Browsing by Subject "Decision Making"
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Item Item Chronic disease management and the shifting sands of payment reform(2018-04-20) Kermani, AsraItem Clinical decision-making in chronic hepatitis C(2002-12-19) Malet, Peter F.Item Dual Process Models of Decision Making: An fMRI Investigation of Framing Effects and Individual Differences(2010-11-02) Murch, Kevin Bertrand; Krawczyk, DanielWhile the manifestation of decisions can be explained in several ways, dual-process models provide a unique purview into the relationship between automatic and controlled components of the decision making process. Although dichotomies in processing can be observed utilizing different experimental paradigms, framing effects provide a unique reflection of these dichotomies. Framing effects have been studied behaviorally for quite some time; however, only recently have investigators begun to examine the neurobiological basis for these effects. Additionally, as these effects mirror dual-process accounts of decision making, the examination of concurrent task demands and individual differences in the manifestation of framing effects could serve to inform dual-process models. The current studies examined two different framing paradigms in the context of experimental manipulations, perspective taking and emotional priming, which were intended to facilitate processing within the subsystems of a dual-process account of social cognition. Framing manipulations included both a previously established risky-choice framing paradigm and a novel, socially relevant attribute framing paradigm. In addition to behavioral studies, an fMRI investigation of the attribute framing paradigm was conducted to examine the neural correlates associated with the observed framing effect within the neurobiological framework of the X- and C-System model of social cognition. Finally, the current studies sought to examine the role that individual differences (e.g., personality, intelligence, need for cognition, cognitive reflection, impulsivity, and attachment style) play in susceptibility to framing phenomena. Results indicated the framing manipulations utilized in these studies were successful in eliciting a bias in decision making behavior. The effects of additional experimental manipulations were mixed, with some evidence for influences on the manifestation of the framing effects. fMRI data generally showed changes in brain activity in a manner consistent with the neurobiological divisions included within the X-and C-System model and provided preliminary evidence suggesting differences in the way frames and counterframes are processed. Individual differences, both in terms of psychological constructs and brain activity, appeared to be associated with susceptibility to framing phenomena. In total, the current series of studies provide several novel contributions to the existing literature on framing effects, and by extension, dual-process accounts of decision making.Item Intersex: implications of umbrella terms in the interest of science(2019-11-12) Wimberly, Jennifer MarkusicThe intersection of science and identity intensifies the complexity of the umbrella term DSD (Disorders of Sex Development)/Intersex. The interest of science to classify DSD/Intersex conditions to formulate evidence-based best practice has implications on personal identity. Fundamental to ethical decision-making in intersex is the right to choose one's identity, which includes categorization within the umbrella term DSD/Intersex. In this lecture I offer a bioethics lens to balance umbrella terms and individuality to normalize the differences in sex development.Item On wealth and wrongdoing: how social class influences unethical behavior(2013-03-12) Piff, Paul K.Social class exerts a significant influence on ethical decisions and behavior. Psychological research finds that individuals from higher social class backgrounds are more likely to prioritize themselves---their individual needs and desires relative to individuals from lower social class backgrounds, who are more likely to be sensitive to others. Guided by this work, Paul K. Piff, Ph.D., will report studies showing that higher social class is associated with increased unethical behavior, decreased altruism, and increased utilitarian moral reasoning, as well as provide data to shed light on the reasons for these class differences. The talk highlights that social class is a powerful force in the realm of ethics.Item Personal choice or predestined?: the road to specialty choice(2019-11-01) Sulistio, MelanieItem Pharmacy ethics: a case-based introduction(2014-01-14) White, Bruce D.Pharmacy ethics deals with better rather than worse decision-making and the safe and effective use of drug products. Pharmacists and pharmaceutical manufacturers should struggle with their motives, intent, acts, and outcomes when their decisions and acts so impact the quality of life of those who use the medicines they dispense, make, and market. Understanding the normative ethical and legal standards can be challenging at times -- particularly in borderline and gray areas -- when it is hard to predict consequences. However, good professional decision-making is essential if pharmacists and drug manufacturers are to act in patients' best interests and maintain the public trust.Item Physician stewardship of healthcare resources(2013-01-08) Goold, Susan DorrStewardship may be defined as the judicious management of resources that others entrust to one's care. Physicians are entrusted with decision-making authority in health care; decision making that often draws on pooled community resources, whether through private insurance or government programs. Physicians' roles and responsibilities in stewardship are a matter of intense and pressing concern for professional organizations, physicians, policy makers and patients. Most agree that physicians should play a leadership role in controlling costs through, for instance, identifying unnecessary services and developing evidence based practice guidelines. The proper role for physicians as stewards when caring for individual patients "at the bedside," however, remains in dispute. Knowledge of clinical alternatives and of patients' preferences and needs enable physicians to individualize recommendations and minimize harms, unlike decision-makers who are more distant from the bedside. On the other hand, allocation decisions should be transparent and open to critique, and limits on individual patient advocacy could undermine trust. This presentation will first describe and justify existing professional norms and values related to stewardship. Second, it will review existing empirical research on doctors' knowledge, attitudes and behaviors related to practicing within resource constraints and analyze how that evidence compares to existing professional ethical norms and values. Finally, questions will be posed to the attendees about professional ethics, trust and stewardship.Item Surrogate decision making in the internet age(2018-02-13) Berg, Jessica W.[Note: The slides are not available from this event.] The technology revolution has had an enormous effect on all aspects of the practice of medicine, from record-keeping to scheduling to billing to treatments to research. But although there have been efforts to create online decision-aids to facilitate informed consent, little thought has been given to the role of social media in surrogate decision making. Many people have been using various outlets for years, and left significant electronic documentation of their preferences. As social media users age, questions of how and whether to use social media to assist surrogate decision making will become more prevalent. This presentation considers the ethical and legal issues involved in the use of social media -- such as Facebook and Twitter -- in determining medical treatment preferences for surrogate decision making.Item Tolerance & integrity: defining boundaries of acceptable treatment & non-treatment decisions(2020-12-08) Feudtner, ChrisClinical ethics consultations often involve some degree of conflict between patients (or their parents) and clinical teams regarding pursuing--or not pursuing--a specific treatment, or regarding some other request or behavior. Examples include refusal of immunizations or potential life-sustaining therapy; requests for care outside the standard of practice, or to withhold diagnostic or prognostic information, or to provide invasive interventions; or the challenges of providing medical care in the context of extreme non-adherence or verbal abuse. This talk outlines key concepts of what we will call principled conflict management. Principled conflict management requires the exercise of tolerance--which is to say, the virtue of having the judgment to discern which refusals or requests to accommodate and which to resist (and to what degrees), and having the ability to abide by this judgment. Practical guidance will be provided.