The intellectual debates on wise entrepreneurship behavior such as decision making tend to focus on the relationship between economic rationality and morality, while overlooking the important role affect plays. To fill in this gap, this paper proposes a theoretical framework based on the Confucian concepts of ren and yi and studies their practical manifestation in qing and li 1 for decision making. Drawing from 32 in-depth interviews and 52 vignettes with Chinese SME entrepreneurs, this study has found that qing plays (...) an essential role in decision making. Chinese entrepreneurs had to deal with the dilemma relating to qing and li 1 holistically to reach a balanced outcome in their everyday business practices. As a major contribution, this study extends the study of Confucian ethics by highlighting ren-yi as an important perspective for understanding Chinese entrepreneurial decision making and also for promoting the affective dimensions for entrepreneurial ethical decision making in general. (shrink)

Fairness-related decision making is an important issue in the field of decision making. Traditional theories emphasize the roles of inequity aversion and reciprocity, whereas recent research increasingly shows that emotion plays a critical role in this type of decision making. In this review, we summarize the influences of three types of emotions (i.e., the integral emotion experienced at the time of decision making, the incidental emotion aroused by a task-unrelated dispositional or situational source, and the interaction of emotion and cognition) (...) on fairness-related decision making. Specifically, we first introduce three dominant theories that describe how emotion may influence fairness-related decision making (i.e., the wounded pride/spite model, affect infusion model, and dual-process model). Next, we collect behavioral and neural evidence for and against these theories. Finally, we propose that future research on fairness-related decision making should focus on inducing incidental social emotion, avoiding irrelevant emotion when regulating, exploring the individual differences in emotional dispositions, and strengthening the ecological validity of the paradigm. (shrink)

Incommensurability is the impossibility to determine how two options relate to each other in terms of conventional comparative relations. This book features new research on incommensurability from philosophers who have shaped the field into what it is today, including John Broome, Ruth Chang and Wlodek Rabinowicz. The book covers four aspects relating to incommensurability. In the first part, the contributors synthesize research on the competing views of how to best explain incommensurability. Part II illustrates how incommensurability can help us deal (...) with seemingly insurmountable problems in ethical theory and population ethics. The contributors address the Repugnant Conclusion, the Mere Addition Paradox and so-called Spectrum Arguments. The chapters in Part III outline and summarize problems caused by incommensurability for decision theory. Finally, Part IV tackles topics related to risk, uncertainty and incommensurability. Value Incommensurability: Ethics, Risk, and Decision-Making will be of interest to researchers and advanced students working in ethical theory, decision theory, action theory, and philosophy of economics. (shrink)

Death and grief in the ancient world -- Predictions and disability in Rome.

In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding goals of care. What (...) this implies in terms of the importance that we have reason to attach to (non-)adherence and how has, however, not been explained. In this article, we explore the relationship between different forms of shared decision-making, patient autonomy and adherence. Distinguishing between dynamically and statically framed adherence we show how the version of shared decision-making advocated will have consequences for whether one should be interested in a dynamically or statically framed adherence and in what way patient adherence should be assessed. In contrast to the former compliance paradigm (where non-compliance was necessarily seen as a problem), using observations about (non-)adherence to assess the success of health care decision making and professional-patient interaction turns out to be a much less straightforward matter. (shrink)

The necessity of consent is widely justified on the basis of the principle of respect for autonomy. Also, it is widely believed that shared decision making (SDM) is the practical device to seek patients’ consent for medical treatment. In this essay, I argue that SDM, while necessary, is insufficient for consent; because, in the paradigm of evidence-based medicine, SDM is contingent upon other practices to identify appropriate treatments that form the subjects of SDM. Indeed, case law emphasises normative decision-making practices (...) that precede SDM. Furthermore, case law supplies a nuanced understanding of SDM, which includes not only exchange of information but also attention to human vulnerability that persists despite formal retention of decision-making capacity. In addition, the law marks out a space in which people with capacity are absolutely entitled to self-determination. Thus, a four-step framework of decision making can be induced from legal doctrine. This legal framework corresponds to a construct of respect for autonomy that draws upon feminist theory. Feminist scholars have objected to the focus on individuals in traditional theories of autonomy; instead, they insist that people have to be considered in the context of their social influences and relationships. Feminists separate out four ideas of autonomy, and these ideas can be used to construct a four-layered model of respect for autonomy, in which each layer corresponds sequentially to a step in the legal framework of decision making. This model of respect for autonomy provides both conceptual clarity and theoretically robust justification for doctors’ various obligations in decision-making practices for consent. (shrink)

Purpose – The study aims at clarifying whether locus of control may act as a bias in organisational decision-making or not. -/- Design/methodology/approach – Altogether 44 managers working at Skanska (a Swedish multinational construction company) participated in the study. They were asked to complete a booklet including a locus of control test and a couple of decision tasks. The latter were based on case scenarios reflecting strategic issues relevant for consultative/participative decision-making. -/- Findings – The results revealed that managers with (...) low external locus of control used group consultative decision-making more frequently than those with high locus of control. There was also a tendency showing that high externals more frequently used participative decision-making than low externals. This was in line with the general trend, indicating that managers on the whole predominantly used participative decision-making. -/- Originality/value – The results of the present study are valuable for HRM practice, especially with regard to the selection of individuals to management teams. (shrink)

Recent allegations of unethical decision-making by leaders in prominent business organizations have jeopardized the world's confidence in American business. The purpose of this research was to develop a measure of managerial moral judgment that can be used in future research and managerial assessment. The measure was patterned after the Defining Issues Test, a widely used general measure of moral judgment. With content validity as the goal, we aimed to sample the domain of managerial ethical situations by establishing links to dimensions (...) of managerial performance, as well as to the types of organizational justice issues managers encounter. Proposed scenarios were evaluated for realism by ethics officers and human resource managers. Results indicated that the new measure is reliable and correlates with a number of relevant variables in the hypothesized manner, demonstrating evidence of construct validity. Implications for future research and for human resources management are discussed. (shrink)

This paper begins by reviewing dominant themes in current teaching of professional ethics in engineering education. In contrast to more traditional approaches that simulate ethical practice by using ethical theories to reason through micro-level ethical dilemmas, this paper proposes a pragmatic approach to ethics that places more emphasis on the practical plausibility of ethical decision-making. In addition to the quality of ethical justification, the value of a moral action also depends on its effectiveness in solving an ethical dilemma, cultivating healthy (...) working relationships, negotiating existing organizational cultures, and achieving contextual plausibility in everyday professional practice. This paper uses a cross-cultural ethics scenario to further elaborate how a pragmatic approach can help us rethink ethical reasoning, as well as ethics instruction and assessment. This paper is expected to be of interest to educators eager to improve the ability of engineers and other professional students to effectively and appropriately deal with the kinds of everyday ethical issues they will likely face in their careers. (shrink)

Peterson, Karlawish, and Largent’s “Supported Decision Making with People at the Margins of Autonomy” brings welcome attention to the rights of people with cognitive impairment and provides...

Free and informed choice is an oft-acknowledged ethical basis for living kidney donation, including parental living kidney donation. The extent to which choice is present in parental living kidney donation has, however, been questioned. Since parents can be expected to have strong emotional bonds to their children, it has been asked whether these bonds make parents unable to say no to this donation. This article combines a narrative analysis of parents’ stories of living kidney donation with a philosophical discussion of (...) conditions for parental decision-making. Previous research has shown that parents often conclude that it is “natural” to donate. Our study shows that this naturalness needs to be understood as part of a story where parental living kidney donation is regarded as natural and as a matter of non-choice. Our study also highlights the presence of a parenthood moral imperative of always putting one’s child’s needs before one’s own. On the basis of these results, we discuss conditions for decision-making in the context of parental LKD. We argue that the presence of a parenthood moral imperative can matter with regard to the decision-making process when parents consider whether to volunteer as living kidney donors, but that it need not hamper choice. We emphasise the need for exploring relational and situational factors in order to understand parental decision-making in the context of parental LKD. (shrink)

Research on human decision making is at the present time undergoing rapid changes. From previously being much focused on models and approaches with an origin in economy, much of the present day research finds its inspiration from disciplinary approaches concerned with incorporating more of the context that the decision making takes place in. This context includes psychological aspects of the decision maker and social-cultural aspects of the situation he or she acts in. All human decision making occurs in dynamically changing (...) contexts. One factor contributing to this is that human beings or groups in many situations act as entrepreneurs trying to improve the situation for themselves or their organization. Given that this is the case, it is of increasing interest for both researchers and practitioners interested in the social aspects of decision making to consider the relation between creativity and decision making. (shrink)

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that value (...) judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

In today's global marketplace, the Philippines provide a unique example of an Asian culture with established economic ties to the West. In this study, Philippine and United States undergraduate business students responded to 13 vignettes describing questionable ethical actions in business situations. Results reveal significant differences between groups for 9 of the 13 vignettes. For 4 vignettes, Philippine participants were more disapproving of the actions, and for another 5, United States participants were more disapproving. The study suggests that cultural differences (...) continue and the implications of these differences should be considered in today's global economy. (shrink)

The purpose of this paper is to develop an approach to multiattribute group decision making under interval-valued hesitant fuzzy environment. To do this, this paper defines some new operations on interval-valued hesitant fuzzy elements, which eliminate the disadvantages of the existing operations. Considering the fact that elements in a set may be interdependent, two generalized interval-valued hesitant fuzzy operators based on the generalized Shapley function and the Choquet integral are defined. Then, some models for calculating the optimal fuzzy measures on (...) the expert set and the ordered position set are established. Because fuzzy measures are defined on the power set, it makes the problem exponentially complex. To simplify the complexity of solving a fuzzy measure, models for the optimal 2-additive measures are constructed. Finally, an investment problem is offered to show the practicality and efficiency of the new method. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

Diffusion models are widely-used and successful accounts of the time course of two-choice decision making. Most diffusion models assume constant boundaries, which are the threshold levels of evidence that must be sampled from a stimulus to reach a decision. We summarize theoretical results from statistics that relate distributions of decisions and response times to diffusion models with time-varying boundaries. We then develop a computational method for finding time-varying boundaries from empirical data, and apply our new method to two problems. The (...) first problem involves finding the time-varying boundaries that make diffusion models equivalent to the alternative sequential sampling class of accumulator models. The second problem involves finding the time-varying boundaries, at the individual level, that best fit empirical data for perceptual stimuli that provide equal evidence for both decision alternatives. We discuss the theoretical and modeling implications of using time-varying boundaries in diffusion models, as well as the limitations and potential of our approach to their inference. (shrink)

Despite significant ethical advances in recent years, including professional developments in ethical review and codification, research deception continues to be a pervasive practice and contentious focus of debate in the behavioral sciences. Given the disciplines' generally stated ethical standards regarding the use of deceptive procedures, researchers have little practical guidance as to their ethical acceptability in specific research contexts. We use social contract theory to identify the conditions under which deception may or may not be morally permissible and formulate practical (...) recommendations to guide researchers on the ethical employment of deception in behavioral science research. (shrink)

Incompetent patients need to have someone else make decisions on their behalf. According to the Substituted Judgment Standard the surrogate decision maker ought to make the decision that the patient would have made, had he or she been competent. Objections have been raised against this traditional construal of the standard on the grounds that it involves flawed counterfactual reasoning, and amendments have been suggested within the framework of possible worlds semantics. The paper shows that while this approach may circumvent the (...) alleged problem, the way it has so far been elaborated reflects insufficient understanding of the moral underpinnings of the idea of substituted judgment. Proper recognition of these moral underpinnings has potentially far-reaching implications for our normative assumptions about accuracy and objectivity in surrogate decision making. (shrink)

Some options to single out the foremost function of philosophy in culture are discussed. As any functioning part has to possess definite level of the internal unity, I begin by tracing out the main views on the unanimity of philosophical knowledge and demonstrate that the opposed variants can be reduced to well‐known contraposition between subject matter (a strong variant) and method (a weak one). I show further that at least one strong version, which identifies philosophical subject matter with the concrete (...) universal being, seizes on only one piece of metaphysics. As a result, the boundary line between strong and weak versions erodes and the strong version converges into the weak one. Finally, I argue that fundamental philosophical themes can be united on the base of three famous Kant’s questions: What can I know? What may I hope? What ought I to do? Difference across modalities testifies against the interpretation of these questions as synopsis. Moreover, these questions correlate well with the three core parts of the making‐decision situation. Such a situation includes a set of possible alternatives and a system or an aggregate of selection criteria for a choice of the variant desired. These two components are logically prior to goal setting. Clearly, to achieve desired object one is to determine what steps are necessary for success. It is no less clear that in the structure of an action, they represent something one ought to do. Thus, specific cultural mission of philosophizing lies in the design and justification of Weltanschauung. (shrink)

Decision-making adhering to the “principle of autonomy" takes place within the wider context of decision-making processes in modern society. Within the medical area, as regards the decision through informed consent, the patient's intention assumes vital importance. The principle of autonomy is derived from the modern thought that the essence of human being is the reason. It becomes difficult, however, to rely on decision-making based on the principle of autonomy when a person’s intention is not clear and the opinions of those (...) who are involved differ from each other. Here, I think that the principle of consensus, which seeks the agreement of those who are concerned, becomes as important as the principle of autonomy. This paper examines the problems of certainty, reliability, andcreativity of medical action through the consideration of the principle of consensus. (shrink)

Shared decision making has become the standard of care, yet there remains no consensus about how it should be conducted. Most accounts are concerned with threats to patient autonomy, and they address the dangers of a power imbalance by foregrounding the patient as a person whose complex preferences it is the practitioner's task to support. Other corrective models fear that this level of mutuality risks abdicating the practitioner's responsibilities as an expert, and they address that concern by recovering a nuanced (...) but genuinely directive clinical role. Cribb and Entwistle helpfully categorize models of shared decision making as ‘narrower’ and ‘broader’ and praise the latter's ‘open‐ended and fully dialogical ways of relating’. However, they stop short of providing a philosophical account of how that dialogue works. In this paper, a nurse–midwife and a philosopher collaborate to argue that the Socratic model of dialogue offers a solution to the practitioner–patient dilemma. In the Theaetetus, Socrates compares dialogical reasoning to ‘midwifery with all its standard features’. By means of a three‐way analogy, elements of midwifery practice are used to illuminate features of Socrates' claim that his dialogue is like midwifery; those features are then translated into an approach to shared decision making as the ‘midwifery of good thinking’ which both midwives and physicians would do well to adopt. A key concept that emerges is the need for practitioners to make a risk‐confidence assessment of the particular content of any decision to appropriately modulate their role in the practice of shared decision making. (shrink)

As professional football stadiums continue to grow in popularity worldwide, fans are able to watch the game in closer proximity, but the design of professional football stadiums to shorten the distance between fans and the playing field also exacerbates the impact of the home advantage on the referee’s decision to call a penalty. Studies have confirmed the existence of the home advantage and found that experienced referees can reduce the impact of this interference, but the neural mechanisms behind this phenomenon (...) have not been adequately investigated. In this study, we designed a soccer referee decision making task based on a home field effect scenario in a real soccer game, and used event-related potentials to compare the decision making and EEG differences between individuals with different experience levels when faced with foul actions under spectator noise interference. The experiments showed that individuals with different experience levels triggered a significant ERN EEG component when performing the penalty decision task under the home field effect factor, suggesting that the interference of the home field effect may lead referees to correct their previous decision-making behavior patterns in the penalty decision and reduce unfavorable calls against the home team. In contrast, referees with officiating experience elicited smaller ERN amplitudes compared to other subjects, suggesting that experience factors may inhibit this tendency to change behavioral patterns. This study suggests that in response to the increasing trend of professional football stadiums, policy makers should place more emphasis on enhancing the experience level of referees in the training of referees to ensure the fairness of the game. (shrink)

I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two decades and creating serious roadblocks (...) to health-care providers' ability to render appropriate patient care. The Wisconsin Supreme Court held that Edna's legal guardian could not authorize withdrawal of Edna's treatment, ruling that as a matter of law, if an incompetent person is not in a persistent vegetative state, it is not in his or her best interests for life-sustaining treatment to be withdrawn unless (s)he has executed an advance directive or other statement clearly indicating his or her desires. (shrink)

Where a person is unable to make medical decisions for themselves, law and practice allows others to make decisions on their behalf. This is common at the end of a person’s life where decision-making capacity is often lost. A further, and separate, decision that is often considered at the time of death (and often preceding death) is whether the person wanted to act as an organ or tissue donor. However, in some jurisdictions, the lawful decision-maker for the donation decision (the (...) ‘donation decision-maker’) is different from the person who was granted decision-making authority for medical decisions during the person’s life. To date, little attention has been given in the literature to the ethical concerns and practical problems that arise where this shift in legal authority occurs. Such a change in decision-making authority is particularly problematic where premortem measures are suggested to maximise the chances of a successful organ donation. This paper examines this shift in decision-making authority and discusses the legal, ethical and practical implications of such frameworks. (shrink)

Both the fast and frugal heuristics and the naturalistic decision making research programmes have identified important areas of inquiry previously neglected in the traditional study of human judgment and decision making, and have greatly contributed to the understanding of people's real-world decision making under environmental constraints. The two programmes share similar theoretical arguments regarding the rationality, optimality, and role of experience in decision making. Their commonalities have made them appealing to each other, and efforts have been made, by their leading (...) academics, to promote synergy and integration. However, there has been little progress towards this during the last decade. This paper seeks to address this gap by seeking to better understand their commonalities and differences. To do so, literature relating to the two programmes is reviewed. The findings of the review indicated that an integration of the two could enhance FFHs' field research in applied settings, facilitate its investigation on boundary conditions of people's decision strategy selection, enable NDM to embrace emerging research opportunities in the age of big data, as well as permit each programme to enlighten the research topics and to validate the research findings of the other. (shrink)

Much discussion of decision-making processes in medicine has been patient-centred. It has been assumed that there is, most often, one patient. Less attention has been given to shared decision-making processes where two or more patients are involved. This article aims to contribute to this special area. What conditions need to be met if decision-making can be said to be shared? What is a shared decision-making process and what is a shared autonomous decision-making process? Why make the distinction? Examples are drawn (...) from the area of new reproductive medicine and clinical genetics. Possible gender-differences in shared decision-making are discussed. (shrink)

The danger of human operators devolving responsibility to machines and failing to detect cases where they fail has been recognised for many years by industrial psychologists and engineers studying the human operators of complex machines. We call it “the control problem”, understood as the tendency of the human within a human–machine control loop to become complacent, over-reliant or unduly diffident when faced with the outputs of a reliable autonomous system. While the control problem has been investigated for some time, up (...) to this point its manifestation in machine learning contexts has not received serious attention. This paper aims to fill that gap. We argue that, except in certain special circumstances, algorithmic decision tools should not be used in high-stakes or safety-critical decisions unless the systems concerned are significantly “better than human” in the relevant domain or subdomain of decision-making. More concretely, we recommend three strategies to address the control problem, the most promising of which involves a complementary coupling between highly proficient algorithmic tools and human agents working alongside one another. We also identify six key principles which all such human–machine systems should reflect in their design. These can serve as a framework both for assessing the viability of any such human–machine system as well as guiding the design and implementation of such systems generally. (shrink)

It is a commonplace that in making decisions agents often have to juggle competing values, and that no choice will maximise satisfaction of them all. However, the prevailing account of these cases assumes that there is always a single ranking of the agent's values, and therefore no unresolvable conflict between them. Isaac Levi denies this assumption, arguing that agents often must choose without having balanced their different values and that to be rational, an act does not have to be optimal, (...) only what Levi terms 'admissible'. This book explores the consequences of denying the assumption and develops a general approach to decision-making under unresolved conflict. Professor Levi discusses conflicts of value in several domains - those arising in moral dilemmas, the drawing of scientific inferences, decisions taken under uncertainty, and in social choice. In each of these he adapts his theoretical framework, showing how conflict may often be reduced though not always altogether eliminated. (shrink)

Case studies and first-person stories about decision-making, written by professionals in the field, bring a uniquely personal touch to this valuable text.

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

BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...) large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire and the Measure of Moral Distress for Healthcare Professionals tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians. They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units and also demonstrated lower moral distress scores and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated ; moral distress and "intention to leave" was positively correlated ; and ethical climate and “intention to leave” were negatively correlated.ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care. (shrink)

Decision-making Capacity matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that dmc matters because autonomy matters. And this is thought to justify dmc as a gatekeeper for autonomy – whereby autonomy concerns arise if but only if a patient has dmc. But appeals to autonomy invoke two distinct concerns: concern for authenticity – concern that a choice is consistent with an individual’s commitments; and concern for (...) sovereignty – concern that an individual exercises control over that which is hers to control. Here, I argue, neither concern can alone explain why dmc matters. Instead, dmc matters because it indicates a harmony between the two concerns – the demands of each concern are more likely to agree if a patient has dmc. This vindicates the standard story, but also makes clear that dmc is an inappropriate gatekeeper for autonomy. (shrink)

Our research’s aim is to assess the effect of cultural factors on business ethical decision-making process in a Western cultural context and in a non-Western cultural context. Specifically, this study investigates ethical perceptions, religiosity, personal moral philosophies, corporate ethical values, gender, and ethical intentions of U.S. and Moroccan business managers. The findings demonstrate that significant differences do exist between the two countries in idealism and relativism. Moroccan managers tend to be more idealistic than the U.S. managers. There is a strong (...) positive relationship between religiosity and idealism. There were mixed findings in examining the correlates of religiosity and various components of ethical intentions. Moroccan managers were more homogenous in their corporate ethical values than were the U.S. managers. The results demonstrate that (in general) idealism is a good predictor of ethical intentions and behaviors. Additionally, managers from the two countries differed in the degree of relationship between perceptions and intentions in three of the four scenarios. This study’s results confirm other research findings that, in general, female business managers have higher ethical sensitivity in terms of their ethical judgment than their male counterparts. Managerial implications are also discussed. (shrink)

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

ArgumentThis article studies the roles three science-based models play in Dutch policy and decision making processes. Key is the interaction between model construction and environment. Their political and scientific environments form contexts that shape the roles of models in policy decision making. Attention is paid to three aspects of the wider context of the models: a) the history of the construction process; b) the political and scientific environments; and c) the use in policy processes over longer periods of time. Models (...) are more successfully used when they are constructed in astablepolitical and scientific environment. Stability and certainty within a scientific field seems to be a key predictor for the usefulness of models for policy making. The economic model is more disputed than the ecology-based model and the model that has its theoretical foundation in physics and chemistry. The roles models play in policy processes are too complex to be considered as straightforward technocratic powers. (shrink)

The objective of this paper is to construct an implementable theory of rational decision-making for cognitive agents subject to realistic resource constraints. It is argued that decision-making should select actions indirectly by selecting plans that prescribe them. It is also argued that although expected values provide the tool for evaluating plans, plans cannot be compared straightforwardly in terms of their expected values, and the objective of a realistic agent cannot be to find optimal plans. The theory of Locally Global planning (...) is proposed as a realistic alternative to standard "maximizing" theories of rational decision-making. (shrink)