Annemarie Kalis

This article focuses on both daily forms of weakness of will as discussed in the philosophical debate and psychopathological phenomena as impairments of decision making. We argue that both descriptions of dysfunctional decision making can be organized within a common theoretical framework that divides the decision making process in three different stages: option generation, option selection, and action initiation. We first discuss our theoretical framework, focusing on option generation as an aspect that has been neglected by previous models. In the main body of this article, we review how both philosophy and neuropsychiatry have provided accounts of dysfunction in each decision-making stage, as well as where these accounts can be integrated. Also, the neural underpinnings of dysfunction in the three different stages are discussed. We conclude by discussing advantages and limitations of our integrative approach.

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values.

Autonomous e-coaching systems offer their users suggestions for action, thereby affecting the user's decision-making process. More specifically, the suggestions that these systems make influence the options for action that people actually consider. Surprisingly though, options and the corresponding process of option generation --- a decision-making stage preceding intention formation and action selection --- has received very little attention in the various disciplines studying decision making. We argue that this neglect is unjustified and that it is important, particularly for designers of autonomous e-coaching systems, to understand how human option generation works. The aims of this paper are threefold. The first aim is to generate awareness with designers of autonomous e-coaching systems that these systems do in fact influence their users' options. The second is to show that understanding the interplay between a person's options and the e-coaching system's suggestions is important for improving the effectiveness of the system. The third is that the very same interplay is also crucial for designing e-coaching systems that respect people's autonomy.