Pre-Authorization: A Novel Decision-Making Heuristic That May Promote Autonomy
Authors: Fay Niker, Peter B. Reiner, Gidon Felsen
Journal: The American Journal of Bioethics (2016)

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.We agree with Blumenthal-Barby's recognition that "the relevant question for judgements of autonomous action is the person's attitude towards the influence that is leading them towards one decision or action or another" (emphasis added).But what does it mean to have an attitude towards an influence?When an influence is entirely alienating or controlling, one can reasonably adopt an attitude of rejection, lest one's decisions be influenced unduly by forces that we deem inappropriate.But in navigating our lives, we sometimes welcome certain influences, and under those circumstances there seems to be little threat to meaningful autonomy.So what is different about the influence that is welcomed from the one that is resisted?We suggest one solution: that the extent to which the source of an influence is preauthorized critically determines how it affects autonomy.We have been studying this idea within the context of investigating the welcome or unwelcome nature of socio-relational influences upon people's attitudes about autonomy, but it also has implications for thinking about the effects of cognitive biases and heuristics on autonomy more generally.We understand pre-authorization as an evaluative stance by which an individual gives a certain agent preferential access to influencing her decision-making processes.Commonly, pre-authorization occurs before a specific decision is made, and usually for decisions about which certain values, convictions, or viewpoints of the pre-authorized agent are relevant, although it can also occur contemporaneously.This evaluative stance arises on account of the fact that the individual perceives the agent as sharing the same or very similar values, commitments, and goals as those which they hold, or the agent is thought to have specific knowledge or expertise that the individual is willing to trust, given previous direct or indirect interactions.As a result, the individual feels comfortable incorporating the influence of the agent into her decision-making processes.We propose that pre-authorization is a decision-making heuristic: a shortcut that generally improves decision outcomes with minimal cognitive load.The core claim is that preauthorization allows us to capture the importance of interpersonal relations for autonomy by explaining why certain external influences, which individualistic accounts would take to be threats to a person's autonomy, may not only be autonomy-preserving but potentially even autonomy-promoting.