From virility to virtue: the psychology of apology in honor cultures.

In honor cultures, relatively minor disputes can escalate, making numerous forms of aggression widespread. We find evidence that honor cultures' focus on virility impedes a key conflict de-escalation strategy-apology-that can be successfully promoted through a shift in mindset. Across five studies using mixed methods (text analysis of congressional speeches, a cross-cultural comparison, surveys, and experiments), people from honor societies (e.g., Turkey and US honor states), people who endorse honor values, and people who imagine living in a society with strong honor norms are less willing to apologize for their transgressions (studies 1-4). This apology reluctance is driven by concerns about reputation in honor cultures. Notably, honor is achieved not only by upholding strength and reputation (virility) but also through moral integrity (virtue). The dual focus of honor suggests a potential mechanism for promoting apologies: shifting the focus of honor from reputation to moral integrity. Indeed, we find that such a shift led people in honor cultures to perceive apologizing more positively and apologize more (study 5). By identifying a barrier to apologizing in honor cultures and illustrating ways to overcome it, our research provides insights for deploying culturally intelligent conflict-management strategies in such contexts.

Physician Humility: A Review and Call to Revive Virtue in Medicine.

Physician virtues, including humility, are crucial for shaping a physician's identity and practice. The health care literature offers varied views on humility, and the rising call for discussing virtues as a framing for professional identity formation underscores the need for a clearer understanding of physician humility. This review aimed to develop a cohesive conceptualization of physician humility and to define how it functions in medical practice. To achieve this, a comprehensive search was done across PubMed, Ovid MEDLINE, Web of Science, Embase, ERIC, and PsycInfo, covering all records up to 30 October 2023. Articles were included if they discussed physician humility and excluded if they were unrelated to physician humility, focused on nonphysician health professionals, lacked conceptual depth, or focused solely on cultural humility. An applied thematic analysis was conducted. The results provide a synthesized conceptualization of physician humility across stances toward self, others, and the profession. The included articles identified the pivotal role of physician humility within the following 5 domains of medical practice: learning and professional growth, navigating error, uncertainty tolerance, trust and entrustment, and teamwork and communication. The authors highlight some of the intrapersonal, interpersonal, and sociocontextual challenges to cultivating and practicing physician humility. These findings highlight the importance of promoting humility in shaping physicians' actions, thoughts, and relationships with patients, colleagues, and their profession. Integrating such virtues as humility into medical education is essential for upholding the ideals of the medical profession and cultivating moral agents who engage in self-reflection and embody the principles of exemplary physicians.

Model Virtues in Computational Cognitive Neuroscience.

There is an abundance of computational models in cognitive neuroscience. A framework for what is desirable in a model, what justifies the introduction of a new one, or what makes one better than another is lacking, however. In this article, we examine key qualities ("virtues") that are desirable in computational models, and how these are interrelated. To keep the scope of the article manageable, we focus on the field of cognitive control, where we identified six "model virtues": empirical accuracy, empirical scope, functional analysis, causal detail, biological plausibility, and psychological plausibility. We first illustrate their use in published work on Stroop modeling and then discuss what expert modelers in the field of cognitive control said about them in a series of qualitative interviews. We found that virtues are interrelated and that their value depends on the modeler's goals, in ways that are not typically acknowledged in the literature. We recommend that researchers make the reasons for their modeling choices more explicit in published work. Our work is meant as a first step. Although our focus here is on cognitive control, we hope that our findings will spark discussion of virtues in other fields as well.

Preregistered Replication and Extension of "Moral Hypocrisy: Social Groups and the Flexibility of Virtue".

The tendency for people to consider themselves morally good while behaving selfishly is known as moral hypocrisy. Influential work by Valdesolo and DeSteno (2007) found evidence for intergroup moral hypocrisy such that people were more forgiving of transgressions when they were committed by an in-group member than an out-group member. We conducted two experiments to examine moral hypocrisy and group membership in an online paradigm with Prolific workers from the United States: a direct replication of the original work with minimal groups (N = 610; nationally representative) and a conceptual replication with political groups (N = 606; 50% Democrats and 50% Republicans). Although the results did not replicate the original findings, we observed evidence of in-group favoritism in minimal groups and out-group derogation in political groups. The current research finds mixed evidence of intergroup moral hypocrisy and has implications for understanding the contextual dependencies of intergroup bias and partisanship.

Virtue ethics and the unsettled ethical questions in controlled human infection studies.

Controlled human infection studies (CHIs) involve the intentional infection of human subjects for a scientific aim. Though some past challenge trials have involved serious ethical abuses, in the last few decades, CHIs have had a strong track record of safety. Despite increased attention to the ethics of CHIs during the COVID-19 pandemic, CHIs remain controversial, and there has been no in-depth treatment of CHIs through the lens of virtue ethics. In this article, we argue that virtue theory can be helpful for addressing CHIs that present a constellation of controversial, unresolved, and/or under-regulated ethical issues. We begin with some brief background on virtue ethics. We then substantiate our claim that some CHIs raise a constellation of ethical issues that are unresolved in the ethics literature and/or lack adequate regulatory guidance by demonstrating that CHIs can present indeterminate social value, risks to third parties, limitations on the right to withdraw from research, and questions about the upper limit of allowable risk. We argue that the presence of a virtuous investigator, with virtues such as prudence, compassion, and integrity, is especially important when these unresolved research ethics issues arise, which is the case for certain types of controlled human infection studies. We use the historical example of Walter Reed and the Yellow Fever Commission to illustrate this claim, and we also highlight some contemporary examples. We end by sketching some practical implications of our view, such as ensuring that investigators with experience running CHIs are involved in novel CHI models.

Virtue in Pursuit of Goals: A Goals-Based Approach to Patience Measurement.

In this paper, we provide a contextualized assessment of virtue through validation of a goals-based approach to measuring patience, the Goals-Based Virtue-Patience Scale (GBV-P). To assess virtue in a way congruent with its definition requires consideration of situational and contextual factors; however, most extant measures of virtue instead assess virtue at a decontextualized, global level (Ng & Tay, 2020). As such, we developed a contextualized and motivationally attuned goals-based assessment of the virtue of patience, the ability to remain calm in the face of frustration, suffering, or delay in goal pursuit. We engaged multilevel structural equation modeling to validate a new measure of patience in pursuit of goals nested within people. Across three studies (N = 798) assessing the GBV-P, data were consistent with reliability and structural validity tests, and associations of the new measure with other regulatory virtues or constructs (e.g., global patience, self-control, conscientiousness, perseverance, emotion regulation) as well as well-being (e.g., life satisfaction, goal orientation, meaning) and ill-being outcomes (e.g., depression and anxiety symptoms, loneliness, stress) provided evidence of convergent validity. Likewise, patience was differentially engaged depending on the goal domain and type; approach (vs. avoidance), interpersonal (vs. intrapersonal), and generativity goals were pursued with more patience.

Virtues of impact financing: Do financial institutions benefit from considering the environmental impact on financing decisions?

The impact investing literature largely focuses on private equity investing and overlooks the investments made through debt financing that actually dominate the market. To address this research gap, this paper investigates whether impact financing is associated with financial benefits. By using COVID-19 as an exogenous shock to China's stock market, this paper applies fixed effects panel data analysis with a difference-in-differences research design to provide robust empirical outcomes. The results reveal those financial institutions that better integrated environmental impacts into their financing process experienced positive stock return changes in response to the shock. This study answers the question of how well an impact scales. The findings suggest that impact financing is an effective model, as the impacts incorporated in the debt can be scaled up compared to impact investing funds with low volumes. Impact financing has enormous potential for financial institutions to engage in the green transition since they can derive pecuniary utility while delivering environmental impacts. The revelation of financial benefits also contributes to overcoming the lack of knowledge about impact financing and helps to remove the barriers that advance industry growth.

A practice-based study of relational virtues and alliance correspondence in psychodynamic psychotherapy.

OBJECTIVE: Treatment outcome monitoring typically emphasizes pathology. In contrast, we responded to the need to establish psychodynamic psychotherapy as evidence-based by modeling changes in gratitude and forgiveness. METHOD: We utilized a practice-based research design involving non-manualized outpatient treatment. We employed a longitudinal mixture modeling approach to evaluate treatment effectiveness. We did so by testing the theorized role for relational virtues (i.e., gratitude, forgiveness) as signs of progress in psychodynamic treatment, with relational virtues referring to the application of character strengths to specific situations. We modeled clients' self-reported level on the virtues as a joint process over five time points, and examined the influence of early treatment alliance correspondence on patterns of change using a sample of outpatient clients (N = 185; Mage = 40.12; 60% female; 74.1% White). RESULTS: A 3-class solution best fit the data, with one class exhibiting growth in gratitude and forgiveness, improved symptoms, and a greater likelihood of symptom improvement relative to well-being gains. Alliance correspondence predicted the classes of change patterns, with greater similarity between clinicians' and clients' perceptions about the alliance predicting greater likelihood of belonging to the subgroup showing highest levels of virtues and well-being, lowest symptoms, and improved well-being. CONCLUSION: Clinical implications involve monitoring gratitude and forgiveness as signs of progress and navigating the dialectic between implicit alliance processes and explicit virtue interventions. The former involves nurturing a strong alliance and repairing ruptures, whereas the latter involves direct in-session conversation and/or the practice of virtue interventions in and/or outside of session.

Technology and the Situationist Challenge to Virtue Ethics.

In this paper, I introduce a "promises and perils" framework for understanding the "soft" impacts of emerging technology, and argue for a eudaimonic conception of well-being. This eudaimonic conception of well-being, however, presupposes that we have something like stable character traits. I therefore defend this view from the "situationist challenge" and show that instead of viewing this challenge as a threat to well-being, we can incorporate it into how we think about living well with technology. Human beings are susceptible to situational influences and are often unaware of the ways that their social and technological environment influence not only their ability to do well, but even their ability to know whether they are doing well. Any theory that attempts to describe what it means for us to be doing well, then, needs to take these contextual features into account and bake them into a theory of human flourishing. By paying careful attention to these contextual factors, we can design systems that promote human flourishing.

Organizational Virtue Ethics and Moral Distress among Healthcare Workers.

AbstractMoral distress is traditionally defined as situations where one knows the right thing to do but external constraints make it nearly impossible to pursue the right course of action. Many interventions to mitigate moral distress focus on making healthcare workers more resilient or courageous in the face of adverse circumstances. While these "virtue cultivation" responses might be valuable traits for individuals, I want to argue that cultivating virtue is at best an incomplete strategy for dealing with moral distress in an organizational setting. The individualistic character of these approaches ignores how an organization's policies may be contributing to many morally distressing situations. I will argue that resources from the virtue tradition can still play a valuable theoretical role in addressing moral distress in healthcare settings if we transpose them to the organizational level. The policies of a hospital or healthcare institution can be seen as virtuous to the degree that they further the organization's goals of medicine. Organizational virtue ethics can then illuminate the issue of moral distress in healthcare organizations. If an organization's policies contribute to its members suffering from moral distress, then that policy may well inhibit the organization from carrying out its mission of providing excellent healthcare. Organizations should respond to moral distress and seek ways to mitigate if not eliminate it.

Pandemic ethics and beyond: Creating space for virtues in the social professions.

BACKGROUND: During the pandemic, social and health care professionals operated in 'crisis conditions'. Some existing rules/protocols were not operational, many services were closed/curtailed, and new 'blanket' rules often seemed inappropriate or unfair. These experiences provide fertile ground for exploring the role of virtues in professional life and considering lessons for professional ethics in the future. RESEARCH DESIGN AND AIM: This article draws on an international qualitative survey conducted online in May 2020, which aimed to explore the ethical challenges experienced by social workers during Covid-19. PARTICIPANTS AND RESEARCH CONTEXT: 607 social workers responded from 54 countries, giving written online responses. This article first summarises previously published findings from the survey regarding the range of ethical challenges experienced, then develops a new analysis of social workers' accounts of ethically challenging situations from a virtue ethics perspective. This analysis took a narrative ethics approach, treating respondents' accounts as stories featuring the tellers as moral agents, with implicit or explicit implications for their professional ethical identity and character. The article is illustrated with accounts from the 41 UK respondents, drawing particularly on two case examples. ETHICAL CONSIDERATIONS: Ethical approval was gained from Durham University and anonymity was ensured for participants. FINDINGS/RESULTS: This article explores the nature of the ethical space created during the pandemic showing how practitioners were able to draw more on 'inner resources' and professional discretion than usual, displaying virtues such as professional wisdom, care, respectfulness and courage as they took account of the specific contexts of their work, rather than simply adhering to blanket rules. CONCLUSION: Exploring practice through a virtue ethical lens provides valuable lessons for 'building back better' in social and health care professions.

Bodily contrast experiences in cultivating character for care.

Since 2008, in Flanders, we organize immersion sessions in a simulated context with the aim of stimulating student nurses and health professionals to learn virtuous caring. In this contribution, we first outline the purpose of this experiential learning: the cultivation of moral character. We come to the core of what we mean by moral character for care. We refer to Joan Tronto and Stan van Hooft to claim that caring is central to all aspects of nursing practice and is the basis of its moral quality. We also stipulate that caring involves the integration of action with emotions, motivations, and knowledge. Second, we briefly explain how the immersion sessions in the care ethics lab take place and, in particular, reflect on what it yields in terms of experiences for the participants who take on the role of simulant patients in this experiential learning process. We focus on the significant role contrast experiences play in these experiences. Especially the negative contrast experiences do not wear off easily; care professionals remember even long after the immersion session and continue to carry them with them as a "corporeal built-in alarm." Third, we discuss the role of contrast experiences in cultivating moral character for care. In particular, we explore the role of the body in the kind of knowing it cultivates and, by extension, its role in cultivating virtuous caring. By referring to specific philosophical ideas of Gabriël Marcel, Hans Jonas and Emmanuel Levinas, we try to understand how contrast experiences bring about an integration of virtuous action into knowledge, motivation, and emotion. We conclude that we need more space for contrast experiences in cultivating moral character. More attention should be paid to the role of the body in this learning process.

Beyond compassion fatigue, compassion as a virtue.

One of the great problems of caregivers and health professionals in recent times has been the so-called compassion fatigue and its association with burnout syndrome. Another pole of compassion has been described in terms of compassion satisfaction. Both propositions could be problematic in the caregiving setting. This is an analytical reflective article that through an apparent aporia tries to problematize and propose a theoretical synthesis that allows to denote compassion as a virtue in Aristotelian terms. To this end, it resorts to etymologies, translations and mainly to the classical theoretical references regarding compassion fatigue, compassion satisfaction and, of course, Aristotelian ethics. This is a theoretical bet that leaves open the discussion regarding the dichotomies compassion fatigue and compassion satisfaction; apathy and hyperpathy; and proposes to rethink compassion as a virtue, a reasoned middle ground, contextualized in the framework of care between two possible excesses.

When it's not easy to do the right thing: Developmental changes in understanding cost drive evaluations of moral praiseworthiness.

Recent work identified a shift in judgments of moral praiseworthiness that occurs late in development: adults recognize the virtue of moral actions that involve resolving an inner conflict between moral desires and selfish desires. Children, in contrast, praise agents who do the right thing in the absence of inner conflict. This finding stands in contrast with other work showing that children incorporate notions of cost and effort into their social reasoning. Using a modified version of Starmans and Bloom's (2016) vignettes, we show that understanding the virtue of costly moral action precedes understanding the virtue of resolving inner conflict. In two studies (N = 192 children, range = 4.00-9.95 years; and N = 193 adults), we contrasted a character who paid a personal cost (psychological in Study 1, physical in Study 2) to perform a moral action with another who acted morally without paying a cost. We found a developmental progression; 8- and 9-year-old children and adults recognized the praiseworthiness of moral actions that are psychologically or physically costly. Six- and 7-year-old children only recognized the praiseworthiness of moral actions that are physically costly, but not actions that are psychologically costly. Moreover, neither adults nor children inferred that paying a cost to act morally required having a moral desire or resolving inner conflict. These results suggest that both adults and children conceptualize obligation as a direct motivational force on actions. They further suggest that costly choice-a hallmark of moral agency-is implicated in judgments of praiseworthiness early in development.

Professional virtue of civility and the responsibilities of medical educators and academic leaders.

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of ethical reasoning, namely ethical analysis informed by pertinent prior work, followed by identifying the implications of clearly articulated ethical concepts, to meet these goals. The professional virtue of civility and the related concept of professional etiquette was first described by the English physician-ethicist Thomas Percival (1740-1804). Based on a historically informed philosophical account, we propose that the professional virtue of civility has cognitive, affective, behavioural and social components based on a commitment to excellence in scientific and clinical reasoning. Its practice prevents a dysfunctional organisational culture of incivility and sustains a civility-based organisational culture of professionalism. Medical educators and academic leaders are in a pivotal and powerful position to role model, promote and inculcate the professional virtue of civility as essential to an organisational culture of professionalism. Academic leaders should hold medical educators accountable for discharge of this indispensable professional responsibility.

Surrogacy: beyond the commercial/altruistic distinction.

In this article, I critique the commonly accepted distinction between commercial and altruistic surrogacy arrangements. The moral legitimacy of surrogacy, I claim, does not hinge on whether it is paid ('commercial') or unpaid ('altruistic'); rather, it is best determined by appraisal of virtue-abiding conditions constitutive of the surrogacy arrangement. I begin my article by problematising the prevailing commercial/altruistic distinction; next, I demonstrate that an assessment of the virtue-abiding or non-virtue-abiding features of a surrogacy is crucial to navigating questions about the moral legitimacy of surrogacy; in the final part, I reject other moral heuristics that might be proposed as alternatives to the commercial/altruistic dichotomy, and reiterate that a virtue-ethical framework is the most suitable way forward.

Harnessing legal structures of virtue for planetary health.

Humans and other species depend on the planet's well-being to survive and flourish. The health of the planet and its ecosystems is under threat from anthropogenic climate change, pollution and biodiversity loss. The promotion of planetary health against entrenched degradation of nature urgently requires ethical guidance. Using an ecocentric virtue jurisprudence approach, this article argues that the highest end of safeguarding planetary health is to secure the flourishing of the Earth community, of which the flourishing of humanity is but one component. The article demonstrates how law, despite its historic role in facilitating our present planetary crisis, has an untapped potential to redeem itself by promoting planetary flourishing through the creation of conditions conducive to the practice of moral virtues, which can help meet the challenges of the Anthropocene. Once given an ecocentric interpretation, the cardinal virtues of prudence, justice, courage and moderation, as well as their subvirtues, can justify or produce legal structures that address everything from the human right to a healthy environment to the rights of nature.

Out of This World: re-grounding justice through science fiction.

Good science fiction can be a successful vehicle for portraying justice. Science fiction can stimulate moral imagination in much the same way as the most effective justice theories, connecting the world in which we live with a range of alternative futures deliberately and creatively made plausible. A selective examination of classic and recent science fiction stories and novels provides contextual framing for considering questions of climate justice, virtuous personal action in the face of structural injustice, and the problem of what justice means when some people are regarded as "other." By connecting compelling images of individual responsibility with the complex challenges posed by striving for social justice, science fiction can also help render justice work appealing and achievable-an essential step that is reinforced in closing by a brief set of maxims.

A Heresy of No Consequence: Duties and Virtues in Medicine and Professionalism.

In The Trusted Doctor: Medical Ethics and Professionalism (2020), Rosamond Rhodes presents a new theory of medical ethics based on 16 duties she considers central to medical ethics and professionalism. She asserts that her theory is "bioethical heresy," as it contradicts established "principlism" and "common morality" approaches to ethics in medicine. Rhodes advocates the development of parallelism between clinical and ethical decision-making and a systematic approach that emphasizes duties over principles and rules to facilitate the development of a "doctorly character" among medical decision-makers. Rhodes further asserts that her theory and approach necessitate the cultivation of virtues contained in Aristotle's Nicomachean Ethics. But Rhodes's insistence that "medical professionals," not just doctors, are covered by her theory is open to critique, as is her conflation of ethic and morals, especially around the question of the "doctorly character" upon which her duty-based theory hinges. This assessment argues that applicants to medical schools and allied health training programs be screened for specific virtues-honesty, diligence, curiosity, and compassion-to facilitate reinforcement of these pre-professionalized inclinations throughout the habituation processes of medical training. This would increase the probability of turning fear and hope to cure and care via reasoning and affective models performed within an ethical medical framework-even while what this ethical framework should reference remains under debate.

Character and virtue development in medical learners: another role for the arts?

Medical education serves to teach students how to think and act as future physicians. Doing so successfully requires supporting learners' acquisition of clinical skills and knowledge, but also attending to their character education and virtue development. The arts and humanities are widely embraced as a fundamental component of a complete medical education. While not frequently touted as a useful pedagogical tool for teaching character and virtue, we argue the integration of arts-based activities into medical education can promote virtue development. In this article, we use the virtues framework from the Jubilee Centre for Character and Virtues at the University of Birmingham to review existing empirical studies of arts-based programs for each of these virtue domains of intellectual, moral, civic, and performance virtues. Learners may benefit from further exploration-both conceptual and empirical-of how the arts can scaffold character development in medical education.