arguments: a ‘public reason’ argument and a ‘fiduciary argument’, both of which contend that theology and religious considerations have no place in medical reasoning. We find that two central errors undergird these arguments. First is the fraught notion of an epistemically and ethically normative public reason, and second is a fundamental mischaracterisation of the fiduciary nature of the patient–physician relationship and the nature of medicine itself. In response, we argue that all physicians essentially ‘do theology’ and that, rather than divorcing theology from medical practice, clinicians should make it their business to do theology well. To support the exclusion of religious reasoning from medical decision-making, the authors open with a ‘public reason argument’, suggesting that physicians serve in roles closely resembling those of public officials. As such, the physician as public official ought to limit himself …. (shrink)

The case states that a male same-sex couple entered into a surrogacy arrangement with an unrelated surrogate using donor sperm and the surrogate’s eggs. M is the legal mother pursuant to s33 of the Human Fertilisation and Embryology Act 2008. Though the facts tell us that there was no legally binding arrangement, this is in fact the position of the law: under s1A Surrogacy Arrangements Act, no surrogacy arrangements can ever be binding on the parties. It is not clear whether (...) the donor sperm is from one of the same-sex couple or not. If it was donor sperm and not from either intended father, this is not an arrangement that would be recognised in law, as one of the men must be genetically related to the child in order for them to obtain legal parenthood via a parental order, under s54 HFEA 2008. They could apply to adopt the child, although they may fall foul of adoption legislation1 if any money has moved between them and M and they do not fall within an exemption.2 In any event, an adoption cannot be achieved in time for them to obtain legal parenthood in a crisis situation. In the absence of a biological connection and the resulting legal parenthood, in order to obtain parental responsibility for the child to allow them to make decisions about Baby T’s care, the men would need to apply for leave to apply for a child arrangements order pursuant to s10 Children Act 1989. However, in the …. (shrink)

Differences across fields and experience levels are frequently considered in discussions of ethical decision making and ethical behavior. In the present study, doctoral students in the health, biological, and social sciences completed measures of ethical decision making. The effects of field and level of experience with respect to ethical decision making, metacognitive reasoning strategies, social-behavioral responses, and exposure to unethical events were examined. Social and biological scientists performed better than health scientists with respect to ethical decision (...) class='Hi'>making. Furthermore, the ethical decision making of health science students decreased as experience increased. Moreover, these effects appeared to be linked to the specific strategies underlying participants' ethical decision making. The implications of these findings for ethical decision making are discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Female in Aristotle’s Biology: Reason or RationalizationTony PreusRobert Mayhew. The Female in Aristotle’s Biology: Reason or Rationalization. Chicago: University of Chicago Press, 2004. Pp. xi +136. Cloth, $28.00.Aristotle's views on the ethical, social, and political roles of women have repeatedly drawn the attention of scholars. Often, the central focus of the discussion is Politics I.13, 1260 a13, where Aristotle says that although women have a (...) deliberative faculty, it is akuron, "without authority." A charitable (from our point of view) interpretation of that word would have him mean that women are capable of ethical and political decision-making, but fourth-century BCE Athenian social arrangements prevent their exercising that capacity outside the home. However, many readers of Aristotle suppose that he means to indicate a natural difference between men and women, some mental or moral inferiority of women. A few passages in the Politics support that interpretation (e.g., Pol. I.2, 1254 b13, 12.1259 a40), but those do not provide a "scientific" or "biological" grounding of female inferiority. That sort of thing one would expect to find in the biological works. Mayhew's monograph is an exposition of the errors and exaggerations of some of those writers, from the usually careful Martha Nussbaum to the usually unreliable Luce Iragaray.The least cautious critics of Aristotle's views on women typically fasten on his views on sexual generation; as Mayhew shows (ch. 3), such critics either claim that Aristotle believed that women contribute only a place for generation to occur, or that women contribute totally passive matter. Mayhew is able to demonstrate, rather easily, that either claim depends on total ignorance or total misunderstanding of the actual contents of the Generation of Animals. In Aristotle's opinion, the female provides proximate matter for the offspring, something that is almost able to develop into a new individual and needing only the impetus and form provided by the male contribution. Having started with the "form/matter" distinction, it is pretty obvious that the female provides the matter (a bird egg is all of the matter that goes to make the chick), and the male is necessary for reproduction to [End Page 109] occur, so it must be a source of movement (at least) and some element of form (since the offspring partially resembles its male parent) that comes from that source. (For older discussions of this issue, see my Science and Philosophy in Aristotle's Biological Works [Hildesheim, 1975], ch. 2, and J. Morsink, "Was Aristotle's Biology Sexist?" J. Hist. Biol.12 [1979]:83-112, neither noted by Mayhew). But what would be the ethical or political implications of that distinction? Aristotle says that it is "better" to provide form, but there's no straightforward way to conclude from that difference that a woman's deliberative faculty is less authoritative than a man's, any more than there is any straightforward way to argue from the fact that a woman might spend some time pregnant that a permanent pay differential is justified. And Aristotle does not try to make that sort of argument, as a matter of fact.Mayhew deals with most of the other arguments that some have derived from the biological works to support their view that Aristotle's "science" is the foundation of his (supposed) sexism. For example, he points out that although Aristotle does call "kings" the bees that we call "queens," he also calls the analogue among wasps the "mothers" or "wombs"; Mayhew says that Aristotle seems to have thought that the king/queen bee was hermaphroditic and parthenogenetic. Mayhew also has an original and interesting chapter on Aristotle's comparisons between women and eunuchs; although he notes that Aristotle was friendly with at least one eunuch, Hermeias, the uncle of Aristotle's young wife, he leaves out Aristotle's poetic praise of Hermeias (see R. Renehan, in Greek, Roman, and Byz. Stud.23 [1982]: 251-74). Suppose women were "eunuchoid" according to Aristotle, it couldn't mean that they were consequently intellectually inferior, since at least one eunuch was, in Aristotle's opinion, intellectually superior.Mayhew also discusses, adequately enough, the issues of brain... (shrink)

This article examines how parents should make health decisions for one child when they may have a negative impact on the health interests or other interests of their siblings. The authors discuss three health decisions made by the parents of Alex Jones, a child with developmental disabilities with two older neurotypical siblings over the course of eight years. First, Alex’s parents must decide whether to conduct sequencing on his siblings to help determine if there is a genetic cause (...) for Alex’s developmental disabilities. Second, Alex’s parents must decide whether to move to another town to maximize the therapy options for Alex. Third, Alex’s parents must decide whether to authorize the collection of stem cells from Alex for a bone marrow transplant for his sibling who developed leukemia. We examine whether the consensus recommendations by Salter and colleagues (2023) regarding pediatric decision-making apply in families with more than one child. (shrink)

In principle, all patients deserve to receive optimal medical treatment equally. However, in situations in which there is scarcity of time or resources, medical treatment must be prioritized based on a triage. The conventional guidelines of medical triage mandate that treatment should be provided based solely on medical necessity regardless of any non-medical value-oriented considerations (“worst-first”). This study empirically examined the influence of value-oriented considerations on medical triage decision–making. Participants were asked to prioritize medical treatment relating to four case (...) scenarios of an emergency situation resulting from a car collision. The cases differ by situational characteristics pertaining to the at-fault driver, which were related to culpability attribution. In three case scenarios most participants gave priority to the most severely injured individual, unless the less severely injured individual was their brother. Nevertheless, in the aftermath of a vehicle-ramming terror attack most participants prioritized the less severely injured individual (“victim-first”). Our findings indicate that when caregivers are presented with concrete highly conflictual triage situations their choices may be based on value-oriented considerations related to contextual characteristics of the emergency situation. Philosophical and practical ramifications of our findings are discussed. (shrink)

Much recent work on the ethics of new biomedical technologies is committed to hidden, contestable views about the nature of biological reality. This selection of essays by Tim Lewens explores and scrutinises these biological foundations, and includes work on human enhancement, synthetic biology, and justice in healthcare decision-making.

Economic markets are not morally free zones. Contrary to popular misconceptions, market functioning rests on the ethical principles of fairness and voluntariness. This ethical foundation can be traced back at least to moral philosopher Adam Smith, one of the founders of modern economics. In the inconspicuous form of microeconomic axioms, these moral foundations are preserved. Thus, virtually all “neo-classic” economic concepts presuppose a market ethics of fairness and voluntariness. In a world of pervasive uncertainty on the long-term development of the (...) human-environment interaction, the protection of the global life-support systems is an important test case for the scope of the ethical content of market ethics. We review risk protection strategies in the face of this uncertainty that are (i) based on the insurance effect of biological diversity, and (ii) that employ a safe minimum standard (SMS). Because the fairness principle of market ethics requires that economic agents who cause “external” costs must, at least, compensate those who are burdened with these costs, the interests of future generations have to be included in responsible economic decision-making. The market and market ethics approach is applied to the analysis of a SMS for biological diversity, and to the inherent problems of such an approach. At the microeconomic level of individual decision-making, an unconditional protection is supported by market ethics neither for the putative interests of future generations nor for biological diversity: Poor people who struggle to cover their basic needs cannot not be required to care for biological diversity. In all other cases, the protection of biological diversity in favour of future generations is supported—if costs are not “unacceptably high”. At which cost level this point is approached, market ethics is not designed to decide. (shrink)

Medical anthropologists have long recognized variation between cultures with regard to the locus of healing in different systems and traditions: that is, in some cultures, the human body is a “bounded physical unit” and healing is thus focused on the body alone. This perspective will be most familiar to Western health-care providers, and indeed, many providers do not imagine an alternative perspective. However, in many cultures, experiences of health, illness, disease, and healing are intricately connected with the social spheres. In (...) these contexts, healing practices and rituals may seek to address family dynamics, alter roles within a community, and resolve social rifts, and illness itself may be... (shrink)

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

How can the forensic scientist rationally justify performing a sequence of tests and analyses in a particular case? When is it worth performing a test or analysis on an item? Currently, there is a large void in logical frameworks for making rational decisions in forensic science. The aim of this paper is to fill this void by presenting a step-by-step guide on how to apply Bayesian decision theory to routine decision problems encountered by forensic scientists on performing or (...) not performing a particular laboratory test or analysis. A decision-theoretic framework, composed of actions, states of nature, and utilities, models this problem, and an influence diagram translates its notions into a probabilistic graphical network. Within this framework, the expected value of information (EVOI) for the submission of an item to a particular test or analysis addresses the above questions. The development of a classical case example on whether to perform presumptive tests for blood before submitting the item for a DNA analysis illustrates the use of this model for source level questions in forensic biology (i.e., questions that ask whether a crime stain consisting of a particular body fluid comes from a particular person). We show how to construct an influence diagram for this example, and how sensitivity analyses lead to an optimal analytical sequence. The key idea is to show that such a Bayesian decisional approach provides a coherent framework for justifying the optimal analytical sequence for a particular case in forensic science. (shrink)

This research is an investigation of whether consciousness—one's ongoing experience—influences one's behavior and, if so, how. Analysis of the components, structure, properties, and temporal sequences of consciousness has established that, (1) contrary to one's intuitive understanding, consciousness does not have an active, executive role in determining behavior; (2) consciousness does have a biological function; and (3) consciousness is solely information in various forms. Consciousness is associated with a flexible response mechanism (FRM) for decision-making, planning, and generally responding in nonautomatic (...) ways. The FRM generates responses by manipulating information and, to function effectively, its data input must be restricted to task-relevant information. The properties of consciousness correspond to the various input requirements of the FRM; and when important information is missing from consciousness, functions of the FRM are adversely affected; both of which indicate that consciousness is the input data to the FRM. Qualitative and quantitative information (shape, size, location, etc.) are incorporated into the input data by a qualia array of colors, sounds, and so on, which makes the input conscious. This view of the biological function of consciousness provides an explanation why we have experiences; why we have emotional and other feelings, and why their loss is associated with poor decision-making; why blindsight patients do not spontaneously initiate responses to events in their blind field; why counter-habitual actions are only possible when the intended action is in mind; and the reason for inattentional blindness. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Issue on Pediatric Decision-MakingErica K. SalterUnlike in the traditional decisional dyad in adult-based care, pediatric decision-making typically involves a triadic relationship among the patient, their parents, and the health-care providers. This complex relationship raises questions and concerns regarding each party’s expectations, obligations, and authority. For example, should a parent be allowed to withhold a poor diagnosis from an adolescent patient? Should an HLA-matched six-year-old (...) sister be permitted to serve as a bone marrow donor for her older sibling with lysosomal storage disease? Or, should parents be given decisional authority to consent to gender-affirming care for an adolescent with gender dysphoria? Cases like these are among the most ethically challenging decisions faced by parents and health-care providers because they present competing interests and values, and it’s not always clear what is in the best interests of the child.In the context of American medicine, the best interest standard has been identified as the primary ethical and legal guide for decision-making. In its most prominent form, the best interest standard requires parents and pediatric practitioners to choose the medical treatment that maximizes benefits and minimizes harms to the particular child in question. However, over the past few decades, the standard has come under significant scrutiny, with discussions and debate in the academic bioethics literature asking whether the standard is able to serve the [End Page 181] purposes it is thought to serve and whether alternative standards might be better suited to the task(s). Despite vigorous interest in these issues, the academic literature did not seem to generate any sense of identifiable consensus about how others ought to make health-care decisions on behalf of children.Thus, in June 2022, 17 scholar-experts on pediatric decision-making standards gathered in St. Louis, MO, for a three-day symposium of discussion and consensus-building. The participating authors represented different disciplinary perspectives and different viewpoints in the debate about guidance principles that underlie pediatrics. Despite apparent disagreement about such standards in the literature, the group was able to generate a set of six consensus-based recommendations (see Table 1) for pediatric decision-making. These recommendations, as well as their application, justification, and limitations, were published as a special article in Pediatrics in August 2023 (Salter et al. 2023), which was composed with the primary goals of accessibility, teachability, and implementability for practicing pediatric clinicians. Click for larger view View full resolutionTable 1.Six consensus recommendations for pediatric decision-makingWhile the group was able to find agreement about these six central principles of pediatric decision-making, there remained several related issues that were outside of the scope of the symposium aims. For example, should these recommendations apply to neonates, children in state custody, or adolescents, and if so, how would their application be operationalized? What specific conditions should justify state intervention on parental authority? How should parents and health-care providers think about obligations to siblings in health-care decisions? This [End Page 182] special issue of Perspectives in Biology and Medicine provides a forum for our authors and collaborators to further explore these, and other, important questions.The issue opens with a piece by the symposium organizers and editors of this special issue, Erica Salter, Lainie Friedman Ross, and D. Micah Hester, describing the symposium’s inspiration and design, its execution, and the implications it might have for pediatric ethics. This contribution compares the six symposium recommendations with existing statements about pediatric decision-making, in particular the statements developed by the American Academy of Pediatrics (AAP). In “How We Found Consensus on Pediatric Decision-Making and Why It Matters,” readers will find a detailed account of the process engaged to develop the six consensus-based recommendations, as well as a discussion of the value and limitations of such a process, which may serve as a model of consensus-building useful for other unsettled topics of interest in the bioethics community.The issue’s second article, “Childhood Interests: What They Are, and Why It Matters,” by Johan Bester and Jeffrey Blustein, dives into the conceptual foundation of the symposium’s first two recommendations. This... (shrink)

ArgumentThis study contributes to the discussion on the development of eugenics in Central-Eastern Europe by tracing the way that eugenic ideas entered into medical decision-making in Hungary. Through a case study that reviews the professional argumentation of the gynecological management of tuberculosis pregnancies, this paper shows that the subordination of individual reproductive rights to state interests was influenced by the ideas of eugenics, which had begun to enter into the professional public health discourse. A eugenically informed morality was envisioned, (...) to guide decision-making in the interest of the Hungarian “race.” This biopolitically important morality can be viewed as an early influence on the formulation of biological citizenship. Leading figures were divided on how to ensure such morality: some scholars argued that education is the key, others thought that the state, and state actors, should act radically in the interest of the population and decide on behalf of the individual. Radical methods, such as the termination of pregnancies and sterilization of women, were among the practices of gynecologists. Although abortion and sterilization were not widespread and never became official therapeutic solutions for tuberculosis pregnancies, they were nonetheless part of a discourse that preceded the eugenic institutions of the interwar years. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Female in Aristotle’s Biology: Reason or RationalizationTony PreusRobert Mayhew. The Female in Aristotle’s Biology: Reason or Rationalization. Chicago: University of Chicago Press, 2004. Pp. xi +136. Cloth, $28.00.Aristotle's views on the ethical, social, and political roles of women have repeatedly drawn the attention of scholars. Often, the central focus of the discussion is Politics I.13, 1260 a13, where Aristotle says that although women have a (...) deliberative faculty, it is akuron, "without authority." A charitable (from our point of view) interpretation of that word would have him mean that women are capable of ethical and political decision-making, but fourth-century BCE Athenian social arrangements prevent their exercising that capacity outside the home. However, many readers of Aristotle suppose that he means to indicate a natural difference between men and women, some mental or moral inferiority of women. A few passages in the Politics support that interpretation (e.g., Pol. I.2, 1254 b13, 12.1259 a40), but those do not provide a "scientific" or "biological" grounding of female inferiority. That sort of thing one would expect to find in the biological works. Mayhew's monograph is an exposition of the errors and exaggerations of some of those writers, from the usually careful Martha Nussbaum to the usually unreliable Luce Iragaray.The least cautious critics of Aristotle's views on women typically fasten on his views on sexual generation; as Mayhew shows (ch. 3), such critics either claim that Aristotle believed that women contribute only a place for generation to occur, or that women contribute totally passive matter. Mayhew is able to demonstrate, rather easily, that either claim depends on total ignorance or total misunderstanding of the actual contents of the Generation of Animals. In Aristotle's opinion, the female provides proximate matter for the offspring, something that is almost able to develop into a new individual and needing only the impetus and form provided by the male contribution. Having started with the "form/matter" distinction, it is pretty obvious that the female provides the matter (a bird egg is all of the matter that goes to make the chick), and the male is necessary for reproduction to [End Page 109] occur, so it must be a source of movement (at least) and some element of form (since the offspring partially resembles its male parent) that comes from that source. (For older discussions of this issue, see my Science and Philosophy in Aristotle's Biological Works [Hildesheim, 1975], ch. 2, and J. Morsink, "Was Aristotle's Biology Sexist?" J. Hist. Biol.12 [1979]:83-112, neither noted by Mayhew). But what would be the ethical or political implications of that distinction? Aristotle says that it is "better" to provide form, but there's no straightforward way to conclude from that difference that a woman's deliberative faculty is less authoritative than a man's, any more than there is any straightforward way to argue from the fact that a woman might spend some time pregnant that a permanent pay differential is justified. And Aristotle does not try to make that sort of argument, as a matter of fact.Mayhew deals with most of the other arguments that some have derived from the biological works to support their view that Aristotle's "science" is the foundation of his (supposed) sexism. For example, he points out that although Aristotle does call "kings" the bees that we call "queens," he also calls the analogue among wasps the "mothers" or "wombs"; Mayhew says that Aristotle seems to have thought that the king/queen bee was hermaphroditic and parthenogenetic. Mayhew also has an original and interesting chapter on Aristotle's comparisons between women and eunuchs; although he notes that Aristotle was friendly with at least one eunuch, Hermeias, the uncle of Aristotle's young wife, he leaves out Aristotle's poetic praise of Hermeias (see R. Renehan, in Greek, Roman, and Byz. Stud.23 [1982]: 251-74). Suppose women were "eunuchoid" according to Aristotle, it couldn't mean that they were consequently intellectually inferior, since at least one eunuch was, in Aristotle's opinion, intellectually superior.Mayhew also discusses, adequately enough, the issues of brain... (shrink)

The ArgumentCell lines and other human-derived biological materials have since 1980 become valuable forms of patentable matter. This paper revisits the much-critiqued legal caseMoore v. Regents of the University of Cahfornia, in which John Moore claimed property rights in a patented cell line made from his spleen. Most work to date has critiqued the text of the decision and left the relevant scientific and technical literature unexamined. By mapping out the construction of discontinuity and continuity between human body and cell (...) line in this literature, this paper provides a novel critique of the Moore case regarding the source and mobilization of scientific information in the decision. At the same time, the elisions of the case are used to move to a larger set of questions. Comparative material from the history of the first widely used cell line, HeLa, and a discussion of the relation of the scientific and economic value of cell lines, are aimed at analysis of how new objects such as patented human cell lines come into existence through science and law, and what kinds of definitions and practices make them valued objects of contention in the first place. (shrink)

To approach the issue of the recent proposal of an Extended Evolutionary Synthesis (EES) put forth by Massimo Pigliucci and Gerd Müller, I suggest to consider the EES as a metascientific view: a description of what’s new in how evolutionary biology is carried out, not only a description of recently learned aspects of evolution. Knowing ‘what is it to do research’ in evolutionary biology, today versus yesterday, can aid training, research and career choices, establishment of relationships and collaborations, (...) decision of funding and research policies, in order to make the field advance for the better. After reviewing the concepts associated to the EES proposal (categorized for convenience as mechanisms, measures, fields, perspectives and applications), I show their transience, and sketch out ongoing disagreements about the EES. Then I examine the deep difficulties, i.e., the enormity and complexity of the covered field, affecting the achievement of trusted metascientific views; the insufficiency of conceptual analysis to capture the substance of scientific research; the entanglement between empirical and metascientific concepts, between multiple chronologies, and between descriptive and normative intentions; and the ineliminable stakeholding of any reviewer involved in the reviewed field. I propose that disciplines such as scientometrics, ethnography, sociology, economics and history, combined with conceptual analysis, inspire a more rigorous approach to the evolutionary biology scientific community, more grounded and shared, confirming or transforming claims for ‘synthesis’ while preserving their maintenance goals. (shrink)

... and the baby has a large VSD. Otherwise appears well, gaining weight, smiling. No apnea, never been on ventilator. Local cardiac surgeon refused to operate, saying that surgery would be inappropriate. Have reached out to other centers, and some state that they never perform what they said was “futile” heart surgery on children with Trisomy 18, while other sites say they have and will continue to perform these operations. Can someone explain to me what is going on? In the (...) realm of medical care—given enough patients, clinicians, and time—conflict is inevitable. Someone will want to do something, such as give a drug or start a new form of technologic support, and someone else will think that this is a... (shrink)

We agree with Cushman that rationalizations are the product of biological adaptations, but we disagree about their function. The data available do not show that rationalizations allow us to reason better and make better decisions. The data suggest instead that rationalizations serve reputation management goals, and that they affect our behaviors because we are held accountable by our peers.

The modern science of judgment and decision making began to emerge in the 1950s, and was thus unknown when Abraham Flexner wrote Medical Education in the United States and Canada (1910). This did not stop Flexner from highlighting the unique challenges facing the physician as a decision maker, as part of his effort to press for requiring some college education as a prerequisite for medical school:The engineer deals mainly with measurable factors. His factor of uncertainty is within fairly narrow (...) limits. The reasoning of the medical student is much more complicated. He handles at one and the same time elements belonging to vastly different categories: physical, biological, psychological elements are involved in .. (shrink)

The pupils of the eyes reflexively constrict in light and dilate in dark to optimize retinal illumination. Non-visual cognitive factors, like attention, arousal, decision-making, etc., also influence pupillary light response. During passive viewing, the eccentricity of a stimulus modulates the pupillary aperture size driven by spatially weighted corneal flux density, which is the product of luminance and the area of the stimulus. Whether the scope of attention also influences PLR remains unclear. In this study, we contrasted the pupil dynamics (...) between diffused and focused attentional conditions during decision-making, while the global CFD remained the same in the two conditions. A population of 20 healthy humans participated in a pair of forced choice tasks. They distributed attention to the peripheral decision cue in one task, and concentrated at the center in the other to select the target from four alternatives for gaze orientation. The location of this cue did not influence participants’ reaction time. However, the magnitude of constriction was significantly less in the task that warranted attention to be deployed at the center than on the periphery. We observed similar pupil dynamics when participants either elicited or canceled a saccadic eye movement, which ruled out pre-saccadic obligatory attentional orientation contributing to PLR. We further addressed how the location of attentional deployment might have influenced PLR. We simulated a biomechanical model of PLR with visual stimulation of different strengths as inputs corresponding to the two attentional conditions. In this homeomorphic model, the computational characteristic of each element was derived from the physiological and/or mechanical properties of the corresponding biological element. The simulation of this model successfully mimicked the observed data. In contrast to common belief that the global ambient luminosity drives pupillary response, the results of our study suggest that the effective CFD determined via the luminance multiplied by the size of the stimulus at the location of deployed attention in the visual space is critical for the magnitude of pupillary constriction. (shrink)

Why do some organisms rely on mental representations for making decisions? Why don’t we rely merely on direct mappings from perception to behavior? Armin W. Schulz’ book, Efficient Cognition: The Evolution of Representational Decision Making, offers a novel and empirically-informed perspective on a problem that has not received the amount of philosophical attention it deserves. In his view, representational decision making evolved because creatures that use it have enhanced cognitive and neurological efficiency. Here I provide an (...) overview of the book’s contents and a critical assessment of his proposal. (shrink)

Key legislations in many countries emphasize the importance of involving children in decisions regarding their own health at a level commensurate with their age and capacities. Research is engaged in developing tools to assess capacity in children in order to facilitate their responsible involvement. These instruments, however, are usually based on the cognitive criteria for capacity assessment as defined by Appelbaum and Grisso and thus ill adapted to address the life-situation of children. The aim of this paper is to (...) revisit and critically reflect upon the current definitions of decision-making capacity. For this purpose, we propose to see capacity through the lens of essential contestability as it warns us against any reification of what it means to have capacity. Currently, capacity is often perceived of as a mental or cognitive ability which somehow resides within the person, obscuring the fact that capacity is not just an objective property which can be assessed, but always operates within a dominant cultural framework that “creates” that same capacity and defines the threshold between capable and incapable in a specific situation. Defining capacity as an essentially contested concept means using it in a questioning mode and giving space to alternative interpretations that might inform and advance the debate surrounding decision-making. (shrink)

In recent years, there has been an intense debate about the concept of “biological” or “genetic citizenship.” The growing literature on this topic mostly refers to the importance of patients’ associations, disease advocacy organizations, and self-help groups that are giving rise to new forms of subjectivation and collective action. The focus is on the extension of rights, the emergence of new possibilities of participation, and the choice-enhancing options of the new genetics. However, this perspective tends to neglect the potential for (...) exclusion and restriction of citizenship rights based on biological traits. We aim to broaden and complement the existing theoretical discussion on biological citizenship, which so far has concentrated on the medical sphere, by investigating a new empirical field. The article analyzes the use of DNA analysis for family reunification and shows that biological criteria still play an important role in decision making on citizenship rights in nation-states. Presenting Germany as an exemplary case, we argue that the use of parental testing endorses a biological concept of the family that is mobilized to diminish citizenship rights. The argument is based on documentary analysis and on interviews with representatives of nongovernmental organizations and immigration authorities, lawyers, geneticists, and applicants for family reunification. (shrink)

BackgroundConcurrent with efforts to establish national and regional biorepositories in Africa is widespread endorsement of ethics committees as stewards of the interests of individual donors and their communities. To date, ethics training programs for IRB members in Botswana have focused on ethical principles and international guidelines rather than on the ethical dimensions of specific medical technologies and research methodologies. Little is known about the knowledge and concerns of current and prospective IRB members in Botswana with respect to export, reuse, storage, (...) and benefit-sharing of biospecimens.MethodsThis qualitative study examined perspectives of IRB members in Botswana about the collection and use of biospecimens in research. Forty-one IRB members representing five committees in Botswana participated in discussions groups in March 2013. Transcriptions of audiotapes and field notes were analyzed to identify issues of concern that might be alleviated through education and capacity-building, and areas that required ongoing discussion or additional regulatory guidance.ResultsAreas of concern included lack of understanding among patients and providers about the use of biospecimens in clinical care and research; reuse of biospecimens, particularly issues of consent, ownership and decision-making; export of specimens and loss of control over reuse and potential benefits; and felt need for regulatory guidance and IRB-member training. Local belief systems about bodily integrity and strong national identity in the construct of benefits may be at odds with initiatives that involve foreign biorepositories or consider such collections to be global public goods.ConclusionEducation is needed to strengthen IRB-member capacity to review and monitor protocols calling for the collection and use of biospecimens, guided by clear national policy on priority-setting, partnerships, review, and oversight. Engagement with local stakeholders is needed to harmonize fundamentally different ways of understanding the human body and community identity with the aims of contemporary biomedicine. (shrink)

Decisions regarding the end-of-life of minor patients are amongst the most difficult areas of decision-making in pediatric health care. In this field of medicine, such decisions inevitably occur early in human life, which makes one aware of the fact that any life—young or old—cannot escape its temporal nature. Belgium and the Netherlands have adopted domestic regulations, which conditionally permit euthanasia and physician-assisted suicide in minors who experience hopeless and unbearable suffering. One of these conditions states that the (...) minor involved must be legally competent and able to express an authentic and lasting wish to die. This contribution is different from other legal texts on end-of-life decisions in modern health care. Foremost, it deals with the role time-bound components play in our views on the permissibility of such decisions with regard to minor patients. While other disciplines provide profound reflections on this issue, from a legal point of view this side has hardly been explored, let alone examined with regard to its relevance for the legal permissibility of end-of-life decisions in pediatrics. Therefore, the manuscript inquires whether there are legal lessons to be learned if we look more closely to temporality-related aspects of these end-of-life decisions, particularly in connection to a minor patient’s assumable ability to choose death over an agonizing existence. (shrink)