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Moral Choice When Harming Is Unavoidable.

ABSTRACT: Past research suggests that actors often seek to minimize harm at the cost of maximizing social welfare. However, this prior research has confounded a desire to minimize the negative impact caused by one's actions (harm aversion) with a desire to avoid causing any harm whatsoever (harm avoidance). Across six studies (N = 2,152), we demonstrate that these two motives are distinct. When decision-makers can completely avoid committing a harmful act, they strongly prefer to do so. However, harming cannot always be avoided. Often, decision-makers must choose between committing less harm for less benefit and committing more harm for more benefit. In these cases, harm aversion diminishes substantially, and decision-makers become increasingly willing to commit greater harm to obtain greater benefits. Thus, value trade-offs that decision-makers refuse to accept when it is possible to completely avoid committing harm can suddenly become desirable when some harm must be committed.

SUBMITTER: Berman JZ

PROVIDER: S-EPMC7549286 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Moral Choice When Harming Is Unavoidable.

Berman Jonathan Z JZ Kupor Daniella D

Psychological science 20200908 10

Past research suggests that actors often seek to minimize harm at the cost of maximizing social welfare. However, this prior research has confounded a desire to minimize the negative impact caused by one's actions (harm aversion) with a desire to avoid causing any harm whatsoever (harm avoidance). Across six studies (<i>N</i> = 2,152), we demonstrate that these two motives are distinct. When decision-makers can completely avoid committing a harmful act, they strongly prefer to do so. However, ha ...[more]

PMID: 32900283

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Project description:Moral distress is common among critical care physicians and can impact negatively healthcare individuals and institutions. Better understanding inter-individual variability in moral distress is needed to inform future wellness interventions.ObjectivesTo explore when and how critical care physicians experience moral distress in the workplace and its consequences, how physicians' professional interactions with colleagues affected their perceived level of moral distress, and in which circumstances professional rewards were experienced and mitigated moral distress.DesignInterview-based qualitative study using inductive thematic analysis.Setting and participantsTwenty critical care physicians practicing in Canadian ICUs who expressed interest in participating in a semi-structured interview after completion of a national, cross-sectional survey of moral distress in ICU physicians.ResultsStudy participants described different ways to perceive and resolve morally challenging clinical situations, which were grouped into four clinical moral orientations: virtuous, resigned, deferring, and empathic. Moral orientations resulted from unique combinations of strength of personal moral beliefs and perceived power over moral clinical decision-making, which led to different rationales for moral decision-making. Study findings illustrate how sociocultural, legal, and clinical contexts influenced individual physicians' moral orientation and how moral orientation altered perceived moral distress and moral satisfaction. The degree of dissonance between individual moral orientations within care team determined, in part, the quantity of "negative judgments" and/or "social support" that physicians obtained from their colleagues. The levels of moral distress, moral satisfaction, social judgment, and social support ultimately affected the type and severity of the negative consequences experienced by ICU physicians.Conclusions and relevanceAn expanded understanding of moral orientations provides an additional tool to address the problem of moral distress in the critical care setting. Diversity in moral orientations may explain, in part, the variability in moral distress levels among clinicians and likely contributes to interpersonal conflicts in the ICU setting. Additional investigations on different moral orientations in various clinical environments are much needed to inform the design of effective systemic and institutional interventions that address healthcare professionals' moral distress and mitigate its negative consequences.

Dataset Information

Moral Choice When Harming Is Unavoidable.

Publications

Moral Choice When Harming Is Unavoidable.

Similar Datasets

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