Decision Making and Ethical Reasoning in Psychology

Ricou, M. University of Porto, Porto, Portugal CINTESIS - Center for Health Technology and Services Research, Porto, Portugal

Marina, S. University of Porto, Porto, Portugal CINTESIS - Center for Health Technology and Services Research, Porto, Portugal

Introduction

Throughout life, people are called upon to make decisions. Some are simple and occur intuitively, while others are more complex and require a more significant effort of reflection. In this regard, two processes are responsible for decision making (Frith & Singer, 2008): one is controlled by intuition, and the other requires rational justification (Moll, Zahn, Oliveira, Krueger, & Grafman, 2005). The meaning of the situation and the context in which the person is called upon to decide, can be crucial to the decision-making process. Thus, the role of emotions, or the emotional significance associated with the decision to be made, is essential.

For a long time, emotions were seen as playing a secondary role in decision making, as well as an obstacle to people’s rational functioning (Mayer, DiPaolo, & Salovey, 1990). The role of emotions gained acceptance from work in the neurosciences, especially that by Antonio Damásio (1994/2001, 2010), on the importance of emotions in decision making (Ceitil, 2006). According to Damásio (2010), emotions allow human beings to have a sense of their will and to satisfy their needs. Reason, in turn, allows the adaptation of these aspirations to social reality, combining the interests of the individual with those of their peers (Damásio, 2010; Kahneman, 2015; Thaler & Sunstein, 2008). 

In professional decision making, it is only through reason that it becomes possible to help others make the choices that are in their best interests. In the field of psychological intervention, decision making plays a central role, since it aims to provide the person with maximum knowledge about him- or herself, thus allowing for conscious and responsible choices (Ricou, 2017). Psychologists must be able to identify and understand their own emotions, in order to be able to recognize identifytheir intuitions. The psychologist’s emotional balance can be considered a fundamental precondition for his or her practice; otherwise, the professional would risk being too focused on his or her own emotional problems, which would make it difficult to understand the client. Understanding the other implies understanding one’s own emotions, and can be achieved only through a well-established relationship of trust and by different technical assumptions (Ricou, 2014). The development of this capability is based on the exercise of ethical reasoning as explored in the present study work, and should promote personal understanding and increased self-knowledge.

It is essential to reflect on and understand the processes involved in the development of ethical reasoning. Thus, we intend to explore the role of reason, emotions, and intuition in decision making. To this end, throughout this text we present the role that each of these dimensions can play in people's decision-making processes. In addition, we advocate the application of this model to professional decision making in the field of psychology.

Rationality

A rational decision is a decision based on a hypothetical-deductive model after all the necessary information has been obtained. Although this definition is clear, it is difficult for the individual to have full control over the process. The importance of rationality in decision making has been advocated and strengthened over time (Filliozat, 1997/2001). In ancient Greece, only rationality and logic were considered (Lehrer, 2009). The idea of a dichotomy between reason and emotion, in which the former controlled the latter, was accepted.

The theory of limited rationality (Simon, 1977, 1987) contradicts the idea of a perfect and comprehensive rationality. In Simon’s (1977,1987) author'sview, human reasoning is subject to environmental, cognitive, and psychological limitations which influence the decision-making process. Rationality in the decision-making process is often approached in an instrumental manner for a specific purpose. According to Over (2004), our mental processes are rational when we aim to achieve our own goals and integrate them with the needs of other people. The distinction between reason and emotions has been overcome, and the integration of all dimensions has been achieved. Damásio (1994/2001), for example, argues that emotions are part of the process of rational choice; without them it would be difficult for a person to make any decision at all.

According to Goleman (1997/1995), the appropriate combination of reason and emotion allows for the strengthening of intellectual capacity. In this regard, Coricelli, Dolan, and Sirigu (2007) state that human decisions cannot be explained through rationality alone. The authors highlight the fact that certain types of affective states can induce specific mechanisms of cognitive control over the processes of choice, such as the reinforcement or avoidance of experienced behaviors.

In professional practice the exercise of rationality should be to understand emotions, learn how to deal with them, and interpret the information they provide, i.e., promote the identification and knowledge of feelings (Ricou, 2014).

Emotions

Decisions made strictly from a rational standpoint would result in such complex hypotheses that they would render useless the reasoning and effort exerted to make the decision (Damásio, 1994/2001); thus it is accepted that other dimensions are involved in the decision-making process.

Oatley and Jenkins (1998/2002) consider emotions to be at the center of human mental life since they connect people with events and are central to the decision-making process. By reflecting on their emotions, people can use them as intelligent cognitive phenomena and promote behaviors adapted to their goals.

According to Lehrer (2009), both rational and emotional dimensions are involved in decision making. To make a decision based on a deductive logical perspective would be a lengthy process. Therefore, Damásio (1994/2001) proposes the somatic marker hypothesis. According to his theory, the somatic markers involve the use of feelings created through learning from secondary emotions, which serve as an alarm or incentive for the choice of a particular option. From this perspective, it is important to note that Damásio identifies both primary and secondary emotions.  The secondary ones correspond to the notion of somatic alterations juxtaposed to mental images, while the primary ones refer to a set of innate emotional responses, commanded mainly by the amygdala. Primary emotions can promote predispositions that can, however, be adjusted workedin an adaptive way. The rapid and explosive manifestations of these emotions can limit the exercise of human rationality. 

Primary emotions are considered innate and similar for all persons, while secondary emotions are defined as self-conscious. Secondary emotions are acquired throughout an individual’s personal history and evoked through self-reflection and self-evaluation (Tangney, Stuewig, & Mashek, 2007). If we considered only the primary emotions, it would be essential to learn to control them in order to promote more adaptive responses and select emotionally competent stimuli (Damásio, 2010). The recognition of secondary emotions, influenced by the characteristics of each human being, is in line with the idea that the person is much more than his or her rationality. Therefore, to achieve the best possible results from individual choices, it is not sufficient to simply understand the logical and factual side of events, exercising what Damásio (2010) calls the “autobiographical self.” It is also necessary to look in-depth at the motivations, phenomenology, and complexity of people’s emotions, in order to increase one’s real knowledge about them and promote an understanding of their feelings (Ricou, 2014). In addition, the evaluation of the role of intuition in the decision-making process is crucial (Kahneman, 2015; Thaler & Sunstein, 2008).

Intuition

To define intuition and arrive at a consensus regarding its role in the decision-making process has been a challenge. McBain (2005) refers to intuition as a temporary mental state that allows one to quickly make decisions; he defines it as a "propositional attitude" that we can express through beliefs, desires, hopes, and fears. Damásio (1994/2001) refers to intuition as a hidden mechanism, outside consciousness, through which we can solve problems without reasoning. Reber and Reber (2001) consider intuition a response to unperceivable signs which are captured unconsciously. In other words, the authors point to the possibility of making decisions in an almost involuntary way. According to Johnson-Laird (2006), when there is very limited information, intuition enables one to make the best decisions; in these situations, he believes that the use of conscious reasoning makes it difficult to find answers.

Haidt (2001), in his model of social intuition, highlights the difference between intuition and rationality. He argues that intuition is automatic and unconscious in relation to its processing; it is faster and requires less effort than the reasoning process. On the other hand, reason justifies intuitive answers, either when we try to make others agree with us, or in cases where our own personal intuitions are dissonant (Moll et al., 2005). McBain (2005) argues that it is intuition that the person primarily values when he or she has to make a decision. In a situation that requires a quick answer, it is difficult to imagine that a cognitive process of anticipatory assessment of the benefits and the harms of a given situation would be used to determine the path to follow. This process would certainly take a very long time and make it difficult to reach a conclusion. Besides, human beings do not deal well with uncertainty; they need answers that give them confidence in their integrity (Ricou, 2014). Therefore, in all situations, we seek quick answers, at least initially.

Even in situations that can be considered predominantly cognitive, such as trying to solve an enigma, the brain does not stop until it finds a solution, even if the conclusion is that there is no answer. If the brain does not find a satisfactory answer, we can say that the person is in crisis (Ricou, 2014). This crisis may induce suffering, which can be felt in the form of emotional activation, and may be perceived as distress if the person does not find an adequate solution (Ricou, 2014).

Reason does not seem to be sufficient for obtaining a quick and adequate answer. Intuition is apparently linked to emotions but also to learning, values, and the social context (Moll et al. 2005). It seems to be at the center of the decision-making process. We can say that intuition corresponds to the secondary emotions proposed by Damásio (1994/2001) or to the complex emotions of Johnson-Laird (2006). Therefore, it represents the result of the relationship between the core nuclearand autobiographical consciousness of Damásio (2010), i.e., between emotions and rationality.

According to several authors (e.g., Ariely, 2009; Damásio, 1994/2001; Filliozat, 1997/2001; Thaler & Sunstein, 2008), the role of intuition or secondary emotions is to provide fusion with reason in order to enhance the ability to make the best choices, at least in situations where serious consequences are at stake.

Professional decision making: Ethical reasoning

In a profession like psychology, the goal is not to have psychologists give their personal opinions about a given situation. Instead, we need answers based on a professional perspective and the best interests of the clients (Ricou, 2014). Therefore, the decision-making process used in personal dilemmas may not be sufficient to solve the ethical dilemmas in the psychology profession. Professionals have to move away from their personal frames of reference to achieve a better empathic understanding of their clients (Rogers, 1942/1974). To do this, professionals should be able to critically question their own intuition in order to intervene as little as possible with their personal judgment, and also to analyze their feelings.

Moral or ethical judgments cannot be based solely on intuition. These judgments include concepts about groups, interpersonal relationships, and social perspectives, and notions about when certain rights should be applied, and when they should be denied (Turiel, 2006). According to Frith and Singer (2008), there are two processes that are responsible for decision making in the face of moral dilemmas. The first is guided by intuition, which is often unconscious and quick, and evokes in the individual a feeling of congruence in relation to the answer. The second is a conscious and rational process that is influenced by education, culture, and context (Moll et al. 2005) and provides legitimacy for the decision. These assumptions can correspond to secondary emotions and autobiographical memory, respectively (Damásio, 1994/2001). According to Ricou (2014), it seems clear that the mechanisms that underlie the analysis of an ethical dilemma are the same as those used in moral judgment. However, he states that caution should be exercised, because psychologists must make decisions, not for themselves, but in the client’s best interest. 

We presented the role of emotions in decision-making processes since they are the result of complex procedures that involve all the dimensions of human functioning. Emotions seem to be the basis for important decision-making processes, providing guidance about what can be best for the individual. In other words, emotions help the person understand what is best for them, both individually and in a social context.          However, to assess what can be better for others, only reason allows the necessary discernment. So it can be argued that the basis for ethical reasoning in the resolution of any dilemma is reason (Ricou, 2014). It is no coincidence that personal difficulties evoke more significant emotional processing than impersonal problems (Myyry & Helkama, 2007). Thus, reason can increase the distinction between what is best for oneself, and what is best for another person. Furthermore, reason seems to allow psychologists not to confuse their personal interest with the interest of others. In addition, an emotional assessment can lead to a reading based on what "I" think would be the best if "I" were in the other's shoes. This scenario is not acceptable in the psychological intervention setting. Respecting the dignity of the human person is more than respecting differences; it is helping the person to express him or herself, while promoting the person’s autonomy (Ricou, 2014).

Emotions support empathy and allow the establishment of a relationship of trust that makes it easier to know the other person. However, we emphasize that this recognition of the other person should be done on a rational basis. Therefore, a sentimental assessment of reality, i.e., a reflection on the intuitive response to the other, may not be sufficient.

Psychologists should remove themselves from the situation and focus on their clients. In other words, they should detach their judgment from themselves, to become solely  psychologists, guided by the ethical principles that guide their profession and the associated models and techniques. Thus, the psychologist becomes a professional guided by the autobiographical (Damásio, 2010) self, and the intuitive or nuclear self disappears. Of course it is not possible to fully achieve this goal. In the setting of psychological intervention, professionals cannot remove themselves totally from their emotions and evaluate situations according to reason alone. It seems appropriate to point out that psychologists are not perfect, and that error is an intrinsic part of professional practice. It is important that each psychologist be aware of this fact and question his or her performance, in order to decrease the risk of making decisions that harm the client.

Bricklin (2001) defined some points that a psychologist should take into account for an adequate exercise of his or her profession. These ideas were adopted and adapted by Ricou (2014) (seeTable 1).

Table 1

Preconditions for ethical reasoning

1. Self-Knowledge

2. Excellent Training

3. Experience or Supervision

4. Humility

5. Intervision

The first precondition concerns the psychologists knowing their own beliefs about right and wrong, not allowing these views to influence their professional behavior, and avoiding an attitude of judgment toward the client. It is important to recognize that understanding one’s intuitions is central to avoiding making moral judgments. Psychologists cannot mistake the client’s best interest with what he or she would do in a similar situation. The psychologist should guide the client on the basis of psychological science, not his or her own life history.

The second precondition involves ensuring an excellent level of training for psychologists. Poor training can lead to personal intuitive decisions. Training should include a strong grounding in the principles and norms that guide and govern the exercise of the profession, and in the psychological science and techniques associated with its practice. The psychologist needs excellent training to be able to apply psychological theory and restrain the influence of his or her personal experience, i.e., intuitions. The psychologist has the responsibility for achieving this high level of training. 

The third precondition for ethical reasoning relates to experience. It is crucial to be aware that intuitive answers can arise in situations in professional practice. It is experience that makes it possible to have a clear awareness of how we can solve problems answer, and acquire intuitions appropriate to psychological practice. It would be difficult for an inexperienced professional to achieve competence immediately, because there are too many variables for the psychologist to be aware of when dealing with clients. Hence, supervision in the training of psychologists is very important.

Associated with the previous preconditions is the need for the psychologist to be humble. Humility is central to ensuring a responsible attitude in reaching conclusions. All psychologists have personal limitations in their work related to the decision-making process. Even when a psychologist has good self-knowledge, excellent training, and a good deal of experience, he or she should take into account the fact that all hypotheses made about the client’s situation are fallible. This is not only because the science is indeterminate, but also because it is impossible for a person to disconnect totally from personal experience. The psychologist must recognize this fallibility and not present absolute scenarios, but rather leave space for the possibility of other options.

Finally, the last point regarding ethical reasoning is intervision. Asking for help from other professionals ensures different perspectives. We are prone to using mechanisms to simplify information in order to be able to streamline the process of finding solutions and making decisions. The more experience a psychologist has, the greater the probability he or she will simplify information. This could lead to the psychologist putting the client into the framework of a comprehensive model that could reduce the understanding of the person’s uniqueness. This explains why psychologists should seek intervision. They should discuss their interpretations and proposals for intervention with colleagues, listen to alternatives, and increase their awareness of other perspectives.

The central precondition for good psychological practice seems to be psychologists engaging in deep reflection about their own desires and intuition. 

Conclusion

Decision making seems to stem from the combination of an individual’s core nuclearconsciousness with an autobiographical consciousness (Damásio, 2010). Only reason can increase the probability of helping someone from a psychological perspective. Emotions will reflect personal desires.

Bearing in mind that intuition is the basis for decision making, it is essential for psychologists to be aware of the high probability of having an intuitive response in each situation. Psychologists must be able to increase their ability to discern when they are relying on their intuition. As previously argued, it is not possible to stop core consciousness and make decisions only from an autobiographical consciousness (Damásio, 1994/2001). From this perspective, we think it is essential to value the role of reason. The exercise of ethical reasoning seems to be the central precondition for achieving solutions that are in the client’s best interest.

These preconditions for the exercise of ethical reasoning identified by Ricou (2014), which we support, come from careful reflection on the principles that guide professional psychological practice. The objective is to increase the psychologist’s perspectives about the dilemma situation.  The psychologist needs a clear awareness of the variables involved in his or her judgment, and should then try to discern the best choice for the client. This includes admitting that it is possible to fail. It means humbly recognizing the need to improve one’s knowledge about others and the world. It is a highly cognitive reflection. The first step for psychologists should be to understand their own reasoning and try to avoid the personal intuitions and feelings that tell them what the best choice is. This is difficult, but a decision made on this basis is what’s suitable for the client.

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