By comparing developments in two southern Italian factories, this article contrasts “aggregative” and “deliberative” procedures in trade unions. In one of the plants, the preferences of some of the workers appear to have been changed by deliberation. The process of rational persuasion seems to have required, however, more than sheer circulation of information. Based on this evidence, the article argues that when a potential conflict of interests is involved, speakers need to provide evidence that they are animated by a (...) “communicative” rather than “strategic” intent. This implies validating their implicit claim to sincerity of communication. (shrink)

The number of admissions to hospitals of patients without a proxy decision maker is rising. Very often these patients need fairly immediate medical intervention for which informed consent—or informed refusal—is required. Many have recommended that there be a process in place to make these decisions, and that it include a variety of perspectives. People are particularly wary of relying solely on medical staff to make these decisions. The University Hospitals Case Medical Center recruits community members from its Ethics Committee (...) to serve on a subcommittee, the Patients Without Proxies (PWP) Committee, which works with medical staff during the decision-making process for these patients. Generally, the community members go to the bedside to observe patients. This article looks at how those unused to observing hospitalized patients who are sick and/or dying are affected, comparing them to mock jurors in a research study who are exposed to graphic photographs related to a fabricated crime scene. Judgments made by the mock jurors are affected by viewing such images. The personal experience of witnessing unfamiliar and shocking scenes affects their subsequent judgments. While it may be difficult to tease out whether observing patients causes PWP members to be benefited or harmed, they are affected by what they see. If a variety of perspectives is desirable to reduce possible bias or error, this article argues that at least one community member should refrain from seeing the patient in order to add a different and valuable voice to the decision-making process. Members of the subcommittee base their judgments on the various kinds of information available. Sometimes the things they see, hear, or feel may affect them particularly deeply, and affect their judgments as well. In this article I explore the idea that something like this may be happening in a particular kind of clinical ethics case consultation. (shrink)

Norton has argued for the salience of deliberative strategies for making environmental decisions which is supposed to be preferable to formal decision analysis. This paper argues that formal multicriteria decision analysis, when deployed with care, has the flexibility to absorb the advantages of deliberative decision making. It can also be used for decision support during a deliberative process. This feature of decision analysis is illustrated using a case study from Merauke (...) in Papua province of Indonesian New Guinea. (shrink)

In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making (...) are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice. (shrink)

In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, (...) different versions of SDM are explored, versions compatible with paternalism and patient choice as well as versions that go beyond these traditional decision making models. Whenever SDM is discussed or introduced it is of importance to be clear over which of these different versions are being pursued, since they connect to basic values and ideals of health care in different ways. It is further argued that we have reason to pursue versions of SDM involving, what is called, a high level dynamics in medical decision-making. This leaves four alternative models to choose between depending on how we balance between the values of patient best interest, patient autonomy, and an effective decision in terms of patient compliance or adherence: Shared Rational Deliberative Patient Choice, Shared Rational Deliberative Paternalism, Shared Rational Deliberative Joint Decision, and Professionally Driven Best Interest Compromise. In relation to these models it is argued that we ideally should use the Shared Rational Deliberative Joint Decision model. However, when the patient and professional fail to reach consensus we will have reason to pursue the Professionally Driven Best Interest Compromise model since this will best harmonise between the different values at stake: patient best interest, patient autonomy, patient adherence and a continued care relationship. (shrink)

Each of us makes a number of decisions, from the less important to those with far-reaching consequences. As members of different groups, we are also actors of group decision making. In order to make a rational decision, a choice-making procedure must satisfy a number of assumptions of rationality. In addition, when it comes to group decisions, those procedures should also be?fair.? However, it is not possible to define a procedure of choice-making that would transform individual (...) orders of alternatives based on preferences of perfectly rational individuals into a single social order and still meet conditions of rationality and ethics. The theory of deliberative democracy appeared in response to the impossibility of Social Choice theory. The basic assumption of deliberative democracy is that individuals adjust their preferences taking into account interests of the community. They are open for discussion with other group members and are willing to change their attitudes in order to achieve common interests. Ideally, group members come to an agreement during public discussion. Still, this concept cannot completely over?come all the difficulties posed by the theory of social choice. Specifically, there is no solution for strategic and manipulative behavior of individuals. Also, the concept of deliberative democracy faces certain problems particular to this approach, such as, to name but a few, problems with the establishment of equality of participants in the debate and their motivation, as well as problems with the organization of public hearings. (shrink)

Integrative Social Contracts Theory is a popular framework to assist managers in making decisions on international moral dilemmas. Although the theory has been praised for its comprehensiveness and sophistication, commentators have raised concerns regarding the justification and identification of substantive hypernorms, fundamental moral principles valid across cultures. This paper introduces the deliberative test, a new method for testing the cross-cultural validity of ethical norms in ISCT. The test relies on the concept of Deliberative Capacity, arising from new (...) developments in system-level deliberative democracy research, which studies deliberation at the level of national societies and over time. Based on this recent stream of research, the deliberative test has the potential of providing better guidance for managers to decide which norms to follow in case of conflicting standards between home and host countries. (shrink)

It is widely accepted in psychology and cognitive science that there are two “systems” in the mind: one system is characterized as quick, intuitive, perceptive, and perhaps more primitive, while the other is described as slower, more deliberative, and responsible for our higher-order cognition. I use the term “reflectivism” to capture the view that conscious reflection—in the “System 2” sense—is a necessary feature of good moral judgment and decision-making. This is not to suggest that System 2 must (...) operate alone in forming our moral decisions, but that it plays a normatively ineliminable role. In this paper, I discuss arguments that have been offered in defense of reflectivism. These arguments fit into two broad categories; let us think of them as two sides of a coin. On the first side are arguments about the efficaciousness of conscious reasoning—for example, without conscious deliberation we will make bad moral judgments and decisions. On the other side of the coin are arguments about the centrality of conscious deliberation to normative actions—for example, without conscious deliberation we are no more agential than animals or automatons. Despite their attractiveness, I argue that these arguments do not successfully establish that reflection is a necessary component of good moral judgment and decision-making. If I am right, the idea that good moral judgment and decision-making can result from entirely automatic and subconscious processes gains traction. My goal in this paper is to show that reflectivism fails to include the full range of cases of moral decision-making and that a theory of automaticity may do a better job. I briefly discuss at the end of the paper how an account of successful automatic moral judgment and decision-making might begin to take shape. (shrink)

Shared Decision-Making is a widely accepted model of the physician–patient relationship providing an ethical environment in which physician beneficence and patient autonomy are respected. It acknowledges the moral responsibility of physician and patient by promoting a deliberative collaboration in which their individual expertise—complementary in nature, equal in importance—is emphasized, and personal values and preferences respected. Its goal coincides with Pellegrino and Thomasma’s proximate end of medicine, that is, a technically correct and morally good healing decision for (...) and with a particular patient. We argue that by perfecting the intellectual ability to apprehend the complexity of clinical situations, and through a perfection of the application of the first principles of practical reason, prudence is able to point toward the right and good shared medical decision. A prudent shared medical decision is therefore always in keeping with the kind of person the physician and the patient have chosen to be. (shrink)

We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.

The model of clinical ethics consultation (CEC) defended in the ASBH Core Competencies report has gained significant traction among scholars and healthcare providers. On this model, the aim of CEC is to facilitate deliberative reflection and thereby resolve conflicts and clarify value uncertainty by invoking and pursuing a process of consensus building. It is central to the model that the facilitated consensus falls within a range of allowable options, defined by societal values: prevailing legal requirements, widely endorsed organizational policies, (...) and professional standards of practice and codes of conduct. Moreover, the model stipulates that ethics consultants must refrain from giving substantive recommendations regarding how parties to a moral disagreement in the clinic should evaluate their options. We argue that this model of CEC is incomplete, because it wrongly assumes that what counts as the proper set of allowable options among which the parties are to deliberate will itself always be clearly discernible. We illustrate this problem with a recent case on which one of us consulted—a neonate born with trisomy 18 (T18). We try to show that law, policy, and standards of practice reveal no clear answer to the question posed by the case: namely, whether forgoing gastrostomy tube feedings for a baby with T18 is allowable. We suggest there may be other kinds of cases in which it may simply be unsettled whether a given choice falls within the set of allowable options within which consensus is to be facilitated. What should an ethicist do when confronting such unsettled cases? We agree with the facilitation model that an ethicist should remain neutral among the allowable options, when it is clear what the allowable options are. But, in unsettled cases, the role of a consultant should be expanded to include a process of moral inquiry into what the allowable options should be. We end by raising the issue of whether this means an ethicist should share his or her own conclusions or views about the allowability of a given clinical option. (shrink)

Nondirective genetic counseling developed as a means of promoting informed and independent decision-making. To the extent that it minimizes risks of coercion, this counseling approach effectively respects client autonomy. However, it also permits clients to make partially informed, poorly reasoned or ethically questionable choices, and denies counselors a means of demonstrating accountability for the use of their services. These practical and ethical tensions result from an excessive focus on noncoercion while neglecting the contribution of adequate information and (...) class='Hi'>deliberative competence to autonomous decision-making. A counseling approach that emphasizes the role of deliberation may more reliably produce thoroughly reasoned decisions. In such an approach, characterized by dialogue, counselors are responsible for ensuring that decisions are fully informed and carefully deliberated. Counseling remains nonprescriptive, but in the course of discussion counselors may introduce unsolicited information and/or challenge what they believe are questionable choices. By this means clients can be better assured that the decisions they make are fully considered, while counselors demonstrate a limited degree of professional accountability. (shrink)

Artificial intelligence is set to transform healthcare. Key ethical issues to emerge with this transformation encompass the accountability and transparency of the decisions made by AI-based systems, the potential for group harms arising from algorithmic bias and the professional roles and integrity of clinicians. These concerns must be balanced against the imperatives of generating public benefit with more efficient healthcare systems from the vastly higher and accurate computational power of AI. In weighing up these issues, this paper applies the (...) class='Hi'>deliberative balancing approach of the Ethics Framework for Big Data in Health and Research. The analysis applies relevant values identified from the framework to demonstrate how decision-makers can draw on them to develop and implement AI-assisted support systems into healthcare and clinical practice ethically and responsibly. Please refer to Xafis et al. in this special issue of the Asian Bioethics Review for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end of this paper. (shrink)

I present an original model in judgment aggregation theory that demonstrates the general impossibility of consistently describing decision-making purely at the group level. Only a type of unanimity rule can guarantee a group decision is consistent with supporting reasons, and even this possibility is limited to a small class of reasoning methods. The key innovation is that this result holds when individuals can reason in different ways, an allowance not previously considered in the literature. This generalizes judgment (...) aggregation to subjective decision situations, implying that the discursive dilemma persists without individual agreement on the logical constraints. Notably, the model mirrors the typical method of choosing political representatives, and thus suggests that no voting procedure other than unanimity rule can guarantee representation that reflects electorate opinion. Finally, I apply the results to a normative argument for unanimity rule in contract theory and juries, as well as to problems posed for deliberative democratic theory and the concept of representation. (shrink)

The question of whether old age should or should not play a role in medical decision-making for the elderly patient is regularly debated in ethics and medicine. In this paper we investigate exactly how age influences the decision-making process. To explore the normative argumentation in the decisions regarding an elderly patient we make use of the argumentation model advanced by Toulmin. By expanding the model in order to identify normative components in the argumentation process it is (...) possible to analyse the way that age-related value judgements influence the medical decision-making process. We apply the model to practice descriptions made by medical students after they had attended consultations and meetings in medical practice during their clinical training. Our results show the pervasive character of age-related value judgements. They influence the physician’s decision in several ways and at several points in the decision-making process. Such explicit value judgements were not exclusively used for arguments against further diagnosis or treatment of older patients. We found no systematic “ageist” pattern in the clinical decisions by physicians. Since age plays such an important, yet hidden role in the medical decision-making process, we make a plea for revealing such normative argumentation in order to gain transparency and accountability in this process. An explicit deliberative approach will make the medical decision-making process more transparent and improve the physician–patient relationship, creating confidence and trust, which are at the heart of medical practice. (shrink)

This paper presents methods and challenges attendant on the use of protocol analysis to develop a model of heuristic processing applied to research ethics. Participants are exposed to ethically complex scenarios and asked to verbalize their thoughts as they formulate a requested decision. The model identifies functional parts of the decision-making task: interpretation, retrieval, judgment and editing and seeks to reliably code participant verbalizations to those tasks as well as to a set of cognitive tools generally useful (...) in such work. Important difficulties in the reliability and external validity of measurement are evaluated and a small set of illustrative data is used in support of that discussion. Results indicate that both intuitive emotional but also more deliberative cognition is present which is consistent with work in related literatures in expertise and in neuropsychology. Finally, the theoretical and practical potential of the approach is elaborated, particularly through links to a framing in Aristotelian ethics. (shrink)

This paper presents methods and challenges attendant on the use of protocol analysis to develop a model of heuristic processing applied to research ethics. Participants are exposed to ethically complex scenarios and asked to verbalize their thoughts as they formulate a requested decision. The model identifies functional parts of the decision-making task: interpretation, retrieval, judgment and editing and seeks to reliably code participant verbalizations to those tasks as well as to a set of cognitive tools generally useful (...) in such work. Important difficulties in the reliability and external validity of measurement are evaluated and a small set of illustrative data is used in support of that discussion. Results indicate that both intuitive emotional but also more deliberative cognition is present which is consistent with work in related literatures in expertise and in neuropsychology. Finally, the theoretical and practical potential of the approach is elaborated, particularly through links to a framing in Aristotelian ethics. (shrink)

This article concerns itself with the relationship between implicit moral cognitions and decisions in the realm of business ethics. Traditionally, business ethics research emphasized the effects of overt or explicit attitudes on ethical decision-making and neglected intuitive or implicit attitudes. Therefore, based on an implicit social cognition approach it is important to know whether implicit moral attitudes may have a substantial impact on managerial ethical decision-making processes. To test this thesis, a study with 50 participants was (...) conducted. In this study the participants were asked to work on a deliberative managerial ethical decision-making task, in which they had to decide on one of two options. Implicit moral attitudes towards the two options were measured using the implicit association test (IAT). A semantic differential scale was used to diagnose explicit moral attitudes towards the two options. Each step taken within the deliberative decision-making process, as well the decision itself, was assessed using a scoring model-based decision analysis and a decision-making questionnaire. The results of this study show that implicit moral attitude has a great influence on the deliberative ethical decision-making process. The derived conclusion is that complex and deliberative decision-making processes in the context of business ethics can be affected by implicit social cognitions such as implicit moral attitudes. (shrink)

Shift work is a fixture of our 24-hour economy, with approximately 18 per cent of workers in the USA engaging in shift work, many overnight. Since shift work has been linked to an increased risk for an array of serious maladies, including cardiometabolic disorders and cancer, and is done disproportionately by the poor and by minorities, shift work is a highly prevalent economic and occupational health disparity. Here we draw primarily on the state of science around shift work and breast (...) cancer to argue that shift work represents a public health threat serious enough to warrant a precautionary stance. We use the precautionary principle to advance our case and view it as a moral compass for shift work research, empowering public health to cast shift work within the domain of health disparities deserving action despite scientific uncertainty. With the precautionary principle, we call for a deliberative decision-making process and formation of a broad shift work research collaboration to protect the health of many millions who work at night. (shrink)

Three studies test eight hypotheses about (1) how judgment differs between people who ascribe greater vs. less moral relevance to choices, (2) how moral judgment is subject to task constraints that shift evaluative focus (to moral rules vs. to consequences), and (3) how differences in the propensity to rely on intuitive reactions affect judgment. In Study 1, judgments were affected by rated agreement with moral rules proscribing harm, whether the dilemma under consideration made moral rules versus consequences of choice salient, (...) and by thinking styles (intuitive vs. deliberative). In Studies 2 and 3, participants evaluated policy decisions to knowingly do harm to a resource to mitigate greater harm or to merely allow the greater harm to happen. When evaluated in isolation, approval for decisions to harm was affected by endorsement of moral rules and by thinking style. When both choices were evaluated simultaneously, total harm -- but not the do/allow distinction -- influenced rated approval. These studies suggest that moral rules play an important, but context-sensitive role in moral cognition, and offer an account of when emotional reactions to perceived moral violations receive less weight than consideration of costs and benefits in moral judgment and decision making. (shrink)

The paper reflects on the methods democratic systems use for arriving at decisions. The most popular ones are elections where the majority rules and deliberative democracy. I argue that both of these do not measure up to the demands of democracy. Whether we use voting with majority rule or deliberative methods, only a portion of the citizenry is allowed to rule itself; minorities are always excluded. Instead of voting with majority ruler or deliberative methods, I suggest that (...) we employ mediation to reach agreement in democratic publics. (shrink)

The paper reflects on the methods democratic systems use for arriving at decisions. The most popular ones are elections where the majority rules and deliberative democracy. I argue that both of these do not measure up to the demands of democracy. Whether we use voting with majority rule or deliberative methods, only a portion of the citizenry is allowed to rule itself; minorities are always excluded. Instead of voting with majority ruler or deliberative methods, I suggest that (...) we employ mediation to reach agreement in democratic publics. (shrink)

In debates about genetic testing of children, as well as about disclosing unsolicited findings (UFs) of pediatric exome sequencing, respect for future autonomy should be regarded as a prima facie consideration for not taking steps that would entail denying the future adult the opportunity to decide for herself about what to know about her own genome. While the argument can be overridden when other, morally more weighty considerations are at stake, whether this is the case can only be determined in (...) concrete cases. Importantly, when children grow into adolescents, respect for future autonomy will have to give way to respecting their emerging autonomy. When pediatric exome sequencing is done for complex conditions not involving developmental delay, respect for the child’s future or emerging autonomy should be a primary consideration for those charged with deciding on behalf of the child. Building on what Emanuel and Emanuel have termed the ‘deliberative model’ of shared decision making, we argue that if parents fail to give these considerations their due, professionals should actively invite them to do so. Taking a directive stance may be needed in order to make sure that the future or emerging autonomy of the child are duly considered in the decision-making process, but also to help the parents and themselves to shape their respective roles as responsible care-givers. (shrink)

The consideration of deliberate versus automatic processing of numeric representations is important to math education, memory for numbers, and decision-making. In this commentary, we address the possible roles for numeric representations in such higher-level cognitive processes. Current evidence is consistent with important roles for both automatic and deliberative processing of the representations.

Environmental problems have an ethical dimension. They are not just about the efficient use of resources. Justice in the distribution of environmental goods and burdens, fairness in the processes of environmental decision-making, the moral claims of future generations and non-humans, these and other ethical values inform the responses of citizens to environmental problems. How can these concerns enter into good policy-making processes?Two expert-based approaches are commonly advocated for incorporating ethical values into environmental decision-making. One is (...) an 'economic capture' approach, according to which existing economic methods can be successfully extended to include ethical concerns. For example, stated preference methods, especially contingent valuation, have been developed to try and capture ethical responses as 'non-use values' of the environment, in particular 'existence values'. The other is a 'moral expert' approach which confines economic methods to the analysis of welfare gains, and assumes committees of ethical experts will complement economic expertise.Both approaches face problems in terms of addressing many widely held ethical values about the environment. Furthermore, both face problems concerning the democratic legitimacy of their procedures. How can policy-making be made responsive to different ethical values? What role is there for new deliberative and participatory methods? How far do existing decision-making institutions have the capacities to incorporate different modes of articulating environmental values?This policy brief examines the limitations of current attempts to capture ethical values within existing economic instruments and considers how these limitations might be overcome. Section 1 examines the assumptions that standard economic theory makes about individuals when they express values and make choices about the environment. The current models of agents that inform policy-making are seen to be ill-suited to incorporating the ethical responses of agents and this reveals some of the policy failures that may result. Section 2 shows how the physical and social properties of many environmental goods prevent their being treated as commodities. Section 3 considers the problems surrounding conceptions of fairness and legitimacy in processes for environmental valuation. Section 4 raises questions concerning the capacities of policy-making institutions to take cognisance of the results of different methods for articulating environmental values. (shrink)

Environmental problems have an ethical dimension. They are not just about the efficient use of resources. Justice in the distribution of environmental goods and burdens, fairness in the processes of environmental decision-making, the moral claims of future generations and non-humans, these and other ethical values inform the responses of citizens to environmental problems. How can these concerns enter into good policy-making processes?Two expert-based approaches are commonly advocated for incorporating ethical values into environmental decision-making. One is (...) an 'economic capture' approach, according to which existing economic methods can be successfully extended to include ethical concerns. For example, stated preference methods, especially contingent valuation, have been developed to try and capture ethical responses as 'non-use values' of the environment, in particular 'existence values'. The other is a 'moral expert' approach which confines economic methods to the analysis of welfare gains, and assumes committees of ethical experts will complement economic expertise.Both approaches face problems in terms of addressing many widely held ethical values about the environment. Furthermore, both face problems concerning the democratic legitimacy of their procedures. How can policy-making be made responsive to different ethical values? What role is there for new deliberative and participatory methods? How far do existing decision-making institutions have the capacities to incorporate different modes of articulating environmental values?This policy brief examines the limitations of current attempts to capture ethical values within existing economic instruments and considers how these limitations might be overcome. Section 1 examines the assumptions that standard economic theory makes about individuals when they express values and make choices about the environment. The current models of agents that inform policy-making are seen to be ill-suited to incorporating the ethical responses of agents and this reveals some of the policy failures that may result. Section 2 shows how the physical and social properties of many environmental goods prevent their being treated as commodities. Section 3 considers the problems surrounding conceptions of fairness and legitimacy in processes for environmental valuation. Section 4 raises questions concerning the capacities of policy-making institutions to take cognisance of the results of different methods for articulating environmental values. (shrink)

While deliberation has traditionally played a central role in philosophical and behavioral accounts of ethical decision-making, several recent studies challenge the value of deliberation. These studies find that deliberative thinking, such as considering divergent views or different perspectives, leads to less ethical decisions. We observe, however, that these studies do not address normative deliberation, in which decision-makers consider or apply a normative standard. We predict that normative deliberation improves ethical decision-making. Across six experiments, we (...) examine the effects of non-normative deliberation and normative deliberation on ethical decision-making. We find that normative deliberation improves ethical decision-making and, in contrast to recent studies, no form of deliberation harms ethical decision-making. (shrink)

ABSTRACT Sensory Processing Sensitivity is an individual difference that affects people’s thinking and behavior. People who are high in SPS, Highly Sensitive People, are more sensitive to stimuli and prefer to take their time in thinking through problems. This study examined the effects of SPS and analytic mind-set on ethical decision-making. Mind-Set was manipulated by instructing participants to either think thoroughly through the ethical problem or focus on finding a concrete, practical solution when solving the problems. HSPs performed (...) better in the deliberative mind-set, allowing them to solve the problem using their natural problem-solving approach. People low in SPS performed better in the implementation mind-set. Results suggest that ethics interventions should not be “one size fits all,” and should consider a person’s natural problem-solving tendencies. (shrink)

In this essay I defend an institutional approach to democratic legitimacy against proceduralist approaches that are commonly endorsed by deliberative democrats. Although deliberative democrats defend a complex view of democratic legitimacy that aims to account for both the procedural and substantive dimensions of legitimacy, most accounts of the relationship between these dimensions currently on offer are too proceduralist to be plausible (I). By contrast, I argue that adopting an institutional approach helps provide a more convincing account of the (...) interplay between procedural and substantive aspects of democratic legitimacy which in turn illuminates the intricate relationship between public deliberation and decision-making procedures such as voting (II). This account also enables us to see what is wrong with interpreting the legitimacy of majoritarian and non-majoritarian institutions in terms of an alleged conflict between popular sovereignty and rights protections. In opposition to this view, I argue that the proper standard for judging the democratic legitimacy of both majoritarian and non-majoritarian institutions is whether they enable an ongoing recursive process of deliberative contestation or whether they generate antidemocratic shortcuts instead (III). (shrink)

The study of ethical decision-making has made significant advances, particularly with regard to the ways in which different types of processing are implicated. In recent decades, much of this advancement has been driven by the influence of dual-process theories of cognition. Unfortunately, the wealth of findings in this context can be confusing for management scholars and practitioners who desire to know how best to encourage ethical behavior. While some studies suggest that deliberate reflection leads to more ethical behavior, (...) other studies find, in contrast, that intuitive decision-making leads to more ethical results. The goal of this integrative conceptual review is to help make sense of such apparently contradictory findings by identifying the moderating influences that lead to more versus less ethical decisions, whether they are made via intuitive or deliberative processes. Based on our integrative review of moderators from different disciplines and eras, we develop a taxonomy that can aid researchers in the task of identifying when similar constructs have been studied under different names. We organize our findings concerning these influences in accordance with four emergent moderator categories—psychological, situational, social, and physiological. This work helps us identify patterns of moderating factors across both intuitive and deliberative ethical decision-making, gaps that suggest future research directions and practical implications. (shrink)

Direct-democratic processes have won popular support but fall far short of the standards of deliberative democracy. Initiative and referendum processes furnish citizens with insufficient information about policy problems, inadequate choices among policy solutions, flawed criteria for choosing among such solutions, and few opportunities for reflection on those choices prior to decision making. We suggest a way to make direct democracy more deliberative by grafting randomly selected citizen assemblies onto existing institutions and practices. After reviewing the problems (...) that beset modern direct-democratic elections and the long history of randomly selected citizen assemblies, we propose five different varieties of randomly constituted citizen bodies—Priority Conferences, Design Panels, Citizens’ Assemblies, Citizens’ Initiative Reviews, and Policy Juries. After selecting members through stratified random sampling of citizens, each of these assemblies would operate at a different stage of the legislative process, from initial problem identification through approval of a finished ballot measure. Highly structured procedures guided by professional moderators and featuring expert testimony on policy and legal matters would help to ensure deliberative quality, and careful institutional designs would make each body politically powerful. In the end, these citizen bodies would be likely to address the deliberative deficit of direct democracy and better achieve the public’s desired policy objectives. (shrink)

In her book Democracy and Truth: The Conflict between Political and Epistemic Virtues, Snjezana Prijic Samarzija advocates that a purely procedural justification which defines the authority and legitimacy of democracy only in relation to the fairness of the procedure itself is not enough for a full justification of democracy. Some epistemic values should also be included. This epistemic quality of democracy depends on the quality of the decisions that the democratic procedures produce. In that sense, the author is advocating a (...) hybrid theory that secures harmony between political and epistemic values, favoring deliberative procedure for this purpose, and thus promotes equal respect for both democratic values. In doing so, she is advocating the specific type of division of epistemic labor that I will attempt to critically re-examine here, as well as to bring into question the privileged role of the experts in democratic decision-making. (shrink)

We have it on the authority of Aristotle that “reason (nous) is the best thing in us” (EN X.7, 1177a20). This idealization of reason permeates his account of eudaimonia, a term commonly translated as ‘happiness’, which Aristotle identifies with living and doing well (EN I.4, 1095a18-20). In harmony with a certain intellectualism peculiar to the mainstream of ancient philosophical accounts of eudaimonia, Aristotle holds that living well requires the unique practical application of rationality of which only humans are capable (EN (...) I.7, 1098a13-15/EE I.7, 1217a25-27). This dissertation investigates Aristotle’s substantive view on the practical application of reason by examining how, according to him, human agents use reason to decide what to do, what kind of person to be, and indeed how to live well. A distinctively human way of making decisions is deliberation (bouleusis), an exercise of practical reason par excellence. The first chapter reconstructs Aristotle’s account of deliberation from a wide range of texts in the corpus. It argues that deliberation is a complex decision-making process that, for the most part, unfolds into four stages: (1) positing a provisional goal; (2) constructing a set of alternatives; (3) identifying the best alternative; (4) forming an intention to do the most proximate action as identified in the penultimate stage. This reading offers a comprehensive representation of Aristotle’s theory while rendering his theory more sophisticated—and indeed more modern—than the alternatives in recent years. Deciding what to do often requires that we confront the question, “Which is preferable (hairetōteron) or better (beltion) between two or more options?” In Topics III, a text widely acknowledged as the inaugural treatment of the logic of preference, Aristotle articulates a set of principles to guide our preference-ranking. While scholars pay historical homage to Aristotle, there is little engagement with his treatment of preference logic. The second chapter addresses the need for a current study and reassessment of Aristotle’s preference-ranking principles. It argues that, despite differences in scope and methodology between the Aristotelian and modern systems, the description inaugural treatment of preference logic comfortably, and accurately, applies to Topics III. When one looks at the role that Aristotle allows reason to play in the production and motivation of action, it is tempting to conclude that Aristotle endorses the Humean division of labor. For Aristotle claims that deliberation is about “the things towards the goal” (EN III.3, 1112b11-16) and that virtue (aretē) makes our goals right (EN VI.12, 1144a7-9). Chapter three seeks to show, against a recent influential quasi-Humean interpretation, that the primary function of practical reason is mapping the landscape of value corresponding to the agent’s reasoned conception of what eudaimonia consists in, as a rational being that she is. Aristotle notoriously defends the political subordination of individuals he believes to have a defective deliberative capacity. In Politics I.13, he claims that the deliberative faculty is undeveloped in children and “ineffectual” (akuron) in women (1260a12). The concluding chapter considers a puzzle about the development of the female’s deliberative faculty: How do women become ineffective in their deliberation, but freemen do not, given that all children have deliberative faculties that are unperfected? Drawing from the theories defended in previous chapters, I argue that the female’s deliberative defect is primarily due to her lack of moral education rather than inalterable sexual, biological differences—a thesis widely endorsed by scholars lately. (shrink)

Deliberative scholars have suggested that citizens should be able to exchange arguments in public forums. A key element in this exchange is the rational mode of communication, which means speaking through objective argumentation. However, some feminists argue that this mode of communication may create or intensify epistemic injustices. Furthermore, we should not assume that everyone is equally equipped to take part in deliberation. Certain groups, such as Indigenous peoples, for instance, who may not be versed in rational forms of (...) argumentation, may not be listened to or involved sufficiently in the deliberative process. Therefore, it seems we need an alternative mode of communication, such as storytelling, which is a first-person or collective narrative. Given this, how should we pursue this goal? This article aims to answer this question by analysing a local conflict involving an Indigenous tribe and a neighbouring community in Brazil and exploring the underlying testimonial and hermeneutical injustices. I argue that storytelling has an important normative and institutional role in public deliberation and show that its applied version could overcome epistemic injustices and lead to better public policies. (shrink)

The recent surge of populism, nationalism and authoritarian tendencies in the political arena as well as the widespread propagation of fake news, conspiracy theories and disinformation in social media are increasingly worrisome and pose a severe threat to democratic societies and the rule of law. Political decisions in such societies must, first and foremost, be guided by evidence and reason. Unfortunately, the events of the last years have shown that the existing institutions and mechanisms are more and more vulnerable to (...) misuse, leaving democracies well and truly adrift from wholesome deliberative practices. It thus seems imperative that those institutions and mechanisms be redesigned in an attempt to make democracy “foolproof” – that is, to provide some sort of immunisation against these threats, even if it is, of course, nearly impossible to achieve such a lofty ideal in practice. This is the second part of a special issue that explores ways to make democracies “foolproof” in the explicated sense. (shrink)

Deliberative democrats conceive of the democratic process as a transformative process, one that requires citizens to participate in authentic deliberation with others rather than engaging in the strategic behaviour characteristic of existing democratic practices. Current practices often pit factions of society against one another in a struggle to win or retain political power. The moralized conception of democracy defended by deliberative democrats is one that emphasizes the importance of being open-minded, reasonable and accommodating. These civic virtues are necessary (...) if we are to treat others as equals when decisions are made concerning the use of political power, power that will influence the life prospects of everyone. Deliberative democrats are thus concerned with the normative legitimacy of a democratic decision; this legitimacy depends ‘on the degree to which those affected by it have been included in the decision-making processes and have had the opportunity to influence the outcomes’. (shrink)

This paper analyses the possibility of granting legitimacy to democratic decisionmaking procedures in a context of deep pluralism. We defend a multidimensional account according to which a legitimate system needs to grant, on the one hand, that citizens should be included on an equal footing and acknowledged as reflexive political agents rather than mere beneficiaries of policies, and, on the other hand, that their decisions have an epistemic quality. While Estlund’s account of imperfect epistemic proceduralism might seem to embody a (...) dualistic conception of democratic legitimacy, we point out that it is not able to recognize citizens as reflexive political agents and is grounded in an idealized model of the circumstances of deliberation. To overcome these ambiguities, we develop an account of democratic legitimacy according to which disagreement is the proper expression of citizens’ reflexive agency and the attribution of epistemic authority does not stem from a major expertise or specific ability, but it comes through the public confrontation among disagreeing agents. Consequently, the epistemic value of deliberation should be derived from the reasons-giving process rather than from the reference to the alleged quality of its outcomes. In this way, we demonstrate the validity of the multidimensional perspective of legitimacy, yet abstain from introducing any outcome-oriented criterion. Finally, we argue that this account of legitimacy is well suited for modeling deliberative democracy as a decision-making procedure that respects the agency of every citizen and grants her opportunity to influence public choices. (shrink)

Evidence about whether reflective thinking may be induced and whether it affects utilitarian choices is inconclusive. Research suggests that answering items correctly in the Cognitive Reflection Test (CRT) before responding to dilemmas may lead to more utilitarian decisions. However, it is unclear to what extent this effect is driven by the inhibition of intuitive wrong responses (reflection) versus the requirement to engage in deliberative processing. To clarify this issue, participants completed either the CRT or the Berlin Numeracy Test (BNT) (...) – which does not require reflection – before responding to moral dilemmas. To distinguish between the potential effect of participants’ previous reflective traits and that of performing a task that can increase reflectivity, we manipulated whether participants received feedback for incorrect items. Findings revealed that both CRT and BNT scores predicted utilitarian decisions when feedback was not provided. Additionally, feedback enhanced performance for both tasks, although it only increased utilitarian decisions when it was linked to the BNT. Taken together, these results suggest that performance in a numeric task that requires deliberative thinking may predict utilitarian responses to moral dilemmas. The finding that feedback increased utilitarian decisions only in the case of BNT casts doubt upon the reflective-utilitarian link. (shrink)

Deliberation and Decision explores ways of bridging the gap between two rival approaches to theorizing about democratic institutions: constitutional economics on the one hand and deliberative democracy on the other. The two approaches offer very different accounts of the functioning and legitimacy of democratic institutions. Although both highlight the importance of democratic consent, their accounts of such consent could hardly be more different. Constitutional economics models individuals as self-interested rational utility maximizers and uses economic efficiency criteria such as (...) incentive compatibility for evaluating institutions. Deliberative democracy models individuals as communicating subjects capable of engaging in democratic discourse. The two approaches are disjointed not only in terms of their assumptions and methodology but also in terms of the communication - or lack thereof - between their respective communities of researchers. This book provides a comprehensive overview of the recent debate between the two approaches and makes new and original contributions to that debate. (shrink)

BackgroundThe COVID-19 pandemic has highlighted prosocial behavior as a professional healthcare core competency. Although medical students are expected to work in the best interests of their patients, in the pandemic context, there is a greater need for ethical attention to be paid to the way medical students deal with moral dilemmas that may conflict with their obligations.MethodsThis study was conducted in the spring semester of 2019 on 271 students majoring in health professions: medicine, dentistry, and veterinary medicine. All participants provided (...) informed consent and completed measures that assessed utilitarian moral views, cognitive reflections, cognitive reappraisal, and moral judgment.ResultsThe healthcare-affiliated students who scored higher on the instrumental harm subscale in the measurement of utilitarian moral views were more likely to endorse not only other-sacrificial actions but also self-sacrificial ones for the greater good in moral dilemma scenarios. In particular, those engaged in deliberative processes tended to make more self-sacrificial judgments. The mediation analysis also revealed that the effect of deliberative processes on self-sacrificial judgments was mediated by cognitive reappraisal.ConclusionsThese findings suggested that cognitive reappraisal through deliberative processes is involved when the students with utilitarian inclination make prosocial decisions, that it is necessary to consider both moral views and emotional regulation when admitting candidates, and that moral education programs are needed in the healthcare field. (shrink)

The theory of deliberative democracy is a field of democratic theory that studies the contribution of public discussion, argumentation, and reasoning to the normative justification of democratic decision‐making. In this essay, we first explore two competing visions of the moral ideal of deliberative democracy: the rational consensus conception and the wide conception. This establishes a normative framework for analyzing several important applied issues that arise in thinking about deliberative democracy in the real world: the role (...) of cognitive diversity in deliberative decision‐making, the problem of rational ignorance, inequality in public deliberation, and the problem of group polarization. (shrink)

Taken as a model for how groups should make collective judgments and decisions, the ideal of deliberative democracy is inherently ambiguous. Consider the idealised case where it is agreed on all sides that a certain conclusion should be endorsed if and only if certain premises are admitted. Does deliberative democracy recommend that members of the group debate the premises and then individually vote, in the light of that debate, on whether or not to support the conclusion? Or does (...) it recommend that members individually vote on the premises, and then let their commitment to the conclusion be settled by whether or not the group endorses the required premises? Deliberative-democratic theory has not addressed this issue, and this is a problem. The discursive dilemma of my title--a generalisation of the doctrinal paradox from analytical jurisprudence--shows that the procedures distinguished can come apart. Thus deliberative democrats must make up their minds on where they stand in relation to the issue; they cannot sit on the fence. This paper is an attempt to address the issue and look at the grounds on which it may be resolved. (shrink)