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Citation

Felsen G, Niker F & Reiner PB (2016) Pre-Authorization: A Novel Decision-Making Heuristic That May Promote Autonomy. The American Journal of Bioethics, 16 (5), pp. 27-29. https://doi.org/10.1080/15265161.2016.1159761

Abstract
First paragraphs: While the nature of autonomy has been debated for centuries, recent scholarship has been re-examining our conception(s) of autonomy in light of findings from the behavioral, cognitive, and neural sciences (Felsen and Reiner 2011; Blumenthal-Barby 2016). Blumenthal-Barby’s target article provides us with a timely and helpful framework for thinking about this issue in a systematic way, specifically in relation to the wide range of cognitive biases and heuristics that we employ in our decision making. Building on this, we wish to expand the framework beyond the article’s focus on the threat posed by biases and heuristics by suggesting that it is possible for at least some heuristics to promote autonomy. We hope to demonstrate this point by introducing the conceptual framework for a novel heuristic that we call pre-authorization. Blumenthal-Barby argues that biases and heuristics “pose a serious threat to autonomous decision-making and human agency” and that, consequently, efforts should be made to remove, mitigate, or counter them. While recognizing the autonomy-threatening potential of these ‘fast thinking’ mechanisms, as well as agreeing with the author about the types of cases in which this potential is likely to be actualized, we suggest that it does not capture the full range of interactions that are relevant to a balanced assessment of their impact on autonomy. If, as is widely acknowledged, at least some heuristics are adaptive responses to particular real-world decision-making situations (Gigerenzer 2008), the issue at hand becomes elucidating whether, and under what conditions, the cognitive influence of any particular heuristic is autonomy-threatening, autonomy-preserving, or even autonomy-promoting. Blumenthal-Barby focuses on the first of these categories; and, with respect to the component of absence of controlling or alienating influence, she contends that if the person’s attitude towards the influence is one of feeling controlled or alienated from her decision on account of the workings of a cognitive bias or heuristic, her autonomy is diminished

Keywords
Heuristic; Autonomy; Decision making

Journal
The American Journal of Bioethics: Volume 16, Issue 5

• AAM Pre-Authorization: A Novel Decision-Making Heuristic