Is It Fair to Kill One to Save Five? How Just World Beliefs Shape Sacrificial Moral Decision-making.

Sacrificing a target to save a group violates deontological ethics against harm but upholds utilitarian ethics to maximize outcomes. Although theorists examine many factors that influence dilemma decisions, we examined justice concerns: We manipulated the moral character of sacrificial targets, then measured participants' dilemma responses and just world beliefs. Across four studies (N=1116), participants considering guilty versus innocent targets scored lower on harm-rejection (deontological) responding, but not outcome-maximizing (utilitarian) responding assessed via process dissociation. Just world beliefs (both personal and general) predicted lower utilitarian and somewhat lower deontological responding, but these effects disappeared when accounting for shared variance with psychopathy. Results suggest that dilemma decisions partly reflect the moral status of sacrificial targets and concerns about the fairness implications of sacrificing innocent targets to save innocent groups.

The Impact of Clinical Ethics Consultations on Physicians in a Latin American Context.

Clinical bioethics plays a significant role in hospital settings through bioethics consultations, which focus on providing ongoing assistance in complex situations within the doctor-patient dynamic. These consultations entail regular interaction between physicians and clinical bioethicists. This situation prompts an exploration into how bioethics consultations affect physicians. The current research aims to understand the influence of bioethics consultations on physicians' bioethical knowledge by analyzing the lexical content in their patients' medical records. Medical records are a synthesis carried out by physicians, often reflecting collaborative efforts, and capturing verbal statements indicative of thought processes suggestive of learning. The study is a sequential mixed-methods design with a retrospective descriptive approach, comparing medical records from the early years of the Department of Humanism and Bioethics' operation (2013-2015) to the more recent ones (2019). Technical bioethical terminology such as "therapeutic effort limitation," "futility," "beneficence," and "respect for autonomy" is more prevalent in recent medical records. This trend may stem from the positive impact of bioethics consultations conducted by the Department, with haptic communication serving as a particularly effective form of interaction with others during experiences of moral distress. This appears to be characteristic of cultures like those in Latin America.

Antibiotic prescription, dispensing and use in humans and livestock in East Africa: does morality have a role to play?

BACKGROUND: Antimicrobial resistance (AMR) is a global threat to human and livestock health. Although AMR is driven by use of antimicrobials, it is often attributed to "misuse" and "overuse", particularly for antibiotics. To curb resistance, there has been a global call to embrace new forms of moral personhood that practice "proper" use, including prescription, dispensing and consumption of antimicrobials, especially antibiotics. This paper seeks to reflect on complex questions about how morality has become embedded /embodied in the AMR discourse as presented in the data collected on antimicrobial prescription, dispensing and use in human and livestock health in Tanzania, primarily focusing on antibiotics. METHODS: This reflection is anchored on Jarrett Zigon's morality framework that is comprised of three dimensions of discourse; the institutional, public, and embodied dispositions. The data we use within this framework are derived from a qualitative study targeting human and animal health care service providers and community members in northern Tanzania. Data were collected through 28 in-depth interviews and ten focus group discussions and analysed through content analysis after translation and transcription. In addition, a review of the Tanzania's National Action Plans on antimicrobial resistance was conducted. RESULTS: Application of the framework demonstrates points of convergence and divergence in the institutional morality discourse articulated by the Tanzania National Action Plans, the public discourse and the embodied dispositions/ lived experiences of human and animal health care service providers and community members. We demonstrate that AMR is not just associated with "inappropriate" behaviour on the part of drug prescribers, dispensers, and users but also with shortcomings in health systems and service delivery. CONCLUSION: Antibiotic dispensing and use practices that may be associated with the development of AMR should not be viewed in isolation from the broader health context within which they occur.

People's judgments of humans and robots in a classic moral dilemma.

How do ordinary people evaluate robots that make morally significant decisions? Previous work has found both equal and different evaluations, and different ones in either direction. In 13 studies (N = 7670), we asked people to evaluate humans and robots that make decisions in norm conflicts (variants of the classic trolley dilemma). We examined several conditions that may influence whether moral evaluations of human and robot agents are the same or different: the type of moral judgment (norms vs. blame); the structure of the dilemma (side effect vs. means-end); salience of particular information (victim, outcome); culture (Japan vs. US); and encouraged empathy. Norms for humans and robots are broadly similar, but blame judgments show a robust asymmetry under one condition: Humans are blamed less than robots specifically for inaction decisions-here, refraining from sacrificing one person for the good of many. This asymmetry may emerge because people appreciate that the human faces an impossible decision and deserves mitigated blame for inaction; when evaluating a robot, such appreciation appears to be lacking. However, our evidence for this explanation is mixed. We discuss alternative explanations and offer methodological guidance for future work into people's moral judgment of robots and humans.

The Moral Brain: a Neuropsychiatric Perspective on Moral Behavior and Motivation.

This review explores the interplay between neurobiological, psychological, and social factors that underpin moral behavior and motivation. Integrating insights from neuropsychiatry, it examines the roles of key brain regions such as the prefrontal cortex, amygdala, and anterior cingulate cortex, as well as neurotransmitters like serotonin and dopamine, in shaping moral reasoning and ethical decision-making. The historical evolution of moral motivation theories, from ancient philosophy to modern psychological and neurobiological perspectives, provides a foundation for understanding intrinsic and extrinsic motivators, emotional influences, and the impact of social norms and cultural contexts. The review also addresses the effects of psychiatric disorders on moral behavior, highlighting how conditions like antisocial personality disorder, frontotemporal dementia, and schizophrenia can lead to moral deficits. By presenting a multidisciplinary approach, this review offers a comprehensive understanding of moral motivation and behavior, emphasizing the importance of fostering ethical conduct and addressing moral challenges in clinical, educational, and societal settings.

Examining Physicians' Approaches to Treating Relatives in Primary Health Care Centers: Insights from a Qualitative Study.

Introduction: Family medicine physicians take care of a diverse population of patients with a variety of acute and chronic diseases. These patients include family, friends, and acquaintances who may ask for direct medical care or help in accessing healthcare products and services within or outside of officially approved procedures. This is ethically challenging due to an ambiguous medical code of ethics, but it is commonly accepted as normal behavior by society. The aim of this study was to explore family medicine physicians' perspectives regarding the benefits, difficulties, and ethics of responding to medical care requests and/or favors from family, relatives, friends, and acquaintances and to make recommendations. Methods: The study sample consisted of junior and senior family medicine physicians working in primary healthcare centers affiliated with the Ministry of Health in Saudi Arabia. In-depth semi-structured interviews were conducted to collect data. Using social exchange theory, this qualitative study explores how family medicine physicians perceive and handle requests for medical favors from family members and others. Results: Semi-structured interviews were conducted with 19 family medicine physicians (six focus groups) with clinical experience ranging from 3 to 20 years. The data analysis identified three themes: perceived benefits and costs of cultural and social connectedness, shortcomings in patient management and healthcare systems, and recommendations to address challenges between physicians and patients who are relatives. Discussion and Conclusions: This study shows that treating others outside of normal access to healthcare services presents several ethical, moral, and professional challenges. Therefore, policy adaptation requires understanding this intricate dilemma and improving laws, system regulations, and guidelines for physicians and community members to improve access to care, reduce system abuse, empower providers, and enhance community awareness and compliance.

Don't be rash: how effort, religion, and decision-type influence judgments of morality.

The present study explored how knowledge (Study 1) and inferences (Study 2) about religiosity influence impressions of morality depending on whether effort is exerted to reach a morally controversial decision. In Study 1, undergraduates judged a [religious/nonreligious] doctor who exerted [little/great] effort into their decision to euthanize a patient. Results indicated that when the doctor was nonreligious or exerted low effort, they were considered less moral compared to when they were religious or exerted high effort. In Study 2, Turk Prime participants evaluated a doctor who decided in favor or against euthanizing a patient, with the same effort manipulation as Study 1. Results indicated that the doctor who favored euthanasia was considered less religious than the doctor who did not. As in Study 1, greater morality was associated with the doctor who exerted greater effort, particularly when they favored euthanasia. When the doctor favored euthanasia, they were rated as more moral when their background was inferred to be more religious; however, the opposite pattern of results emerged when the doctor decided against euthanasia.

Moral Future-Thinking: Does the Moral Circle Stand the Test of Time?

Humanity's long-term welfare may lie in the hands of those who are presently living, raising the question of whether people today hold the generations of tomorrow in their moral circles. Five studies (NTotal = 1652; Prolific) reveal present-oriented bias in the moral standing of future generations, with greater perceived moral obligation, moral concern, and prosocial intentions for proximal relative to distal future targets. Yet, present-oriented bias appears stronger for socially close compared with socially distant targets and for human targets relative to non-human animals and entities in nature. Individual differences, including longtermism beliefs and subjective imaginative vividness, predict greater concern for and obligation to the future. Likewise, concern and obligation predict greater future-oriented generosity. Our studies are among the first to explore moral considerations for targets across deep temporal expanses, reconcile conflicting evidence in the extant literature on moral judgment and future-thinking, and offer practical implications for bettering the shared societal future.

Unethical prosocial behaviour and self-dehumanization: The roles of social connectedness and perceived morality.

Unethical prosocial behaviour (UPB) refers to acts where people violate widely held moral rules to benefit others. In light of previous research on the association between immoral behaviours and dehumanization, we examined whether and how engaging in UPB would impact the tendency to self-dehumanize. Across four studies (valid N = 1640), we found that UPB led to less self-dehumanization than unethical proself behaviour, which was mediated sequentially by social connectedness and perceived morality (Studies 2-4). Moreover, the comparison between UPB and ethical prosocial behaviour indicated that UPB did not necessarily lead to more self-dehumanization than ethical prosocial behaviour (Study 4). Although UPB was rated as less moral, it was associated with similar levels of social connectedness as ethical prosocial behaviour. These results have significant implications for research on morality and dehumanization and highlight the role of social connectedness in reducing dehumanization.

Evolution of the Moral Lexicon.

Morality is central to social well-being and cognition, and moral lexicon is a key device for human communication of moral concepts and experiences. How was the moral lexicon formed? We explore this open question and hypothesize that words evolved to take on abstract moral meanings from concrete and grounded experiences. We test this hypothesis by analyzing semantic change and formation of over 800 words from the English Moral Foundations Dictionary and the Historical Thesaurus of English over the past hundreds of years. Across historical text corpora and dictionaries, we discover concrete-to-abstract shifts as words acquire moral meaning, in contrast with the broad observation that words become more concrete over time. Furthermore, we find that compound moral words tend to be derived from a concrete-to-abstract shift from their constituents, and this derivational property is more prominent in moral words compared to alternative compound words when word frequency is controlled for. We suggest that evolution of the moral lexicon depends on systematic metaphorical mappings from concrete domains to the moral domain. Our results provide large-scale evidence for the role of metaphor in shaping the historical development of the English moral lexicon.

What motivates early lies? Deception in 2½- to 5-year-olds.

What motivates young children to produce early lies? A total of 217 2½- to 5-year-old children (Mage = 44.5 months, SD = 8.45; 54% girls; 61.7% White) from the southeastern United States were tested using a modified third-party transgression paradigm to examine the motivation behind their deception. Children were assigned to one of three conditions-baseline, self-motivated, or other-motivated condition-and their propensity to lie was captured through both verbal and nonverbal measures. Results show that children's early lies are primarily driven by a self-serving motivation. However, the motivation to lie diversifies by 4 years of age, when children begin to lie for both self-serving and other-serving motivations.

Morality through the lens of Confucian heritage countries: collective self variations and moral worldviews.

The issue of Western, Educated, Industrialized, Rich, and Democratic (WEIRD) samples dominating research has been ongoing for decades, and now the emerging trend is to turn to theoretical perspectives from the Majority World. Adopting Western-centric methods based on reductionism can overlook important details and differences between similar cultures, particularly in East Asian cultures, where the Confucian values of relational harmony take many forms. We discuss a novel theoretical perspective on moral constitutions in Confucian heritage cultures. Our central tenet is that divergent moral concepts and ideals are present in Confucian cultures because each culture emphasizes a specific pillar and the self is situated differently in the social relationships that define the scope of interpersonal moral obligations. We consider three Confucian countries: China, Japan, and South Korea as examples. Despite geographical proximity and conventional categorization in cultural psychology, each Confucian country manifests distinct patterns of the self, moral ideals, and behavior in socio-moral contexts. To understand how and why moral worldviews vary within a region, we need to examine how the self in socio-cultural contexts differs and guides interpersonal norms and behaviors across sociocultural contexts. We conclude this paper by offering methodological recommendations for including indigenous moral concepts outside the WEIRD context.

The Rhetoric of Healthcare and the Moral Debate About Theatre-Funded Hospitals in Early Modern Spain.

While early modern Spain may seem a world away, it is an extremely rich and relevant context for gaining a better understanding of the Rhetoric of Health, specifically the power of metaphor, in the related spheres of policy-making and public debate. It was a time and place in which the urban populace's physical well-being depended upon the fortunes of theatrical performances due to a system of alms for hospitals driven by ticket receipts. Anti-theatricalists argued that the immoral nature of theatrical performances made them spiritually and medically detrimental to society. Pro-theatricalists argued that plays were always a public good on balance because they raised much-needed funds for hospitals. Instead of producing a conflict between morality and public health, each side reinforced their connection until the two topics became nearly inseparable in the sphere of public debate. While pro-theatricalists mainly stayed with their arguments about funding hospitals, anti-theatricalists developed a new strategy of literalising the metaphor of theatre as a "plague of the republic" and arguing that immoral entertainment brought literal disease to the populace as a punishment from God. This exemplifies Stephen Pender's observation of how, in an early modern medical context, "Rhetoric as a way of perceiving probabilities and adjusting one's argument to the audience and circumstance offers a model of ethical action and interaction". This article is organised chronologically to track specific adjustments to a specific public-health debate that rely upon moral metaphors of medicine. Each side wrangled over these metaphors in an effort to break a deadlock in a public-health policy debate with entertainment, finance, and morality at its centre. By the end of the seventeenth century, anti-theatricalists finally found their best rhetorical weapon in the literalisation of the "plague of the republic" metaphor, but it only offered a short-term solution to banning theatre contingent upon the ebb and flow of epidemics. Simultaneously, the finance structure of funding hospitals began to erase the role of hospitals from the longstanding debate about the morality of public theatre. The case of early modern Spain provides valuable lessons about the power of metaphor in the Rhetoric of Healthcare that are still applicable today.

Third-party punishment-like behavior in a rat model.

Third-party punishment (TPP) is an altruistic behavior or sense willing to punish transgressors as a third party not directly involved in the transgression. TPP is observed worldwide, regardless of tradition and culture, and is essential for morality in human society. Moreover, even preverbal infants display TPP-like judgement, suggesting that TPP is evolutionarily conserved and innate. Thus, it is possible that non-human animals display TPP-like behavior, although TPP has been said to be human-specific. We investigated whether or not male mature Wistar rats displayed TPP-like behaviors when they witnessed deadly aggression by an unknown aggressive mouse toward another unknown victim mouse. Normally reared rats did not display TPP-like behaviors, but rats reared with extensive affectionate handling by human caretakers as beloved pets contacted the unknown aggressive mice in a gentle manner leading to reduced aggression toward the unknown victim mice, even when the aggressive mice fought back. Furthermore, the handled rats touched unknown rat pups that were drowning in water and anesthesia-induced comatose rats more frequently than control rats. These findings suggest a possibility that TPP is not in fact human-specific and innate but rather an acquired behavior that flourishes in affectionate circumstances.

Association of tooth loss and periodontal disease with all-cause mortality in cancer survivors: A cohort study based on NHANES.

Background: Increasing evidence supports the association between impaired oral health and elevated mortality. However, there is currently a lack of research on the impact of tooth loss and periodontal disease on survival outcomes in cancer survivors. This study aims to clarify the effect of tooth loss and periodontitis on all-cause mortality on cancer survivors. Methods: The clinical data of cancer survivors were collected from National Health and Nutrition Examination Survey (NHANES) 1999-2018. Mortality data were obtained by linking to records in the National Death Index until December 31, 2019. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal threshold for discriminating mortality based on the number of teeth lost. Kaplan-Meier survival curves and Cox regression analysis were performed to calculate hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for tooth loss and periodontitis. Results: A total of 3271 cancer survivors were assessed for tooth loss status, while 1267 patients were evaluated for periodontitis status. The prevalence of any tooth loss and CDC-AAP periodontitis was 83.5 % and 47.2 %, respectively. The ROC curve showed the cut-off point of tooth loss for predicting mortality is > 5. Cancer survivors with tooth loss>5 had significantly lower bone density (1.06 vs. 1.13 g/cm2, P < 0.001), elevated C-reactive protein level (0.3 vs. 0.18 mg/dL, P < 0.001), and a trend of lower lean body mass (46.9 vs. 47.6 kg, P = 0.093). Besides, cancer survivors with severe periodontitis also exhibited elevated C-reactive protein level (0.34 vs. 0.21 mg/dL, P = 0.033). All-cause mortality significantly increased in cancer survivors with either tooth loss>5 (HR = 1.290, P = 0.001) or severe CDC-AAP periodontitis (HR = 1.682, P = 0.016) in the multivariate Cox regression analysis. Conclusion: Tooth loss and periodontitis are strong risk factors for reduced overall survival in cancer survivors. Cancer survivors should emphasize diligent oral hygiene and consistent dental check-ups to optimize long-term oral health. The causal relationship between oral health and survival rates in cancer survivors requires further validation through randomized controlled trials.

How people evaluate individuals who act morally prior to acting immorally: An examination of developmental change in moral evaluation, social preference, and prediction of moral behaviors.

Recent studies have enthusiastically examined the developmental origin of moral self-licensing, which is a tendency to act immorally after acting morally. However, it has not been considered enough how children evaluate personality traits of individuals who show moral licensing behavior and whether there is any developmental change in this evaluation. This study examined the developmental change in moral evaluation, social preference, and prediction of moral behaviors for moral licensing characters as well as moral or immoral characters. In total, 36 5- and 6-year-old children, 36 7- and 8-year-old children, and 58 university students participated in the study. The results revealed that 7- and 8-year-olds and adults evaluated moral licensing characters as more moral and likable than those who behave immorally, unlike 5- and 6-year-olds, who did not distinguish between the immoral and moral licensing characters. Importantly, 7- and 8-year-olds judged the moral licensing character as neutral in both moral evaluation and judgment of social preference, suggesting that they thought the immoral behavior was canceled out owing to prior moral behavior in the moral licensing character. However, adults still judged the moral licensing character as immoral and dislikable. Moreover, children's prediction of moral behavior for all characters showed the same tendency as moral evaluation, whereas adults' prediction was slightly different from their moral evaluation. Taken together, our findings revealed that the evaluation of individuals who show moral licensing behavior changed developmentally, and a moral licensing effect was found when evaluating others' moral traits from around 7 or 8 years of age.

From Non-Traditional Sexual Behavior to Non-Legitimate Victims: Moral Virtue, Victim Blame, and Helping Intentions Toward a Woman Victim of Image-Based Sexual Abuse.

Image-based sexual abuse represents an increasingly common form of gender-based violence, consisting of the act of non-consensually capturing, distributing, or threatening to distribute sexually explicit material depicting another person. The purpose of the present study was to investigate how women victims' noncompliance with traditional female sexuality influences bystanders' perceptions of the phenomenon. Specifically, we experimentally examined whether a woman's sexual agency (high vs. low) and the length (steady vs. transient) of the relationship with the perpetrator affected her moral evaluation, victim blaming, and participants' willingness to support her. A sample of 597 adults (65.7% women, Mage = 31.29 years) took part in the study. The findings indicated that while a transient (vs. steady) relationship with the perpetrator significantly lowered the woman's perceived moral virtue and increased the extent to which she was blamed for the incident, a high (vs. low) woman's sexual agency decreased participants' helping intentions towards her. Additionally, results showed that men were less likely than women to attribute moral virtue and help the victim. Lastly, through the mediation of moral virtue and victim blaming, the length of the relationship indirectly influenced participants' helping intentions.

Striving Against Sonlessness: The Moral Uses of Medical Pluralism in Western Indian Quests for a Boy.

Amid patriarchal conditions that render one son necessary and multiple daughters burdensome, selective abortion of female fetuses has become pervasive in India. Public responses often cast sex selection as self-evidently ignorant, cruel, and misogynistic - an obvious evil meriting denunciation and eradication. Drawing on ethnographic fieldwork in Gujarat state, this article zooms out from ultrasound and abortion to survey the landscape of biomedical, herbal, and religious son production techniques surrounding them. Doing so clarifies the lived moral experience in which sex selection is embedded. Resort to multiple son production techniques is both an abstract moral indicator reflecting prevailing concerns and a pragmatic moral intervention aimed at harnessing every available means in response to those concerns. Fundamentally, people live out the multimodal quest that sometimes leads to selective abortion as aspiration - social, bodily, spiritual - toward an indispensable good, not as heartless rejection of daughters. Pluralistic son production illuminates the moral uses of medical pluralism for care-seekers, social scientists, and policymakers and practitioners. The case underscores that "complementary" therapies, rather than being just desperate behaviors, barriers to biomedical therapy, or curiosities to be integrated into care, may in fact be the clearest markers of the moral conditions in which public health problems unfold.

National politics ignites more talk of morality and power than local politics.

Politics and the media in the United States are increasingly nationalized, and this changes how we talk about politics. Instead of reading the local news and discussing local events, people are more often consuming national media and discussing national issues. Unlike local politics, which can rely on shared concrete knowledge about the region, national politics must coordinate large groups of people with little in common. To provide this coordination, we find that national-level political discussions rely upon different themes than local-level discussions, using more abstract, moralized, and power-centric language. The higher prevalence of abstract, moralized, and power-centric language in national vs. local politics was found in political speeches, politician Tweets, and Reddit discussions. These national-level linguistic features lead to broader engagement with political messages, but they also foster more anger and negativity. These findings suggest that the nationalization of politics and the media may contribute to rising partisan animosity.