Although people who endorse conspiracy theories related to medicine often have negative attitudes toward particular health care measures and may even shun the healthcare system in general, conspiracy ...theories have received rather meager attention in bioethics literature. Consequently, and given that conspiracy theorizing appears rather prevalent, it has been maintained that there is significant need for bioethics debate over how to deal with conspiracy theories. While the proposals have typically focused on the effects that unwarranted conspiracy theories have in the public health context, Nathan Stout's recent argument concentrates on the impacts that such theories have at the individual level of clinical decision‐making. In this article, I maintain that duly acknowledging the impacts of conspiracy theories that raise Stout's concern does not require bioethics debate over the proper response to the influence of conspiracy theories in healthcare. Having evaluated two possible objections, I conclude by briefly clarifying the purported import of the response to Stout.
Perhaps no kind of regulation is more common or less useful than mandated disclosure-requiring one party to a transaction to give the other information. It is the iTunes terms you assent to, the ...doctor's consent form you sign, the pile of papers you get with your mortgage. Reading the terms, the form, and the papers is supposed to equip you to choose your purchase, your treatment, and your loan well.More Than You Wanted to Knowsurveys the evidence and finds that mandated disclosure rarely works. But how could it? Who reads these disclosures? Who understands them? Who uses them to make better choices?
Omri Ben-Shahar and Carl Schneider put the regulatory problem in human terms. Most people find disclosures complex, obscure, and dull. Most people make choices by stripping information away, not layering it on. Most people find they can safely ignore most disclosures and that they lack the literacy to analyze them anyway. And so many disclosures are mandated that nobody could heed them all. Nor can all this be changed by simpler forms in plainer English, since complex things cannot be made simple by better writing. Furthermore, disclosure is a lawmakers' panacea, so they keep issuing new mandates and expanding old ones, often instead of taking on the hard work of writing regulations with bite.
Timely and provocative,More Than You Wanted to Knowtakes on the form of regulation we encounter daily and asks why we must encounter it at all.
Aims
To examine hospital nurses’ perception of their actual and potential contribution to shared decision‐making about life‐prolonging treatment and their perception of the pre‐conditions for such a ...contribution.
Design
A qualitative interview study.
Methods
Semi‐structured face‐to‐face interviews were conducted with 18 hospital nurses who were involved in care for patients with life‐threatening illnesses. Data were collected from October 2018‐January 2019. The interviews were recorded, transcribed verbatim and analysed using thematic analysis by two researchers.
Results
Nurses experienced varying degrees of influence on decision‐making about life‐prolonging treatment. Besides, we identified different points of contact in the treatment trajectory at which nurses could be involved in treatment decision‐making. Nurses’ descriptions of behaviours that potentially contribute to shared decision‐making were classified into three roles as follows: checking the quality of a decision, complementing shared decision‐making and facilitating shared decision‐making. Pre‐conditions for fulfilling the roles identified in this study were: (a) the transfer of information among nurses and between nurses and other healthcare professionals; (b) a culture where there is a positive attitude to nurses' involvement in decision‐making; (c) a good relationship with physicians; (d) knowledge and skills; (e) sufficient time; and (f) a good relationship with patients.
Conclusion
Nurses described behaviour that reflected a supporting role in shared decision‐making about patients’ life‐prolonging treatment, although not all nurses experienced this involvement as such. Nurses can enhance the shared decision‐making process by checking the decision quality and by complementing and facilitating shared decision‐making.
Impact
Nurses are increasingly considered instrumental in the shared decision‐making process. To facilitate their contribution, future research should focus on the possible impact of nurses’ involvement in treatment decision‐making and on evidence‐based training to raise awareness and offer guidance for nurses on how to adopt this role.
摘要
目标
研究医院护士对延长生命治疗共同决策的实际贡献和潜在贡献的认识,以及对此类贡献前提条件的认识。
设计
定性访谈研究。
方法
对18名医院护士进行半结构化的面对面访谈,这些护士均参与了患有命危疾病患者的护理工作。收集2018年10月至2019年1月之间的数据。两名研究员对访谈内容进行录制、逐字转录和主题分析。
结果
护士对延长生命治疗决策有着不同程度的影响作用。此外,我们确定了护士在治疗过程中可以参与治疗决策的不同接触点。护士对可能促进共同决策行为的可描述为以下三个角色:检查决策质量、对共同决策进行补充和促进共同决策。履行本研究中确定角色作用的先决条件是:(a)护士之间以及护士和其他保健专业人员之间的信息传递;(b)对护士参与决策持积极态度的文化;(c)与医生的良好关系;(d)知识和技能;(e)充裕的时间;以及(f)与患者的良好关系。
结论
护士会说明能反映对患者延长生命治疗共同决策中起到支持作用的行为,尽管并非所有护士都会经历此类参与过程。护士可以通过检查决策质量、补充和促进共同决策来增强在共同决策过程中的作用。
影响
护士在共同决策过程中的作用越来越大。为促进他们的贡献,未来的研究应侧重于护士参与治疗决策的影响可能性,以及循证培训,以提高他们对于其如何发挥这一作用的认识并提供相关指导。
An authoritative graduate textbook on information choice, an exciting frontier of research in economics and finance Most theories in economics and finance predict what people will do, given what they ...know about the world around them. But what do people know about their environments? The study of information choice seeks to answer this question, explaining why economic players know what they know—and how the information they have affects collective outcomes. Instead of assuming what people do or don't know, information choice asks what people would choose to know. Then it predicts what, given that information, they would choose to do. In this textbook, Laura Veldkamp introduces graduate students in economics and finance to this important new research.The book illustrates how information choice is used to answer questions in monetary economics, portfolio choice theory, business cycle theory, international finance, asset pricing, and other areas. It shows how to build and test applied theory models with information frictions. And it covers recent work on topics such as rational inattention, information markets, and strategic games with heterogeneous information. * Illustrates how information choice is used to answer questions in monetary economics, portfolio choice theory, business cycle theory, international finance, asset pricing, and other areas * Teaches how to build and test applied theory models with information frictions * Covers recent research on topics such as rational inattention, information markets, and strategic games with heterogeneous information
This analysis of the law's approach to healthcare decision-making critiques its liberal foundations in respect of three categories of people: adults with capacity, adults without capacity and adults ...who are subject to mental health legislation. Focusing primarily on the law in England and Wales, the analysis also draws on the law in the United States, legal positions in Australia, Canada, Ireland, New Zealand and Scotland and on the human rights protections provided by the ECHR and the Convention on the Rights of Persons with Disabilities. Having identified the limitations of a legal view of autonomy as primarily a principle of non-interference, Mary Donnelly questions the effectiveness of capacity as a gatekeeper for the right of autonomy and advocates both an increased role for human rights in developing the conceptual basis for the law and the grounding of future legal developments in a close empirical interrogation of the law in practice.
Readers will be enabled to compare, contrast and comprehend how the 'decision making strategies and tools' from different lenses are delivered in different parts of the world. The text includes an ...interesting mix of theory, primary research findings, and practice that will appeal to students, academics, and practitioners alike.
Many complex systems in civil and military operations are highly automated with the intention of supporting human performance in difficult cognitive tasks involving information processing. The ...complex systems can involve teams or individuals working on real-time tasks where a number of constraints must be satisfied. Decision Making in Complex Environments addresses the role of the human, the technology and the processes in complex socio-technical and technological systems.
The Best Worst Method (BWM) is a multi-criteria decision-making method that uses two vectors of pairwise comparisons to determine the weights of criteria. First, the best (e.g. most desirable, most ...important), and the worst (e.g. least desirable, least important) criteria are identified by the decision-maker, after which the best criterion is compared to the other criteria, and the other criteria to the worst criterion. A non-linear minmax model is then used to identify the weights such that the maximum absolute difference between the weight ratios and their corresponding comparisons is minimized. The minmax model may result in multiple optimal solutions. Although, in some cases, decision-makers prefer to have multiple optimal solutions, in other cases they prefer to have a unique solution. The aim of this paper is twofold: firstly, we propose using interval analysis for the case of multiple optimal solutions, in which we show how the criteria can be weighed and ranked. Secondly, we propose a linear model for BWM, which is based on the same philosophy, but yields a unique solution.
•Interval analysis is used to analyze the multi-optimality of BWM.•Multi-optimality of BWM is an advantage when debating has a role in decision-making.•A linear BWM model is proposed.•The linear BWM model results in a unique solution.
Abstract The concept of 'agentic shift,' introduced by Stanley Milgram, suggests that obedience reduces the sense of agency. In a recent study simulating the seminal work of Milgram, Caspar et al., ...2016 examined this idea in a financial harm context. They demonstrated that, compared to situations of voluntary decision-making, coercion increases the perceived time between action and outcomes—suggested as a marker of diminished agency. Importantly, in this study, participants were agent and victim (relying on a reciprocal relationship) and first experienced free choices, followed by forced choices. This diverts from Milgram’s original study, where participants were no victims but only agents who were forced to harm. The current study replicates and extends findings from the 2016 study by Caspar et al. in an online meeting setting, where participants served only as agents—similar to the original Milgram studies—while controlling the order of free and forced choice blocks. Substantiating earlier findings, forced choices reduced temporal binding (increased time interval estimations) compared to free choices independent of the order. We briefly discuss the importance of replications of coercion effects on the sense of agency, particularly in online decision-making settings.