Researchers in moral psychology and social justice have agreed that morality is about matters of harm, rights, and justice. On this definition of morality, conservative opposition to social justice programs appears to be immoral, and has been explained as a product of various non-moral processes such as system justification or social dominance orientation. In this article we argue that, from an anthropological perspective, the moral domain is usually much broader, encompassing many more aspects of social life and valuing institutions as much or more than individuals. We present theoretical and empirical reasons for believing that there are five psychological systems that provide the foundations for the world’s many moralities. The five foundations are psychological preparations for detecting and reacting emotionally to issues related to harm/care, fairness/reciprocity, ingroup/loyalty, authority/respect, and purity/sanctity. Political liberals have moral intuitions primarily based upon the first two foundations, and therefore misunderstand the moral motivations of political conservatives, who generally rely upon all five foundations.
Moral foundations theorists propose that the moral domain should include not only “liberal” ethics of justice and care but also ostensibly “conservative” concerns about the virtues of ingroup loyalty, obedience to authority, and enforcement of purity standards. This proposal clashes with decades of research in political psychology connecting the latter set of characteristics to “the authoritarian personality.” We demonstrate that liberal-conservative differences in moral intuitions are statistically mediated by authoritarianism and social dominance orientation, so that conservatives’ greater valuation of ingroup, authority, and purity concerns is attributable to higher levels of authoritarianism, whereas liberals’ greater valuation of fairness and harm avoidance is attributable to lower levels of social dominance. We also find that ingroup, authority, and purity concerns are positively associated with intergroup hostility and support for discrimination, whereas concerns about fairness and harm avoidance are negatively associated with these variables. These findings might lead some to question the wisdom and appropriateness of efforts to “broaden” scientific conceptions of morality in such a way that preferences based on authoritarianism and social dominance are treated as moral—rather than amoral or even immoral—and suggest that the explicit goal of incorporating conservative ideology into the study of moral psychology (in order to increase ideological diversity) may lead researchers astray.
Moral foundations theorists propose that the moral domain should include not only "liberal'' ethics of justice and care but also ostensibly "conservative'' concerns about the virtues of ingroup loyalty, obedience to authority, and enforcement of purity standards. This proposal clashes with decades of research in political psychology connecting the latter set of characteristics to "the authoritarian personality.'' We demonstrate that liberal-conservative differences in moral intuitions are statistically mediated by authoritarianism and social dominance orientation, so that conservatives' greater valuation of ingroup, authority, and purity concerns is attributable to higher levels of authoritarianism, whereas liberals' greater valuation of fairness and harm avoidance is attributable to lower levels of social dominance. We also find that ingroup, authority, and purity concerns are positively associated with intergroup hostility and support for discrimination, whereas concerns about fairness and harm avoidance are negatively associated with these variables. These findings might lead some to question the wisdom and appropriateness of efforts to "broaden'' scientific conceptions of morality in such a way that preferences based on authoritarianism and social dominance are treated as moral-rather than amoral or even immoral-and suggest that the explicit goal of incorporating conservative ideology into the study of moral psychology (in order to increase ideological diversity) may lead researchers astray.
This article investigates the psychometric properties of a self-report inventory for measuring individual differences in four components of justice sensitivity (JS): victim sensitivity, observer sensitivity, beneficiary sensitivity, and perpetrator sensitivity. A representative sample (N = 2510) was employed to (a) estimate the reliability of a newly developed perpetrator sensitivity scale, (b) test the factorial validity of this scale together with three previously developed scales (victim, observer, and beneficiary sensitivity), (c) estimate correlations between JS and demographic variables (gender, age, education, employment status, marital status, and residency in East versus West Germany), and (d) provide normative data for the computation of standard scores. A demographically heterogeneous convenience sample (N = 327) was used to locate the JS dimensions in the personality space of narrow facet factors. Results from confirmatory factor analyses demonstrated the factorial validity of the JS scales. Regression analyses with JS scales as criteria and personality facet scales as predictors suggested that JS cannot be reduced to combinations of personality facets. Demographic effects were small, explaining a maximum of 1.4% of JS variance. Women and East Germans were found to be more justice sensitive than men and West Germans, respectively. Victim sensitivity decreased with age; perpetrator sensitivity decreased with education. Taken together, our results corroborate the validity of the JS Inventory and contribute to a better psychological understanding of JS.
Individuals often need to negotiate how to distribute jointly produced goods—equally (e.g., 50:50) or equitably (e.g., proportionally to their contributions). We examined whether people have stable preferences, or whether they switch between equality and equity in different situations. Pairs of anonymous participants first produced a common pie, and then distributed it in an ultimatum game. Results suggest that individuals apply different justice principles depending on their contribution. When they produced less than 50%, proposers divided the pie equally. However, when they produced more than 50%, their offers fell between equality and equity. Responders’ ratings of fairness and satisfaction varied similarly; with low production, equality was preferred, whereas with high production, equity was preferred. Nevertheless, equal and equitable offers were generally accepted, and only outright unfair offers were rejected. This suggests that individuals are relatively flexible about which justice principle should be applied, but punish proposers whose offers violate both principles.
Under national health services (NHS), non-urgent access to specialist doctors is not straightforward and sometimes leads to long waiting times. Consequently, some citizens may decide to pay for private specialist care to complement the services provided publicly, trying to shorten their NHS waiting times. This strategic behaviour may lead to inequities in access to public specialist services. A way to approach this phenomenon is to analyse those patients that use private and public specialist care simultaneously. The aim of this paper is to determine the proportion of patients who combine both types of services, their profile and to analyse whether the recent economic crisis has accentuated this phenomenon or not. With survey data from the Spanish Health Barometer between 2005 and 2015, probit models of the probability of combining public and private specialist visits are estimated, controlling for socio-economic, demographic and other individual characteristics. Models are estimated using the Heckman correction technique to solve the potential selection bias problem. Almost one in ten patients who visited a public specialist in the previous year also visited a private specialist. Insofar as these patients have used private specialist care strategically, as complementary services to those of the Spanish NHS, this phenomenon might contribute to generate horizontal inequity in access favouring such individuals, whose profiles respond to a high socio-economic level, young and resident in the regions of Canarias, C. Valenciana, Cataluña, Navarra or Cantabria. With the economic crisis and public budget cuts, the proportion of patients who combine private and public specialist care has declined probably due to the predominance of a “household income effect”.
Social justice is often described as the ‘foundation of public health.’ Yet, outside of the theoretical literature the polysemous nature of the concept is rarely acknowledged. To complement recent contributions to normative theory specifically motivated by questions of social justice in public health, this study explores public health policy-makers’ perspectives on the meaning and role of social justice in their practice. This study involved twenty qualitative, semi-structured interviews with public health policy-makers recruited from two programmatic areas of public health [chronic disease prevention (CDP) and public health emergency preparedness and response (PHEPR)] within public health organizations in Canada. Participants’ perspectives appeared to be influenced by the perceived goals belonging to the programmatic area of public health in which they practiced. Those involved in PHEPR indicated that justice-based considerations are viewed as a ‘constraint’ on the aims of this area of practice, which are to minimize overall morbidity and mortality, whereas those involved in CDP indicated that justice-based considerations are ‘part and parcel’ of their work, which seeks primarily to address the unique health needs of (and thus, disparities between) population groups. The aims and activities of different programmatic areas of public health may influence the way in which social justice is perceived in practice. More ought to be done (in theory and in practice) to interrogate how the unique contributions that individual programmatic areas of public health can and should cohere in order to realize the broader aim that public health has as an institution to promote social justice.
This paper analyses the allocation of R&D investments within rare diseases and identifies the characteristics of rare diseases that appear to lead R&D resources. Rare diseases affect less than 1 in 2000 citizens. With over 7000 recognised rare diseases and 350 million people affected worldwide, rare diseases are not so rare when considered collectively. Rare diseases are generally underserved by drug development because pharmaceutical industries consider R&D investments in rare diseases too costly and risky in comparison with the low expected returns due to the small population involved. We use data on rare diseases research from Orphanet along with academic publications per rare disease from bibliographic databases. We test the existence of inequalities in R&D investments within rare diseases and identify the disease characteristics that appear to lead R&D investments using dominance tools and bilateral tests. We show that rare diseases in children and with a smaller prevalence, such as ultra-rare diseases, are underserved by R&D. R&D investments appear to be concentrated in more profitable research areas with potentially larger sample size and adult population.
The links among social inequality, economic inequality, and health have long been of interest to social scientists, but causal links are difficult to investigate empirically. In particular, studies examining the impact of social status on one’s own health may overlook important effects of inequality on the health of populations as a whole occurring due to negative externalities of social forces. A recent literature on caste, sanitation, and child net nutrition provides an example of one social context where social inequality makes an entire population less healthy. This paper presents new observational analysis of the India Human Development Survey that provides descriptive evidence of this mechanism. We show that, on average, children in rural India are shorter if they live in villages where more people report practicing untouchability—meaning that they enforce caste hierarchies in their interactions with people from the lowest castes. This association is explained by the association between casteism and the prevalence of rural open defecation.
Labiaplasty, an invasive surgical procedure that reduces the size of the labia minora, has dramatically increased in popularity, particularly among adolescent and young adult women in Western cultures. To understand this increase, we examined two possible underlying factors: self-objectification and system justifying beliefs. In Study 1, we predicted that system justifying beliefs would moderate the relationship between self-objectification and the desire to undergo labiaplasty. In Study 2, we also examined the unique role of labia-specific surveillance. Moreover, we predicted that system justification would be related to differences in the labia lengths that were considered normal versus desirable. In both studies, system justifying beliefs moderated the effect of self-objectification on dissatisfaction with one’s labia and consideration for getting a labiaplasty, but the nature of this effect was different for general indicators of self-objectification and labia-specific surveillance.
In this article, we explore the associations of people’s valuations of universal healthcare with risk exposure and humanitarianism across diverse institutional contexts. We argue that both micro-level factors increase the valuations. Furthermore, interactions between material interests and humanitarians are expected. This work also hypothesizes that institutional contexts with employment-independent healthcare systems should modify the effect of risk exposure. Following a comparative framework, we test the expectations by using the International Social Survey Programme 2011 health module for 28 developed and developing countries. Results suggest opposite effects for the factors under analysis. While risk exposure decreases the willingness to pay taxes for the provision of universal healthcare, humanitarianism strongly fosters the valuation. Furthermore, we find statistical significant interactions between material interests and humanitarianism. Results also suggest substantive cross-level interactions between risk exposure and healthcare systems. Findings are robust to different modeling strategies that control for standard micro-level variables (income and egalitarianism), individual factors and observed and unobserved country characteristics. The article lays out implications of these findings.
The links among social inequality, economic inequality, and health have long been of interest to social scientists, but causal links are difficult to investigate empirically. In particular, studies examining the impact of social status on one's own health may overlook important effects of inequality on the health of populations as a whole occurring due to negative externalities of social forces. A recent literature on caste, sanitation, and child net nutrition provides an example of one social context where social inequality makes an entire population less healthy. This paper presents new observational analysis of the India Human Development Survey that provides descriptive evidence of this mechanism. We show that, on average, children in rural India are shorter if they live in villages where more people report practicing untouchability-meaning that they enforce caste hierarchies in their interactions with people from the lowest castes. This association is explained by the association between casteism and the prevalence of rural open defecation.
This paper draws on a literature in sociology, psychology and economics that has extensively documented the unfulfilled promise of meritocracy in education. I argue that the lesson learned from this literature is threefold: (1) educational institutions in practice significantly distort the ideal meritocratic process; (2) opportunities for merit are themselves determined by non-meritocratic factors; (3) any definition of merit must favor some groups in society while putting others at a disadvantage. Taken together, these conclusions give reason to understand meritocracy not just as an unfulfilled promise, but as an unfulfillable promise. Having problematized meritocracy as an ideal worth striving for, I argue that the pervasiveness of meritocratic policies in education threatens to crowd out as principles of justice, need and equality. As such, it may pose a barrier rather than a route to equality of opportunity. Furthermore, meritocratic discourse legitimates societal inequalities as justly deserved such as when misfortune is understood as personal failure. The paper concludes by setting a research agenda that asks how citizens come to hold meritocratic beliefs; addresses the persistence of (unintended) meritocratic imperfections in schools; analyzes the construction of a legitimizing discourse in educational policy; and investigates how education selects and labels winners and losers.
In a publicly financed health system, it is important that priority-setting reflects social values. Many studies investigate public preferences through surveys taken from samples, but to be representative, these samples must reflect value judgments of all relevant population subgroups. In this study, we explore whether, next to better-understood sources of heterogeneity such as age, education or gender, also differences in personality play a role in how people want to set limits to health care. We investigate the influence of dispositional optimism: whether someone anticipates a good or bad future. This is an important personality dimension that has been shown to widely reverberate into people's lives and that can also be expected to influence people's views on health care. To test our hypothesis, we asked a representative sample of the Belgian population (N=750) to complete both the revised life orientation test and a discrete choice experiment about allocating healthcare resources, and we investigated the relationships between both measurements. We found that more pessimistic individuals were less supportive of using patients' age as a selection criterion and more hesitant to invest in prevention. Since individual dispositions are usually not part of the criteria for selecting representative samples, our findings point at a potential non-response bias in studies that elicit social values.
Research on children and the law has recently renewed its focus on the development of children's ties to law and legal actors. We identify the developmental process through which these relations develop as legal socialization, a process that unfolds during childhood and adolescence as part of a vector of developmental capital that promotes compliance with the law and cooperation with legal actors. In this paper, we show that ties to the law and perceptions of law and legal actors among children and adolescents change over time and age. We show that neighborhood contexts and experiences with legal actors shape the outcomes of legal socialization. Children report lower ratings of legitimacy of the law and greater legal cynicism when they view interactions with legal actors as unfair and harsh. We show that perceived legitimacy of law and legal authorities shapes compliance with the law, and that these effects covary with social contexts including neighborhood. We identify neighborhood differences in this relationship that reflect differential experiences of children with criminal justice authorities and other social control agents. The results suggest that legal actors may play a role in socialization processes that lead to compliance with or rejection of legal and social norms.
This paper examines the root of unethical dicisions by identifying the psychological forces that promote self-deception. Self-deception allows one to behave self-interestedly while, at the same time, falsely believing that one's moral principles were upheld. The end result of this internal con game is that the ethical aspects of the decision “fade” into the background, the moral implications obscured. In this paper we identify four enablers of self-deception, including language euphemisms, the slippery slope of decision-making, errors in perceptual causation, and constraints induced by representations of the self. We argue that current solutions to unethical behaviors in organizations, such as ethics training, do not consider the important role of these enablers and hence will be constrained in their potential, producing only limited effectiveness. Amendments to these solutions, which do consider the powerful role of self-deception in unethical decisions, are offered.
Although measures of sensitivity to inequality are important in judging the welfare effects of health-care programmes, it is far from straightforward how to elicit them and apply them in health-care decision-making. This paper provides an overview of the literature on the measurement of inequality aversion, examines some of the features specific of the health domain that depart from the income domain, and discusses its implementation in health-system priority-setting decisions. We find evidence that individuals exhibit a preference for more equitable health distribution, but inequality aversion estimates from the literature are unclear. Unlike the income-inequality literature, standard approaches in the health economics do not follow a veil-of-ignorance' approach and elicit mostly bivariate (income-related health) inequality aversion estimates. We suggest some ideas to reduce the disconnect between the income inequality and health economics literature.
All healthcare systems operate with limited resources and therefore need to set priorities for allocating resources across a population. Trade-offs between maximising health and promoting health equity are inevitable in this process. In this paper, we use the UK's National Institute for Health and Care Excellence (NICE) as an example to examine how efforts to promote healthcare innovation in the priority-setting process can complicate these trade-offs. Drawing on NICE guidance, health technology assessment reports and relevant policy documents, we analyse under what conditions NICE recommends the National Health Service fund technologies of an innovative nature, even when these technologies do not satisfy NICE's cost-effectiveness criteria. Our findings fail to assuage pre-existing concerns that NICE's approach to appraising innovative technologies curtails its goals to promote health and health equity. They also reveal a lack of transparency and accountability regarding NICE's treatment of innovative technologies, as well as raising additional concerns about equity. We conclude that further research needs to evaluate how NICE can promote health and health equity alongside healthcare innovation and draw some general lessons for healthcare priority-setting bodies like NICE.
According to a long-standing school of thought, the improvement in equal oppor-tunity is said to reduce the support for equality of outcomes. Yet, some scholars challenge this wisdom and maintain that equalizing opportunities introduces higher uncertainty about individuals’ future rank in their society, which, in turn, leads to more demand for equalizing incomes. Based on the 2013 survey of French residents (N = 4000), this paper argues that both claims are correct. Two pieces of evidence are provided. First, the relationship between perceived equality of opportunity and preference for equality of outcomes is asymmetrically U-shaped. Second, using split samples, this relationship proves to be decreasing among the poorest and increasing among the richest. The article provides some clues supporting the generalizability of such results, based on the analysis of the four waves of the International Social Survey Program in 27 countries.