Improving bioethical decision-making with a little help from legal argumentation

The most appropriate method for clinical decision-making is deliberation. The deliberative procedure aims to achieve wise and prudent decisions about health care taking into account facts, values and norms. Since deliberative reasoning is shared by healthcare professions, ethics and law, this paper introduces the structure and features of the bioethical deliberative procedure and suggests to improve it with some contributions from legal science and theories of argumentation.El método más adecuado para la toma de decisiones biomédicas es la deliberación. El procedimiento deliberativo pretende alcanzar decisiones prudentes y razonables tras tomar en consideración hechos, valores y normas. Al ser la racionalidad deliberativa un rasgo compartido por las profesiones asistenciales, la ética y el derecho, el presente artículo expone la estructura y las características del método bioético deliberativo y propone mejorarla mediante algunas contribuciones de la ciencia jurídica y las teorías de la argumentación

Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: NL

Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: N

Applying evidence-based medicine in general practice : a video-stimulated interview study on workplace-based observation

BACKGROUND: Evidence-based medicine (EBM) in general practice involves applying a complex combination of best-available evidence, the patient's preferences and the general practitioner's (GP) clinical expertise in decision-making. GPs and GP trainees learn how to apply EBM informally by observing each other's consultations, as well as through more deliberative forms of workplace-based learning. This study aims to gain insight into workplace-based EBM learning by investigating the extent to which GP supervisors and trainees recognise each other's EBM behaviour through observation, and by identifying aspects that influence their recognition. METHODS: We conducted a qualitative multicentre study based on video-stimulated recall interviews (VSI) of paired GP supervisors and GP trainees affiliated with GP training institutes in Belgium and the Netherlands. The GP pairs (n = 22) were shown fragments of their own and their partner's consultations and were asked to elucidate their own EBM considerations and the ones they recognised in their partner's actions. The interview recordings were transcribed verbatim and analysed with NVivo. By comparing pairs who recognised each other's considerations well with those who did not, we developed a model describing the aspects that influence the observer's recognition of an actor's EBM behaviour. RESULTS: Overall, there was moderate similarity between an actor's EBM behaviour and the observer's recognition of it. Aspects that negatively influence recognition are often observer-related. Observers tend to be judgemental, give unsolicited comments on how they would act themselves and are more concerned with the trainee-supervisor relationship than objective observation. There was less recognition when actors used implicit reasoning, such as mindlines (internalised, collectively reinforced tacit guidelines). Pair-related aspects also played a role: previous discussion of a specific topic or EBM decision-making generally enhanced recognition. Consultation-specific aspects played only a marginal role. CONCLUSIONS: GP trainees and supervisors do not fully recognise EBM behaviour through observing each other's consultations. To improve recognition of EBM behaviour and thus benefit from informal observational learning, observers need to be aware of automatic judgements that they make. Creating explicit learning moments in which EBM decision-making is discussed, can improve shared knowledge and can also be useful to unveil tacit knowledge derived from mindlines

Exploiting Parallelism for Hard Problems in Abstract Argumentation

Abstract argumentation framework (AF) is a unifying framework able to encompass a variety of nonmonotonic reasoning approaches, logic programming and computational argumentation. Yet, efficient approaches for most of the decision and enumeration problems associated to AF s are missing, thus potentially limiting the efficacy of argumentation-based approaches in real domains. In this paper, we present an algorithm for enumerating the preferred extensions of abstract argumentation frameworks which exploits parallel computation. To this purpose, the SCC-recursive semantics definition schema is adopted, where extensions are defined at the level of specific sub-frameworks. The algorithm shows significant performance improvements in large frameworks, in terms of number of solutions found and speedup