Correlations of trait and state emotions with utilitarian moral judgements.

In four experiments, we asked subjects for judgements about scenarios that pit utilitarian outcomes against deontological moral rules, for example, saving more lives vs. a rule against active killing. We measured trait emotions of anger, disgust, sympathy and empathy (the last two in both specific and general forms, the latter referring to large groups of people), asked about the same emotions after each scenario (state emotions). We found that utilitarian responding to the scenarios, and higher scores on a utilitarianism scale, were correlated negatively with disgust, positively (but weakly and inconsistently) with anger, positively with specific sympathy and state sympathy, and less so with general sympathy or empathy. In a fifth experiment, we asked about anger and sympathy for specific outcomes, and we found that these are consistently predictive of utilitarian responding.

The concept of voluntary consent.

Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals' perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research.

Relationship of external influence to parental distress in decision making regarding children with a life-threatening illness.

OBJECTIVE: To examine the relationship of external influence to parental distress when making a decision about research or treatment for a child with a life-threatening illness and to test potential moderators of this relationship. METHODS: Parents (n = 219) who made a decision about research or treatment for a child completed measures of external influence, distress, decision-making preference, and coping. RESULTS: More external influence was associated with more hostility, uncertainty, and confusion. Decision-making preference and coping style moderated the relationship between external influence and distress: More external influence was associated with more distress when decision-making preference was low and task-focused coping was high. CONCLUSIONS: External influence appears to be related to distress in parents making research and treatment decisions for children with life-threatening illnesses. However, it is important to consider parent characteristics, such as decision-making preference and coping style, when examining the effects of contextual factors on distress during decision making.

The decision making control instrument to assess voluntary consent.

BACKGROUND: The decision to participate in a research intervention or to undergo medical treatment should be both informed and voluntary. OBJECTIVE: The aim of the present study was to develop an instrument to measure the perceived voluntariness of parents making decisions for their seriously ill children. METHODS: A total of 219 parents completed questionnaires within 10 days of making such a decision at a large, urban tertiary care hospital for children. Parents were presented with an experimental form of the Decision Making Control Instrument (DMCI), a measure of the perception of voluntariness. Data obtained from the 28-item form were analyzed using a combination of both exploratory and confirmatory factor analytic techniques. RESULTS: The 28 items were reduced to 9 items representing 3 oblique dimensions: Self-Control, Absence of Control, and Others' Control. The hypothesis that the 3-factor covariance structure of our model was consistent with that of the data was supported. Internal consistency for the scale as a whole was high (0.83); internal consistency for the subscales ranged from 0.68 to 0.87. DMCI scores were associated with measures of affect, trust, and decision self-efficacy, supporting the construct validity of the new instrument. CONCLUSION: The DMCI is an important new tool that can be used to inform our understanding of the voluntariness of treatment and research decisions in medical settings.

Hope, pride, and processing during optimal and nonoptimal times of day.

We examine the conditions under which the distinct positive emotions of hope versus pride facilitate more or less fluid cognitive processing. Using individuals' naturally occurring time of day preferences (i.e., morning vs. evening hours), we show that specific positive emotions can differentially influence processing resources. We argue that specific positive emotions are more likely to influence processing and behavior during nonoptimal times of day, when association-based processing is more likely. We show in three experiments that hope, pride, and a neutral state differentially influence fluid processing on cognitive tasks. Incidental hope facilitates fluid processing during nonoptimal times of day (compared with pride and neutral), improving performance on tasks requiring fluid intelligence (Experiment 1) and increasing valuation estimates on tasks requiring that preferences be constructed on the spot (Experiments 2 and 3). We also provide evidence that these differences in preference and valuation occur through a process of increased imagination (Experiment 3). We contribute to emotion theory by showing that different positive emotions have different implications for processing during nonoptimal times of day.

Challenges in measuring a new construct: perception of voluntariness for research and treatment decision making.

RELIABLE AND VALID MEASURES OF RELEVANT constructs are critical in the developing field of the empirical study of research ethics. The early phases of scale development for such constructs can be complex. We describe the methodological challenges of construct definition and operationalization and how we addressed them in our study to develop a measure of perception of voluntariness. We also briefly present our conceptual approach to the construct of voluntariness, which we defined as the perception of control over decision making. Our multifaceted approach to scale development ensured that we would develop a construct definition of sufficient breadth and depth, that our new measure of voluntariness would be applicable across disciplines, and that there was a clear link between our construct definition and items. The strategies discussed here can be adapted by other researchers who are considering a scale development study related to the empirical study of ethics.

Separate neural mechanisms underlie choices and strategic preferences in risky decision making.

Adaptive decision making in real-world contexts often relies on strategic simplifications of decision problems. Yet, the neural mechanisms that shape these strategies and their implementation remain largely unknown. Using an economic decision-making task, we dissociate brain regions that predict specific choices from those predicting an individual's preferred strategy. Choices that maximized gains or minimized losses were predicted by functional magnetic resonance imaging activation in ventromedial prefrontal cortex or anterior insula, respectively. However, choices that followed a simplifying strategy (i.e., attending to overall probability of winning) were associated with activation in parietal and lateral prefrontal cortices. Dorsomedial prefrontal cortex, through differential functional connectivity with parietal and insular cortex, predicted individual variability in strategic preferences. Finally, we demonstrate that robust decision strategies follow from neural sensitivity to rewards. We conclude that decision making reflects more than compensatory interaction of choice-related regions; in addition, specific brain systems potentiate choices depending on strategies, traits, and context.

Boundary conditions on unconscious thought in complex decision making.

Should individuals delegate thinking about complex choice problems to the unconscious? We tested two boundary conditions on this suggestion. First, we found that in a decision environment similar to those studied previously, self-paced conscious thought and unconscious thought had similar advantages over conscious thought constrained to a long fixed time interval in terms of identifying the option with the highest number of positive outcomes. Second, we found that self-paced conscious thought performed better than unconscious thought in a second decision environment where performance depended to a greater extent on magnitudes of the attributes. Thus, we argue that it is critical to take into account the interaction of forms of processing with task demands (choice environments) when considering how to approach complex choice problems.

Decision making as coping.

This article reviews a model of emotional trade-off difficulty in decision making. The model argues that decision makers are motivated to cope with the negative emotion associated with decision-processing operations, notably emotion generated by explicit trade-offs between highly valued attributes. The article begins to explore implications of this model for patient decision making in the cancer control domain. For instance, the model points to emotional reactions to decisions as both a cost and a barrier in the move toward greater patient participation in health care decision making.