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Jane was in imminent danger of an impending thyroid storm from her goiter and was experiencing intermittent psychosis. The clinical team was focusing on capacity evaluations as they found Jane to be angry, hostile, and difficult, and believed an involuntary hold was necessary as she was not consistently consenting to the surgery and trying to leave. As soon as Jane had the thyroidectomy she would return to her baseline as if nothing had happened. When I was training, I shared with a few close colleagues and mentors my nervousness about how I would be received as a clinical ethicist. I was cognizant that there would be some patients who may not appreciate my disability or see it as of value. In reality, Jane had a big ally in me and my disability helped me untangle some aspects of the case in a way that validated her experience. Nonetheless, clinical ethicists have a responsibility to actively assess and check for implicit bias within ourselves. As we caution our clinical colleagues not to be paternalistic in their practice, we, too, must not be paternalistic in ours.
Decision-making in oncology care is at best consequential and complex. This chapter explores a clinical ethics consultation exploring the difficult task of determining cancer directed therapy for a patient with a profound neurocognitive disability. The case highlights the ethics consultant’s and the multidisciplinary team’s missteps and failure to recognize that the true ethical question was not only “How can we ensure that this patient is treated equitably and receives the standard of care treatment,” but also “Is surgery really the right treatment option for this patient?” While disability rights activists have long proclaimed that all individuals should be granted equal access to healthcare, it is ethically permissible to tailor standards of care to meet the specific and unique needs of the patient sitting in front of you. This chapter illustrates the noble intent of clinicians and the limitations of substituted judgment in deciding for others.
Accountability in grant-making requires a valid, fair and transparent selection process. This study proposes a four-step framework for validating such a process: determine standards for qualified applicants, assess inter-reviewer reliability, assess factorial validity, and assess reliability. This framework is applied to the Corporation for National and Community Service’s 2013 RSVP grant-making process. The standards were close to the highest points of reliability. Inter-reviewer reliability was above 0.90, a common threshold for high-stakes measurement. After conducting confirmatory factor analysis, the final model merged two of the original five domains of selection criteria, resulting in four domains. The final model was found to have strict measurement invariance, high convergent validity, and measurement reliability between 0.88 and 0.93 for all domains. The results validate the 2013 review process and indicated that the scores exhibited high degrees of reliability, giving public assurance that the process was sufficiently objective and accurately reflected program priorities.
This article investigates the combined effect of experiential and reflective learning on student learning in international politics. It proceeds from the premise that students need a more realistic view of decision-makers so as to understand the logic and context of foreign policy-making better. A board game was used to model the foreign policy decision-making environment, and written and oral reflections were utilised to link students’ personal experience to abstract concepts of foreign policy analysis. Using a quasi-experimental design, both qualitative and quantitative data were used to test the hypotheses about students’ altered views of decision-making and their interest in and learning about foreign policy analysis. Results show that, in comparison with the impact of traditional lecturing combined with discussions, the benefits of experiential and reflective learning are very small. The little support for the existence of such benefits that was uncovered comes from qualitative data and a few statistical measures based on student self-evaluation. Quantitative analyses based on objective measures provided little evidence for a difference between the two teaching approaches. The article concludes with a call for improving the effectiveness and evaluation of reflective learning methods and putting the theories of reflective learning into practice more profitably in international relations.
This study presents an interdisciplinary systematic review of the literature on donation-based and reward-based crowdfunding. The literature to date has explored differences in crowd’s behavior and incentives for participating in the platform, as well as the factors governing funding and post-funding success. The authors summarize the main findings to date and synthesize the different theoretical explanations for the decision-making behavior of the crowd. The investigation reveals how the literature to date has upheld the importance of crowdfunding as a social and democratic tool, one that demonstrates wise judgment and clairvoyance in recognizing potential successes and creating value for society.
The importance of associations in contemporary democratic societies is out of the question. Still, there is a need for a new approach that considers them as a specific and singular organization type, different from business firms and government agencies. There is also a need to evaluate their performance. Based on case studies and diverse theoretical insights, this article lays out some criteria for assessing the effects on associational performance of cohesion, decision-making and relation to environment.
Multi-party coalitions are an increasingly common type of government across different political regimes and world regions. Since they are the locus of national foreign-policy-making, the dynamics of coalition government have significant implications for International Relations. Despite this growing significance, the foreign-policy-making of coalition governments is only partly understood. This symposium advances the study of coalition foreign policy in three closely related ways. First, it brings together in one place the state of the art in research on coalition foreign policy. Second, the symposium pushes the boundaries of our knowledge on four dimensions that are key to a comprehensive research agenda on coalition foreign policy: the foreign-policy outputs of multi-party coalitions; the process of foreign-policy-making in different types of coalitions; coalition foreign policy in the ‘Global South’; and coalition dynamics in non-democratic settings. Finally, the symposium puts forward promising avenues for further research by emphasising, for instance, the value of theory-guided comparative research that employs multi-method strategies and transcends the space of Western European parliamentary democracies.
This article explores processes of coalition governance in foreign policy. Specifically, it argues that such processes are shaped by two interrelated dimensions of coalition set-up: first, the allocation of the foreign ministry to the senior or a junior coalition partner and, second, the degree of policy discretion which is delegated to that ministry. Bringing these two dimensions together, the article distinguishes four types of coalition arrangement for the making of foreign policy, which are expected to have predictable implications for the process of foreign policy-making and, ultimately, for the foreign policy outputs of multi-party coalitions and their quality.
Women face a variety of sociocultural and individual obstacles that can trap them in violent relationships. In this study, we aimed to explore the role of cognitive distortions in women’s decision-making (loyalty and exit) within their current relationships, distinguishing between those who experienced intimate partner violence (IPV) and those who did not. Additionally, we examined the moderating effects of the traditional female role and the dependency between the group condition (IPV victims versus nonvictims) and cognitive distortions. Results showed that the IPV victims present higher levels of the traditional female role, dependency, cognitive distortions, and use of loyalty and exit strategies to a greater extent compared with the nonvictims. Similarly, two explanatory models were tested, revealing that women who were victims of IPV by their current partner (compared to the nonvictims group) exhibited greater cognitive distortions and, consequently, were more likely to use loyalty and exit strategies. The moderating effects of the traditional female role among the group of IPV victims and cognitive distortions were obtained. These findings contribute to a better understanding of how cognitive distortions and adherence to the traditional female role can influence women’s decision-making (loyalty and exit), reinforcing the notion that they are responsible for maintaining the relationship.
Periviable births, occurring between 20 and 25 weeks of gestation, present significant challenges due to varying survival rates and potential morbidities for survivors. Medical decision-making in this context raises ethical and legal questions, including considerations of sanctity of life versus quality of life and challenges in the clinician-parent relationship. This article outlines the complex ethical and legal landscape surrounding parental medical decision-making for periviable infants in the United States, discussing the evolution of federal and state laws. Existing laws highlight a vitalist approach that prioritizes life preservation despite potential harm and overlook non-heteronormative and non-traditional family structures, complicating decision-making. The impact of post-Dobbs state abortion bans on parental and clinician autonomy have exacerbated these challenges. We advocate for legislative support for inclusive definitions of legal parenthood to facilitate evidence-based decision-making centered on patients and families. Also needed are legal frameworks that accommodate the intricacies of periviable birth decisions while respecting patient autonomy and medical expertise, especially amidst the evolving legislative environment.
Integrated pest management (IPM) is the dominant pest management paradigm in agriculture, and adoption of IPM is a policy goal at various levels of government. However, with over 67 definitions, what is considered IPM varies, and some implementations of IPM fail to achieve desired results (e.g., reduced pesticide use). The natural complexity of agriculture and pest management leads growers to rely on professionals, usually certified crop advisors (CCAs), to help make management decisions. Though communication with crop advisors is one way to improve IPM, this effort requires an understanding of CCA education, knowledge, and information sources. Previous surveys in North America found most crop advisors were very experienced (>20 years), which may present a concern for the adequate supply of crop advisors in the future, since they will very likely retire in the coming decades. In this survey, nearly 95% of CCAs earned a bachelor’s level degree (or higher). Independent crop advisors reported spending about 43% less time communicating with growers than CCAs employed by consultancies. Most crop advisors gave appropriate, but incomplete, definitions of IPM, and adoption of specific guidelines (i.e., scouting recommendations for red sunflower seed weevil, Smicronyx fulvus) was also low. Some CCAs expressed an opinion that universities (and the federal government) were less valued than other sources of information (e.g., their own CCA network). Collectively, survey responses show room for improvement to IPM through CCA education, but because crop advisors are most likely to be influenced through their network of peers, outreach might be best accomplished through targeting early adopters of IPM practices among the CCA population.
The possible neural and neurochemical bases of the hubris syndrome are reviewed by considering relevant evidence from behavioural and cognitive neuroscience in relation to biological psychiatry. This multidisciplinary evidence includes studies of brain-damaged patients and functional neuroimaging and identifies the prefrontal cortex as a crucial region of a brain network undertaking decision-making. The prefrontal cortex is also identified as important for the subjective and behavioural expression of relevant personality traits such as narcissism and impulsivity. Factors that adversely affect so-called executive functions of the prefrontal cortex, such as stress, drug abuse and illness, are also taken into account to highlight possible neurochemical and endocrine influences. A novel hypothesis is presented which postulates a key role for the chronic stress of leadership status depleting monoamine neurotransmitters such as serotonin, dopamine and noradrenaline, which interact with pre-existing temperamental traits, to produce dysfunctional modulation of decision-making circuits controlled by the ventromedial prefrontal cortex
CEO hubris is a vital construct in research on the psychology of organisational decision-makers. Hubristic CEOs influence strategic decisions, from acquisitions to product and geographic market entry. To date, research has mainly focused on how and when CEO hubris impacts CEOs and their organisations. I offer a framework in which CEOs predisposed to inflated self-evaluation engage in behavioural processes that yield overconfident strategic decisions associated with hubris. The framework reviews and summarises how such evaluations stem from CEOs’ psychological and social circumstances. It then links inflated self-evaluation to the three drivers of over-confidence that are associated with hubris: over-estimation, or the tendency to exaggerate prospective outcomes; over-placement, or the tendency to rank one’s capabilities and situation ahead of others; and over-precision, or the tendency to issue unduly bounded or narrow forecasts which tend to be inaccurate. The framework is illustrated by the case study of Elizabeth Holmes, formerly founder and CEO of Theranos, who was lauded as a celebrity entrepreneur before being convicted of crimes associated with her hubris.
The intelligible world of machines and predictive modelling is an omnipresent and almost inescapable phenomenon. It is an evolution where human intelligence is being supported, supplemented or superseded by artificial intelligence (AI). Decisions once made by humans are now made by machines, learning at a faster and more accurate rate through algorithmic calculations. Jurisprudent academia has undertaken to argue the proposition of AI and its role as a decision-making mechanism in Australian criminal jurisdictions. This paper explores this proposition through predictive modelling of 101 bail decisions made in three criminal courts in the State of New South Wales (NSW), Australia. Indicatively, the models’ statistical performance and accuracy, based on nine predictor variables, proved effective. The more accurate logistic regression model achieved 78% accuracy and a performance value of 0.845 (area under the curve; AUC), while the classifier model achieved 72.5% accuracy and a performance value of 0.702 (AUC). These results provide the groundwork for AI-generated bail decisions being piloted in the NSW jurisdiction and possibly others within Australia.
In this chapter, we define our key concepts (e.g., interstate crisis and major-state war), justify our case selection strategy, establish and explain our methodological approach (i.e., the logic of discovery), and outline the conceptual/theoretical framework that guides our analysis of each crisis case. The framework involves a set of variables that commonly appear in studies of international conflict. We therefore introduce these variables, organize them, and explain the questions through which we look for their influence on crisis (de-)escalation in each case.
The Lydian logos is indebted to tragedy for many features: its large-scale narrative structure and (in its constituent stories) small-scale episodic structure, narrative motifs and themes, even vocabulary. However, Herodotus also diverges from his tragic sources in ways that clarify the nature of his own inquiries. The source of the constraint under which Gyges makes his fateful decisions is not divine (as in Aeschylus), but the will of his king and queen, highlighting a characteristic feature of Eastern monarchy. In the final sentence of the Atys/Adrastus story, the distinctive ethnographic formula that describes Adrastus’ suicidal thoughts marks him as a uniquely Herodotean tragic hero. Croesus’ pyre scene contains both an echo of the Aeschylean Cassandra (the king’s dramatic breaking of his silence) and a defining feature of Herodotean historiē: the citation of a Lydian source for Apollo’s epiphany demonstrates the critical attitude that Herodotus brings to popular and poetic traditions.
Sebastián MachadoThe activities of international organizations have been traditionally analysed through categories which rely on classical notions of subjectivity and contractual relativity. International organizations, however, routinely engage the world beyond their own internal structure through a variety of actions. This presents a choice for their theorization, as we can characterize the relationship in ways that go beyond conventional legal types and can include broader themes such as markets, effects or costs and benefits. Within this context, this chapter takes the World Health Organization’s handling of the A1H1 Pandemic as a case-study for a (re)conceptualization that can account for the political economy of international institutional decision-making. While this opens up some research possibilities and brings the cost-and-benefit redistribution to the forefront, the reality is that international organizations have a powerful capacity to affect third parties even through non-conventional and unpredictable ways. The organization’s officials regularly engage in a balancing act where institutional activity must be seen to fit within their mission. Considering the sensibility of the different external and relevant markets, this chapter concludes by suggesting that international organizations and their officials must remain highly aware of their redistributive potential.
This chapter describes the economic model of ideal decision-making under uncertainty. It also outlines the economic theory of the value of information – when a decision-maker should incur time or money cost to obtain additional evidence. It contracts these two theories with the informal decision-making processes often used by mangers, based on their recent experience or expertise, as well as with an unqualified “evidence-based” model endorsed by government that requires full information before a choice can be made. It offers an extended discussion of Medicare’s choice to put its hospital readmissions reduction program in place based on imperfect and incomplete evidence about how financial penalties would affect hospital behavior and suggests how the decision could have been improved.
The brain faces an array of behavioral control challenges varying in complexity, abstraction, and temporal scale. Leveraging multiple decision-making strategies offers a clear advantage, allowing for adaptability to different contexts. Even when solving a single problem, the selection from or combination of different strategies can enhance the likelihood of success. Consequently, the brain faces the critical task of arbitrating between experts effectively. Here, we review theories of multiple controllers in value-driven decision-making, the mechanisms of arbitration between them, and the neural correlates of such processes. Although these theories have provided meaningful explanations for observed behavior and neural activity, fundamental questions persist regarding the precise nature of these controllers, their interactions, and their neural underpinnings. Notably, the role of subjective states in these computations has been largely overlooked, despite their obvious importance in the experience of making decisions.
As discussed in earlier chapters, a company has the legal powers and capacity of an individual, in addition to any specific powers conferred by law. The two key decision-making organs that can act as the company in exercising these powers are the board of directors and the members in general meeting. The general law and Corporations Act divide the company’s powers and responsibilities between these two groups. This chapter discusses this division of powers. It also discusses how meetings of members and directors are held, and the requirements on companies to prepare and disclose key information, including financial reports.