Beyond sacrificial harm: A two-dimensional model of utilitarian psychology

[Correction Notice: An Erratum for this article was reported in Vol 125(2) of Psychological Review (see record 2018-15704-001). The copyright attribution was incorrectly listed, and the Creative Commons CC-BY license disclaimer was incorrectly omitted from the author note. The correct copyright is "© 2017 The Author(s)" and the omitted disclaimer is found in the erratum. All versions of this article have been corrected.] Recent research has relied on trolley-type sacrificial moral dilemmas to study utilitarian versus nonutilitarian modes of moral decision-making. This research has generated important insights into people's attitudes toward instrumental harm-that is, the sacrifice of an individual to save a greater number. But this approach also has serious limitations. Most notably, it ignores the positive, altruistic core of utilitarianism, which is characterized by impartial concern for the well-being of everyone, whether near or far. Here, we develop, refine, and validate a new scale-the Oxford Utilitarianism Scale-to dissociate individual differences in the 'negative' (permissive attitude toward instrumental harm) and 'positive' (impartial concern for the greater good) dimensions of utilitarian thinking as manifested in the general population. We show that these are two independent dimensions of proto-utilitarian tendencies in the lay population, each exhibiting a distinct psychological profile. Empathic concern, identification with the whole of humanity, and concern for future generations were positively associated with impartial beneficence but negatively associated with instrumental harm; and although instrumental harm was associated with subclinical psychopathy, impartial beneficence was associated with higher religiosity. Importantly, although these two dimensions were independent in the lay population, they were closely associated in a sample of moral philosophers. Acknowledging this dissociation between the instrumental harm and impartial beneficence components of utilitarian thinking in ordinary people can clarify existing debates about the nature of moral psychology and its relation to moral philosophy as well as generate fruitful avenues for further research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Of Mice, Men, and Trolleys: Hypothetical Judgment Versus Real-Life Behavior in Trolley-Style Moral Dilemmas

Scholars have been using hypothetical dilemmas to investigate moral decision making for decades. However, whether people's responses to these dilemmas truly reflect the decisions they would make in real life is unclear. In the current study, participants had to make the real-life decision to administer an electroshock (that they did not know was bogus) to a single mouse or allow five other mice to receive the shock. Our results indicate that responses to hypothetical dilemmas are not predictive of real-life dilemma behavior, but they are predictive of affective and cognitive aspects of the real-life decision. Furthermore, participants were twice as likely to refrain from shocking the single mouse when confronted with a hypothetical versus the real version of the dilemma. We argue that hypothetical-dilemma research, while valuable for understanding moral cognition, has little predictive value for actual behavior and that future studies should investigate actual moral behavior along with the hypothetical scenarios dominating the field.

Reduced empathic concern leads to utilitarian moral judgments in trait alexithymia

Recent research with moral dilemmas supports dual-process model of moral decision making. This model posits two different paths via which people can endorse utilitarian solution that requires personally harming someone in order to achieve the greater good (e.g., killing one to save five people): (i) weakened emotional aversion to the prospect of harming someone due to reduced empathic concern for the victim; (ii) enhanced cognition which supports cost-benefit analysis and countervails the prepotent emotional aversion to harm. Direct prediction of this model would be that personality traits associated with reduced empathy would show higher propensity to endorse utilitarian solutions. As per this prediction, we found that trait alexithymia, which is well-known to have deficits in empathy, was indeed associated with increased utilitarian tendencies on emotionally aversive personal moral dilemmas and this was due to reduced empathic concern for the victim. Results underscore the importance of empathy for moral judgments in harm/care domain of morality.

Utilitarianism and the pandemic

There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory that states that the right action is the action that is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic: (a) Triage: which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? (b) Lockdown: how should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID-19 with causing deaths and reductions in well-being from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay.

Discrepancies between Judgment and Choice of Action in Moral Dilemmas

Everyone has experienced the potential discrepancy between what one judges as morally acceptable and what one actually does when a choice between alternative behaviors is to be made. The present study explores empirically whether judgment and choice of action differ when people make decisions on dilemmas involving moral issues. Two hundred and forty participants evaluated 24 moral and non-moral dilemmas either by judging (“Is it acceptable to…”) or reporting the choice of action they would make (“Would you do…”). We also investigated the influence of varying the number of people benefiting from the decision and the closeness of relationship of the decision maker with the potential victim on these two types of decision. Variations in the number of beneficiaries from the decision did not influence judgment nor choice of action. By contrast, closeness of relationship with the victim had a greater influence on the choice of action than on judgment. This differentiation between evaluative judgments and choices of action argues in favor of each of them being supported by (at least partially) different psychological processes.

Selective impairment of cognitive empathy for moral judgment in adults with high functioning autism

Faced with a moral dilemma, conflict arises between a cognitive controlled response aimed at maximizing welfare, i.e. the utilitarian judgment, and an emotional aversion to harm, i.e. the deontological judgment. In the present study, we investigated moral judgment in adult individuals with high functioning autism/Asperger syndrome (HFA/AS), a clinical population characterized by impairments in prosocial emotions and social cognition. In Experiment 1, we compared the response patterns of HFA/AS participants and neurotypical controls to moral dilemmas with low and high emotional saliency. We found that HFA/AS participants more frequently delivered the utilitarian judgment. Their perception of appropriateness of moral transgression was similar to that of controls, but HFA/AS participants reported decreased levels of emotional reaction to the dilemma. In Experiment 2, we explored the way in which demographic, clinical and social cognition variables including emotional and cognitive aspects of empathy and theory of mind influenced moral judgment. We found that utilitarian HFA/AS participants showed a decreased ability to infer other people's thoughts and to understand their intentions, as measured both by performance on neuropsychological tests and through dispositional measures. We conclude that greater prevalence of utilitarianism in HFA/AS is associated with difficulties in specific aspects of social cognition.

Efficient Kill-Save Ratios Ease Up the Cognitive Demands on Counterintuitive Moral Utilitarianism

The dual-process model of moral judgment postulates that utilitarian responses to moral dilemmas (e.g., accepting to kill one to save five) are demanding of cognitive resources. Here we show that utilitarian responses can become effortless, even when they involve to kill someone, as long as the kill-save ratio is efficient (e.g., 1 is killed to save 500). In Experiment 1, participants responded to moral dilemmas featuring different kill-save ratios under high or low cognitive load. In Experiments 2 and 3, participants responded at their own pace or under time pressure. Efficient kill-save ratios promoted utilitarian responding and neutered the effect of load or time pressure. We discuss whether this effect is more easily explained by a parallel-activation model or by a default-interventionist model.

Ethical and Scientific Pitfalls Concerning Laboratory Research with Non-Human Primates, and Possible Solutions

Basic and applied laboratory research, whenever intrusive or invasive, presents substantial ethical challenges for ethical committees, be it with human beings or with non-human animals. In this paper we discuss the use of non-human primates (NHPs), mostly as animal models, in laboratory based research. We examine the two ethical frameworks that support current legislation and guidelines: deontology and utilitarianism. While human based research is regulated under deontological principles, guidelines for laboratory animal research rely on utilitarianism. We argue that the utilitarian framework is inadequate for this purpose: on the one hand, it is almost impossible to accurately predict the benefits of a study for all potential stakeholders; and on the other hand, harm inflicted on NHPs (and other animals) used in laboratory research is extensive despite the increasing efforts of ethics committees and the research community to address this. Although deontology and utilitarianism are both valid ethical frameworks, we advocate that a deontological approach is more suitable, since we arguably have moral duties to NHPs. We provide suggestions on how to ensure that research currently conducted in laboratory settings shifts towards approaches that abide by deontological principles. We assert that this would not impede reasonable scientific research.

Preferences for scarce medical resource allocation: Differences between experts and the general public and implications for the COVID-19 pandemic

This study concerns what lay people believe is the best way to allocate scarce medical resources. A sample of 515 individuals completed a short questionnaire asking them to rank‐order eight different ethical positions with respect to the allocation of scarce resources. They showed a strong preference for the ‘saves most lives’ and ‘sickest first’ options, with ‘reciprocity’ and a ‘lottery’ being least favoured. There was a reasonable degree of unanimity amongst respondents and comparatively few correlations with individual difference factors such as demography. The preference results are compared to expert recommendations (Emanuel et al., 2020, N. Engl. J. Med., 382, 2049) made in light of the current coronavirus pandemic, and differences are highlighted. Implications for scare medical resource allocations are discussed, and limitations of the study acknowledged.

Utilitarian and deontological ethics in medicine

Medical ethics is a sensible branch of moral philosophy and deals with conflicts in obligations/duties and their potential outcome. Two strands of thought exist in ethics regarding decision-making: deontological and utilitarian. In deontological approach, outcomes/consequences may not just justify the means to achieve it while in utilitarian approach; outcomes determine the means and greatest benefit expected for the greatest number. In brief, deontology is patient-centered, whereas utilitarianism is society-centered. Although these approaches contradict each other, each of them has their own substantiating advantages and disadvantages in medical practice. Over years, a trend has been observed from deontological practice to utilitarian approach leading to frustration and discontentment. Health care system and practitioners need to balance both these ethical arms to bring congruity in medical practice.

Theoretical models and operational frameworks in public health ethics

The article is divided into three sections: (i) an overview of the main ethical models in public health (theoretical foundations); (ii) a summary of several published frameworks for public health ethics (practical frameworks); and (iii) a few general remarks. Rather than maintaining the superiority of one position over the others, the main aim of the article is to summarize the basic approaches proposed thus far concerning the development of public health ethics by describing and comparing the various ideas in the literature. With this in mind, an extensive list of references is provided.

Switching Tracks? Towards a Multidimensional Model of Utilitarian Psychology

Sacrificial moral dilemmas are widely used to investigate when, how, and why people make judgments that are consistent with utilitarianism. However, to what extent can responses to sacrificial dilemmas shed light on utilitarian decision making? We consider two key questions. First, how meaningful is the relationship between responses to sacrificial dilemmas, and what is distinctive about a utilitarian approach to morality? Second, to what extent do findings about sacrificial dilemmas generalize to other moral contexts where there is tension between utilitarianism and common-sense intuitions? We argue that sacrificial dilemmas only capture one point of conflict between utilitarianism and common-sense morality, and new paradigms will be necessary to investigate other key aspects of utilitarianism, such as its radical impartiality.

Collective Reflective Equilibrium in Practice (CREP) and controversial novel technologies

In this paper, we investigate how data about public preferences may be used to inform policy around the use of controversial novel technologies, using public preferences about autonomous vehicles (AVs) as a case study. We first summarize the recent 'Moral Machine' study, which generated preference data from millions of people regarding how they think AVs should respond to emergency situations. We argue that while such preferences cannot be used to directly inform policy, they should not be disregarded. We defend an approach that we call 'Collective Reflective Equilibrium in Practice' (CREP). In CREP, data on public attitudes function as an input into a deliberative process that looks for coherence between attitudes, behaviours and competing ethical principles. We argue that in cases of reasonable moral disagreement, data on public attitudes should play a much greater role in shaping policies than in areas of ethical consensus. We apply CREP to some of the global preferences about AVs uncovered by the Moral Machines study. We intend this discussion both as a substantive contribution to the debate about the programming of ethical AVs, and as an illustration of how CREP works. We argue that CREP provides a principled way of using some public preferences as an input for policy, while justifiably disregarding others.

At the heart of morality lies neuro-visceral integration: lower cardiac vagal tone predicts utilitarian moral judgment

To not harm others is widely considered the most basic element of human morality. The aversion to harm others can be either rooted in the outcomes of an action (utilitarianism) or reactions to the action itself (deontology). We speculated that the human moral judgments rely on the integration of neural computations of harm and visceral reactions. The present research examined whether utilitarian or deontological aspects of moral judgment are associated with cardiac vagal tone, a physiological proxy for neuro-visceral integration. We investigated the relationship between cardiac vagal tone and moral judgment by using a mix of moral dilemmas, mathematical modeling and psychophysiological measures. An index of bipolar deontology-utilitarianism was correlated with resting heart rate variability (HRV)-an index of cardiac vagal tone-such that more utilitarian judgments were associated with lower HRV. Follow-up analyses using process dissociation, which independently quantifies utilitarian and deontological moral inclinations, provided further evidence that utilitarian (but not deontological) judgments were associated with lower HRV. Our results suggest that the functional integration of neural and visceral systems during moral judgments can restrict outcome-based, utilitarian moral preferences. Implications for theories of moral judgment are discussed.

GPs' thoughts on prescribing medication and evidence-based knowledge: the benefit aspect is a strong motivator. A descriptive focus group study

OBJECTIVE

To describe GPs' thoughts of prescribing medication and evidence-based knowledge (EBM) concerning drug therapy.

DESIGN

Tape-recorded focus-group interviews transcribed verbatim and analysed using qualitative methods.

SETTING

GPs from the south-eastern part of Västra Götaland, Sweden.

SUBJECTS

A total of 16 GPs out of 178 from the south-eastern part of the region strategically chosen to represent urban and rural, male and female, long and short GP experience.

METHODS

Transcripts were analysed using a descriptive qualitative method.

RESULTS

The categories were: benefits, time and space, and expert knowledge. The benefit was a merge of positive elements, all aspects of the GPs' tasks. Time and space were limitations for GPs' tasks. EBM as a constituent of expert knowledge should be more customer adjusted to be able to be used in practice. Benefit was the most important category, existing in every decision-making situation for the GP. The core category was prompt and pragmatic benefit, which was the utmost benefit.

CONCLUSION

GPs' thoughts on evidence-based medicine and prescribing medication were highly related to reflecting on benefit and results. The interviews indicated that prompt and pragmatic benefit is important for comprehending their thoughts.

Interindividual Differences in the Sensitivity for Consequences, Moral Norms, and Preferences for Inaction: Relating Basic Personality Traits to the CNI Model

Research on moral decision making usually focuses on two ethical principles: the principle of utilitarianism (= morality of an action is determined by its consequences) and the principle of deontology (= morality of an action is valued according to the adherence to moral norms regardless of the consequences). Criticism on traditional moral dilemma research includes the reproach that consequences and norms are confounded in standard paradigms. As a remedy, a multinomial model (the CNI model) was developed to disentangle and measure sensitivity to consequences (C), sensitivity to moral norms (N), and general preference for inaction versus action (I). In two studies, we examined the link of basic personality traits to moral judgments by fitting a hierarchical Bayesian version of the CNI model. As predicted, high Honesty-Humility was selectively associated with sensitivity for norms, whereas high Emotionality was selectively associated with sensitivity for consequences. However, Conscientiousness was not associated with a preference for inaction.

Behavioral and autonomic reactivity to moral dilemmas in frontotemporal dementia versus Alzheimer's disease

The personal/impersonal distinction of moral decision-making postulates intuitive emotional responses from medial frontal activity and rational evaluation from lateral frontal activity. This model can be analyzed in behavioral variant frontotemporal dementia (bvFTD), a disorder characterized by impaired emotional intuitions, ventromedial prefrontal cortex (vmPFC) involvement, and relative sparing of lateral frontal regions. Moral dilemmas were presented to 10 bvFTD, 11 Alzheimer's disease (AD), and 9 healthy control (HC) participants while recording skin conductance responses, a measure of emotional arousal. We evaluated their personal versus impersonal conflict, subjective discomfort, and adherence to social norms. Replicating prior work, bvFTD participants were more willing to harm in the personal, but not the impersonal, dilemma compared to AD and HC groups. BvFTD participants had lower arousal and less of an increase in conflict on the personal versus the impersonal dilemma, in contrast to increased arousal and conflict for the AD and HC groups. Furthermore, bvFTD participants verbalized less discomfort, a correlate of low adherence to social norms. These findings support impaired emotional reactions to moral dilemmas in bvFTD and vmPFC lesions and the personal/impersonal model. It suggests a reversion to utilitarian-like considerations when emotional intuition is impaired in the brain.

Just Better Utilitarianism

Utilitarianism could still be a viable moral and political theory, although an emphasis on justice as distributing burdens and benefits has hidden this from current conversations. The traditional counterexamples prove that we have good grounds for rejecting classical, aggregative forms of consequentialism. A nonaggregative, liberal form of utilitarianism is immune to this rejection. The cost is that it cannot adjudicate when the basic needs of individuals or groups are in conflict. Cases like this must be solved by other methods. This is not a weakness in liberal utilitarianism, on the contrary. The theory clarifies what we should admit to begin with: that ethical doctrines do not have universally acceptable solutions to all difficult problems or hard cases. The theory also reminds us that not all problems are in this sense difficult or cases hard. We could alleviate the plight of nonhuman animals by reducing meat eating. We could mitigate climate change and its detrimental effects by choosing better ways of living. These would imply that most people's desire satisfaction would be partly frustrated, but liberal utilitarianism holds that this would be justified by the satisfaction of the basic needs of other people and nonhuman animals.

Are Utilitarian/Deontological Preferences Unidimensional?

Utilitarian versus deontological inclinations have been studied extensively in the field of moral psychology. However, the field has been lacking a thorough psychometric evaluation of the most commonly used measures. In this paper, we examine the factorial structure of an often used set of 12 moral dilemmas purportedly measuring utilitarian/deontological moral inclinations. We ran three different studies (and a pilot) to investigate the issue. In Study 1, we used standard Exploratory Factor Analysis and Schmid-Leimann (g factor) analysis; results of which informed the a priori single-factor model for our second study. Results of Confirmatory Factor Analysis in Study 2 were replicated in Study 3. Finally, we ran a weak invariance analysis between the models of Study 2 and 3, concluding that there is no significant difference between factor loading in these studies. We find reason to support a single-factor model of utilitarian/deontological inclinations. In addition, certain dilemmas have consistent error covariance, suggesting that this should be taken into consideration in future studies. In conclusion, three studies, pilot and an invariance analysis, systematically suggest the following. (1) No item needs to be dropped from the scale. (2) There is a unidimensional structure for utilitarian/deontological preferences behind the most often used dilemmas in moral psychology, suggesting a single latent cognitive mechanism. (3) The most common set of dilemmas in moral psychology can be successfully used as a unidimensional measure of utilitarian/deontological moral inclinations, but would benefit from using weighted averages over simple averages. (4) Consideration should be given to dilemmas describing infants.

Chronic Stress and Moral Decision-Making: An Exploration With the CNI Model

Stress is prevalent in our daily life, and people often make moral decision-making in a stressful state. Several studies indicated the influence of acute stress on moral decision-making and behavior. The present study extended the investigation to chronic stress, and employed a new approach, the CNI model, to add new insights regarding the mechanism underlying the association between chronic stress and moral decision-making. A total of 197 undergraduates completed the Perceived Stress Scale and made moral decision-making on a series of deliberately designed moral dilemmas. The results indicated that higher chronic stress was related to more deontological moral choices. The process-dissociation analyses revealed that chronic stress was marginally significantly associated with deontological inclinations but not with utilitarian inclinations. And the CNI model analyses suggested that the high-stress group (above the median) showed a stronger general preference for inaction than the low-stress group (below the median) did, but there were no significant differences in sensitivity to consequences or sensitivity to moral norms between the two groups. Finally, the implications of the findings were discussed.

What makes moral dilemma judgments "utilitarian" or "deontological"?

The distinction between utilitarianism and deontology has become a prevailing framework for conceptualizing moral judgment. According to the principle of utilitarianism, the morality of an action depends on its outcomes. In contrast, the principle of deontology states that the morality of an action depends on its consistency with moral norms. To identify the processes underlying utilitarian and deontological judgments, research in psychology and neuroscience has investigated responses to moral dilemmas that pit one principle against the other (e.g., trolley dilemma). However, the interpretation of responses in this paradigm is ambiguous, because the defining aspects of utilitarianism and deontology, outcomes and norms, are not manipulated. We illustrate how this shortcoming distorts interpretations of empirical findings and describe an alternative approach that overcomes the limitations of the traditional paradigm.

Scrutinizing the Criteria for Character Strengths: Laypersons Assert That Every Strength Is Positively Morally Valued, Even in the Absence of Tangible Outcomes

This study examines Peterson and Seligman’s (2004, p. 19) claim that every VIA character strength “(…) is morally valued in its own right, even in the absence of obvious beneficial outcomes”. Although this criterion assumes a pivotal role in distinguishing character from personality, no previous study has investigated its validity. Based on what Peterson and Seligman (2004) have provided us with, we describe how we built our study around indirectly testing every strength’s assumed moral evaluation, in which inclinations toward deontology (e.g., “torture is wrong regardless of tangible positive outcomes”) and consequentialism (e.g., “torture can be good if it accounts for more positive than negative outcomes”) may play a critical role. We used Peterson and Seligman’s (2004) handbook to construct four ultra-short stories for every strength: the stories depict various agents engaging in strength-related behavior (e.g., a young student courageously stepping up against school bullies). We prompted participants to rate these and twelve anchor stories multiple times as to whether the agents acted morally correct: In the first block, the actions’ consequences were undetermined while in the second block, the actions had either positive, negative, or mixed consequences, which we used to compute proxies of participants’ inclinations toward deontology and consequentialism. The ratings of N = 230 German-speaking laypersons suggest that the criterion stands: participants perceived every strength as positively morally valued when consequences were undetermined, and positive consequences did not account for or increase this effect. However, moral value seems to come in degrees, and some strengths were valued more strongly than others (top five: judgment, honesty, kindness, fairness, and hope). Furthermore, specific character strengths (measured by self-report) were connected with more positive evaluations (e.g., endorsing spirituality was connected with rating spirituality as more positively valued). Both deontology and consequentialism were connected with more positive evaluations, and we suggest two hypotheses to explain how such inclinations can lead to perceiving character strengths as positively valued. Our findings highlight the importance of scrutinizing the criteria for character strengths, and our experimental paradigm can offer a template to further investigate character strengths’ moral evaluation and other fundamental assumptions in upcoming studies.

The COVID-19 Pandemic: Healthcare Crisis Leadership as Ethics Communication

Governmental reactions to crises like the COVID-19 pandemic can be seen as ethics communication. Governments can contain the disease and thereby mitigate the detrimental public health impact; allow the virus to spread to reach herd immunity; test, track, isolate, and treat; and suppress the disease regionally. An observation of Sweden and Finland showed a difference in feasible ways to communicate the chosen policy to the citizenry. Sweden assumed the herd immunity strategy and backed it up with health utilitarian arguments. This was easy to communicate to the Swedish people, who appreciated the voluntary restrictions approach and trusted their decision makers. Finland chose the contain and mitigate strategy and was towards the end of the observation period apparently hesitating between suppression and the test, track, isolate, and treat approach. Both are difficult to communicate to the general public accurately, truthfully, and acceptably. Apart from health utilitarian argumentation, something like the republican political philosophy or selective truth telling are needed. The application of republicanism to the issue, however, is problematic, and hiding the truth seems to go against the basic tenets of liberal democracy.