RESUMEN
During the COVID-19 pandemic, healthcare professionals have often faced moral challenges, which required them to choose between endorsing self- or other-sacrifice for the greater good. Drawing on the altruistic rationalization hypothesis and trait-activation theory, this study investigates (a) whether healthcare students' endorsement of utilitarian solutions to sacrificial moral dilemmas varies when they are confronted with the minority group, majority group, or third-person perspective on the given dilemma and (b) whether individual differences in utilitarian thinking, as measured by the Oxford Utilitarianism Scale (both instrumental harm and impartial beneficence), predict endorsement of utilitarian solutions to moral dilemmas. The study population was divided into a group of healthcare students and a group of non-healthcare students. It was found that the members of both groups expressed a stronger pro-utilitarian position when making moral dilemma judgments from a majority perspective than from the two other perspectives. However, a difference was observed with healthcare students being more reluctant to endorse the utilitarian action than their non-healthcare counterparts in the self-in-majority context. The instrumental harm component was a significant predictor of utilitarian judgments in the healthcare group, but impartial beneficence significantly predicted utilitarian judgments in the non-healthcare group in the self-in-majority context. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04380-z.
RESUMEN
BACKGROUND: The COVID-19 pandemic has highlighted prosocial behavior as a professional healthcare core competency. Although medical students are expected to work in the best interests of their patients, in the pandemic context, there is a greater need for ethical attention to be paid to the way medical students deal with moral dilemmas that may conflict with their obligations. METHODS: This study was conducted in the spring semester of 2019 on 271 students majoring in health professions: medicine, dentistry, and veterinary medicine. All participants provided informed consent and completed measures that assessed utilitarian moral views, cognitive reflections, cognitive reappraisal, and moral judgment. RESULTS: The healthcare-affiliated students who scored higher on the instrumental harm subscale in the measurement of utilitarian moral views were more likely to endorse not only other-sacrificial actions but also self-sacrificial ones for the greater good in moral dilemma scenarios. In particular, those engaged in deliberative processes tended to make more self-sacrificial judgments. The mediation analysis also revealed that the effect of deliberative processes on self-sacrificial judgments was mediated by cognitive reappraisal. CONCLUSIONS: These findings suggested that cognitive reappraisal through deliberative processes is involved when the students with utilitarian inclination make prosocial decisions, that it is necessary to consider both moral views and emotional regulation when admitting candidates, and that moral education programs are needed in the healthcare field.
Asunto(s)
COVID-19 , Pandemias , Atención a la Salud , Humanos , Principios Morales , EstudiantesRESUMEN
Morality is defined as prescriptive norms regarding how people should treat one another, and includes concepts of fairness, justice, and rights. One recent study with moral dilemmas suggested that testosterone administration increases utilitarian judgments, which depends on second-to-fourth (2D: 4D) digit ratio, as a proxy of prenatal priming. However, the neural mechanism by which acute testosterone modulates moral reasoning remains to be determined. Using a placebo-controlled within-subject design, the current study examined the neuromodulatory effect of testosterone in young females by combining moral dilemmas, 2D: 4D, functional magnetic resonance imaging (fMRI), and subjective ratings of morally laden scenarios. Results showed that testosterone administration elicited more utilitarian responses to evitable dilemmas. The high 2D: 4D group scored more punishments for moral evaluation, whereas the low 2D: 4D group did the opposite. The activity in the amygdala, anterior insular cortex, and dorsolateral prefrontal cortex (dlPFC) was increased when participants evaluated morally unorthodox actions (intentional harm). The activity in the posterior superior temporal sulcus/temporoparietal junction (pSTS/TPJ) to accidental harm was decreased, specific to the high 2D: 4D group. The functional connectivity between the amygdala and dlPFC was reduced. The activity in the pSTS/TPJ to perceived agency predicted utilitarian responses to evitable dilemmas. The findings demonstrate the acute effect of testosterone on neural responses associated with moral judgment, and provide evidence to support that prenatal sex-hormones priming could be important for early neurodevelopment, which plays a crucial role in the neural and behavioral manifestations of testosterone on adult moral reasoning. Hum Brain Mapp 37:3417-3430, 2016. © 2016 Wiley Periodicals, Inc.
Asunto(s)
Encéfalo/fisiología , Juicio/fisiología , Principios Morales , Testosterona/metabolismo , Adulto , Afecto/efectos de los fármacos , Afecto/fisiología , Encéfalo/diagnóstico por imagen , Encéfalo/efectos de los fármacos , Mapeo Encefálico , Circulación Cerebrovascular/fisiología , Estudios Cruzados , Método Doble Ciego , Femenino , Dedos/anatomía & histología , Humanos , Juicio/efectos de los fármacos , Estudios Longitudinales , Imagen por Resonancia Magnética , Vías Nerviosas/efectos de los fármacos , Vías Nerviosas/fisiología , Pruebas Neuropsicológicas , Psicotrópicos/farmacología , Saliva/efectos de los fármacos , Saliva/metabolismo , Testosterona/farmacología , Percepción Visual/efectos de los fármacos , Percepción Visual/fisiología , Adulto JovenRESUMEN
BACKGROUND: Recent studies of moral reasoning in patients with alcohol use disorders have indicated a "utilitarian" bias, whereby patients are more likely to endorse emotionally aversive actions in favor of aggregate welfare (e.g., throwing a dying person into the sea to keep a lifeboat of survivors afloat). Here, we investigate the underlying psychological and neuropsychological processes. METHODS: Alcohol-dependent individuals (n = 31) and healthy comparison participants (n = 34) completed a validated moral judgment task, as well as measures of impulsivity, mood symptoms (anxiety and depression), and emotional face recognition. RESULTS: Alcohol-dependent individuals were more likely to endorse utilitarian choices in personal moral dilemmas compared with controls and rated these choices as less difficult to make. Hierarchical regression models showed that poorer decoding of fear and disgust significantly predicted utilitarian biases in personal moral dilemmas, over and above alcohol consumption. Impulsivity and mood symptoms did not predict moral decisions. CONCLUSIONS: These findings suggest that impaired fear and disgust decoding contributes to utilitarian moral decision-making in alcohol-dependent individuals.