How do senior business executives rank their preferences for various ethical principles? And how strongly do the executives believe in these principles? Also, how do these preference rankings relate to the way the executives see the future (wherein business decisions play out)? Research on these questions may provide us with an appreciation of the complexities of ethical behavior in management beyond the traditional issues concerning ethical decision-making in business. Based on a survey of 585 vice presidents (...) of U.S. businesses it was found that: (1) there is a distinct set of principles of ethical conduct that is considered favorable as opposed to another set considered unfavorable among a comprehensive list of 14 ethical principles; (2) the executives believed overwhelmingly that their own individual ethical preferences are better than those of other executives; (3) the strength of their preferences for ethical principles is associated with whether the executives are relatively near-future oriented or more distant-future oriented; and (4), there are very few significant differences in terms of gender, age, education level, private/public education, prestigious/other schools, business/non-business academic backgrounds, and length of job experience. Implications of these findings are discussed. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 57-59, June 2011.

The absence of appropriate information about imperceptible and ethical food characteristics limits the opportunities for concerned consumer/citizens to take ethical issues into account during their inescapable food consumption. It also fuels trust crises between producers and consumers, hinders the optimal embedment of innovative technologies, “punishes” in the market ethical producers, and limits the opportunities for politically liberal democratic governance. This paper outlines a framework for the ethical characterization and subsequent optimization of foods (ECHO). The framework applies (...) to “imperceptible,” “pragmatic,” and “reasonable” food characteristics about which consumers/citizens maintain concerns. A political perspective is assumed in that valid information is taken to serve the politically liberal and democratic functions of the market by allowing concerned citizens to make informed choices in their role as food consumers. Information is aggregated by multi-attribute modeling. It takes the form of “maximized” (“utilitarian”) to “most balanced” (MINMAX) non-binary aggregate comparative rankings of perceptibly substitutable food products. The model requires the description of characteristics by means of criteria and weights (structural input), and technical input on the performance of food for these criteria (product input). Structural input is grounded on relevantly concerned citizen/consumers’ perceptions. It is culture and times dependent. Availability of product input is assumed. Uses for the amelioration of the aforementioned limitations are discussed. So long as, and to the extent that, certain ethical concerns are not addressed by public policy, the ECHO framework may facilitate offering members of society a necessary (though not a sufficient) condition for regulating the ethical aspects of food production in self-regulated markets as consumers, when they are constrained to do so through their government as citizens. In doing that, the framework may contribute to the development of the ethical dimension of food production and may bring rewards for food supply actors that take reasonable concerns of citizen/consumers into account. (shrink)

In this paper, I address the question of whether aerosol geoengineering (AG) ought to be deployed as a response to climate change. First, I distinguish AG from emissions mitigation, adaptation, and other geoengineering strategies. Second, I discuss advantages and disadvantages of AG, including its potential to result in substantial harm to some persons. Third, I critique three arguments against AG deployment, suggesting reasons why these arguments should be rejected. Fourth, I consider an argument that, in scenarios in which all available (...) climate change strategies would result in net harm to persons, we ought to adopt that response to climate change which would result in the least net harm. I suggest that under .. (shrink)

The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable alternative.? Our (...) goal is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)

Collectively, lawyers probably seek in vain to be sufficiently trusted, even when most individual lawyers appear to do their utmost to behave responsibly. Efforts to address lawyers' behavioural failures remain an important social policy objective and a professional obligation. In this article we argue that it is politically sensible and socially responsible for the legal profession to continue to address its misbehaving members in a more fundamental manner than just the post-facto disciplinary process. We suggest that pre-emptive (pre-offence), ethics self-assessments (...) may limit the later incidence of misbehaviour and assist in rehabilitation programs for disciplined lawyers. We report on an experimental approach to lawyers' discovering more about their innate ethics. We have trialled lawyers' responses to a series of concrete statements about their ethical priorities and developed a statistically valid 'scale' (or set of statements) to allow lawyers in an Australian context to observe and reflect upon, their differing ethical approaches. To date, no such a scale has been developed for lawyers' ethics. The results of this scale development process are sufficiently encouraging to justify further work on similar scales for different cultures and legal traditions, in the interest of producing a tailored, reliable and valid instrument for general pre-emptive use within each local profession. The proposition that awareness improves conscious decision-making is not revolutionary or particularly contentious. While raising lawyers' awareness of how they make choices may only make a modest contribution to enhancing the ethical quality of their professional behaviour, it nevertheless seems plausible that it will raise their awareness and is therefore a worthwhile exercise. (shrink)

_ Source: _Page Count 28 Recent debates over climate change policy have made it clear that the choice of a social discount rate has enormous consequences for the amount of mitigation that will be recommended. The social discount rate determines how future costs are to be compared to present costs. Philosophers, however, have been almost unanimous in endorsing the view that the only acceptable social rate of time preference is zero, a view that, taken literally, has either absurd or extremely (...) radical implications. The first goal of this paper is to show that the standard arguments against temporal preference are much less persuasive than they are usually taken to be. The second goal is to explore two different avenues of argument that could be adopted, in order to show that temporal discounting of welfare may be permissible. The first involves simply an application of the method of reflective equilibrium, while the second involves consideration of the way that our abstract moral commitments are institutionalized. (shrink)

Artificial intelligence (AI) systems are quickly gaining ground in healthcare and clinical decision-making. However, it is still unclear in what way AI can or should support decision-making that is based on incapacitated patients’ values and goals of care, which often requires input from clinicians and loved ones. Although the use of algorithms to predict patients’ most likely preferred treatment has been discussed in the medical ethics literature, no example has been realised in clinical practice. This is due, arguably, to the (...) lack of a structured approach to the epistemological, ethical and pragmatic challenges arising from the design and use of such algorithms. The present paper offers a new perspective on the problem by suggesting that preference predicting AIs be viewed as sociotechnical systems with distinctive life-cycles. We explore how both known and novel challenges map onto the different stages of development, highlighting interdisciplinary strategies for their resolution. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 45-46, June 2011.

The Patient Preference Predictor (PPP) is intended to improve treatment decision making for incapacitated patients. The PPP would collect information about the treatment preferences of people with different demographic and other characteristics. It could be used to indicate which treatment option an individual patient would be most likely to prefer, based on data about the preferences of people who resemble the patient. The PPP could be incorporated into existing US law governing treatment for incapacitated patients, although it is (...) unclear whether it would be classified as evidence of a specific patient’s preferences or those of a reasonable person sharing certain characteristics with the patient. Ethical concerns about the quality and significance of PPP choices could influence legal decision makers’ views of the PPP. (shrink)

In many ways, Maddie’s case brings together some of the most challenging features seen in clinical ethics consultation. First, it centers around a heart-wrenching event—the near-drowning of a young...

Law and economics scholarship suggests that, in appropriate cases, the law can improve people’s behavior by changing their preferences. For example, the law can curb discriminatory hiring practices by providing employers with information that might change their discriminatory preference. Supposedly, if employers no longer prefer one class of employees to another, they will simply stop discriminating, with no need for further legal intervention. The current Article aims to add some depth to this familiar analysis by introducing the insights of (...) behavioral ethics into the law and economics literature on preference change. Behavioral ethics research shows that wrongdoing often originates from semi-deliberative or non-deliberative cognitive processes. These findings suggest that the process of preference change through the use of the law is markedly more complicated and nuanced than previously appreciated. For instance, even if an employer’s explicit discriminatory stance is changed, and the employer no longer consciously prefers one class of employees over another, discriminatory behavior might persist if it originates from semi-conscious, habitual, or non-deliberative decision-making mechanisms. Therefore, actual change in behavior might necessitate a close engagement with people’s level of moral awareness. We discuss the institutional and normative implications of these insights and evaluate their significance for the attempt to improve preferences through the different functions of the legal system. (shrink)

How the diversity of membership of research ethics committees is arrived at has, to date, largely been fairly arbitrary. However, a tool to help determine one's moral preference is now available and it is introduced here as, arguably, having the potential to assist with ensuring a more meaningful diversity amongst an ethics committee's membership. The tool is seen to be easily applied – but, it is argued, may be conceived on at least two false premises. Firstly, despite different theories of (...) ethics, none can be proved to give the ‘right’ answer other than in its own terms. Secondly, if there is an ethical hierarchy, as the model suggests, then ethical diversity must become redundant for the possibility of achieving ethical excellence. (shrink)

This study surveyed investors to determine the extent to which they preferred ethical behavior to profits and their interest in having information about corporate ethical behavior reported in the corporate annual report. First, investors were asked to determine what penalties should be assessed against employees who engage in profitable, but unethical, behavior. Second, investors were asked about their interest in using the annual report to disclose the ethical performance of the corporation and company officials. Finally, investors were (...) asked if they felt that ethics reports should be audited.The survey results indicate that many shareholders (42%) do not expect a high level of ethical behavior from corporate employees or officers. There is a significant amount of interest in disclosure of ethical issues (72%) and unwillingness to trust management to provide unbiased reports of ethical behavior. If such reports are included with the financial statements, 32 percent of the investors surveyed would prefer to have them audited to provide independent verification. (shrink)

Interest in the use of medical data for health research is increasing. Yet, as Elizabeth Ford and colleagues rightly note, there are open questions about the suitability of existing ethical and regulatory oversight frameworks for these research approaches. In their feature article, ‘Should free text data in electronic medical records be shared for research? A citizen’s jury study in the United Kingdom’, Ford et al report the results of a deliberative engagement study in which 18 members of the public (...) were asked whether and under what conditions free text data from medical records should be shared for research purposes. The authors’ explicit aim was to inform national policy on sharing medical text. Public attitudes—stated otherwise, the attitudes of patients whose medical information will ultimately be used under any data sharing policy—are a necessary input into ethical and regulatory decision-making about use of medical data for health research. Though public attitudes will rarely be determinative, they must be weighed in order to uphold the ethical principle of respect for persons.1 Ford et al ’s article is, therefore, an important contribution to …. (shrink)

Monitoring and assistive technologies (MATs) are being used more frequently in healthcare. A central ethical concern is the compatibility of these systems with the moral preferences of their users—an issue especially relevant to participatory approaches within the ethics-by-design debate. However, users’ incapacity to communicate preferences or to participate in design processes, e.g., due to dementia, presents a hurdle for participatory ethics-by-design approaches. In this paper, we explore the question of how the value preferences of users in (...) the field of dementia care can be integrated into AI-based MATs. First, we briefly introduce different ethics-by-design approaches and explain the challenges they face in dementia care. Next, we introduce a novel approach for addressing these challenges. Through a qualitative content analysis of interviews with persons with dementia and their family caregivers (n = 27), we identified multiple ideal–typical value preference profiles. We then applied these profiles in a computer simulation, by which we also introduce the concept of ethical compliance quantification to scale the moral preferences of the interviewees for the simulation. Finally, we discuss study results, the advantages of using computer simulations, and general study limitations before drawing conclusions for further research. The study contributes to the ongoing debate on participatory ethics-by-design by defining on the basis of empirical data ideal–typical value preference frameworks that can be used to guide MAT actions and their outcomes. Going forward, MAT end-users with dementia and other communication-impaired persons could be enabled to choose a value profile that best fits their moral preferences. (shrink)

Introduction: The use of human samples in genomic research has increased ethical debate about informed consent (IC) requirements and the information that subjects should receive regarding the results of the research. However, there are no quantitative data regarding researchers’ attitudes about these issues. Methods: We present the results of a survey of 104 US and 100 Spanish researchers who had published genomic epidemiology studies in 61 journals during 2006. Results: Researchers preferred a broader IC than the IC they had (...) actually obtained in their published papers. US authors were more likely than their Spanish colleagues to support obtaining a broad IC, covering either any future research project or any projects related to a group of diseases (67.6% vs 43%; adjusted OR = 4.84, 95% CI, 2.32 to 10.12). A slight majority of researchers (55.8%) supported informing participants about individual genomic results only if the reliability and clinical validity of the information had been established. Men were more likely than women to believe that patients should be informed of research results even if these conditions were not met (adjusted OR = 2.89, 95% CI = 1.46 to 5.72). Conclusions: This study provides evidence of a wide range of views among scientists regarding some controversial ethical issues related to genomic research, suggesting the need for more study, debate and education. In the interim, journals might consider including the investigators’ policies regarding these ethical issues in the papers they publish in the field of genomic epidemiology. (shrink)

Inspired by the recent trends in education towards learner autonomy with their emphasis on the interests and desires of the students, and borrowing ideas from philosophy (particularly ethics), the present study is an attempt to investigate the discrepancy in the findings of the studies addressing error correction in L2 writing instruction, and suggest the (oft-neglected) students’ beliefs, interests and wants as what can point the way out of confusion. To this end, a questionnaire was developed and 56 advanced adult EFL (...) learners were asked to complete the questionnaire. The opinions of 20 EFL teachers were also collected using another questionnaire. Twenty-three of the students and 13 of the teachers were then interviewed in an attempt to collect explanations for their answers in the questionnaires. The results indicated that all the learners wanted the errors in their writings to be corrected. About 90 percent of them believed that all the errors in their writings should be corrected and only less than 10 percent of them agreed that there is no need to correct all the errors and that only “important” errors should be rectified. On the contrary, of the teachers who participated in the study, only 20 percent believed that all the errors in the students’ writings should be corrected. While most of the interviewed students attributed their preference of choice to feeling more confident and efficient in learning when they can recognize all the errors in their written assignments, most of the teachers believed that by correcting important errors (and not all errors), learners can get the most of their writings. Given the incongruity between teachers’ and (advanced) students’ beliefs over writing error correction, and considering advanced students as legitimate decision makers for their own learning, some suggestions are offered for EFL writing teachers. -/- . (shrink)

Recent research in empirical moral psychology attempts to understand (rather than place judgment on) the salient normative differences that laypeople have when making moral decisions by using survey methodology that is based on the operationalized principles from moral theories. The PPIMT is the first measure designed to assess respondents’ preference for the precepts implied in the three dominant moral theories: virtue ethics, deontology, and consequentialism. The current study used a latent modeling approach to determine the most theoretically and psychometrically-sound model (...) for the PPIMT using a combined sample of college students from a southeastern university in U.S. and MTurk respondents. The PPIMT model fit was acceptable (χ2 = 84.125, df = 40, p = 0.001; RMSEA = 0.052, 90%CI = 0.037 to 0.068; CFI = 0.980; SRMR = 0.035) with four items for Virtue, four items for Deontology, and three items for Consequentialism. (shrink)

An analysis is presented of the relationships between consumers ethical beliefs, ethical ideology, Machiavellianism, political preference and the individual difference variable "need for closure". It is based on a representative survey of 286 Belgian respondents. Standard measurement tools of proven reliability and robustness are used to measure ethical beliefs (consumer ethics scale), ethical ideology (ethical positioning), Machiavellianism (Mach IV scale) and need for closure. The analysis finds the following. First, individuals with a high need for (...) closure tend to have beliefs that are more ethical as regards possible consumer actions, and score higher on idealism and lower on Machiavellianism, than those with a low need for closure. Second, a correlation exists between political preference and ethical beliefs. Third, a significant relationship exists between ethical ideology and political preference for the two largest political parties. Fourth, individuals with a high and low need for closure have different political preferences for right-wing and left-wing parties. (shrink)

This chapter examines how social- scientific research on public preferences bears on the ethical question of how those resources should in fact be allocated, and explain how social-scientific researchers might find an understanding of work in ethics useful as they design mechanisms for data collection and analysis. I proceed by first distinguishing the methodologies of social science and ethics. I then provide an overview of different approaches to the ethics of allocating scarce medical interventions, including an approach—the complete (...) lives system—which I have previously defended, and a brief recap of social-scientific research on the allocation of scarce medical resources. Following these overviews, I examine different ways in which public preferences could matter to the ethics of allocation. Last, I suggest some ways in which social scientists could learn from ethics as they conduct research into public preferences regarding the allocation of scarce medical resources. (shrink)

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

Adults with dysphagia experience difficulties swallowing food and fluids with potentially harmful health and psychosocial consequences. Speech pathologists who manage patients with dysphagia are frequently required to address ethical issues when patients' food culture and/ or preferences are inconsistent with recommended diets. These issues incorporate complex links between food, identity and social participation. A composite case has been developed to reflect ethical issues identified by practising speech pathologists for the purposes of illustrating ethical concerns in dysphagia (...) management. The case examines a speech pathologist's role in supporting patient autonomy when patients and carers express different goals and values. The case presents a 68-year-old man of Australian/Italian heritage with severe swallowing impairment and strong values attached to food preferences. The case is examined through application of the dysphagia algorithm, a tool for shared decision-making when patients refuse dietary modifications. Case analysis revealed the benefits and challenges of shared decision-making processes in dysphagia management. Four health professional skills and attributes were identified as synonymous with shared decision making: communication, imagination, courage and reflection. (shrink)

The Mohists may have been the first consequentialists on earth. Their most important principles are that right action is what benefits the world and that the underlying outlook for benefiting the world is inclusive care, whereby each person receives equal consideration. The early Mohists are clearly objective-list consequentialists, whereby benefiting the world amounts to promoting the most basic goods. Stephens argues that the later Mohists shift to a preference-satisfaction consequentialism whereby benefiting the world amounts to promoting what happens to please (...) individual people. Stephens argues that while the direct texts are ambiguous between an objective-list interpretation and a preference-satisfaction interpretation, the latter better explains later Mohist engagement with opponents. I argue that the direct texts actually preclude Stephens’ preference-satisfaction interpretation, which moreover has the later Mohists concede an implausible amount to their opponents. (shrink)

There is a problem within contractarian ethics that I wish to resolve. It concerns individual preferences. Contractarianism holds that morality, properly conceived, can satisfy individual preferences and interests better than amorality or immorality. What is unclear, however, is whether these preferences are those individuals actually hold or those that they should hold. The goal of my thesis is to investigate this question. I introduce a version of contractarian ethics that relies on individual preferences in a manner (...) more stringent than has been in the literature to date. "Occurrent contractarianism," as I have called it, is rooted in our social-psychological state. Given the characteristics we have, and given the social situation in which we are embedded, the best resolve we have of furthering our individually defined preferences is to adopt and adhere to a moral system. Occurrent contractarianism remains true to the original contractarian insight; that morality is a rational institution, capable of being designed for and adhered to even by non-tuistic rational beings following merely their own occurrent preferences. (shrink)

Citizens of liberal, affluent societies are regularly encouraged to support reforms meant to improve conditions for badly-off people in the developing world. Our economic and political support is solicited for causes such as: banning child labor, implementing universal primary education, closing down sweatshops and brothels, etc. But what if the relevant populations or individuals in the developing world do not support these particular reforms or aid programs? What if they would strongly prefer other reforms and programs, or would rank the (...) various benefits that might be offered differently than seems reasonable to the Western, liberal supporters of these campaigns and organizations? What is the proper liberal response here? I argue that the proper liberal response is to support those programs and reforms that the global poor most value. The bulk of the paper is devoted to arguing against the popular liberal argument which states that we can safely disregard the preferences of the oppressed when they seem very unreasonable because these individuals suffer from “adaptive preferences.” This typically is taken to mean that their preferences are “not their own” in an important sense. I put forward various different proposals for why adaptive preferences can be safely dismissed, but ultimately argue that they are not persuasive. And if it is no longer legitimate to appeal to adaptive preferences as a basis for disregarding what oppressed people want, then I argue that to do so is straightforward paternalism, and so is unjustifiable in all but the most extreme cases. Finally, I argue for the following concrete recommendations: Given that resources are not infinite, we should (1) Support programs that give oppressed people increased access to information, such as access to technology, (2) support those reforms and aid programs that the oppressed themselves regard as most important, with special emphasis on those opportunities for education that they deem valuable, and (3) refrain from supporting coercive policies intended to thwart adaptive preferences. (shrink)

Effective documentation is considered a core competency for clinical ethics consultation. Ethics consultants within the Cleveland Clinic in Cleveland, Ohio, observed variation in the formatting of ethics chart notes across consultants and realized that this formatting was based on their own views of effectiveness. To minimize variation and optimize the readability and understandability of ethics chart notes for end users, a team undertook a quality improvement project to assess the formatting preferences of healthcare professionals who rely on ethics consultation (...) notes. The team developed three sample templates and conducted interviews with stakeholders to understand their preferences. A single standardized template was developed based on the preferences that emerged, which all consultants on the ethics consultation service then utilized. In the first five months of implementation, the percentage of end user respondents marking the highest Likert scale option on a post-consultation survey regarding whether the ethics consultation service provided helpful documentation increased from 60 percent to 72 percent compared to the same five-month period in the year prior. (shrink)

In the past 40 years, a global shift has taken place towards a constellation of values known as “expansive values”, which de-emphasize pursuits of money, possessions, and status, and instead focus on quality of life and humanistic goals. This study investigated what students holding expansive values desired in business school course content and student quality of life, and how these preferences differed from students holding materialistic values. Results revealed a number of different factors that were associated only with expansive (...) values, though on a few factors the two student values cohorts shared similar preferences or had inverse preferences. One clear implication of this study is that business schools need to consider offering more ethics classes in order to satisfy the growing number of students with expansive values. (shrink)

I consider the plausibility of discounting for kinship, the view that a positive rate of pure intergenerational time preference is justifiable in terms of agent-relative moral reasons relating to partiality between generations. I respond to Parfit's objections to discounting for kinship, but then highlight a number of apparent limitations of this approach. I show that these limitations largely fall away when we reflect on social discounting in the context of decisions that concern the global community as a whole, such as (...) those related to global climate change. (shrink)

Existence value refers to the value humans ascribe to the existence of something, regard­less of whether it is or will be of any particular use to them. This existence value based on preference satisfaction should be taken into account in evaluating activities that come with a risk of species extinction. There are two main objections. The first is that on the preference satisfaction interpretation, the concept lacks moral importance because satisfying people’s preferences may involve no good or well-being for (...) them. However, existence value can be based on a restricted version of the preference satisfaction theory, which is not vulnerable to the skeptical arguments about the link between preference satisfaction and well-being. The second objection is that even if preference satisfaction can be linked to well-being, understanding existence value in terms of individual preference satisfaction is incoherent, because existence value reflects disinterested preferences that involve no benefits to the individual. However, the fact that existence value may involve disinterested preferences does not threaten the coherence of the concept, but suggests that it does not fit smoothly into the “utilitarian” or “welfarist” framework it is commonly considered within. A pluralistic normative approach based on prima facie duties can be an alternative to standard utilitarian-style approaches for considering existence value in concrete cases involving a risk of species extinction, such as through deep sea mining. (shrink)

Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others. In this paper, we consider whether _inappropriately adaptive preferences_—preferences that are based on and that may perpetuate social injustice—should be categorised as autonomous in a way that gives them normative authority. Some philosophers have argued that inappropriately adaptive preferences do not (...) have normative authority, because they are only a reflection of a person’s social context and not of their true self. Under this view, medical professionals who refuse to carry out actions which are based on inappropriately adaptive preferences are not in fact violating their patient’s autonomy. However, we argue that it is very difficult to articulate a systematic and principled distinction between normal autonomous preferences and inappropriately adaptive preferences, especially if this distinction needs to be useful for clinicians in real-life situations. This makes it difficult to argue that inappropriately adaptive preferences are straightforwardly non-autonomous. Given this problem, we argue that there are significant theoretical issues with contemporary understandings of autonomy in bioethics. We discuss what this might mean for the practice of medicine and for medical ethics education. (shrink)

Since Chinese scholars are playing an increasingly important role in shaping the national landscape of discussion on AI ethics, understanding their ethical concerns and preferred solutions is essential for global cooperation on governance of AI. This article, therefore, provides the first elaborated analysis on the discourse on AI ethics in Chinese academia, via a systematic literature review. This article has three main objectives. to identify the most discussed ethical issues of AI in Chinese academia and those being left (...) out ; to analyze the solutions proposed and preferred by Chinese scholars ; and to map out whose voices are dominating and whose are in the marginal. Findings suggest that in terms of short-term implications, Chinese scholars’ concerns over AI resemble predominantly the content of international ethical guidelines. Yet in terms of long-term implications, there are some significant differences needed to be further addressed in a cultural context. Further, among a wide range of solution proposals, Chinese scholars seem to prefer strong-binding regulations to those weak ethical guidelines. In addition, this article also found that the Chinese academic discourse was dominated by male scholars and those who are from elite universities, which arguably is not a unique phenomenon in China. (shrink)

Aim: To improve clinical and ethical understanding of patient preferences for information and involvement in decision making.Objectives: To develop and evaluate a clinical tool to elicit these preferences and to consider the ethical issues raised.Design: A before and after study.Setting: Three UK hospices.Participants: Patients with advanced life-threatening illnesses and their doctors.Intervention: Questionnaire on information and decision-making preferences.Main outcome measures: Patient-based outcome measures were satisfaction with the amount of information given, with the way information was given, (...) with family or carer information, and confidence about future decision making. Doctor-based outcome measures were confidence in matching information to patient preference, matching family or carer communication to patient preference, knowing patient preferences and matching future decision making with patient preference.Results: Of 336 admissions, 101 patients completed the study . Patient satisfaction with the way information was given and family communication improved after introduction of the tool. Doctor confidence improved across all outcome measures .Conclusions: Patient satisfaction and doctor confidence were improved by administering the questionnaire, but complex ethical issues were raised by implementing and applying this research. The balance of ethical considerations were changed by advanced life-threatening illness, because there is increased risk of harm through delivery of information discordant with the patient’s own preferences. The importance of truly understanding patient preferences towards the end of life is highlighted by this study. (shrink)

Most ethical work is done at a low level of formality. This makes practical moral questions inaccessible to formal and natural sciences and can lead to misunderstandings in ethical discussion. In this paper, we use Bayesian inference to introduce a formalization of preference utilitarianism in physical world models, specifically cellular automata. Even though our formalization is not immediately applicable, it is a first step in providing ethics and ultimately the question of how to “make the world better” with (...) a formal basis. (shrink)

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

This paper offers a general approach to ethics before considering its implications for the question of how to respond to religious preferences in healthcare, especially those of patients and healthcare workers. The first section outlines the two main components of the approach: (1) demoralizing, that is, seeking to avoid moral terminology in the discussion of reasons for action; (2) welfarism, the view that our ultimate reasons are grounded solely in the well-being of individuals. Section 2 elucidates the notion of (...) religious preferences and describes the history and importance of their protection by human rights legislation. The following section defends the ‘Preference Principle’, according to which there is a reason to satisfy any preference (in so far as that satisfaction advances well-being). Section 4 discusses the implications of this principle for religious preferences in healthcare, again seeking to bring out the special social and political importance of respect, and respect for such preferences in particular. The paper ends with a brief description of how to approach such problems from the perspective of a demoralized welfarism. (shrink)

Nearly all studies of consumers’ willingness to engage in ethical or socially responsible purchasing behavior is based on unconstrained survey response methods. In the present article we ask the question of how well does asking consumers the extent to which they care about a specific social or ethical issue relate to how they would behave in a more constrained environment where there is no socially acceptable response. The results of a comparison between traditional survey questions of “intention to (...) purchase” and estimates of individuals willingness-to-pay for social attributes in products reveal that simple survey questions are too “noisy” to provide operationally meaningful information and overstate intentions to a considerable extent. (shrink)

New technologies not only contribute greatly to society and the economy; they also involve fundamental societal shifts, challenging our values and ideas about ourselves and the world. With a view to aligning technological change and innovation with ethical values, the concept of responsible innovation advocates the inclusion of a variety of stakeholders, in particular from society. In shifting moral responsibility towards the producers of innovations, responsible innovation rejects the standard normative economic view that the ethical evaluation of innovations (...) is a matter of individual consumers’ market-based choices. However, in this article we argue that responsible innovation should not abandon all normative consideration of the individual outright, to which end we present an alternative normative economic approach based on preference learning. We show how this approach can provide an enhanced understanding of responsible innovation by clarifying the redistribution of moral responsibility and casting individuals in the normative role of co-innovators, rather than mere consumers. We argue that responsible innovation should enable individuals to form preferences and evaluate innovations, so as to align innovation with ethical demands. Finally, we show how our proposed approach can be put into practice in so-called laboratories in real-world contexts, using methods from the field of design. In short, drawing on normative economics, this article aims to establish a new understanding of responsible innovation that is conceptually sound and can form the basis for novel innovation practices. (shrink)

Ethical questions normally arise in sport because its participants are human moral agents and because its practice community entails the observance of rules and responsibilities that humans generally owe one another in a social practice of voluntary competition. Since nature sports are not defined by this kind of inter-agential activity, it would appear that there are no comparable ethical constraints on their pursuit. This paper considers conflicts of preference versus right between humans, how these are resolved, and whether (...) these rights are relevant in assessment of nature sport activity vis-à-vis nonhuman creatures. Relying on a goods perspective instead of a rights framework, via Korsgaard, I argue against an assumption that human preference is sufficient to override consideration of nonhuman animals’ functional goods. (shrink)

Machine learning-driven clinical decision support systems (ML-CDSSs) seem impressively promising for future routine and emergency care. However, reflection on their clinical implementation reveals a wide array of ethical challenges. The preferences, concerns and expectations of professional stakeholders remain largely unexplored. Empirical research, however, may help to clarify the conceptual debate and its aspects in terms of their relevance for clinical practice. This study explores, from an ethical point of view, future healthcare professionals’ attitudes to potential changes of (...) responsibility and decision-making authority when using ML-CDSS. Twenty-seven semistructured interviews were conducted with German medical students and nursing trainees. The data were analysed based on qualitative content analysis according to Kuckartz. Interviewees’ reflections are presented under three themes the interviewees describe as closely related: (self-)attribution of responsibility, decision-making authority and need of (professional) experience. The results illustrate the conceptual interconnectedness of professional responsibility and its structural and epistemic preconditions to be able to fulfil clinicians’ responsibility in a meaningful manner. The study also sheds light on the four relata of responsibility understood as a relational concept. The article closes with concrete suggestions for the ethically sound clinical implementation of ML-CDSS. (shrink)

Traditional terms for theology of work, including co-creation and vocation, tend to overvalue work, abetting the alienating conditions of postindustrial labor. To develop a theology that can help workers make sense of work's expansion, abstractness, and precarity, this essay proposes a postindustrial ethic of selective detachment from work. The Benedictine tradition offers a model. According to the Benedictine Rule, monastic work is important as a penitential practice but is strictly circumscribed, with prescriptions to forestall overinvestment in work. By detaching themselves (...) from work, monastics cannot place labor ahead of prayer. In the medieval economy, monastic labor demonstrated work's role in sanctification. Today, the Benedictine Rule demonstrates the need for worldly ascetical practices that will limit work so it does not inhibit someone seeking holiness. (shrink)

Patient preference predictors (PPPs) promise to provide medical professionals with a new solution to the problem of making treatment decisions on behalf of incapacitated patients. I show that the use of PPPs faces a version of a normative problem familiar from legal scholarship: the problem of naked statistical evidence. I sketch two sorts of possible reply, vindicating and debunking, and suggest that our reply to the problem in the one domain ought to mirror our reply in the other. The conclusion (...) is thus conditional: if we think the problem of naked statistical evidence is a serious problem in the legal domain, then we should be concerned about the symmetrical problem for PPPs. (shrink)