Disgust, the emotion of rotting carcasses and slimy animalitos, finds itself at the center of several critical questions about human culture and cognition. This article summarizes recent developments, identify active points of debate, and provide an account of where the field is heading next.

Recently, many critics have argued that disgust is a morally harmful emotion, and that it should play no role in our moral and legal reasoning. Here we defend disgust as a morally beneficial moral capacity. We believe that a variety of liberal norms have been inappropriately imported into both moral psychology and ethical studies of disgust: disgust has been associated with conservative authors, values, value systems, and modes of moral reasoning that are seen as inferior to the values and moral (...) emotions that are endorsed by liberal critics. Here we argue that the meta-ethical assumptions employed by the critics of disgust are highly contentious and in some cases culture bound. Given this, we should avoid adopting simplified meta-ethical positions in experimental moral psychology, as these can skew the design and interpretation of experiments, and blind us to the potential value of moral disgust harnessed in the service of liberal ends. (shrink)

One important discussion raised in this special issue on the ethical spectrum of consciousness involves the possibility of providing machines with human mind-like capabilities to the point of allow...

Anger is often an appropriate reaction to harms and injustices, but is it a politically beneficial one? Martha Nussbaum (Journal of the American Philosophical Association 1 (1), 41–56, 2015, Anger and Forgiveness. Oxford University Press, 2016) has argued that, although anger is useful in initially recruiting agents for action, anger is typically counterproductive to securing the political aims of those harmed. After the initial shockwave of outrage, Nussbaum argues that to be effective at enacting positive social change, groups and individuals (...) alike, must move quickly out of the state of anger. Feminist theorists (Frye, The Politics of Reality. Crossing Press, 1983; Lorde, 1997; Narayan, Hypatia 3 (2): 31–48, 1988) on the other hand have for long highlighted the efficacy of anger, as well as its moral and epistemic value, in fighting against the oppressive status quo. It might be thought therefore that for political action to be effective, a continued state of anger is preferable. Protestors must after all create and sustain a sense of moral obligation and justice. A main way of doing so is to promote successive moral shocks that trigger outrage (Jasper, Emotion Review 6 (3): 208–213, 2014). I present a novel, empirically informed defense of anger’s efficacy in political action. Nussbaum holds a traditional view on the nature of anger, inherited from Aristotle and the Stoics, which holds that anger constitutively involves a desire for retribution. The view that anger is counterproductive falls out of this and is dominant in academic work as well as in our personal and political lives. Based on work in social psychology, I argue that we need to reconsider this. In doing so, I highlight anger’s aim for recognition, rather than retribution, as key. Furthermore, I uncover conditions for anger’s political efficacy, as well as reasons for why the traditional view of anger has been so pervasive. (shrink)

Hume maintains that the boundaries of morality are widely drawn in everyday life. We routinely blame characters for traits that we find disgusting, on this account, as well as those which we perceive as being harmful. Contemporary moral psychology provides further evidence that human beings have a natural tendency to moralize traits that produce feelings of repugnance. But recent work also demonstrates a significant amount of individual variation in our sensitivities to disgust. We have sufficient reason to bracket this emotion, (...) therefore, when adopting the general point of view: if we allow idiosyncratic affective responses to shape our fully considered moral judgments, we could no longer reasonably expect spectators with different sensitivities to agree with us. (shrink)

This paper examines the empirical and armchair evidence concerning the practical profiles of normative judgments. It then argues that the theory of normative judgment that best explains these practical profiles is a version of cognitivism: subjectivism. The preferred version says, roughly, i) each normative predicate is conventionally associated with a certain conative attitude, and ii) for S to judge that x has normative status N is for S to judge that x has a property picked out by the conative attitude (...) associated with N. In short, having a normative judgment about x semantically necessitates having a conative attitude toward x's properties, to be contrasted with conceptual necessitation, metaphysical necessitation, rational necessitation, etiological necessitation, and other flavors of necessitation. (shrink)

Individuals who are more easily disgusted tend to be more politically conservative. Individuals who have a preference for order also tend to be more politically conservative. In the present researc...

Outside Western, predominantly secular‐liberal environments, norms restricting bodily and sexual conduct are widespread. Moralization in the so‐called purity domain has been treated as evidence that some putative violations are victimless. However, respondents themselves disagree: They often report that private yet indecent acts incur self‐harm, or harm to one's family and the wider community—a result which we replicate in Study 1. We then distinguish two cognitive processes that could generate a link between harmfulness and immorality, and recreate them in Studies 2 (...) and 3: Colombian and British participants were randomly assigned to either reflect (decide whether acts are harmful and reconsider their initial moral judgments) or rationalize (decide whether acts are immoral and reconsider their initial harmfulness beliefs). In both countries, reflection promoted opposition to unjust, but not impure, behavior. Additionally, in both countries, ruminating on the moral status of impure acts elevated beliefs in the acts' harmfulness. We conclude by suggesting that rationalization aggravates, while reflection mitigates, intergroup disagreement regarding putative violations of purity and decency. (shrink)

This chapter discusses contemporary scientific research on the role of reason and emotion in moral judgment. The literature suggests that moral judgment is influenced by both reasoning and emotion separately, but there is also emerging evidence of the interaction between the two. While there are clear implications for the rationalism-sentimentalism debate, we conclude that important questions remain open about how central emotion is to moral judgment. We also suggest ways in which moral philosophy is not only guided by empirical research (...) but continues to guide it. (shrink)

An influential argument in bioethics involves appeal to disgust, calling on us to take it seriously as a moral guide (e.g. Kass, Miller, Kahan). Some argue, for example, that genetic enhancement, especially via human reproductive cloning, is repellant or grotesque. While objectors have argued that repugnance is morally irrelevant (e.g. Nussbaum, Kelly), I argue that the problem is more fundamental: it is psychologically irrelevant. Examining recent empirical data suggests that disgust’s influence on moral judgment may be like fatigue: an exogenous (...) influence, yielding a “performance error” that does not reflect our understanding of moral matters. This conclusion also challenges appeals to repugnance on other topics (such as homosexuality) and generally downplays the importance of disgust in moral discourse. (shrink)

When explaining human actions, people usually focus on a small subset of potential causes. What leads us to prefer certain explanations for valenced actions over others? The present studies indicate that our moral attitudes often predict our explanatory preferences far better than our beliefs about how causally sensitive actions are to features of the actor's environment. Study 1 found that high-prejudice participants were much more likely to endorse non-agential explanations of an erotic same-sex encounter, such as that one of the (...) men endured a stressful event earlier that day. Study 2 manipulated participants' beliefs about how the agent's behavior depended on features of his environment, finding that such beliefs played no clear role in modeling participants' explanatory preferences. This result emerged both with low- and high-prejudice, US and Indian participants, suggesting that these findings probably reflect a species-typical feature of human psychology. Study 3 found that moral attitudes also predicted explanations for a woman's decision to abort her pregnancy (3a) and a person's decision to convert to Islam (3b). Study 4 found that luck in an action's etiology tends to undermine perceptions of blame more readily than perceptions of praise. Finally, Study 5 found that when explaining support for a rival ideology, both Liberals and Conservatives downplay agential causes while emphasizing environmental ones. Taken together, these studies indicate that our explanatory preferences often reflect a powerful tendency to represent agents as possessing virtuous true selves. Consequently, situation-focused explanations often appear salient because people resist attributing negatively valenced actions to the true self. There is a person/situation distinction, but it is normative. (shrink)

Psychologists and neuroscientists have recently been unearthing the unconscious processes that give rise to moral intuitions and emotions. According to skeptics like Joshua Greene, what has been found casts doubt on many of our moral beliefs. However, a new approach in moral psychology develops a learning-theoretic framework that has been successfully applied in a number of other domains. This framework suggests that model-based learning shapes intuitions and emotions. Model-based learning explains how moral thought and feeling are attuned to local material (...) and social conditions. Philosophers can draw on these explanations, in some cases, in order to vindicate episodes of moral change. Explanations can support justifications by showing that they are not mere rationalizations. In addition, philosophical justifications are a fertile source for empirical hypotheses about the rational learning mechanisms that shape moral intuitions and emotions. (shrink)

[Selected as EDITOR'S CHOICE] Background: Extant surveys of people’s attitudes toward human reproductive cloning focus on moral judgments alone, not emotional reactions or sentiments. This is especially important given that some (esp. Leon Kass) have argued against such cloning on the grounds that it engenders widespread negative emotions, like disgust, that provide a moral guide. Objective: To provide some data on emotional reactions to human cloning, with a focus on repugnance, given its prominence in the literature. Methods: This brief mixed-method (...) study measures the self-reported attitudes and emotions (positive or negative) toward cloning from a sample of participants in the United States. Results: Most participants condemned cloning as immoral and said it should be illegal. The most commonly reported positive sentiment was by far interest/curiosity. Negative emotions were much more varied, but anxiety was the most common. Only about a third of participants selected disgust or repugnance as something they felt and an even smaller portion had this emotion come to mind prior to seeing a list of options. Conclusions: Participants felt primarily interested and anxious about human reproductive cloning. They did not primarily feel disgust or repugnance. This provides initial empirical evidence that such a reaction is not appropriately widespread. (shrink)

Anger and disgust may have distinct roles in sexual morality; here, we tested hypotheses regarding the distinct foci, appraisals, and motivations of anger and disgust within the context of sexual offenses. We conducted four experiments in which we manipulated whether mutual consent (Studies 1–3) or desire (Study 4) was present or absent within a counter-normative sexual act. We found that anger is focused on the injustice of non-consensual sexual acts, and the transgressor of the injustice (Studies 1 and 3). Furthermore, (...) the sexual nature of the act was not critical for the elicitation of anger—as anger also responded to unjust acts of violence (Study 3). By contrast, we hypothesised and found that disgust is focused on whether or not a person voluntarily engaged in, desired or consented to a counter-normative sexual act (Studies 2–4). Appraisals of abnormality and degradation were the primary appraisals of disgust, and the sexual nature of the act was a critical elicitor of disgust (Study 3). A final study ruled out victimisation as the mechanism of the effect of consent on disgust and indicated that the consenter's sexual desire was the mechanism (Study 4). Our results reveal that anger and disgust have differential roles in consent-related sexual offenses due to the distinct appraisals and foci of these emotions. (shrink)

The self-ownership thesis asserts, roughly, that agents own their minds and bodies in the same way that they can own extra-personal property. One common strategy for defending the self-ownership thesis is to show that it accords with our intuitions about the wrongness of various acts involving the expropriation of body parts. We challenge this line of defense. We argue that disgust explains our resistance to these sorts of cases and present results from an original psychological experiment in support of this (...) hypothesis. We argue further that learning that disgust is responsible for pro-self-ownership intuitions should reduce our confidence in those intuitions. After considering and rejecting some prominent “debunking” arguments predicated on disgust’s evolutionary history, we provide alternative reasons for thinking that disgust is not a reliable source of moral judgments. Rejecting the reliability of disgust as a mechanism for producing moral beliefs coheres with our considered judgments about the general kinds of considerations that are morally relevant and a range of particular moral problems. (shrink)

In the target article, we presented the hypothesis that parasite-stress variation was a causal factor in the variation of in-group assortative sociality, cross-nationally and across the United States, which we indexed with variables that measured different aspects of the strength of family ties and religiosity. We presented evidence supportive of our hypothesis in the form of analyses that controlled for variation in freedom, wealth resources, and wealth inequality across nations and the states of the USA. Here, we respond to criticisms (...) from commentators and attempt to clarify and expand the parasite-stress theory of sociality used to fuel our research presented in the target article. (shrink)

Recent empirical studies have established that disgust plays a role in moral judgment. The normative significance of this discovery remains an object of philosophical contention, however; ‘disgust skeptics’ such as Martha Nussbaum have argued that disgust is a distorting influence on moral judgment and has no legitimate role to play in assessments of moral wrongness. I argue, pace Nussbaum, that disgust’s role in the moral domain parallels its role in the physical domain. Just as physical disgust tracks physical contamination and (...) pollution, so moral disgust tracks social contamination. I begin by examining the arguments for skepticism about disgust and show that these arguments threaten to overgeneralize and lead to a widespread skepticism about the justifiability of our moral judgments. I then look at the positive arguments for according disgust a role in moral judgment, and suggest that disgust tracks invisible social contagions in much the same way as it tracks invisible physical contagions, thereby serving as a defense against the threat of socio-moral contamination. (shrink)

In this article, we advance the perspective that distinct emotions amplify different moral judgments, based on the emotion’s core appraisals. This theorizing yields four insights into the way emotions shape moral judgment. We submit that there are two kinds of specificity in the impact of emotion upon moral judgment: domain specificity and emotion specificity. We further contend that the unique embodied aspects of an emotion, such as nonverbal expressions and physiological responses, contribute to an emotion’s impact on moral judgment. Finally, (...) emotions play a key role in determining which issues acquire moral significance in a society over time, in a process known as moralization (Rozin, 1999). The implications of these four observations for future research on emotion and morality are discussed. (shrink)

Despite the wealth of recent work implicating disgust as an emotion central to human morality, the nature of the causal relationship between disgust and moral judgment remains unclear. We distinguish between three related claims regarding this relationship, and argue that the most interesting claim (that disgust is a moralizing emotion) is the one with the least empirical support.

Minor-attracted persons raise multiple ethical and legal challenges. Sexual contact between adults and children is justly prohibited on child welfare grounds. Advances in technology raise the prospect of interventions for minor-attracted persons that have the potential to reduce harm to children by diverting would-be offenders to other endeavors that nonetheless may generate moral disgust This essay examines three of these potential harm reduction technologies (sex robots, haptic devices and synthetic child pornography) and raises the possibility that their use can be (...) justified and their acceptance morally obligatory if doing so reduces harm to real children. (shrink)

Suppose that disgust can provide evidence of moral wrongdoing. What account of disgust might make sense of this? A recent and promising theory is the social contagion view, proposed by Alexandra Plakias. After criticizing both its descriptive and normative claims, I draw two conclusions. First, we should question the wisdom of drawing so straight a line from biological poisons and pathogens to social counterparts. Second, we don’t need to explain the evidential value of disgust by appealing to what the response (...) tracks. These lessons point toward an alternative: namely, that disgust is a moral heuristic. On the heuristic view, disgust is a trigger for the subconscious use of a particular rule: I show how this view fits with a plausible hypothesis about the social function of disgust, and then apply it to Leon Kass’s famous use of repugnance to criticize cloning. (shrink)

Conservatives commonly claim that systems of formal education are biased against conservative ideology. I argue that this claim is incorrect, but not because there is no bias against conservatives in formal education. A wide swath of psychological evidence linking personality and ideology indicates that conservatives and liberals differ in their learning orientations, that is, in the values, motivations, and beliefs they bring to learning tasks. These differences in operative epistemologies explain many demographic phenomena relating educational achievement and political ideology. Systems (...) of formal education thus disadvantage conservatives, especially in the later stages of formal education. Conservatives are therefore ‘selected against’ in the process of formal education, not due to their values or ideology but because their learning orientations are not especially conducive to academic success beyond a certain point. However, because the bias against conservatives in not ideological in origin, a case cannot be made that conservatives are victims of institutional injustice. This bias against conservatives in formal education could be mitigated were the purposes of formal education radically modified (the education of the military class in Plato’s Republic serves as a model). But such a model of formal education would ill serve the needs of modern, industrialized, information-driven societies. (shrink)

It is by now a well-supported hypothesis in cognitive neuroscience that there exists a functional network for the moral appraisal of situations. However, there is a surprising disagreement amongst researchers about the significance of this network for moral actions, decisions, and behavior. Some researchers suggest that we should uncover those ethics [that are built into our brains ], identify them, and live more fully by them, while others claim that we should often do the opposite, viewing the cognitive neuroscience of (...) morality more like a science of pathology. To analyze and evaluate the disagreement, this paper will investigate some of its possible sources. These may include theoretical confusions about levels of explanation in cognitive science, or different senses of ‘morality’ that researchers are looking to explain. Other causes of the debate may come from empirical assumptions about how possible or preferable it is to separate intuitive moral appraisal from moral decisions. Although we will tentatively favor the ‘Set Aside’ approach, the questions outlined here are open areas of ongoing research, and this paper will be confined to outlining the position space of the debate rather than definitively resolving it. (shrink)

Moral judgment has typically been characterized as a conflict between emotion and reason. In recent years, a central concern has been determining which process is the chief contributor to moral behavior. While classic moral theorists claimed that moral evaluations stem from consciously controlled cognitive processes, recent research indicates that affective processes may be driving moral behavior. Here, we propose a new way of thinking about emotion within the context of moral judgment, one in which affect is generated and transformed by (...) both automatic and controlled processes, and moral evaluations are shifted accordingly. We begin with a review of how existing theories in psychology and neuroscience address the interaction between emotion and cognition, and how these theories may inform the study of moral judgment. We then describe how brain regions involved in both affective processing and moral judgment overlap and may make distinct contributions to the moral evaluation process. Finally, we discuss how this way of thinking about emotion can be reconciled with current theories in moral psychology before mapping out future directions in the study of moral behavior. (shrink)

I argue that much philosophical discussion of moral disgust suffers from two ambiguities: first, it is not clear whether arguments for the moral authority of disgust apply to disgust as a consequence of moral evaluations or instead to disgust as a moralizing emotion; second, it is not clear whether the word ‘moral’ is used in a normative or in a descriptive sense. This lack of clarity generates confusion between ‘fittingness’ and ‘appropriateness’ of disgust. I formulate three conditions that arguments for (...) the moral authority of disgust need—but typically fail—to satisfy, in order to avoid (1) circularity, (2) the naturalistic fallacy, and (3) redundancy. These conditions are, respectively, (1) the identification of the direction of the causal relation between disgust and moral evaluation, (2) a demonstration that disgust is ‘fitting’ to morally relevant properties, and (3) a demonstration that disgust is ‘appropriate’ when elicited by these morally relevant properties. I will also suggest that, regardless of whether an argument for the moral authority of disgust can be made, it would be better to avoid the rather obscure term ‘moral disgust’. (shrink)

Disputes between those holding differing political views are ubiquitous and deep-seated, and they often follow common, recognizable lines. The supporters of tradition and stability, sometimes referred to as conservatives, do battle with the supporters of innovation and reform, sometimes referred to as liberals. Understanding the correlates of those distinct political orientations is probably a prerequisite for managing political disputes, which are a source of social conflict that can lead to frustration and even bloodshed. A rapidly growing body of empirical evidence (...) documents a multitude of ways in which liberals and conservatives differ from each other in purviews of life with little direct connection to politics, from tastes in art to desire for closure and from disgust sensitivity to the tendency to pursue new information, but the central theme of the differences is a matter of debate. In this article, we argue that one organizing element of the many differences between liberals and conservatives is the nature of their physiological and psychological responses to features of the environment that are negative. Compared with liberals, conservatives tend to register greater physiological responses to such stimuli and also to devote more psychological resources to them. Operating from this point of departure, we suggest approaches for refining understanding of the broad relationship between political views and response to the negative. We conclude with a discussion of normative implications, stressing that identifying differences across ideological groups is not tantamount to declaring one ideology superior to another. (shrink)

Conservatives and liberals disagree sharply on matters of morality and public policy. We propose a novel account of the psychological basis of these differences. Specifically, we find that conservatives tend to emphasize the intrinsic value of actions during moral judgment, in part by mentally simulating themselves performing those actions, while liberals instead emphasize the value of the expected outcomes of the action. We then demonstrate that a structural emphasis on actions is linked to the condemnation of victimless crimes, a distinctive (...) feature of conservative morality. Next, we find that the conservative and liberal structural approaches to moral judgment are associated with their corresponding patterns of reliance on distinct moral foundations. In addition, the structural approach uniquely predicts that conservatives will be more opposed to harm in circumstances like the well-known trolley problem, a result which we replicate. Finally, we show that the structural approaches of conservatives and liberals are partly linked to underlying cognitive styles. Collectively, these findings forge a link between two important yet previously independent lines of research in political psychology: cognitive style and moral foundations theory. (shrink)

Vaccine refusers often seem motivated by disgust, and they invoke ideas of purity, contamination and sanctity. Unfortunately, the emotion of disgust and its companion ideas are not directly responsive to the probabilistic and statistical evidence of research science. It follows that increased efforts to promulgate the results of vaccine science are not likely to contribute to increased rates of vaccination among persons who refuse vaccines because of the ‘ethics of sanctity’. Furthermore, the fact that disgust-based vaccine refusal is not monolithic (...) – vaccine refusers manifest disgust at different objects and invoke different ideas about purity and contamination – further complicates public health efforts to increase vaccination rates. (shrink)

Moral foundations research suggests that liberals care about moral values related to individual rights such as harm and fairness, while conservatives care about those foundations in addition to caring more about group rights such as loyalty, authority, and purity. However, the question remains about how conservatives and liberals differ in relation to group-level moral principles. We used two versions of the moral foundations questionnaire with the target group being either abstract or specific ingroups or outgroups. Across three studies, we observed (...) that liberals showed more endorsement of Individualizing foundations with an outgroup target, while conservatives showed more endorsement of Binding foundations with an ingroup target. This general pattern was found when the framed, target-group was abstract and when target groups were specified about a general British-ingroup and an immigrant-outgroup. In Studies 2 and 3, both Individualizing-Ingroup Preference and Binding-Ingroup Preference scores predicted more Attitude Bias and more Negative Attitude Bias toward immigrants, more Implicit Bias, and more Perceived Threat from immigrants. We also demonstrated that increasing liberalism was associated with less Attitude Bias and less Negative Bias toward immigrants, less Implicit Bias, and less Perceived Threat from immigrants. Outgroup-individualizing foundations and Ingroup-Binding foundations showed different patterns of mediation of these effects. (shrink)

Fincher & Thornhill's (F&T's) parasite-stress theory of sociality is supported largely by correlational evidence; its persuasiveness would increase significantly via lab and natural experiments and demonstrations of its mediating role. How the theory is linked to other approaches to group differences in psychological differences and to production and dissemination of cultural ideas and practices, need further clarification. So does the theory's view on the possible reduction of negative group interactions.

Although much research on emotion and morality has treated emotion as a relatively undifferentiated construct, recent work shows that moral transgressions can evoke a variety of distinct emotions. To accommodate these results, we propose a multiple-appraisal model in which distinct appraisals lead to different moral emotions. The implications of this model for our understanding of the relationship between appraisals, emotions and judgments are discussed. The complexity of moral emotional experience presents a methodological challenge to researchers, but we submit that a (...) complete understanding of human morality must acknowledge the differentiated nature of moral emotions. (shrink)

Sociopolitical attitudes are often the root cause of conflicts between individuals, groups, and even nations, but little is known about the origin of individual differences in sociopolitical orientation. We test a combination of economic and evolutionary ideas about the degree to which the mating market, sex, age, and income affect sociopolitical orientation. We collected data online through Amazon’s Mechanical Turk from 1108 US participants who were between 18 and 60, fluent in English, and single. While ostensibly testing a new online (...) dating website, participants created an online dating profile and described people they would like to date. We manipulated the participants’ popularity in the mating market and the size of the market and then measured participants’ sociopolitical attitudes. The sociopolitical attitudes were reduced to five dimensions via Principal Components Analysis. Both manipulations affected attitudes toward wealth redistribution but were largely not significant predictors of the other dimensions. Men reported more unrestricted sociosexual attitudes, and more support for benevolent sexism and traditional family values, than women did, and women supported wealth redistribution more than men did. There was no sex difference in accepting nonconforming behaviors. Younger people and people with lower incomes were more liberal than older people and people with higher incomes, respectively, regardless of sex. Overall, effects were largely not interactive, suggesting that individual differences in sociopolitical orientation may reflect strategic self-interest and be more straightforward than previously predicted. (shrink)

Research on moral psychology has frequently appealed to three, apparently consistent patterns: Males are more likely to engage in transgressions involving harm than females; educated people are likely to be more thorough in their moral deliberations because they have better resources for rationally navigating and evaluating complex information; political affiliations and religious ideologies are an important source of our moral principles. Here, we provide a test of how four factors ‐ gender, education, politics and religion ‐ affect intuitive moral judgments (...) in unfamiliar situations. Using a large-scale sample of participants who voluntarily logged on to the internet-based Moral Sense Test, we analyzed responses to 145 unique moral and conventional scenarios that varied widely in content. Although each demographic or cultural factor sometimes yielded a statistically significant difference in the predicted direction, these differences were consistently associated with extremely small effect sizes. We conclude that gender, education, politics and religion are likely to be relatively insignificant for moral judgments of unfamiliar scenarios. We discuss these results in light of current debates concerning the mechanisms underlying our moral judgments and, especially, the idea that we share a universal moral sense that constrains the range of cross-cultural variation. (shrink)

Contemporary moral psychology has focused on the notion of a universal moral sense, robust to individual and cultural differences. Yet recent evidence has revealed individual differences in the psychological processes for moral judgment: controlled cognition, mental-state reasoning, and emotional responding. We discuss this evidence and its relation to cross-cultural diversity in morality.

Physicians, nurses, and other clinicians readily acknowledge being troubled by encounters with patients who trigger moral judgments. For decades social scientists have noted that moral judgment of patients is pervasive, occurring not only in egregious and criminal cases but also in everyday situations in which appraisals of patients' social worth and culpability are routine. There is scant literature, however, on the actual prevalence and dynamics of moral judgment in healthcare. The indirect evidence available suggests that moral appraisals function via a (...) complex calculus that reflects variation in patient characteristics, clinician characteristics, task, and organizational factors. The full impact of moral judgment on healthcare relationships, patient outcomes, and clinicians' own well-being is yet unknown. The paucity of attention to moral judgment, despite its significance for patient-centered care, communication, empathy, professionalism, healthcare education, stereotyping, and outcome disparities, represents a blind spot that merits explanation and repair. New methodologies in social psychology and neuroscience have yielded models for how moral judgment operates in healthcare and how research in this area should proceed. Clinicians, educators, and researchers would do well to recognize both the legitimate and illegitimate moral appraisals that are apt to occur in healthcare settings. (shrink)