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医院中的道德困境:应该救哪一位枪击受害者?

Moral Dilemmas in Hospitals: Which Shooting Victim Should Be Saved?

作者信息

Navarick Douglas J, Moreno Kristen M

机构信息

Department of Psychology, California State University, Fullerton, Fullerton, CA, United States.

出版信息

Front Psychol. 2022 Mar 25;13:770020. doi: 10.3389/fpsyg.2022.770020. eCollection 2022.

DOI:10.3389/fpsyg.2022.770020
PMID:35401372
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8989733/
Abstract

Moral judgments can occur either in settings that call for impartiality or in settings that allow for partiality. How effective are impartiality settings such as hospitals in suppressing personal biases? Portrayed as decision-makers in an emergency department, 431 college students made judgments on which of two victims of a mass shooting should receive immediate, life-saving care. Patients differed in ways that could reveal biases, e.g., age (8 80 years), kinship (stranger cousin), gender (female male), and villain/hero (shooter policeman who stopped him). Participants rated each patient's moral deservingness to receive immediate care and the likelihood they would choose the patient. Both scales showed young favored over old, cousin (or daughter) over stranger, and policeman over shooter (largest difference). In a hospital-room scenario with high risk of injury from falling, age bias disappeared. With moderate fall risk, age bias reversed and kinship deservingness bias disappeared. Bias decreases when there is a decrease in severity of potential harm to the preferred stakeholder. Settings that call for impartiality are not reliable "boundary conditions" against expressions of bias. In the absence of explicit guidelines for allocating scarce resources, a systematic, objective method of random selection offers a potentially useful strategy.

摘要

道德判断既可能出现在需要公正无私的情境中,也可能出现在允许偏袒的情境中。像医院这样要求公正无私的情境在抑制个人偏见方面效果如何呢?431名大学生被设定为急诊部门的决策者,对大规模枪击事件的两名受害者中哪一位应立即接受挽救生命的治疗做出判断。患者在一些可能揭示偏见的方面存在差异,例如年龄(8岁至80岁)、亲属关系(陌生人与堂兄弟姊妹)、性别(女性与男性)以及反派/英雄(枪手与阻止他的警察)。参与者对每位患者接受立即治疗的道德应得性以及他们选择该患者的可能性进行评分。两个量表都显示年轻人比老年人更受青睐,堂兄弟姊妹(或女儿)比陌生人更受青睐,警察比枪手更受青睐(差异最大)。在一个因跌倒受伤风险高的医院病房场景中,年龄偏见消失了。在跌倒风险适中时,年龄偏见逆转,亲属关系应得性偏见消失。当对偏好的利益相关者潜在伤害的严重程度降低时,偏见也会减少。要求公正无私的情境并非防止偏见表达的可靠“边界条件”。在缺乏分配稀缺资源的明确指导方针的情况下,一种系统、客观的随机选择方法提供了一种可能有用的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/c379600f6a97/fpsyg-13-770020-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/69b4015bbb96/fpsyg-13-770020-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/4bee741b82f5/fpsyg-13-770020-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/fd918d37561a/fpsyg-13-770020-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/c379600f6a97/fpsyg-13-770020-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/69b4015bbb96/fpsyg-13-770020-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/4bee741b82f5/fpsyg-13-770020-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/fd918d37561a/fpsyg-13-770020-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333a/8989733/c379600f6a97/fpsyg-13-770020-g004.jpg

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