IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v10y1990i3p181-194.html
   My bibliography  Save this article

Using Explicit Decision Rules to Manage Issues of Justice, Risk, and Ethics in Decision Analysis

Author

Listed:
  • Raisa B. Deber
  • Vivek Goel

Abstract

Concepts of justice, risk, and ethics can be merged with decision analysis by requiring the analyst to specify explicitly a decision rule or sequence of rules. Decision rules are categorized by whether they consider: 1) aspects of outcome distributions beyond central tendencies; 2) probabilities as well as utilities of outcomes; and 3) means as well as ends. This formulation suggests that distribution-based decision rules could address both risk (for an individual) and justice (for the population). Rational choice under risk if choices are one-time only (vs. repeated events) or if one branch contains unlikely but disastrous outcomes might ignore probability information. Incorporating risk attitude into decision rules rather than utilities could facilitate use of multiattribute approaches to measuring outcomes. Certain ethical concerns could be addressed by prior specification of rules for allowing particular branches. Examples, including selection of polio vaccine strategies, are discussed, and theoretical and practical implications of a decision rule approach noted. Key words: decision making; utility theory; decision analysis; ethics; risk; justice. (Med Decis Making 1990;10:181-194)

Suggested Citation

  • Raisa B. Deber & Vivek Goel, 1990. "Using Explicit Decision Rules to Manage Issues of Justice, Risk, and Ethics in Decision Analysis," Medical Decision Making, , vol. 10(3), pages 181-194, August.
    • Handle: RePEc:sae:medema:v:10:y:1990:i:3:p:181-194
    DOI: 10.1177/0272989X9001000305
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X9001000305
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X9001000305?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Eeckhoudt, L. & Lebrun, T. & Sailly, J. C., 1985. "Risk-aversion and physicians' medical decision-making," Journal of Health Economics, Elsevier, vol. 4(3), pages 273-281, September.
    2. David E. Bell, 1982. "Regret in Decision Making under Uncertainty," Operations Research, INFORMS, vol. 30(5), pages 961-981, October.
    3. James S. Dyer & Rakesh K. Sarin, 1979. "Measurable Multiattribute Value Functions," Operations Research, INFORMS, vol. 27(4), pages 810-822, August.
    4. Dennis J. Mazur, 1986. "Court Viewpoints and Medical Decision Making," Medical Decision Making, , vol. 6(4), pages 224-230, December.
    5. Milton C. Weinstein & Donald S. Shepard & Joseph S. Pliskin, 1980. "The Economic Value of Changing Mortality Probabilities: A Decision-Theoretic Approach," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 94(2), pages 373-396.
    6. Craig W. Kirkwood & Rakesh K. Sarin, 1985. "Ranking with Partial Information: A Method and an Application," Operations Research, INFORMS, vol. 33(1), pages 38-48, February.
    7. George W. Torrance & Michael H. Boyle & Sargent P. Horwood, 1982. "Application of Multi-Attribute Utility Theory to Measure Social Preferences for Health States," Operations Research, INFORMS, vol. 30(6), pages 1043-1069, December.
    8. Ralph L. Keeney & Robert L. Winkler, 1985. "Evaluating Decision Strategies for Equity of Public Risks," Operations Research, INFORMS, vol. 33(5), pages 955-970, October.
    9. John M. Miyamoto & Stephen A. Eraker, 1985. "Parameter Estimates for a QALY Utility Model," Medical Decision Making, , vol. 5(2), pages 191-213, June.
    10. Loomes, Graham & Sugden, Robert, 1982. "Regret Theory: An Alternative Theory of Rational Choice under Uncertainty," Economic Journal, Royal Economic Society, vol. 92(368), pages 805-824, December.
    11. Joao L. Becker & Rakesh K. Sarin, 1987. "Lottery Dependent Utility," Management Science, INFORMS, vol. 33(11), pages 1367-1382, November.
    12. Salk, D., 1988. "Polio immunization policy in the United States: A new challenge for a new generation," American Journal of Public Health, American Public Health Association, vol. 78(3), pages 296-300.
    13. Torrance, George W., 1976. "Social preferences for health states: An empirical evaluation of three measurement techniques," Socio-Economic Planning Sciences, Elsevier, vol. 10(3), pages 129-136.
    14. H. Llewellyn-Thomas & H.J. Sutherland & R. Tibshirani & A. Ciampi & J.E. Till & N.F. Boyd, 1982. "The Measurement of Patients' Values in Medicine," Medical Decision Making, , vol. 2(4), pages 449-462, December.
    15. Hinman, A.R. & Koplan, J.P. & Orenstein, W.A. & Brink, E.W. & Nkowane, B.M., 1988. "Live or inactivated poliomyelitis vaccine: An analysis of benefits and risks," American Journal of Public Health, American Public Health Association, vol. 78(3), pages 291-295.
    16. Harsanyi, John C., 1975. "Can the Maximin Principle Serve as a Basis for Morality? A Critique of John Rawls's Theory," American Political Science Review, Cambridge University Press, vol. 69(2), pages 594-606, June.
    17. J. Leighton Read & Robert J. Quinn & Donald M. Berwick & Harvey V. Fineberg & Milton C. Weinstein, 1984. "Preferences for Health Outcomes," Medical Decision Making, , vol. 4(3), pages 315-329, August.
    18. David E. Bell, 1985. "Disappointment in Decision Making Under Uncertainty," Operations Research, INFORMS, vol. 33(1), pages 1-27, February.
    19. Paul J. Roach & Craig Fleming & Michael D. Hagen & Stephen G. Pauker, 1988. "Prostatic Cancer in a Patient with Asymptomatic HIV Infection," Medical Decision Making, , vol. 8(2), pages 132-144, June.
    20. Harold Bursztajn & Robert M. Hamm & Thomas G. Gutheil & Archie Brodsky, 1984. "The Decision-Analytic Approach to Medical Malpractice Law," Medical Decision Making, , vol. 4(4), pages 401-414, December.
    21. Hinman, A.R. & Koplan, J.P. & Orenstein, W.A. & Brink, E.W., 1988. "Decision analysis and polio immunization policy," American Journal of Public Health, American Public Health Association, vol. 78(3), pages 301-303.
    22. Schoemaker, Paul J H, 1982. "The Expected Utility Model: Its Variants, Purposes, Evidence and Limitations," Journal of Economic Literature, American Economic Association, vol. 20(2), pages 529-563, June.
    23. Stephen G. Pauker & Susan P. Pauker & John B. Wong, 1987. "The Utility of Thresholds and the Threshold Utility," Medical Decision Making, , vol. 7(4), pages 201-202, December.
    24. Rakesh Kumar Sarin, 1985. "Technical Note—Measuring Equity in Public Risk," Operations Research, INFORMS, vol. 33(1), pages 210-217, February.
    25. William G. Stillwell & Detlof von Winterfeldt & Richard S. John, 1987. "Comparing Hierarchical and Nonhierarchical Weighting Methods for Eliciting Multiattribute Value Models," Management Science, INFORMS, vol. 33(4), pages 442-450, April.
    26. Slovic, Paul & Lichtenstein, Sarah, 1983. "Preference Reversals: A Broader Perspective," American Economic Review, American Economic Association, vol. 73(4), pages 596-605, September.
    27. John C. Hershey & Jonathan Baron, 1987. "Clinical Reasoning and Cognitive Processes," Medical Decision Making, , vol. 7(4), pages 203-211, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mark E. Cowen & Brian J. Miles & Daniel F. Cahill & R. Brian Giesler & J. Robert Beck & Michael W. Kattan, 1998. "The Danger of Applying Group-level Utilities in Decision Analyses of the Treatment of Localized Prostate Cancer in Individual Patients," Medical Decision Making, , vol. 18(4), pages 376-380, October.
    2. Claxton, Karl, 1999. "The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies," Journal of Health Economics, Elsevier, vol. 18(3), pages 341-364, June.
    3. Joshua Graff Zivin, 2001. "Cost‐effectiveness analysis with risk aversion," Health Economics, John Wiley & Sons, Ltd., vol. 10(6), pages 499-508, September.
    4. Nelson Borges Amaral & Jinfeng Jiao, 2023. "Responses to Ethical Scenarios: The Impact of Trade-Off Salience on Competing Construal Level Effects," Journal of Business Ethics, Springer, vol. 183(3), pages 745-762, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dolan, P. & Gudex, C. & Kind, P. & Williams, A., 1996. "Valuing health states: A comparison of methods," Journal of Health Economics, Elsevier, vol. 15(2), pages 209-231, April.
    2. David Parkin & Nancy Devlin, 2006. "Is there a case for using visual analogue scale valuations in cost‐utility analysis?," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 653-664, July.
    3. Weber, Elke U., 1989. "A Behavioral Approach To Decision Making Under Uncertainty: Implications And Lessons For Expected Utility Theory," 1989 Quantifying Long Run Agricultural Risks and Evaluating Farmer Responses to Risk Meeting, April 9-12, 1989, Sanibel Island, Florida 271520, Regional Research Projects > S-232: Quantifying Long Run Agricultural Risks and Evaluating Farmer Responses to Risk.
    4. George Wu, 1999. "Anxiety and Decision Making with Delayed Resolution of Uncertainty," Theory and Decision, Springer, vol. 46(2), pages 159-199, April.
    5. Han Bleichrodt & Peter P. Wakker, 2015. "Regret Theory: A Bold Alternative to the Alternatives," Economic Journal, Royal Economic Society, vol. 0(583), pages 493-532, March.
    6. Marc Willinger, 1990. "La rénovation des fondements de l'utilité et du risque," Revue Économique, Programme National Persée, vol. 41(1), pages 5-48.
    7. Andrea C. Hupman & Jay Simon, 2023. "The Legacy of Peter Fishburn: Foundational Work and Lasting Impact," Decision Analysis, INFORMS, vol. 20(1), pages 1-15, March.
    8. Carlos Laciana & Elke Weber, 2008. "Correcting expected utility for comparisons between alternative outcomes: A unified parameterization of regret and disappointment," Journal of Risk and Uncertainty, Springer, vol. 36(1), pages 1-17, February.
    9. Mandy Ryan, 1996. "Using willingness to pay to assess the benefits of assisted reproductive techniques," Health Economics, John Wiley & Sons, Ltd., vol. 5(6), pages 543-558, November.
    10. van Dijk, Wilco W. & van der Pligt, Joop, 1997. "The Impact of Probability and Magnitude of Outcome on Disappointment and Elation," Organizational Behavior and Human Decision Processes, Elsevier, vol. 69(3), pages 277-284, March.
    11. Qin, Jie, 2015. "A model of regret, investor behavior, and market turbulence," Journal of Economic Theory, Elsevier, vol. 160(C), pages 150-174.
    12. Enrico G. De Giorgi & Thierry Post, 2011. "Loss Aversion with a State-Dependent Reference Point," Management Science, INFORMS, vol. 57(6), pages 1094-1110, June.
    13. Ryan, Mandy, 1998. "Valuing psychological factors in the provision of assisted reproductive techniques using the economic instrument of willingness to pay," Journal of Economic Psychology, Elsevier, vol. 19(2), pages 179-204, April.
    14. Ronald Bosman & Frans Van Winden, 2010. "Global Risk, Investment and Emotions," Economica, London School of Economics and Political Science, vol. 77(307), pages 451-471, July.
    15. Han Bleichrodt, 2002. "A new explanation for the difference between time trade‐off utilities and standard gamble utilities," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 447-456, July.
    16. Ivan Barreda-Tarrazona & Ainhoa Jaramillo-Gutierrez & Daniel Navarro-Martinez & Gerardo Sabater-Grande, 2014. "The role of forgone opportunities in decision making under risk," Journal of Risk and Uncertainty, Springer, vol. 49(2), pages 167-188, October.
    17. repec:cup:judgdm:v:9:y:2014:i:5:p:373-386 is not listed on IDEAS
    18. Yan Li, 2011. "Emotions and new venture judgment in China," Asia Pacific Journal of Management, Springer, vol. 28(2), pages 277-298, June.
    19. Patricia H. Born & E. Tice Sirmans, 2019. "Regret in health insurance post‐purchase behavior," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 22(2), pages 207-219, July.
    20. Servaas van Bilsen & Roger J. A. Laeven & Theo E. Nijman, 2020. "Consumption and Portfolio Choice Under Loss Aversion and Endogenous Updating of the Reference Level," Management Science, INFORMS, vol. 66(9), pages 3927-3955, September.
    21. Corina Birghila & Tim J. Boonen & Mario Ghossoub, 2023. "Optimal insurance under maxmin expected utility," Finance and Stochastics, Springer, vol. 27(2), pages 467-501, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:10:y:1990:i:3:p:181-194. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.