Procedural safeguards cannot disentangle MAiD from organ donation decisions

2020 ◽  
pp. medethics-2020-106456
Author(s):  
Zeljka Buturovic
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Ethical Issues ◽  
Rare Event ◽  
Organ Donors ◽  
Medical Assistance In Dying ◽  
Patients With Cancer ◽  
Human Decision ◽  
The One

In the past, a vast majority of medical assistance in dying (MAiD) patients were elderly patients with cancer who are not suitable for organ donation, making organ donation from such patients a rare event. However, more expansive criteria for MAiD combined with an increased participation of MAiD patients in organ donation is likely to drastically increase the pool of MAiD patients who can serve as organ donors. Previous discussions of ethical issues arising from these trends have not fully addressed difficulties involved in separating decision to end one’s life from the one to donate one’s organs. However, realities of organ donation logistics and human decision making suggest that this separation can be extraordinary difficult. The need to maximise quality of donated organs complicates dying experience of the donor and is likely in tension with the dying experience the patient envisioned when first considering MAiD. Furthermore, the idea that patients will think about MAiD first, and only when firmly decided to end their life, consider organ donation, runs contrary to organ donation policies in some countries as well as end of life and everyday decision making. This opens the door for organ donation to serve as an incentive in MAiD decisions. Dispensing with the simplistic assumption that organ donation can never be a factor in MAiD decisions is, therefore, essential first step to properly addressing ethical issues at hand.

Uncertainty Forecasts Improve Decision Making Among Nonexperts

2009 ◽  
Vol 3 (3) ◽  
pp. 209-227 ◽  
Author(s):  
Limor Nadav-Greenberg ◽  
Susan L. Joslyn
Keyword(s):  
Decision Making ◽  
Web Based ◽  
Traditional Research ◽  
Weather Uncertainty ◽  
Human Decision ◽  
The One ◽  
Normative Models ◽  
Uncertainty Information ◽  
The Impact

The objective of this research was to evaluate the impact of weather uncertainty information on decision making in naturalistic settings. Traditional research often reveals deficits in human decision making under uncertainty as compared with normative models of rational choice. However, little research has addressed the question of whether people in naturalistic settings make better decisions when they have uncertainty information as compared with when they have only a deterministic forecast. Two studies investigated the effect of several types of weather uncertainty information on the quality of decisions to protect roads against icing and on temperature predictions and compared them with a control condition that provided deterministic forecast only. Experiment 1 was a Web-based questionnaire that included a single trial. Experiment 2, conducted in lab, included 120 trials and provided outcome feedback and a reward based on performance. Both studies indicated enhanced performance with uncertainty information. The best kind of uncertainty information tested here was the one that provided the probability at the threshold for the task at hand. We conclude that uncertainty information can be used advantageously, even when it does not result in perfectly rational performance, and that uncertainty can be communicated effectively to nonexpert end users, resulting in improved decision making.

Taking Public Administration Seriously

2020 ◽  
pp. 1-45
Author(s):  
Joseph Heath
Keyword(s):  
Decision Making ◽  
Public Administration ◽  
Policy Process ◽  
Civil Service ◽  
Democratic Legitimacy ◽  
Administrative Power ◽  
Liberal Democratic ◽  
The One ◽  
Public Decision

This chapter begins with a series of examples that illustrate the power wielded by unelected state officials. This power includes not only discretion but also control over the policy process, as well as the ability to bring pressure to bear upon elected officials. The exercise of this administrative power, far from being an imperfection in the system, contributes a great deal to the quality of public decision-making. But it raises a difficult normative question concerning how unelected officials can wield power in a way that is consistent with the commitment to political neutrality of the permanent civil service and to the more general principles of democratic legitimacy that govern liberal-democratic states. A contrast is drawn between this position and the one defended by Pierre Rosanvallon.

Human Action in the Loop

2015 ◽  
pp. 352-368
Author(s):  
Hartwig Steusloff ◽  
Michael Decker
Keyword(s):  
Decision Making ◽  
Human Action ◽  
Effective Control ◽  
System Component ◽  
Ethical Reflection ◽  
High Expectations ◽  
Human In The Loop ◽  
Human Decision ◽  
System Life ◽  
The One

Extremely complex systems like the smart grid or autonomous cars need to meet society's high expectations regarding their safe operation. The human designer and operator becomes a “system component” as soon as responsible decision making is needed. Tacit knowledge and other human properties are of crucial relevance for situation-dependent decisions. The uniform modeling of technical systems and humans will benefit from ethical reflection. In this chapter, we describe human action with technical means and ask, on the one hand, for a comprehensive multidisciplinary technology assessment in order to produce supporting knowledge and methods for technical and societal decision making. On the other hand—and here is the focus—we propose a system life cycle approach which integrates the human in the loop and argue that it can be worthwhile to describe humans in a technical way in order to implement human decision making by means of the use case method. Ethical reflection and even ethically based technical decision making can support the effective control of convergent technology systems.

A Brief Comment on Science-based Risk Regulation Within the European Union

2012 ◽  
Vol 3 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Barbara Stibernitz
Keyword(s):  
Decision Making ◽  
European Union ◽  
Central Position ◽  
The European Union ◽  
Risk Regulation ◽  
General Acceptance ◽  
Scientific Experts ◽  
Democratic Control ◽  
The One

Nowadays as political decision making involves such a huge range of complex matters, scientific experts have become more and more involved in European risk regulation. The support by so-called independent experts may, on the one hand, be seen as a guarantee of rational decision making, increasing the quality of decisions as well as the general acceptance of all people affected. On the other hand, the number of expert groups, scientific committees and agencies helping the Commission in fulfilling its duties is vast and confusing.In addition, scientific advisory bodies often face the burden of unrealizable independence, as well as a lack of transparency and democratic control. This article sums up the central position of science-based risk regulation within the European Union (EU), referring to the necessity for expert opinion as well as to consequent problems concerning the involvement of these experts in risk regulatory actions.

scholarly journals Psychotherapy of a Relationship Break-Up in the Context of Assisted Reproductive Technologies

2021 ◽  
Vol 29 (1) ◽  
pp. 132-148
Author(s):  
I.I. Znamenskaya ◽  
M.R. Travkova ◽  
K.R. Arutyunova
Keyword(s):  
Decision Making ◽  
Legal Status ◽  
Ethical Issues ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
The Other ◽  
Fertility Treatment ◽  
Break Up ◽  
The One ◽  
Cryopreserved Embryos

The paper is focused on ethical issues of making decisions about cryopreserved embryos in the context of relationship break-up in the framework of the embryo’s legal status and the church’s stand on the matter. All these issues can be viewed as part of a broader problem of intuitive and rational foundations for decision-making when facing difficult situations in life. On the one hand, the stressful context of the situation implies intuitive-driven decision-making; on the other hand, assisted reproductive technologies are largely counter-intuitive. We describe the peculiarities of family psychotherapy with mixed-agenda couples going through a divorce who have joint cryopreserved embryos but disagree on what to do with them. We introduce a protocol for psychotherapeutic work in the situation when one partner wishes to continue with the fertility treatment and have a child while the other partner is determined to utilize joint embryos as unwanted biological material. In addition, we discuss emotional and social complications that may arise (guilt, unfaithfulness of one of the partners, other losses, and grieving).

Voter Information Processing and Political Decision Making

2019 ◽  
Author(s):  
Alessandro Nai
Keyword(s):  
Decision Making ◽  
Information Processing ◽  
Individual Differences ◽  
Selective Exposure ◽  
Political Information ◽  
The Other ◽  
Electoral Campaigns ◽  
Political Choices ◽  
The One

Contemporary political information processing and the subsequent decision-making mechanisms are suboptimal. Average voters usually have but vague notions of politics and cannot be said to be motivated to invest considerable amount of times to make up their minds about political affairs; furthermore, political information is not only complex and virtually infinite but also often explicitly designed to deceive and persuade by triggering unconscious mechanisms in those exposed to it. In this context, how can voters sample, process, and transform the political information they receive into reliable political choices? Two broad set of dynamics are at play. On the one hand, individual differences determine how information is accessed and processed: different personality traits set incentives (and hurdles) for information processing, the availability of information heuristics and the motivation to treat complex information determine the preference between easy and good decisions, and partisan preferences establish boundaries for information processing and selective exposure. On the other hand, and beyond these individual differences, the content of political information available to citizens drives decision-making: the alleged “declining quality” of news information poses threats for comprehensive and systematic reasoning; excessive negativity in electoral campaigns drives cynicism (but also attention); and the use of emotional appeals increases information processing (anxiety), decreases interest and attention (rage), and strengthens the reliance on individual predispositions (enthusiasm). At the other end of the decisional process, the quality of the choices made (Was the decision supported by “ambivalent” opinions? And to what extent was the decision “correct”?) is equally hard to assess, and fundamental normative questions come into play.

Complexity, Bounded Rationality and Heuristic Search

2002 ◽  
Vol 1 (1) ◽  
Author(s):  
W. Bentley MacLeod
Keyword(s):  
Decision Making ◽  
Rational Choice ◽  
Heuristic Search ◽  
Rational Choice Theory ◽  
Choice Theory ◽  
Heuristic Function ◽  
Heuristic Search Algorithms ◽  
Human Decision

Abstract This paper explores the use of heuristic search algorithms for modeling human decision making. It is shown that this algorithm is consistent with many observed behavioral regularities, and may help explain deviations from rational choice. The main insight is that the heuristic function can be viewed as formal implementation of one aspect of emotion as discussed in Descarte's Error by Antonio Damasio. Consistent with Damasio's observations, it is shown that the quality of decision making is very sensitive to the nature of the heuristic ("emotion"), and hence this may help us better understand the role of emotion in rational choice theory.

scholarly journals Comparing organ donation decisions for next-of-kin versus the self: results of a national survey

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051273
Author(s):  
Christopher Weiyang Liu ◽  
Lynn N Chen ◽  
Amalina Anwar ◽  
Boyu Lu Zhao ◽  
Clin K Y Lai ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Organ Donation ◽  
Family Members ◽  
The Self ◽  
Organ Donors ◽  
Next Of Kin ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Barrier

ObjectivesIntensive care audits point to family refusal as a major barrier to organ donation. In this study, we sought to understand refusal by accounting for the decision-maker’s mindset. This focused on: (1) how decisions compare when made on behalf of a relative (vs the self); and (2) confidence in decisions made for family members.DesignCross-sectional survey in Singapore.SettingParticipants were recruited from community settings via door-to-door sampling and community eateries.Participants973 adults who qualified as organ donors in Singapore.ResultsAlthough 68.1% of participants were willing to donate their own organs, only 51.8% were willing to donate a relative’s organs. Using machine learning, we found that consistency was predicted by: (1) religion, and (2) fears about organ donation. Conversely, participants who were willing to donate their own organs but not their relative’s were less driven by these factors, and may instead have resorted to heuristics in decision-making. Finally, we observed how individuals were overconfident in their decision-making abilities: although 78% had never discussed organ donation with their relatives, the large majority expressed high confidence that they would respect their relatives’ wishes on death.ConclusionsThese findings underscore the distinct psychological processes involved when donation decisions are made for family members. Amidst a global shortage of organ donors, addressing the decision-maker’s mindset (eg, overconfidence, the use of heuristics) may be key to actualizing potential donors identified in intensive care units.

scholarly journals Decision Making with Dynamic Uncertain Events

2015 ◽  
Vol 54 ◽  
pp. 233-275 ◽  
Author(s):  
Meir Kalech ◽  
Shulamit Reches
Keyword(s):  
Decision Making ◽  
Approximation Algorithms ◽  
Optimal Algorithm ◽  
The Other ◽  
Uncertain Information ◽  
Effective Algorithm ◽  
Key Factor ◽  
The One ◽  
The Cost

When to make a decision is a key question in decision making problems characterized by uncertainty. In this paper we deal with decision making in environments where information arrives dynamically. We address the tradeoff between waiting and stopping strategies. On the one hand, waiting to obtain more information reduces uncertainty, but it comes with a cost. Stopping and making a decision based on an expected utility reduces the cost of waiting, but the decision is based on uncertain information. We propose an optimal algorithm and two approximation algorithms. We prove that one approximation is optimistic - waits at least as long as the optimal algorithm, while the other is pessimistic - stops not later than the optimal algorithm. We evaluate our algorithms theoretically and empirically and show that the quality of the decision in both approximations is near-optimal and much faster than the optimal algorithm. Also, we can conclude from the experiments that the cost function is a key factor to chose the most effective algorithm.

scholarly journals Atari-HEAD: Atari Human Eye-Tracking and Demonstration Dataset

2020 ◽  
Vol 34 (04) ◽  
pp. 6811-6820
Author(s):  
Ruohan Zhang ◽  
Calen Walshe ◽  
Zhuode Liu ◽  
Lin Guan ◽  
Karl Muller ◽  
...  
Keyword(s):  
Decision Making ◽  
Eye Movements ◽  
Visual Attention ◽  
Large Scale ◽  
Imitation Learning ◽  
High Quality ◽  
Human Decision ◽  
Public Datasets ◽  
Game Performance

Large-scale public datasets have been shown to benefit research in multiple areas of modern artificial intelligence. For decision-making research that requires human data, high-quality datasets serve as important benchmarks to facilitate the development of new methods by providing a common reproducible standard. Many human decision-making tasks require visual attention to obtain high levels of performance. Therefore, measuring eye movements can provide a rich source of information about the strategies that humans use to solve decision-making tasks. Here, we provide a large-scale, high-quality dataset of human actions with simultaneously recorded eye movements while humans play Atari video games. The dataset consists of 117 hours of gameplay data from a diverse set of 20 games, with 8 million action demonstrations and 328 million gaze samples. We introduce a novel form of gameplay, in which the human plays in a semi-frame-by-frame manner. This leads to near-optimal game decisions and game scores that are comparable or better than known human records. We demonstrate the usefulness of the dataset through two simple applications: predicting human gaze and imitating human demonstrated actions. The quality of the data leads to promising results in both tasks. Moreover, using a learned human gaze model to inform imitation learning leads to an 115% increase in game performance. We interpret these results as highlighting the importance of incorporating human visual attention in models of decision making and demonstrating the value of the current dataset to the research community. We hope that the scale and quality of this dataset can provide more opportunities to researchers in the areas of visual attention, imitation learning, and reinforcement learning.

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