AJOB Empirical Bioethics最新文献

{"title":"Ethical Issues in Intraoperative Neuroscience Research: Assessing Subjects' Recall of Informed Consent and Motivations for Participation.","authors":"Anna Wexler,&nbsp;Rebekah J Choi,&nbsp;Ashwin G Ramayya,&nbsp;Nikhil Sharma,&nbsp;Brendan J McShane,&nbsp;Love Y Buch,&nbsp;Melanie P Donley-Fletcher,&nbsp;Joshua I Gold,&nbsp;Gordon H Baltuch,&nbsp;Sara Goering,&nbsp;Eran Klein","doi":"10.1080/23294515.2021.1941415","DOIUrl":"https://doi.org/10.1080/23294515.2021.1941415","url":null,"abstract":"<p><p><b>Background</b>An increasing number of studies utilize intracranial electrophysiology in human subjects to advance basic neuroscience knowledge. However, the use of neurosurgical patients as human research subjects raises important ethical considerations, particularly regarding informed consent and undue influence, as well as subjects' motivations for participation. Yet a thorough empirical examination of these issues in a participant population has been lacking. The present study therefore aimed to empirically investigate ethical concerns regarding informed consent and voluntariness in Parkinson's disease patients undergoing deep brain stimulator (DBS) placement who participated in an intraoperative neuroscience study.<b>Methods</b>Two semi-structured 30-minute interviews were conducted preoperatively and postoperatively via telephone. Interviews assessed participants' motivations for participation in the parent intraoperative study, recall of information presented during the informed consent process, and participants' postoperative reflections on the research study.<b>Results</b>Twenty-two participants (mean age = 60.9) completed preoperative interviews at a mean of 7.8 days following informed consent and a mean of 5.2 days prior to DBS surgery. Twenty participants completed postoperative interviews at a mean of 5 weeks following surgery. All participants cited altruism or advancing medical science as \"very important\" or \"important\" in their decision to participate in the study. Only 22.7% (<i>n</i> = 5) correctly recalled one of the two risks of the study. Correct recall of other aspects of the informed consent was poor (36.4% for study purpose; 50.0% for study protocol; 36.4% for study benefits). All correctly understood that the study would not confer a direct therapeutic benefit to them.<b>Conclusion</b>Even though research coordinators were properly trained and the informed consent was administered according to protocol, participants demonstrated poor retention of study information. While intraoperative studies that aim to advance neuroscience knowledge represent a unique opportunity to gain fundamental scientific knowledge, improved standards for the informed consent process can help facilitate their ethical implementation.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"13 1","pages":"57-66"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23294515.2021.1941415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10455286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employer-Sponsored Egg Freezing: Carrot or Stick?","authors":"Molly Johnston,&nbsp;Giuliana Fuscaldo,&nbsp;Nadine Maree Richings,&nbsp;Stella May Gwini,&nbsp;Sally Catt","doi":"10.1080/23294515.2021.1941413","DOIUrl":"https://doi.org/10.1080/23294515.2021.1941413","url":null,"abstract":"<p><p><b>Background</b>Since 2014, many companies have followed the lead of Apple and Facebook and now offer financial support to female employees to access egg freezing. Australian companies may soon make similar offers. Employer-sponsored egg freezing (ESEF) has raised concerns and there is academic debate about whether ESEF promotes reproductive autonomy or reinforces the 'career vs. family' dichotomy. Despite the growing availability of ESEF and significant academic debate, little is known about how ESEF is perceived by the public. The aim of this study was to explore women's attitudes toward ESEF.<b>Methods</b>Women aged 18-60<b> </b>years who resided in Victoria, Australia were invited to complete an online, cross-sectional survey investigating views toward egg freezing. Associations between participant demographics and their views about ESEF were assessed using multinominal logistic regression, adjusted for age and free text comments were analyzed using thematic analysis.<b>Results</b>The survey was completed by 656 women, median age 28<b> </b>years (range: 18-60<b> </b>years). Opinions on the appropriateness of employers offering ESEF were divided (Appropriate: 278, 42%; Inappropriate: 177, 27%; Unsure: 201, 31%). There was significantly less support for ESEF among older participants and those employed part-time (p<b> </b><<b> </b>0.05). While some participants saw the potential for ESEF to increase women's reproductive and career options, others were concerned that ESEF could pressure women to delay childbearing and exacerbate existing inequities in access to ARTs.<b>Conclusions</b>Our analysis revealed that while some women identified risks with ESEF, for many women ESEF is not viewed as theoretically wrong, but rather it may be acceptable under certain conditions; such as with protections around reproductive freedoms and assurances that ESEF is offered alongside other benefits that promote career building <i>and</i> family. We suggest that there may be a role for the State in ensuring that these conditions are met.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"13 1","pages":"33-47"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23294515.2021.1941413","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics Consultation in U.S. Hospitals: New Findings about Consultation Practices.","authors":"Ellen Fox,&nbsp;Marion Danis,&nbsp;Anita J Tarzian,&nbsp;Christopher C Duke","doi":"10.1080/23294515.2021.1996117","DOIUrl":"https://doi.org/10.1080/23294515.2021.1996117","url":null,"abstract":"<p><p><b>Background</b>While previous research has examined various aspects of ethics consultation (EC) in U.S. hospitals, certain EC practices have never been systematically studied.<b>Methods</b>To address this gap, we surveyed a random stratified sample of 600 hospitals about aspects of EC that had not been previously explored.<b>Results</b>New findings include: in 26.0% of hospitals, the EC service performs EC for more than one hospital; 72.4% of hospitals performed at least one non-case consultation; in 56% of hospitals, ECs are never requested by patients or families; 59.0% of case consultations involve conflict; the usual practice is to visit the patient in all formal EC cases in 32.5% of hospitals; 56.6% of hospitals do not include a formal meeting in most EC cases; 61.1% of hospitals do not routinely assess ethics consultants' competencies; and 31.6% of hospitals belong to a bioethics network. We estimate the total number of non-case consultations performed in U.S. hospitals to be approximately one half the number of case consultations; we estimate the total number of ECs performed in U.S. hospitals, including both case and non-case consultations, to be just over 100,000 per year.<b>Conclusions</b>These findings expand our current understanding of EC in U.S. hospitals, and raise several concerns that suggest a need for further research.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39631162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in COVID-19 Resource Allocation Protocols and Potential Implementation in the Chicago Metropolitan Area.","authors":"Rupali Gandhi,&nbsp;Gina M Piscitello,&nbsp;William F Parker,&nbsp;Kelly Michelson","doi":"10.1080/23294515.2021.1983667","DOIUrl":"https://doi.org/10.1080/23294515.2021.1983667","url":null,"abstract":"<p><strong>Background: </strong>Scarce resource allocation policies vary across the United States. Little is known about regional variation in resource allocation protocols and variation in their application. We sought to evaluate how Covid-19 scarce resource allocation policies vary throughout the Chicago metropolitan area and whether there are differences in policy application within hospitals when prioritizing hypothetical patients who need critical care resources.</p><p><strong>Methods: </strong>Two cross-sectional surveys were distributed to Chicago metropolitan area hospital representatives and triage officers. Survey responses and categorical variables are described by frequency of occurrence. Intra- and interhospital variation in ranking of hypothetical patients was assessed using Fleiss's Kappa coefficients.</p><p><strong>Results: </strong>Eight Chicago-area hospitals responded to the survey assessing scarce resource allocation protocols (N = 8/18, response rate 44%). For hospitals willing to describe their ventilator allocation protocol (N = 7), most used the sequential organ failure assessment (SOFA) score (N = 6/7, 86%) and medical comorbidities (N = 4/7, 57%) for initial scoring of patients. A majority gave priority in initial scoring to pre-defined groups (N = 5/7, 71%), all discussed withdrawal of mechanical ventilation for adult patients (N = 7/7, 100%), and a minority had exclusion criteria (N = 3/7, 43%). Forty-nine triage officers from nine hospitals responded to the second survey (N = 9/10 hospitals, response rate 90%). Their rankings of hypothetical patients showed only slight agreement amongst all hospitals (Kappa 0.158) and fair agreement within two hospitals with the most respondents (Kappa 0.21 and 0.25). Almost half used tiebreakers to rank patients (N = 23/49, 47%).</p><p><strong>Conclusions: </strong>Although most respondents from Chicago-area hospitals described policies for resource allocation during the COVID-19 pandemic, the substance and application of these protocols varied. There was little agreement when prioritizing hypothetical patients to receive scarce resources, even among people from the same hospital. Variations in resource allocation protocols and their application could lead to inequitable distribution of resources, further exacerbating community distrust and disparities in health.</p><p><p>Supplemental data for this article is available online at https://doi.org/10.1080/23294515.2021.1983667.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"12 4","pages":"266-275"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648102/pdf/nihms-1762842.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39479069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Medical Providers on Morality and Decision-Making Capacity in Withholding and Withdrawing Life-Sustaining Treatment and Suicide.","authors":"Thomas D Harter,&nbsp;Erin L Sterenson,&nbsp;Andrew Borgert,&nbsp;Cary Rasmussen","doi":"10.1080/23294515.2021.1887961","DOIUrl":"https://doi.org/10.1080/23294515.2021.1887961","url":null,"abstract":"<p><strong>Background: </strong>This study attempts to understand if medical providers beliefs about the moral permissibility of honoring patient-directed refusals of life-sustaining treatment (LST) are tied to their beliefs about the patient's decision-making capacity. The study aims to answer: 1) does concern about a patient's treatment decision-making capacity relate to beliefs about whether it is morally acceptable to honor a refusal of LST, 2) are there differences between provider types in assessments of decision-making capacity and the moral permissibility to refuse LST, and 3) do provider demographics impact beliefs about decision-making capacity and the moral permissibility to refuse LST. <b>Methods</b>: A mixed-methods survey using Likert assessment and vignette-based questions was administered to medical providers within a single health system in the upper Midwest (<i>N</i> = 714) to assess their perspectives on the moral acceptance and decision-making capacity in cases of withholding and withdrawing treatment and suicide. <b>Results</b>: Behavioral health providers report accepting of the moral permissibility of suicide (91.2%) more than either medical providers (77.2%) or surgeons (74.4%) (n = 283). Decision-making capacity was questioned more in the vignettes of the patients refusing life-saving surgery (36%) and voluntarily starvation (40.8%) than in the vignette of the patient requesting to deactivate a pacemaker (13%) (n = 283). Behavioral health providers were more concerned about the capacity to refuse life-saving surgery (55.9%) than medical providers (33.8%) or surgeons (23.1%) (n = 283). <b>Conclusions</b>: Respondents endorse the moral permissibility of persons to withhold or withdraw from treatment regardless of motive. Clinical concerns about a patient's treatment decision-making capacity do not strongly correlate to views about the moral permissibility of honoring refusals of LST. Different provider types appear to have different thresholds for when to question treatment decision-making capacity. Behavioral health providers tend to question treatment decision-making capacity to refuse LST more than non-behavioral health providers.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"12 4","pages":"227-238"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23294515.2021.1887961","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25488838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Physician Behaviors that Predict Prudent, Preference Concordant Decisions at the End of Life.","authors":"Andre Morales,&nbsp;Alan Murphy,&nbsp;Joseph B Fanning,&nbsp;Shasha Gao,&nbsp;Kevan Schultz,&nbsp;Daniel E Hall,&nbsp;Amber Barnato","doi":"10.1080/23294515.2020.1865476","DOIUrl":"https://doi.org/10.1080/23294515.2020.1865476","url":null,"abstract":"<p><strong>Background: </strong>This study introduces an empirical approach for studying the role of prudence in physician treatment of end-of-life (EOL) decision making.</p><p><strong>Methods: </strong>A mixed-methods analysis of transcripts from 88 simulated patient encounters in a multicenter study on EOL decision making. Physicians in internal medicine, emergency medicine, and critical care medicine were asked to evaluate a decompensating, end-stage cancer patient. Transcripts of the encounters were coded for actor, action, and content to capture the concept of Aristotelian prudence, and then quantitatively and qualitatively analyzed to identify actions associated with preference-concordant treatment.</p><p><strong>Results: </strong>Focusing on codes that describe characteristics of physician-patient interaction, the code for physicians restating patient preferences was associated with avoiding intubation. Multiple codes were associated with secondary measures of preference-concordant treatment.</p><p><strong>Conclusions: </strong>Prudent actions can be identified empirically, and research focused on the virtue of prudence may provide a new avenue for assessment and training in EOL care.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"12 4","pages":"215-226"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23294515.2020.1865476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38769124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deliberation on Childhood Vaccination in Canada: Public Input on Ethical Trade-Offs in Vaccination Policy.","authors":"Kieran C O'Doherty,&nbsp;Sara Crann,&nbsp;Lucie Marisa Bucci,&nbsp;Michael M Burgess,&nbsp;Apurv Chauhan,&nbsp;Maya J Goldenberg,&nbsp;C Meghan McMurtry,&nbsp;Jessica White,&nbsp;Donald J Willison","doi":"10.1080/23294515.2021.1941416","DOIUrl":"https://doi.org/10.1080/23294515.2021.1941416","url":null,"abstract":"<p><strong>Background: </strong>Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input.</p><p><strong>Methods: </strong>We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood vaccination.</p><p><strong>Results: </strong>25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children.</p><p><strong>Conclusions: </strong>We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"12 4","pages":"253-265"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23294515.2021.1941416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39259504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' Participation in Limited Resuscitation: Gray Areas in End of Life Decision-Making.","authors":"Felicia Stokes,&nbsp;Rick Zoucha","doi":"10.1080/23294515.2021.1907477","DOIUrl":"https://doi.org/10.1080/23294515.2021.1907477","url":null,"abstract":"<p><p>Historically nurses have lacked significant input in end-of-life decision-making, despite being an integral part of care. Nurses experience negative feelings and moral conflict when forced to aggressively deliver care to patients at the EOL. As a result, nurses participate in slow codes, described as a limited resuscitation effort with no intended benefit of patient survival. The purpose of this study was to explore and understand the process nurses followed when making decisions about participation in limited resuscitation. Five core categories emerged that describe this theory: (1) recognition of patient and family values at the EOL; (2) stretching time and reluctance in decision-making; (3) harm and suffering caused by the physical components of CPR; (4) nurse's emotional and moral response to delivering aggressive care, and; (5) choosing limited resuscitation with or without a physician order. Several factors in end-of-life disputes contribute to negative feelings and moral distress driving some nurses to perform slow codes in order to preserve their own moral conflict, while other nurses refrain unless specifically ordered by physicians to provide limited care through tailored orders.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"12 4","pages":"239-252"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23294515.2021.1907477","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38892817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Utilitarian Outcomes to Inform Triage Ethics: Simulated Performance of a Ventilator Triage Protocol under Sars-CoV-2 Pandemic Surge Conditions","authors":"E. Chuang, J. Grand-Clément, J. Chen, Carri W. Chan, Vineet Goyal, M. Gong","doi":"10.1080/23294515.2022.2063999","DOIUrl":"https://doi.org/10.1080/23294515.2022.2063999","url":null,"abstract":"Abstract Background Equitable protocols to triage life-saving resources must be specified prior to shortages in order to promote transparency, trust and consistency. How well proposed utilitarian protocols perform to maximize lives saved is unknown. We aimed to estimate the survival rates that would be associated with implementation of the New York State 2015 guidelines for ventilator triage, and to compare them to a first-come-first-served triage method. Methods We constructed a simulation model based on a modified version of the New York State 2015 guidelines compared to a first-come-first-served method under various hypothetical ventilator shortages. We included patients with SARs-CoV-2 infection admitted with respiratory failure requiring mechanical ventilation to three acute care hospitals in New York from 3/01/2020 and 5/27/2020. We estimated (1) survival rates, (2) number of excess deaths, (3) number of patients extubated early or not allocated a ventilator due to capacity constraints, (4) survival rates among patients not allocated a ventilator at triage or extubated early due to capacity constraints. Results 807 patients were included in the study. The simulation model based on a modified New York State policy did not decrease mortality, excess death or exclusion from ventilators compared to the first-come-first-served policy at every ventilator capacity we tested using COVID-19 surge cohort patients. Survival rates were similar at all the survival probabilities estimated. At the lowest ventilator capacity, the modified New York State policy has an estimated survival of 28.5% (CI: 28.4-28.6), compared to 28.1% (CI: 27.7-28.5) for the first-come-first-served policy. Conclusions This simulation of a modified New York State guideline-based triage protocol revealed limitations in achieving the utilitarian goals these protocols are designed to fulfill. Quantifying these outcomes can inform a better balance among competing moral aims.","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":"13 1","pages":"196 - 204"},"PeriodicalIF":0.0,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41595880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolutely Right and Relatively Good: Consequentialists See Bioethical Disagreement in a Relativist Light.","authors":"Hugo Viciana,&nbsp;Ivar R Hannikainen,&nbsp;David Rodríguez-Arias","doi":"10.1080/23294515.2021.1907476","DOIUrl":"https://doi.org/10.1080/23294515.2021.1907476","url":null,"abstract":"<p><strong>Background: </strong>Contemporary societies are rife with moral disagreement, resulting in recalcitrant disputes on matters of public policy. In the context of ongoing bioethical controversies, are uncompromising attitudes rooted in beliefs about the nature of moral truth?</p><p><strong>Methods: </strong>To answer this question, we conducted both exploratory and confirmatory studies, with both a convenience and a nationally representative sample (total <i>N</i> = 1501), investigating the link between people's beliefs about moral truth (their metaethics) and their beliefs about moral value (their normative ethics).</p><p><strong>Results: </strong>Across various bioethical issues (e.g., medically-assisted death, vaccine hesitancy, surrogacy, mandatory organ conscription, or genetically modified crops), consequentialist attitudes were associated with weaker beliefs in an objective moral truth. This association was not explained by domain-general reflectivity, theism, personality, normative uncertainty, or subjective knowledge.</p><p><strong>Conclusions: </strong>We find a robust link between the way people characterize prescriptive disagreements and their sensibility to consequences. In addition, both societal consensus and personal conviction contribute to objectivist beliefs, but these effects appear to be asymmetric, i.e., stronger for opposition than for approval.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"190-205"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23294515.2021.1907476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38842382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}