In The Conditions for Ethical Chemical Restraint, Crutchfield and Redinger (2024) propose ethical standards for the use of chemical restraints, which they consider normatively distinct from physica...

Introduction: A general trend in the psychological literature suggests that guilt contributes to morality more than shame does. Unlike shame-prone individuals, guilt-prone individuals internalize the causality of negative events, attribute responsibility in the first person, and engage in responsible behavior. However, it is not known how guilt- and shame-proneness interact with the attribution of responsibility to others. -/- Methods: In two Web-based experiments, participants reported their attributions of moral culpability (i.e., responsibility, causality, punishment and decision-making) about morally ambiguous acts of (...) killing in different conditions. In Study 1 the vignettes were presented in the 1st person, while in Study 2 in the 3rd person. To test proneness to guilt and shame, we utilized the GASP scale, which differentiates between the affective and behavioral components of each emotion. Statistical analyses were performed in Matlab and R. -/- Results: We found that guilt- and shame-proneness were associated with the severity of attributions in both the first and the third person, but the effect was strong only in the guilt case (both subtypes) and shame-affect case, and not in the shame-behavior case. We call this the Moralizing Effect. -/- Discussion: We wonder whether our finding that guilt-prone people tend to attribute a higher degree of culpability to others is really consistent with the view that guilt motivates people to choose the “moral paths in life”. This echoes views about the harmful aspects of guilt, which have been expressed historically in philosophy, for example, by Friedrich Nietzsche. (shrink)

RD, a 32-year-old male, was admitted to the hospital with hypoxic COVID pneumonia–a potentially life-threatening condition characterized by dangerously low levels of oxygen in the body- during one of the pandemic’s surges. While RD’s age gave the clinical team hope for his prognosis, his ability to recover was complicated by his being unvaccinated and having multiple comorbidities, including diabetes and obesity. His condition worsened to the point that he required extracorporeal membrane oxygenation (ECMO), a machine that maintains the functioning of (...) a person’s heart and lungs. -/- Given its scarcity–only 264 of the over 6,000 hospitals in the United States offer ECMO, according to the Extracorporeal Life Support Organization–as well as its high cost and the inadequate supply of staff required to maintain it, ECMO primarily serves as a bridge to support critically ill patients until they can receive an organ transplant or implanted medical device. For RD, ECMO was started to support him until he could be evaluated for, and possibly receive, a bilateral lung transplant. Despite its intended use as a treatment of last resort, some patients can remain on ECMO for weeks or months. And some are awake, alert, and capable of medical decision-making. -/- RD was one such patient. However, the transplant evaluation committee ruled out RD’s candidacy for bilateral lung transplantation, based on his poor potential for recovery and a lack of family and friends to provide post-transplant support. This determination raised the prospect of continued ECMO treatment being a bridge to nowhere. But RD was comfortable on ECMO and wanted to remain in the ICU. The ICU intensivist contacted the ethics consult service with questions about whether continued ECMO support was medically and ethically inappropriate. (shrink)