Search

Purpose Necrotizing enterocolitis (NEC) totalis is a devastating disease of the newborn intestine. A precise clinical definition of the extent of gastrointestinal involvement is lacking in the existing literature, and the clinical outcomes are typically viewed as grim. Methods Herein, we present a series of clinical case examples of patients with varying degrees of NEC totalis and other co-morbid conditions, with possible anticipated outcomes based on current data. Results We define the key ethical issues and provide a framework and discussion of the ethical issues involved in the care of patients with NEC totalis and recommendations of how to approach discussions with the family of these patients We discuss the ethical considerations for both the providers caring for these patients, and the patient's family members. Conclusion The management of patients with NEC totalis is complex and ethically challenging. Level of evidence V

The growing interest in the subject of moral judgment in driver and autonomous vehicle behavior highlights the importance of investigating the suitability of sacrificial dilemmas as experimental tools in the context of traffic psychology. To this aim a set of validated sacrificial trolley problems and a new set of trolley-like driving dilemmas were compared through an online survey experiment, providing normative values for rates of participants' choices; decision times; evaluation of emotional valence and arousal experienced during the decision process; and ratings of the moral acceptability. Results showed that while both sets of dilemmas led to a more frequent selection of utilitarian outcomes, the driving-type dilemmas seemed to enhance faster decisions mainly based on the utilitarian moral code. No further differences were observed between the two sets, confirming the reliability of the moral dilemma tool in the investigation of moral driving behaviors. We suggest that as moral judgments and behaviors become more lifelike, the individual's moral inclination emerge more automatically and effectively. This new driving-type dilemma set may help researchers who work in traffic psychology and moral decision-making to approach the complex task of developing realistic moral scenarios more easily in the context of autonomous and nonautonomous transportation.

Cette recherche a pour objet les discussions philosophiques sur des dilemmes moraux avec des adultes détenus. Le dilemme moral est une situation fictive ou réelle dont l’issue pose un problème moral de choix restreint entre deux possibilités contradictoires. De fait, le dilemme moral fait l’objet de controverses entre les participants aux discussions philosophiques. Notre recherche s’intéresse à l’éducation aux controverses entre adultes incarcérés afin de participer à leur développement moral. Sur le plan méthodologique, nous recourons à une méthode qualitative, l’analyse de contenu. A partir de l’analyse des verbatim des discussions sur les dilemmes moraux, nous mettons en évidence les valeurs qui orientent les jugements moraux des personnes détenues, en tenant compte des dimensions rationnelle et émotionnelle convoquées chez les sujets. Nous proposons ensuite d’appréhender le niveau de développement moral des personnes détenues en nous référant à la théorie des stades de développement moral de Kohlberg. Ce travail réflexif sur le dilemme vise l’éducabilité morale du sujet, en se fondant sur le postulat d’une éducabilité toujours possible. This research aims at leading philosophical discussions on moral dilemmas with adult inmates. The moral dilemma deals with a fictitious or real situation whose outcome raises a moral issue with restricted choices between two contradictory possibilities. Actually, the moral dilemma generates a big controversy among the participants in the course of the philosophical discussions. Our research‘s goal is to teach the prisoners how to take part in a controversial debate in order to participate in their moral development. Methodologically, we use a qualitative method, the analysis of the content. From the analysis of the verbatim transcripts of the discussions on the moral dilemmas, we highlight the values ​​which guide the moral judgments of the detained persons, taking into account the rational and emotional dimensions aroused in the subjects. Then, we try to understand the level of the prisoners’ moral development by referring to Kohlberg’s phases of moral development theory. This reflective work on the dilemma aims at the moral educability of the subject, based on the postulate that inmates’ educability is still possible.

Based on prior research, people tend to be more prone to save women before saving men, and this thesis presents two studies examining the social acceptance of having these different preferences. Participants (N=805) were randomly assigned to one of two studies, and within each study they were assigned to one of two conditions (allocation condition or choice condition). The participants first read a description of two medical helping project in which one project can treat only men while the other one can treat only women. Participants then read and rated six targets’ answers (three male targets and three female targets), based on their first impression (level of warmth and competence) of targets expressing a preference towards men, women, an equal preference, or no preference. In the first study, the projects presented the same number of treated patients (three patients), and in the second study, the project treating male patients was higher (four patients) than the project treating female patients (three patients). Results showed that a female preference are viewed as a more socially accepted preference than a male preference, but only when the number of treated patients in each project are equal. Also, when male targets express a female preference, they are seen as more competent than female targets with a female preference, but only when they express their preference in ratings of the project. When the number of treated patients differed between the projects, a female preference is not viewed as a more socially accepted preference than having a male preference, there were also no significant difference between how men and women were perceived in their competence level.

Real life moral decisions are special, as decision makers face two normative standards on their choices simultaneously: Not only do they need to choose what is rational given probabilistic uncertainty over outcomes, as in all kinds of decisions, but also what is right given their moral point of view. However, risk, i.e. probabilistic uncertainty, in moral decisions has received limited attention to date (but see Meder et al. 2019, Shou et al. 2020,). For instance, the two most famous moral dilemma studies (Greene et al. 2001, Awad et al. 2008) assume that moral decisions would be taken under certainty. In other cases, such as when authors have introduced the condition of risk to moral decisions, they do not (fully) consider the distinctly moral drivers for sensitivity to risk in moral decisions (Meder et al. 2019, Shou et al. 2020, Kortenkamp & Moore 2014, Tsalikis 2008, Fleischhut 2013). In this study, we aim to fill this gap by introducing probabilistic outcomes next to other well-known factors to sacrificial moral dilemmas and studying a moral explanation of their influence. First, we address the question whether probability of outcomes at all represents a relevant factor in moral decision-making, compared to other well-known influential factors, such as dilemma emotionality and number and age of involved parties. Second, we check whether the general pattern of neglecting probabilities in high-affect decisions that has been proven for other types of decisions (Pachur et al. 2014), also applies to the moral domain. Third, we test whether participants consider probabilities in moral dilemmas differently according to their moral profile. This last step is particularly relevant, since moral theories suggest a distinct treatment of probabilities: Consequentialists have a moral reason to include probabilities in their moral judgments, while deontologists should stick to a moral rule irrespective of outcome probabilities or at least irrespective of probabilities below a certain materiality threshold (Hansson 2013). The multi-factor design of the current study also allows to check which other factors, if not probability, might drive deontologists’ decisions under risk. To address these questions, we examine moral dilemmas in a conjoint survey experiment (Hainmueller et al. 2013; Bansak et al., 2019), where respondents face a choice about moral acceptability of inflicting harm on one person to save a number of people. • RQ1: [p relevant at all?] How does probability affect decisions in moral dilemmas next to other morally relevant factors? • RQ2: [general patterns of considering p] Does p-neglect in high-affect decisions also exist in the moral domain? • RQ3: [moral patterns of considering p] Does decision makers’ moral point of view influence the way/ extent to which they consider probabilities?

We present the results of a randomized control trial on the effect of the introduction of formalized property rights on individuals’ moral judgments and, in particular, on utilitarian morality. We show that institutions shape morality: being exposed to private property institutions makes individuals more utilitarian when confronted with moral dilemmas. Our results shed light on a possible institutional determinant of the variation of moral judgments across the globe and its geographical patterns, and have implications for the consequences of major institutional reforms—both intended, such as land-titling programs, and unintended, such as those following from recent historical events—on moral attitudes. We discuss two possible channels stemming from the inherent features of property rights: the loosening of social ties and the commodification of rights (JEL codes: K11; O13; Z10; Z13). Marco Fabbri gratefully acknowledges financial support from the Marie Curie Research Grants scheme, grant H2020-MSCA-IF-2017-789596. Giuseppe Dari-Mattiacci gratefully acknowledges research support from Columbia Law School.

The announcement that a vaccine had been discovered for use in the prevention of harmful effects associated with the respiratory SARS COV-2 disease brought much joy, only for the joy to be short lived when high income nations purchased all the vaccines before they had been manufactured. Thus, the following research explored the realm of literature on vaccine nationalism that occurred in the coronavirus pandemic, with the ultimate goal of showing whether actions of vaccine nationalism are included as moral dilemmas, virtuous actions or they are vicious actions that should not be pursued at all when faced with a disaster situation. A philosophical method of research was employed coupled with a scoping review of literature on vaccine nationalism and moral dilemmas, and a reflective equilibrium as the method of analysis. This method was guided by the concepts of moral dilemmas, tenets of principlism, and ideas of virtue ethics from Aristotle and literature that referenced to it. These concepts were used as the framework of constructing arguments over the morality tensions brought by vaccine nationalism. From the review, a total of 65 studies were included for analysis regarding literature on vaccine nationalism, and this study found out that the majority of themes within these studies focused on highlighting the various arguments for pursuing vaccine nationalism, or for going against vaccine nationalism, and the various challenges that arose as a result of pursuing vaccine nationalism. A supplementary search on moral dilemmas was done in the hope of finding out if literature engaged vaccine nationalism as a moral dilemma, and from this search this study found out one study that went to lengths of trying to conceptualise vaccine nationalism as a moral dilemma. The other studies engaged showed the key themes or the various dilemmas reported in literature including health related dilemmas, health versus human rights dilemmas, and other ethical dilemmas noted from the pandemic. From these findings, this study argued that before putting morality litmus tests on vaccine nationalism one has to understand that the act itself was a dilemma that is common in our daily lives. This however did not mean that we should see vaccine nationalism as a dilemma alone, instead this study argued for the need of duty bearers to pursue virtuous deliberation when faced with dilemmas – as life is full of dilemmas but it is virtuous deliberation that helps us navigate against such dilemmas. Towards the end, this study recommended public health policy that is guided by virtuous deliberation and noted the possible limitation of excluding grey literature in the final results, thereby suggesting the need to conduct a systematic review of reasons for future research.