EXPRESS: Judging accidental harm: reasoning style modulates the weight of intention and harm severity

Ethical Dilemmas and Countertransference in Legally Mandated Reporting of Fatal Child Neglect

In the fall of 2019, a much-publicized court case brought to national attention the issues of patient-doctor confidentiality when it comes to reporting the deaths of newborns in the United States. It is unclear whether the recent overturning of Roe v. Wade will lead to more cases like this. This article discusses issues of countertransference, as well as the ethical and legal implications were it to be a psychiatrist, in active treatment of such a patient, who would be required to make such a report. More specifically, as in the publicized court case, the patient could be a minor at the time, receiving treatment from a child psychiatrist. The implications of such a case include how countertransference affects the perception of fatal child neglect compared to intentional neonaticide; the ethical dilemma of generating a mandated report with the goal of child safety when such a report could lead to real legal consequences for a minor child; and considerations regarding continued treatment of a patient after such a report is made. It is likely that countertransference, shaped by attitudes toward mothers and idealized views on mothering, may play a large role in all these circumstances.

Association of sleep with moral severity to accidental harm transgressions: A cross-sectional study

Based on the assumptions that moral judgement activities require cognitive control, a capacity impaired by low sleep quality or a lack of sleep, several studies have explored the association between sleep and moral judgements. However, even if some studies support the association between sleep and both moral awareness and unethical behaviours, others failed to find a robust association between sleep and moral utilitarianism. In the present well-powered preregistered cross-sectional study, we explored the role of sleep in another class of moral judgement, namely third-party punishment (in which people have to assess the morality of an agent who transgressed a moral rule). Specifically, we targeted the association of sleep with judgements of accidental harm transgressions, which are assumed to be especially cognitively costly. Our main analysis showed no association of overall sleep quality during the past month with moral severity in these transgressions. This result was confirmed for other sleep indexes (sleep quantity in the past month, and sleep quantity and quality in the past night). Lastly, we exhaustively explored the associations of all sleep indexes with all classes of moral judgement (accidental, intentional, attempted transgressions and control scenarios). These additional results revealed associations between sleep and moral severity, but none survived correction for multiple testing. Equivalence tests confirmed that the effect sizes of all these associations were relatively low (|r < 0.25|). We ensured that the lack of robust association between natural sleep and third-party punishment could not be explained by a low quality of the data collected.

Sense of agency predicts severity of moral judgments

Sense of Agency (SoA) refers to the awareness of being the agent of our own actions. A key feature of SoA relies on the perceived temporal compression between our own actions and their sensory consequences, a phenomenon known as "Intentional Binding." Prior studies have linked SoA to the sense of responsibility for our own actions. However, it is unclear whether SoA predicts the way we judge the actions of others - including judgments of morally wrong actions like harming others. To address this issue, we ran an on-line pilot experiment where participants underwent two different tasks designed to tap into SoA and moral cognition. SoA was measured using the Intentional Binding task which allowed us to obtain both implicit (Intentional Binding) and explicit (Agency Rating) measures of SoA. Moral cognition was assessed by asking the same participants to evaluate videoclips where an agent could deliberately or inadvertently cause suffering to a victim (Intentional vs. Accidental Harm) compared with Neutral scenarios. Results showed a significant relation between both implicit and explicit measures of SoA and moral evaluation of the Accidental Harm scenarios, with stronger SoA predicting stricter moral judgments. These findings suggest that our capacity to feel in control of our actions predicts the way we judge others' actions, with stronger feelings of responsibility over our own actions predicting the severity of our moral evaluations of other actions. This was particularly true in ambiguous scenarios characterized by an incongruency between an apparently innocent intention and a negative action outcome.