Seeing Gray in a World of Black and White: Children Appreciate Reasoners Who Approach Moral Dilemmas With Humility.

Moral decisions often involve dilemmas: cases of conflict between competing obligations. In two studies (N = 204), we ask whether children appreciate that reasoning through dilemmas involves acknowledging that there is no single, simple solution. In Study 1, 5- to 8-year-old US children were randomly assigned to a Moral Dilemma condition, in which story characters face dilemmas between two prosocial actions, or a Personal Cost control, in which story characters face decisions between a matched prosocial action and a self-interested action. Children were then presented with two reasoners who made the same judgment, but one confidently endorsed one moral action, and the other hesitantly acknowledged both actions. As they aged, children became more likely to prefer the uncertain reasoner's "way of thinking" in the Moral Dilemma compared to the Personal Cost condition. They also inferred that the uncertain reasoner was nicer and more trustworthy than the confident one. In Study 2, when both reasoners acknowledged the dilemma and differed only in their level of uncertainty, 5-year-olds preferred the acknowledgment to be accompanied by a confident decision, 6- and 7-year-olds preferred it be accompanied by uncertainty, and 8-year-olds showed no preference. These results show that, before the age at which children can resolve dilemmas successfully on their own, they recognize and value others who approach dilemmas with appropriate humility.

Is severe alcohol use disorder really associated with increased utilitarian moral judgment? Exploration using the CNI model.

OBJECTIVES: The psychology of moral decision-making classically contrasts utilitarianism (based on consequences) and deontology (based on moral norms). Previous studies capitalizing on this dichotomy have suggested the presence of a utilitarian bias among patients with severe alcohol use disorder (SAUD). We aimed to further disentangle the processes involved in such bias through a more validated approach, the CNI model of moral decision-making. This model allows to go further than the classical approach by distinguishing sensitivity to consequences (C), to moral norms (N), and general preference for inaction over action (I) in response to moral dilemmas. METHODS: Thirty-four recently detoxified patients with SAUD and 34 matched control participants completed a battery of 48 dilemmas derived from the CNI model, as well as social cognition tasks. RESULTS: In contrast with the utilitarian bias suggested in previous studies based on the classical approach, patients with SAUD did not show an increased sensitivity to consequences in comparison with control participants. However, they showed a reduced sensitivity to moral norms, as well as a greater action tendency. These biases were not related to social cognition deficits. CONCLUSIONS: Patients with SAUD are not more utilitarian than healthy controls, this previously reported bias being artificially generated by the methodological limits of the classical approach. Instead, they present a reduced sensitivity to moral norms and an action bias, which might impact their interpersonal relations and contribute to the social isolation frequently reported in this population, thus identifying moral decision-making as a new therapeutic lever in SAUD.

Social context during moral decision-making impacts males more than females.

Moral judgments are often viewed as the outcome of affective and deliberative processes that could be impacted by social factors and individual characteristics. The purpose of this study was to examine the interaction between gender and social context on moral judgment. Participants included 315 undergraduate students (67.3% female). The participants completed the Moral Decision-Making Task while seated at row tables facing the front of the room or round tables facing other participants. The results indicated that males responded in a more utilitarian manner (harm one to save five) than females for moral impersonal (MI) and moral personal (MP) dilemmas regardless of seating arrangements. When seated at round tables, all participants were more likely to respond deontologically (cause no harm) to the moral impersonal dilemmas. In addition, we calculated a moral reasoning difference score for each participant as the difference between the MI and MP scores to represent additional reactivity due to the idea of taking direct action. The moral reasoning difference score was consistent for females but indicated a more deontological response from males at round tables and a more utilitarian response from males at row tables. These results suggest that males are more utilitarian than females and are more likely to be influenced by social context when responding to moral dilemmas. More broadly, the current results indicate that moral judgments are affected by social context particularly in males in ways that have not been incorporated in many models of moral decision making.

Foreign-language effects in cross-cultural behavioral research: Evidence from the Tanzanian Hadza.

Behavioral research in traditional subsistence populations is often conducted in a non-native language. Recent studies show that non-native language-use systematically influences behavior, including in widely used methodologies. However, such studies are largely conducted in rich, industrialized societies, using at least one European language. This study expands sample diversity. We presented four standard tasks-a "dictator" game, two sacrificial dilemmas, a wager task, and five Likert-risk tolerance measures-to 129 Hadza participants. We randomly varied study languages-Hadzane and Kiswahili-between participants. We report a moderate impact of study language on wager decisions, alongside a substantial effect on dilemma decisions and responses to Likert-assessments of risk. As expected, non-native languages fostered utilitarian choices in sacrificial dilemmas. Unlike previous studies, non-native-language-use decreased risk preference in wager and Likert-tasks. We consider alternative explanatory mechanisms to account for this reversal, including linguistic relativity and cultural context. Given the strength of the effects reported here, we recommend, where possible, that future cross-cultural research should be conducted in participants' first language.

"Doing being a good parent" in the pediatric clinic: Parents' knowledge displays in advice requests on infants' everyday care.

Parents and pediatricians play pivotal roles in promoting a nurturing environment for children's growth and development, especially during the critical first thousand days of life. Given the challenges involved in infant care and rearing, parents often rely on pediatricians' professional support in a wide range of daily caregiving practices as diverse as complementary feeding, hygiene management, pacifier use, or sleep routines. Nevertheless, little attention has been devoted to the in vivo observation of how parents actually request advice on babies' everyday care, and how pediatricians attend to such requests. By adopting a conversation analysis approach to a corpus of 23 videorecorded Italian pediatric well-child visits, the article explores the different ways through which parents navigate the face-threatening activity of soliciting the pediatrician's advice on infants' everyday care and management. The analysis illustrates that parents overall display (different degrees of) prior knowledge and competence on the topics brought to the pediatrician's attention while, at the same time, acknowledging the pediatrician's expertise and professional role. In this way, I argue that parents display themselves as competent, knowledgeable, caring, and therefore "good parents". After discussing the results, in the concluding remarks I point to what seems to be a cultural change in parent-healthcare provider interactions.

Does Embodying a Divine Avatar Influence Moral Decisions? An Immersive Virtual Reality Study.

The term Proteus effect refers to the changes in attitudes and behavior induced by the characteristics of an embodied virtual agent. Whether the effect can extend to the moral sphere is currently unknown. To deal with this issue, we investigated if embodying virtual agents (i.e., avatars) with different characteristics modulate people's moral standards differentially. Participants were requested to embody an avatar resembling the Christian God in His anthropomorphic appearance or a control human avatar and to perform a text-based version of incidental and instrumental dilemmas in a virtual environment. For each participant, we recorded (1) chosen options (deontological vs. utilitarian), (2) decision times, (3) postdecision feelings, and (4) physiological reactions (skin conductance response and heart rate). We found that embodying God vs. a control avatar did not change the performance in the moral dilemma task, indicating that no strong Proteus effect was at play in our experimental conditions. We interpreted this result by examining the constraints and limitations of our task, reasoning about the necessary conditions for eliciting the Proteus effect, and discussing future developments and advances in the field. Moreover, we presented compelling effects concerning dilemma type, chosen option, personality traits, and religion affiliation, thus supporting and extending literature on decision making in moral dilemmas.

Children's voices on their values and moral dilemmas when being cared and treated for cancer- a qualitative interview study.

BACKGROUND: Childhood cancers affect about 350 children every year in Sweden and are life-threatening diseases. During the treatment period, situations arise that can become morally challenging for the child. When knowing children's values and morally challenging situations in childhood cancer care, targeted ethics support could be developed and used in care. AIM: To explore children's values and moral dilemmas ​​when undergoing cancer treatment. METHODS: This is a qualitative study based on empirical data. The data collection was conducted through three focus group interviews and six individual interviews with children between 10 and 18 years (n = 16). A content analysis methodology was used to generate themes. Children who were/have been treated for cancer at three childhood cancer centres in Sweden were invited to participate. The study was approved by the Swedish Ethical Review Authority. The children's participation was based on voluntariness and consent/assent. FINDINGS: During the analysis, five themes of values emerged: Personal relationships, Bodily ease and identity, Feeling in control and being involved, Positive distractions and Right care that is needed. Their moral dilemmas were thematized into: Should I consider others or not? Should I rest or not? and Should I refuse treatment or not? CONCLUSION: Children undergoing cancer treatment want to have personal relationships with healthcare professionals. Their moral dilemmas were about questioning their own physical and psychological well-being against their expectations, the values of others and the treatment required. Further research is needed to understand how to deal with moral dilemmas in children undergoing cancer treatment.

Moral caring competency and moral distress among Ghanaian nurses in adult care settings: A descriptive-correlational study.

Background: Nurses in adult care settings frequently encounter moral distress due to the daily ethical obligations they must fulfill. In contrast to other healthcare professionals, nurses often grapple with a heightened frequency of moral dilemmas, resulting in increased moral distress. Objective: This study aimed to explore the levels and relationship between moral caring competency and moral distress among Ghanaian nurses in adult care settings. Methods: This quantitative study utilized a descriptive-correlational design. A multistage sampling was used to select three public hospitals. Simple random sampling was used to recruit 231 nurses from the three public hospitals. Data were collected from June to July 2023 using validated questionnaires. The study utilized frequency and percentages, mean and standard deviation, and Spearman's Correlation. Results: The nurses had a low level of moral caring competency (M = 2.18, SD = 0.340). The composite moral distress score was 227.31, indicating a high level of moral distress among the nurses. Furthermore, there was a moderate, negative significant relationship between moral caring competency and moral distress (rs = -.474, N = 231, p <0.001). Conclusions: Nurses in public hospitals had limited personal cognitive, affective, and psychomotor abilities to address patient moral issues. The nurses also experience significant moral distress when delivering patient care. Furthermore, to decrease the level of moral distress, moral caring competency should be strengthened among nurses. Therefore, it is recommended that nurse administrators provide adequate organizational support and implement continuous moral training to improve nurses' moral caring competency and mitigate their moral distress. Healthcare policymakers are encouraged to develop or refine policies to navigate moral dilemmas and reduce moral distress among nurses. Future studies employing qualitative designs can explore the influence of culture on moral caring competency within the Ghanaian setting.

Pulling the lever in a hurry: the influence of impulsivity and sensitivity to reward on moral decision-making under time pressure.

BACKGROUND: Making timely moral decisions can save a life. However, literature on how moral decisions are made under time pressure reports conflicting results. Moreover, it is unclear whether and how moral choices under time pressure may be influenced by personality traits like impulsivity and sensitivity to reward and punishment. METHODS: To address these gaps, in this study we employed a moral dilemma task, manipulating decision time between participants: one group (N = 25) was subjected to time pressure (TP), with 8 s maximum time for response (including the reading time), the other (N = 28) was left free to take all the time to respond (noTP). We measured type of choice (utilitarian vs. non-utilitarian), decision times, self-reported unpleasantness and arousal during decision-making, and participants' impulsivity and BIS-BAS sensitivity. RESULTS: We found no group effect on the type of choice, suggesting that time pressure per se did not influence moral decisions. However, impulsivity affected the impact of time pressure, in that individuals with higher cognitive instability showed slower response times under no time constraint. In addition, higher sensitivity to reward predicted a higher proportion of utilitarian choices regardless of the time available for decision. CONCLUSIONS: Results are discussed within the dual-process theory of moral judgement, revealing that the impact of time pressure on moral decision-making might be more complex and multifaceted than expected, potentially interacting with a specific facet of attentional impulsivity.

Unveiling the Paradox of Selflessness: Exploring Perceptions of Hypocrisy and Priority Outgroup in Intergroup Moral Dilemmas.

Purpose: This study examines the impact of prioritizing the out-group in intergroup moral dilemmas. The research aims to achieve three primary objectives: 1) investigating the relationship between out-group prioritization and perceptions of hypocrisy, 2) exploring the influence of perceived hypocrisy and negative emotions on moral judgments, and 3) uncovering the underlying reasons for perceiving outgroup prioritization as hypocritical. Methods: Experiments 1, 2 and 3 involved presenting Chinese participants with out-group rescuers and in-group rescuers and asking them to rate the two on three dimensions: level of hypocrisy, level of morality, and negative emotions toward the rescuers. In Experiment 3, the degree of similarity between participants and rescuers was manipulated to control for the level at which participants projected their own intrinsic motivations (ie, self-interest) onto the rescuers. Results: Experiments 1 and 2 jointly showed that participants perceived the out-group rescuer as more hypocritical and immoral compared to the in-group rescuer, and that participants had stronger negative emotions toward the out-group rescuer. Mediation analysis also demonstrated that the perception of hypocrisy and negative emotions largely mediated the relationship between the different rescuers and participants' evaluation of the rescuers' morality. In Experiment 3, participants gave higher hypocrisy ratings to high projection out-group rescuers compared to low projection out-group rescuers. Conclusion: In intergroup dilemmas, choosing to sacrifice the in-group to rescue the outgroup is perceived as more hypocritical, immoral, and objectionable. Perceived hypocrisy arises from an incongruity between individuals' subjective judgments of the rescuers' self-interest motives and the altruistic choice made by the rescuers to rescue the out-group.

Ethical Issues in the Application of IVF from the Perspective of Females Undergoing IVF / 中国医学伦理学

Infertile women experience complex biological and social experiences in the process of receiving IVF. From the perspective of females undergoing IVF, it is helpful to analyze the ethical and social problems that IVF may face more intuitively and concretely. In this study, 213 women who were undergoing IVF were randomly selected to carry out a questionnaire survey. The results showed that the choice of IVF for infertile women was driven by multiple pressures from family and society, not entirely on their own; They are not aware of the technology, but have a positive attitude, and are eager to be fully informed in the treatment process. In addition, the treatment brings great economic pressure to women who were undergoing IVF and has no significant impact on the relationship between husband and wife. Only by paying attention to the above problems and solving them can we benefit more infertile women and help them realize their reproductive wishes.

Research Progress on Moral Injury of Foreign Medical Staff under the Background of COVID -19 Pandemic / 中国医学伦理学

This paper reviewed the research on moral injury among foreign medical staff in the background of the COVID -19 pandemic. It was found that foreign medical staff bore multiple moral pressures and impacts in the face of the epidemic, including the collision between medical practice and utilitarian policy, the inability to meet personal needs, the rapid transformation of medical mode, and a variety of comprehensive factors. Therefore, the moral injury of foreign medical staff is particularly prominent. In order to avoid and reduce the occurrence of moral injury, it is necessary to strengthen the cultivation of moral resilience, provide psychological and social support, and carry out personalized treatment for medical staff.

The effects of explicit reasoning on moral judgements.

We report four experiments that investigate explicit reasoning and moral judgements. In each experiment, some subjects responded to the "footbridge" version of the trolley problem (which elicits stronger moral intuitions), whereas others responded to the "switch" version (which elicits weaker moral intuitions). Experiments 1-2 crossed the type of trolley problem with four reasoning conditions: control, counter-attitudinal, pro-attitudinal, and mixed reasoning (both types of reasoning). Experiments 3-4 examine whether moral judgements vary based on (a) when reasoners engage in counter-attitudinal reasoning, (b) when they make the moral judgement, and (c) by the type of moral dilemma. These two experiments comprised five conditions: control (judgement only), delay-only (2-minute wait then judgement), reasoning-only (reasoning then judgement), reasoning-delay (reasoning, then 2-minute delay, then judgement), and delayed-reasoning (2-minute delay, then reasoning, then judgement). These conditions were crossed with the type of trolley problem. We find that engaging in some form of counter-attitudinal reasoning led to less typical judgements (regardless of when it occurs), but this effect was mostly restricted to the switch version of the dilemma (and was strongest in the reasoning-delay conditions). Furthermore, neither pro-attitudinal reasoning nor delayed judgements on their own impacted subjects' judgements. Reasoners therefore seem open to modifying their moral judgements when they consider opposing perspectives but might be less likely to do so for dilemmas that elicit relatively strong moral intuitions.

The Oxford Utilitarianism Scale: Psychometric properties of a French adaptation (OUS-Fr).

It is well established that one's sense of morality may be readily influenced by one's culture, education, and life situation. Very few psychometric tools are currently available to measure facets of human morality in different cultures. Therefore, the purpose of the present study was to develop a French adaptation of the Oxford Utilitarianism Scale (OUS-Fr) and formally evaluate its validity. The OUS-Fr was developed through a process of back-translation and administered to a sample of 552 participants. Results from exploratory factor analyses revealed a bidimensional structure with satisfactory loadings that was then also supported in the confirmatory factor analysis check. The OUS-Fr scale demonstrated good psychometric properties, with acceptable internal consistency and coherent results in the convergent validity analyses. These findings contribute to morality measurement literature by providing evidence for the reliability and validity of the French adaptation of the OUS. The OUS-Fr can be viewed as a valuable tool for researchers and practitioners for assessing utilitarian tendencies within the French-speaking population, which could pave the way for cross-cultural understandings that are important for fully understanding the intricacies of human morality.

Fear facilitates utilitarian moral judgments: Evidence from a moral judgment task.

Previous research on moral judgment (MJ) has focused on understanding the cognitive processes and emotional factors that influence different types of moral judgment tasks, such as personal and impersonal dilemmas. However, few studies have distinguished between the emotions related to cognition and the complex emotions specifically caused by MJ tasks. This gap in knowledge is important to address to have a better understanding of how emotions influence moral judgment. The aim of this study was to investigate the influence of fear and the role of moral emotions on MJ. Data were collected from 145 participants through jsPsych and analyzed using mixed-model analysis of variance (ANOVA) and correlation analysis. The study found that individuals who were triggered by the fear increased the number of utilitarian moral judgments in personal moral scenarios and lengthened the cognitive process, but not in impersonal moral dilemmas. Hence, we speculate that fear may play a cognitive role in personal moral dilemmas and an emotional role in impersonal moral dilemmas. Another finding is that the complex moral emotions arising from the moral decision-making process may affect the effectiveness of fear and potentially influence moral judgments. However, this study adopts a cautious attitude toward these discoveries, and further verification of this hypothesis should be conducted in the future.

Moral Breakdowns and Ethical Dilemmas of Perioperative Nurses during COVID-19: COREQ-Compliant Study.

(1) Background: The COVID-19 pandemic has led to an increase in the complexity of caregiving, resulting in challenging situations for perioperative nurses. These situations have prompted nurses to assess their personal and professional lives. The aim of this study was to explore the experiences of perioperative nurses during the first wave of the COVID-19 pandemic, with a specific focus on analyzing moral breakdowns and ethical dilemmas triggered by this situation. (2) Methods: A qualitative design guided by a hermeneutical approach was employed. Semi-structured interviews were conducted with 24 perioperative nurses. The interviews were transcribed and thematically analysed following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. (3) Results: The findings revealed three main categories and ten subcategories. These categories included the context in which moral breakdowns emerged, the ethical dilemmas triggered by these breakdowns, and the consequences of facing these dilemmas. (4) Conclusions: During the first wave of COVID-19, perioperative nurses encountered moral and ethical challenges, referred to as moral breakdowns, in critical settings. These challenges presented significant obstacles and negatively impacted professional responsibility and well-being. Future studies should focus on identifying ethical dilemmas during critical periods and developing strategies to enhance collaboration among colleagues and provide comprehensive support.

Do Moral Judgments in Moral Dilemmas Make One More Inclined to Choose a Medical Degree?

The role of moral intuitions and moral judgments has become increasingly prominent in educational and academic choices. The present research aims to examine if the moral judgments elicited in sacrificial trolley dilemmas have a distinct pattern for the decisions made by junior medical students, in comparison to those of senior high school students. We work with this sample because it represents the population out of which medical students are recruited in the case of Bucharest, Romania. Our findings show that moral judgments are indeed a significant predictor for a respondent's status as medical students. This result, albeit with limitations, bears multiple practical implications, from developing empirically informed medical ethics courses in medical schools to evidence-based policy designs which consider factors such as morality alongside financial outcomes and incentives.

The long and the short of it: 5-HTTLPR and moral judgement.

Differences in moral sentiments are widespread. Increasingly, their biological correlates are investigated to elucidate potential sources of divergent moral attitudes and choices. Serotonin is one such potential modulator. We investigated the effects of a functional serotonergic polymorphism, 5-HTTLPR, which was previously linked to moral choices albeit with inconsistent findings. N = 157 healthy young adults completed a set of congruent and incongruent moral dilemmas. In addition to the traditional moral response score, this set allows by using a process dissociation (PD) approach an estimation a deontological and a utilitarian parameter. While there was no main effect of 5-HTTLPR on any of the three moral judgement parameters, there was an interaction effect between 5-HTTLPR and endocrine status on PD parameters, which was mainly due to the deontological but not the utilitarian parameter. In men and free cycling women, LL homozygotes showed reduced deontological tendencies compared to S allele carriers. Contrariwise, in women using oral contraceptives, LL homozygotes had increased deontology parameter scores. Furthermore, LL genotypes in general reported less difficulty in making harmful choices, which were in addition associated with less negative emotions. The findings suggest that 5-HTTLPR might be involved in modulating cognitive and emotional processes contributing to moral decisions.

Personal health monitoring in the armed forces - scouting the ethical dimension : A case study in the Netherlands Armed Forces during the Covid-19 pandemic.

BACKGROUND: The field of personal health monitoring (PHM) develops rapidly in different contexts, including the armed forces. Understanding the ethical dimension of this type of monitoring is key to a morally responsible development, implementation and usage of PHM within the armed forces. Research on the ethics of PHM has primarily been carried out in civilian settings, while the ethical dimension of PHM in the armed forces remains understudied. Yet, PHM of military personnel by design takes place in a different setting than PHM of civilians, because of their tasks and the context in which they operate. This case study therefore focusses on obtaining insights into the experiences and related values of different stakeholders regarding an existing form of PHM, the Covid-19 Radar app, in the Netherlands Armed Forces. METHODS: We carried out an exploratory qualitative study, using semi-structured interviews with twelve stakeholders in the Netherlands Armed Forces. We focussed on participation in the use of PHM, reflections on the practical use and use of data, moral dilemmas and the need for ethics support, all in regard to PHM. The data was analysed using an inductive thematic approach. RESULTS: Three interlinking categories reflecting ethical dimensions of PHM emerged: (1) values, (2) moral dilemmas, and (3) external norms. The main values identified were: security (in relation to data), trust and hierarchy. Multiple related values were found. Some, but no broadly shared, moral dilemmas were identified and no strong need for ethics support was expressed. CONCLUSION: This study shed light on key values, provide insights in the experienced and presumed moral dilemmas and bring to mind ethics support considerations when looking at PHM in the armed forces. Some values bring a certain vulnerability to military users when personal and organisational interests are not aligned. Furthermore, some identified values may hinder a careful consideration of PHM because they potentially conceal parts of ethical dimensions of PHM. Ethics support can assist in uncovering and addressing these concealed parts. The findings highlight a moral responsibility for the armed forces to devote attention to the ethical dimensions of PHM.

The Contribution of Moral Case Deliberation to Teaching RCR to PhD Students.

Teaching responsible conduct of research (RCR) to PhD students is crucial for fostering responsible research practice. In this paper, we show how the use of Moral Case Deliberation-a case reflection method used in the Amsterdam UMC RCR PhD course-is particularity valuable to address three goals of RCR education: (1) making students aware of, and internalize, RCR principles and values, (2) supporting reflection on good conduct in personal daily practice, and (3) developing students' dialogical attitude and skills so that they can deliberate on RCR issues when they arise. What makes this method relevant for RCR education is the focus on values and personal motivations, the structured reflection on real experiences and dilemmas and the cultivation of participants' dialogical skills. During these structured conversations, students reflect on the personal motives that drive them to adhere to the principles of good science, thereby building connections between those principles and their personal values and motives. Moreover, by exploring personal questions and dilemmas related to RCR, they learn how to address these with colleagues and supervisors. The reflection on personal experiences with RCR issues and questions combined with the study of relevant normative frameworks, support students to act responsibly and to pursue RCR in their day-to-day research practice in spite of difficulties and external constraints.