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. 2021 Oct 22;16(10):e0259110. doi: 10.1371/journal.pone.0259110

Reduced utilitarian willingness to violate personal rights during the COVID-19 pandemic

Rea Antoniou 1,*, Heather Romero-Kornblum 1,2, J Clayton Young 1, Michelle You 1,3, Joel H Kramer 1, Winston Chiong 1
Editor: Valerio Capraro4
PMCID: PMC8535394  PMID: 34679124

Abstract

The COVID-19 pandemic poses many real-world moral dilemmas, which can pit the needs and rights of the many against the needs and rights of the few. We investigated moral judgments in the context of the contemporary global crisis among older adults, who are at greatest personal risk from the pandemic. We hypothesized that during this pandemic, individuals would give fewer utilitarian responses to hypothetical dilemmas, accompanied by higher levels of confidence and emotion elicitation. Our pre-registered analysis (https://osf.io/g2wtp) involved two waves of data collection, before (2014) and during (2020) the COVID-19 pandemic, regarding three categories of moral dilemmas (personal rights, agent-centered permissions, and special obligations). While utilitarian responses considered across all categories of dilemma did not differ, participants during the 2020 wave gave fewer utilitarian responses to dilemmas involving personal rights; that is, they were less willing to violate the personal rights of others to produce the best overall outcomes.

Introduction

At the time of this writing, there have been over 222 million global confirmed cases of COVID-19 (i.e., Coronavirus Disease 2019 caused by the novel coronavirus SARS-CoV-2) and over 4 million deaths [1]. The risk for severe illness from COVID-19 increases with age, with older adults being at highest risk for death and major disability [2]. As health systems and economies have been overwhelmed in many countries [3], the pandemic has presented policymakers, medical professionals, and laypeople with stark moral dilemmas that often pit the needs and rights of the many against the needs and rights of the few. Understanding how individuals’ moral reasoning is affected by global crises, such as the COVID-19 pandemic, has implications for public policy and communication about health measures.

In addition, many psychological and philosophical theories regarding human moral decision-making offer predictions about how individuals’ moral reasoning is affected by real-world crises. In a recent article advocating for utilitarian approaches to this crisis, Savulescu and colleagues [4] have claimed that “There are no egalitarians in a pandemic,” suggesting the empirical psychological claim that health crises may reduce the salience of non-utilitarian moral considerations. However, some influential accounts of moral cognition suggest instead that broad psychological effects in such a crisis [57], such as perceived threat or mortality salience, would lead people to adopt fewer utilitarian approaches to moral problems. Investigating changes in moral intuitions during the current pandemic, particularly among those (such as older adults) who are at greatest personal risk, can allow us to test the predictions of these theories.

Differentiating utilitarianism from common-sense morality

In everyday life, we often appeal to what Parfit [8] calls "common‐sense morality"—a morality defined by our relationships to particular people, such as our children, parents, friends, patients or fellow‐citizens. Most societies forbid actions such as lying, cheating, stealing, injuring, and killing directed against community members. In contrast with common-sense morality, utilitarianism judges actions solely according to whether they produce the best outcomes, considered impartially.

Utilitarianism departs from common-sense morality in at least three respects [9]. First, in utilitarianism, pursuit of the best overall outcomes is not constrained by respect for personal rights. In situations where the best outcome can only be produced by violating another individual’s rights (such as by harming or killing one person to save five other innocent people), utilitarianism treats such actions as permissible or even obligatory. Second, utilitarianism is highly "demanding," requiring agents to give their own interests no greater weight than other people; thus, often requiring great altruism (e.g., to donate almost all of one’s material possessions to charity). In contrast, common-sense morality incorporates agent-centered permissions allowing agents to give greater weight to their own personal interests. Finally, the same spirit of impartiality means that utilitarianism does not encompass special obligations, which in common-sense morality direct agents to give greater weight to the interests of their own family, friends, patients, clients, students or compatriots than to the interests of those to whom they lack such ties.

Utilitarian and non-utilitarian judgments

Most empirical moral psychological research has focused on contrasting utilitarian and non-utilitarian responses to hypothetical dilemmas involving personal rights [10], also referred to as "personal moral dilemmas" [11] or "sacrificial moral dilemmas" [12]. For example: An epidemic has spread worldwide, killing millions of people. You have developed two substances in your underground shelter. One of them is a cure, but the other one is deadly. You do not know which is which. Two people have run downstairs to your shelter, trying to avoid the epidemic. The only way to identify the cure is to inject each of these people with one of the two substances. One person will live, but the other will die. Then you will be able to start saving lives with the cure. Would you kill one of these people with a deadly injection to identify a cure that will save millions of lives?

While such scenarios have been critiqued as "complex, far-fetched and often convoluted," [12] they have proven highly influential in part because they have robust and reliable neural and psychological effects, in many cases yielding surprising insights into fundamental aspects of neural organization and mental processes [10, 13]. But while some individuals and clinical populations give responses to such dilemmas that are more consistent with utilitarianism than others’, it remains controversial whether such responses represent general utilitarian patterns of moral reasoning. Some evidence suggests that willingness to violate personal rights may be dissociable from impartial concern (as present in utilitarian judgments about dilemmas involving agent-centered permissions and special obligations) [14].

More broadly, making hypothetical decisions regarding particular cases may not entail that a decision-maker accepts the broader tenets of any ethical theory [12]. For the purposes of this and other empirical studies involving hypothetical cases, calling a decision "utilitarian" may only mean that this decision is consistent with utilitarianism, and may leave open various motivational or psychological outlooks that could underlie such choices.

Dual-process theories in moral cognition

One influential account of individual differences in moral reasoning is Greene’s dual-process theory [11, 13]. Informed by broader dual-process models of "intuitive" fast judgments and "deliberative" slow judgments [15, 16], on Greene’s account characteristically deontological (non-utilitarian) judgments are driven by automatic emotional responses, while characteristically utilitarian judgments are driven by controlled cognitive processes. According to Greene’s dual-process model of moral cognition, decisions to avoid causing harm, such as deciding not to administer a lethal injection, reflect more emotionally laden responses to the harm in question; whereas decisions that accept harm to minimize net suffering (thus optimizing aggregate welfare), such as lessening the impact of the epidemic, would reflect more deliberative cognitive control processes [17].

Decisions in personal rights dilemmas are associated with other psychological and emotional phenomena in decision-makers. Prior work [18] suggests that post-decisional emotions elicited by utilitarian options are stronger in moral dilemmas that involve delivering harm personally as opposed to impersonally. In addition, emotions associated with counterfactual comparisons drive decision-making in personal rights moral dilemmas, as people find it aversive both to cause harm [19] and to witness others’ suffering [20]. The ensuing emotions can reduce willingness to cause harm [21], while emotion reappraisal or suppression can attenuate the impact of emotion on non-utilitarian (e.g., harm-avoidance) judgments [16, 21, 22].

Terror management theory and threat perception

The current threat of the COVID-19 outbreak is likely to enhance the emotional salience of death and other personal risks. Prior research drawing on terror management theory suggests that individuals who are primed with thoughts of impending death are less likely to give utilitarian responses on moral conflicts [6]. In a similar vein, disease threat perception is related to sensitivity towards moral violations [5, 7] in domains consistent with common-sense morality (i.e., binding moral domains).

Terror management theory additionally posits that death-related thoughts may lead to existential fear, which can be attenuated by maintaining faith in an internalized cultural worldview. Accordingly, seeking emotional safety in one’s worldview leads to greater confidence in one’s values [23]. Older adults, who are at higher risk for death and disability from COVID-19, may be especially likely to demonstrate these effects.

Hypotheses and research questions

The current study utilizes a unique opportunity to study utilitarian judgments within the context of COVID-19 pandemic. In 2014, we collected older adults’ responses to a series of hypothetical moral dilemmas as part of piloting an online testing platform in an existing research cohort. In March 2020, we preregistered (https://osf.io/g2wtp) a new study utilizing these data by delivering the same moral dilemma instrument to older adults during the 2020 COVID-19 pandemic. This population is of particular interest because older adults are at greatest risk of death and major disability due to this infection [2].

We hypothesized that individuals would give fewer utilitarian responses to moral dilemmas during the 2020 COVID-19 pandemic than prior to this outbreak (Hypothesis 1) and would rate their decisions as made with greater confidence (Hypothesis 2) consistent with terror management theories. Last, we hypothesized that ratings of emotion elicitation would be higher (Hypothesis 3), consistent with dual-process theories.

In our pre-registered primary analyses (https://osf.io/g2wtp), we considered together utilitarian responses to three categories of hypothetical dilemmas: those involving personal rights, agent-centered permissions, and special obligations. Because dilemmas involving personal rights have been the primary focus of the literature to date, and given controversies over the degree to which utilitarian responses to these dilemmas rely upon the same psychological mechanisms as utilitarian responses to dilemmas involving agent-centered permissions and special obligations [14], we also pre-registered planned subsidiary analyses focusing exclusively on the subset of dilemmas involving personal rights.

We had planned a sensitivity analysis restricting the 2020 wave to participants who were personally affected (i.e., described themselves as worried and/or had taken at least two actions in response to the outbreak), but all 2020 participants met this criterion (see Results section below). An additional planned sensitivity analysis re-included all excluded data.

Method

Ethics statement

The Hillblom Aging Network protocol was reviewed and approved by the UCSF Committee on Human Research. This study was conducted in full compliance with the ethical principles set forth by the Declaration of Helsinki. All participants provided written informed consent.

Participants

Our sample was drawn from community-dwelling older adults enrolled in the Hillblom Aging Network, a longitudinal study of healthy brain aging at the University of California, San Francisco (UCSF), Memory and Aging Center. Participants in this cohort are verified as neurologically normal based on a multidisciplinary assessment including a neurological examination, in-person neuropsychological testing, and an informant interview. As part of the Hillblom Aging Network, participants complete online web-based tasks in addition to in-person neuropsychological testing and neuroimaging.

Participants were recruited in two waves of data collection, prior to (2014 wave) and during the COVID-19 pandemic (2020 wave). Participants for the 2020 wave were recruited from the same longitudinal cohort of neurologically healthy older adults, restricted to cohort members that did not participate in the 2014 wave; thus, including participants either newly recruited to the broader cohort study since 2014, or who did not participate in the original data collection.

Some differences between the 2014 and 2020 waves include aesthetic differences in questionnaire formatting and preliminary instructions. Participants in the 2014 wave received a $20 Amazon gift card for completing the instrument; we did not have IRB approval for participant payment in the 2020 wave in the timeframe required for this study, so compensation was omitted. Members of both waves in this cohort received an email inviting them to participate in an online instrument that included the moral reasoning task described below.

Materials

Moral reasoning task

In this task (S1 Appendix), participants read and were asked to make hypothetical decisions regarding twenty-four moral dilemmas from three categories as adapted by Chiong and colleagues [10], as part of a broader instrument on moral reasoning.

1. The Personal Rights (PR) category, composed of eight items, concerned choices in which the best overall outcome could only be produced by violating another individual’s personal rights. For instance, whether to give a deadly injection to one person, which would identify a cure for an epidemic and save millions of people.

2. The Agent-centered Permissions (AP) category, composed of eight items, concerned choices in which the best overall outcome could be produced only at cost to the agent’s own interests. For example, whether to make a donation or keep the money for one’s own personal use.

3. The Special Obligation (SO) category, composed of eight items, concerned choices in which the best overall outcome could only be produced by forgoing opportunities to benefit the agent’s family members, friends, or close others. For example, parental choices in which common-sense morality would prioritize one’s own child’s well-being over the well-being of other children.

They were then asked to rate, on a scale of 1–5, how confident they were in their decision and how emotional they were when making the decision. To ensure task engagement and comprehension, after each hypothetical decision participants were presented with a control question testing comprehension of the details of the dilemma situation (binary format yes/no).

Questions about the personal impact of COVID-19

We also collected responses to questions [24] about the impact of the COVID-19 outbreak on participants who responded in the 2020 wave. The first question assessed how worried respondents were about becoming sick, or about a friend or relative becoming sick, from the coronavirus. The second question assessed whether the participant had taken any of the following actions in response to the pandemic: a) decided not to travel or changed travel plans, b) bought or worn a protective mask, c) stocked up on items such as food, household supplies, or prescription medications, d) stayed home instead of going to work, school, or other regular activities, e) canceled plans to attend large gatherings, such as concerts or sporting events. These questions were used to confirm that participants in the 2020 wave had been personally affected by the outbreak.

Procedure

The survey was administered online through Qualtrics. Participants first read information about the study, where prospective participants were advised about the sensitive nature of the task and that participation was optional. Each subsequent screen contained a moral dilemma, followed by questions assessing confidence/emotionality and a control question. Participants in the 2020 wave also received questions related to the COVID-19 pandemic following completion of the dilemmas. The last page provided a debriefing statement and thanked participants for taking the survey.

Utilizing a pre-registered analytic plan (https://osf.io/g2wtp), for Hypothesis 1 we summed each participant’s utilitarian responses across the PR, AP, and SO categories. The total sum of utilitarian responses was entered as the outcome variable in a linear model with wave, age (mean centered), gender and educational attainment (mean centered) as predictors.

For Hypotheses 2 and 3, we extracted each participant’s mean confidence and emotion elicitation scores across the PR, AP and SO moral categories. These scores were entered as outcome variables in linear models with wave, age, gender, and educational attainment as predictors. In pre-registered subsidiary analyses, we repeated these analyses using only responses to the PR category of moral dilemmas. Analyses were performed using the statistical programming language R [25].

Exclusion criteria

We excluded data from participants that:

  1. Incorrectly answered seven or more out of twenty-four control questions.

  2. Did not give an answer to one (or more) moral dilemma.

  3. Did not give an answer to one (or more) moral dilemma’s follow up questions regarding emotionality and confidence.

Results

We recorded responses of 281 older adults. We excluded 17 participants that incorrectly answered seven or more out of twenty-four control questions (2014 wave = 12, 2020 wave = 5) and 23 participants that did not give an answer to one (or more) moral dilemma (2014 wave = 10, 2020 wave = 13). For Hypotheses 2 and 3, we additionally excluded 55 participants that did not give an answer to one (or more) moral dilemma’s follow up questions regarding emotionality (2014 wave = 11, 2020 wave = 23) and confidence (2014 wave = 10, 2020 wave = 11).

Some participants met more than one exclusion criterion and thus can be counted more than once (e.g., for not giving a response to one or more moral dilemma and for missing seven out of twenty-four control questions).

Demographics

Descriptive statistics for the eligible sample are provided in Table 1. Reflecting the research cohort from which the sample was derived, the study sample was highly educated and predominantly white, with a mean age of 76.

Table 1. Descriptive statistics: Age, education, gender, and race.

Demographics 2014 wave 2020 wave Total p
Age .243
Mean (SD) 76.8 (6.0) 75.9 (6.1) 76.3 (6.0)
Education .329
Mean (SD) 17.8 (2.1) 17.6 (1.9) 17.7 (2.0)
Gender .170
Male 66 (52.8%) 58 (43.6%) 124 (48.1%)
Female 59 (47.2%) 75 (56.4%) 134 (51.9%)
Race .005
White 121 (96.8%) 114 (85.7%) 235 (91.1%)
Asian 4 (3.2%) 11 (8.3%) 15 (5.8%)
Other Race 0 (0.0%) 4 (3.0%) 4 (1.6%)
Black/African American 0 (0.0%) 4 (3.0%) 4 (1.6%)

Note: Descriptive statistics for participants who met inclusion criteria (N = 258) in the 2014 wave (N = 125) and 2020 wave (N = 133). Continuous variables of age and education are represented as mean (standard deviation), with p values from t-tests between waves; categorical variables of gender and race as count (percentages) with p derived from Fisher’s exact test between waves. One observation was missing for the education variable (N = 257).

Personal impact of COVID-19

The majority of respondents in the 2020 wave were personally affected by the COVID-19 outbreak, most reporting worry and all adopting precautions against the pandemic (Tables 2 and 3; S1 Table).

Table 2. Descriptive statistics: Worry about COVID-19.

Worry 2020 wave
Very worried 22 (16.5%)
Somewhat worried 73 (54.9%)
Not too worried 33 (24.8%)
Not at all worried 3 (2.3%)
(Missing) 2 (1.5%)

Note: Descriptive statistics for worry are represented as mean (percentages) for participants who met the inclusion criteria in the 2020 wave (N = 133). Participants were asked to respond the question: How worried, if at all, are you that you or someone in your family or close friends will get sick from the coronavirus?.

Table 3. Descriptive statistics: Frequency of actions adopted against COVID-19.

N Frequency % Total % Total Cum.
5 70 52.63 52.63
4 45 33.83 86.47
3 13 9.77 96.24
2 5 3.76 100.00

Note: Descriptive statistics for the frequency of actions adopted are represented as count, frequency, percentages, and cumulative percent for participants who met the inclusion criteria in the 2020 wave (N = 133).

Utilitarian judgments—overall and in personal rights dilemmas

In a linear regression analysis including wave, age, gender and educational attainment as predictors, utilitarian responses to dilemmas from all three categories (PR, AP and SO) were not significantly associated with wave (Table 4 and Fig 1).

Table 4. Utilitarian responses—All dilemmas.

Term Estimate SE 95% CI t p
LL UL
Intercept 15.41 0.34 14.74 16.08 45.35 < .001
Wave (2020) -0.39 0.39 -1.17 0.38 -1.00 .32
Age (years) 0.04 0.03 -0.02 0.11 1.33 .18
Education (years) -0.02 0.10 -0.22 0.18 -0.17 .87
Female gender 0.22 0.40 -0.57 1.01 0.55 .58

Note: The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following rows. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 257).

Fig 1. Utilitarian responses—All dilemmas.

Fig 1

This violin plot represents the distribution of utilitarian responses in all three moral categories before (2014 wave) and during (2020 wave) the COVID-19 pandemic. The black dots represent the means with 95% confidence intervals (N = 258).

However, utilitarian responses to dilemmas in the personal rights category differed significantly (p = .001) across waves (Table 5 and Fig 2); out of eight dilemmas in this category, participants in the 2020 wave gave 0.72 fewer utilitarian responses after adjusting for age, gender and education.

Table 5. Utilitarian responses—Personal rights dilemmas.

Term Estimate SE 95% CI t p
LL UL
Intercept 5.52 0.19 5.14 5.90 28.51 < .001
Wave (2020) -0.72 0.22 -1.16 -.28 -3.24 .001
Age (years) 0.03 0.02 0.00 0.07 1.75 .08
Education (years) 0.01 0.06 -0.11 0.12 0.12 .91
Female gender -0.08 0.23 -0.53 0.37 -0.35 .73

Note: The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following rows. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 257).

Fig 2. Utilitarian responses—Personal rights dilemmas.

Fig 2

This violin plot represents the distribution of utilitarian decisions in the personal rights (PR) category of moral dilemmas before (2014 wave) and during (2020 wave) the COVID-19 pandemic. The black dots represent the means with 95% confidence intervals (N = 258).

In sensitivity analyses re-including data from 17 excluded participants, who incorrectly answered seven or more out of twenty-four control questions, estimated coefficients and p values differed only trivially (statistical significance of effects was unchanged). In addition, to examine whether the findings were driven by self-reported worry about COVID-19 pandemic, we repeated our analyses by splitting the sample (2020 wave) in two categories: Worried (by collapsing Very worried and Somewhat worried levels, see Table 2) and Not worried (by collapsing Not too worried and Not at all worried levels, see Table 2). Estimated coefficients and p values differed only trivially with no significant effect of level of worry on utilitarian responses (overall and in personal rights dilemmas).

Confidence and emotion elicitation—overall and in personal rights dilemmas

In responses to dilemmas from all three categories (PR, AP and SO), confidence and emotion elicitation did not differ significantly across waves (p = .39 and p = .61, respectively). Confidence was negatively associated with female gender (b = -0.23, t(237) = -3.03, p = .003) and emotion elicitation was positively associated with female gender (b = 0.33, t(237) = 3.37, p < .001) across waves (S2 and S3 Tables). In addition, confidence was negatively associated with educational attainment across waves (b = -0.04, t(237) = -2.07, p = .04).

In analyses restricted to the personal rights category of dilemmas (S4 and S5 Tables), emotion elicitation and confidence did not differ significantly across waves (p = .82 and p = .35, respectively), but were associated with gender (emotion elicitation: b = 0.48, t(237) = 3.77, p < .001; confidence: b = -0.47, t(237) = -4.61, p < .001).

Discussion

In this preregistered study, we examined individual judgments about hypothetical moral dilemmas during a global health crisis in a cohort of older adults at increased personal risk of severe complications from infection. We found that utilitarian judgments were not broadly affected by the COVID-19 pandemic, but that participants did make fewer utilitarian judgments about dilemmas involving conflicts between personal rights and the best overall outcome. Because emotion elicitation was not affected by the COVID-19 pandemic (both in analyses for all dilemmas and personal rights dilemmas), we did not find evidence that decreased utilitarian judgment in personal rights dilemmas was mediated by greater emotional elicitation in moral judgment, as suggested by dual-process theories. However, a dual-process specification of terror management theory posits that mortality salience and threat perception may promote non-utilitarian reasoning by depleting cognitive resources rather than by enhancing emotional elicitation, and our findings are congruent with the experimental manipulation by Trémolière and colleagues [6].

On the other hand, it is noteworthy that this finding was not observed for utilitarian judgments generally, but instead only for judgments about personal rights dilemmas. On dual-process accounts of moral cognition, it seems that utilitarian responses to agent-centered permissions (AP) and special obligations (SO) dilemmas should demand cognitive resources in a way analogous to personal rights (PR) dilemmas, and so should be similarly affected. This observed dissociation provides indirect support for psychological accounts that distinguish utilitarian willingness to harm from utilitarian impartial concern [12, 14].

Expressed confidence in moral judgments was also not affected by the COVID-19 pandemic, as expected by terror management theories. Gender was not a focus of our preregistered analysis, but we did observe that females reported less confidence in judgments and greater emotion elicitation than males; however, there was no effect of gender on utilitarian judgment whether examined across all dilemmas or only within personal rights dilemmas. Whether these differences reflect gender differences in the actual experience of confidence and emotion, or differences (e.g., due to socialization) in self-reporting of confidence and emotion, is unclear; particularly in the absence of gender differences in the primary outcome of interest (i.e., utilitarian decisions). Educational attainment was nominally associated with decreased reported confidence in moral judgments, although this effect was not a focus of our preregistered analysis, would not persist if adjusted for multiple comparisons, and also was not associated with differences in utilitarian judgment.

While age‐related alterations in decision making are mostly associated with declines in deliberative abilities [26], whether moral judgements during the pandemic are susceptible to this effect is controversial. For instance, it has been hypothesized that older adults exhibit a reduced tendency to make utilitarian judgments due to working memory decline and affective processing improvement [27, 28]. Those accounts draw from dual process models of moral cognition and suggest that older adults make more deontological (i.e., less utilitarian) judgments due to the mediation of negative affective reactions [28]. Our study in both waves of data collection did not find a link between emotional elicitation and diminished utilitarian judgment (overall and in personal rights dilemmas), suggesting that age related differences in dual process frameworks do not explain our finding. Of note, in a recent study measuring demographic factors that may affect moral judgments during the pandemic, age was negatively associated with utilitarian judgments reflecting equitable public health and positively related with judgments maximizing human life expectancy [29], indicating possibly more complex influences of age on moral considerations in the current pandemic.

A principal limitation of the present study is the asymmetry of our samples between the 2014 and 2020 wave. For instance, most participants in the 2020 wave had changed their lives in at least two ways in response to the pandemic (increased level of worry and adopting a measure against COVID-19), which prevents having a true control group (i.e., older adults with no fear of the pandemic). Another important limitation constitutes the demographic homogeneity of our study sample, which was largely white and highly educated. Racial and ethnic minorities comprise an estimated 23% of the older adult population within the United States [30], and Black and Latino populations have been disproportionately affected by the COVID-19 pandemic [31]. The generalizability of our findings to populations with the greatest burden of illness may then be limited, particularly given other known sociocultural influences on moral judgment [32]. Still, questions about the personal impact of the pandemic in the 2020 wave indicate that participants in our sample were affected, with most reporting worry and all reporting practical measures such as mask-wearing and refraining from regular activities outside the home.

A further limitation was that, because the 2020 wave was collected in an actual pandemic and not in the setting of a laboratory manipulation, some forms of experimental control were not available to exclude alternative explanations for differences between waves. The effects we observed could be attributable to other psychological, cultural, economic and political changes between task administration in 2014 and 2020. Also, given logistical constraints in promptly responding to the 2020 pandemic, we could not match all test features between waves (as in the gift card given to participants in the 2014 wave). This could produce biases due to differential study enrollment in the 2014 versus 2020 wave of data collection and altered responses to the moral dilemmas tested, where the direction of such effects are unknown. We note that the observed effect was large (adjusted 0.72 out of 8 possible responses); it would be unexpected and itself interesting if this effect could be attributed to more general trends over a short cultural timescale or subtle differences in task features. Meanwhile, our questions about personal impact confirm that the COVID-19 pandemic was highly significant to our participants, all of whom were older adults at high risk of death and disability from the coronavirus.

Our findings are in opposition with those reported by Francis and McNabb in a recent preprint [33]. These authors fielded a similar online instrument on a crowd working platform that included 14 personal rights dilemmas in August 2019 and in April 2020 yet did not find significant differences in the number of utilitarian responses prior to and during the COVID-19 pandemic. Several differences between our study and this study may account for this discrepancy in findings. The Francis and McNabb study utilized a within-subjects rather than between-subjects design in a smaller number of participants (N = 83). Because consistency in moral judgment is itself morally valued [34], administering the same questionnaire twice within 9 months could induce consistency effects. Participants in their study were substantially younger (M = 35.5, SD = 12.6) and therefore generally at much lower risk of death and major morbidity from the COVID-19 pandemic than participants in the present study.

It is important to contextualize our main finding, i.e., participants during the COVID-19 pandemic gave fewer utilitarian judgments in personal rights dilemmas. Meanwhile, another observed moral trend was broad adoption of utilitarian principles in facets of the healthcare domain [35], suggesting a shift from a more individualistic, notably deontological (non-utilitarian) medical approach to a focus on the net health benefit to populations (i.e., overall welfare). Our finding and this trend might not be mutually exclusive. Operating during a crisis with limited resources might demand clinicians to endorse utilitarian decisions (e.g., favoring treatment for younger over older individuals), without necessarily indicating an associated utilitarian willingness to violate personal rights. Non-utilitarian and utilitarian considerations may engage distinct social and individual ramifications depending on actors’ roles in a health-crisis context. Other contextual factors, including regional variations in COVID-19 severity, could also affect the salience of different moral and public health considerations during this health crisis [29].

In summary, the present study represents a unique opportunity to examine utilitarian judgments during a global health crisis. Respondents during the COVID-19 pandemic gave fewer utilitarian responses to hypothetical dilemmas concerning conflicts between individual personal rights and the best overall outcome. This finding indicates a reluctance to promote the best overall outcome when individual personal rights are at stake. This finding has important implications for policy decisions and public communication about pandemic-related issues such as clinical research, compulsory vaccination and enforced quarantines, in which such tradeoffs can arise. This finding is also noteworthy for psychological accounts of human moral reasoning that generate testable predictions about how global crises may affect individuals’ judgments about cases. To that end, a reduced utilitarian willingness to violate individual rights for the greater good might reflect an intrinsic humanness and consideration for others as discrete individuals which is activated during times of crisis.

Supporting information

S1 Appendix. Moral reasoning task.

Moral reasoning task with the follow up questions on confidence/emotionality and the control question, categorized by moral category: Non-Moral (NM), Impersonal Moral (IM), Personal Right (PR), Agent-centered Permissions (AP), and Special Obligations (SO). Per our pre-registered analysis, only responses to PR, AP and SO dilemmas are reported in this paper.

(RTF)

S1 Table. Descriptive statistics: Actions adopted against COVID-19.

Descriptive statistics for the actions adopted are represented as count (percentages) for participants who met the inclusion criteria in 2020 wave (N = 133).

(DOCX)

S2 Table. Self-reported confidence—All dilemmas.

The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

(DOCX)

S3 Table. Self-reported emotionality—All dilemmas.

The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

(DOCX)

S4 Table. Self-reported emotionality—Personal rights dilemmas.

The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

(DOCX)

S5 Table. Self-reported confidence—Personal rights dilemmas.

The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

(DOCX)

Acknowledgments

The authors thank the Hillblom Aging Network study volunteers for their generous contributions to our research, particularly during the COVID-19 pandemic. We thank Agnieszka Jaworska and Ryan Preston-Roedder for philosophical review of the content of tested dilemmas.

Data Availability

De-identified behavioral data (https://osf.io/w9r4b/) are available in the Open Science Framework repository.

Funding Statement

The authors received funding by the National Institutes of Health-National Institute on Aging (R01AG058817 and R01AG022983) and by the Larry L. Hillblom Foundation (2018-A-006-NET).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Decision Letter 0

Valerio Capraro

25 Jun 2021

PONE-D-21-14926

No utilitarians in a pandemic? Shifts in moral reasoning during the COVID-19 global health crisis

PLOS ONE

Dear Dr. Antoniou,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please find below the reviewers' comments, as well as those of mine.

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Valerio Capraro

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Additional Editor Comments (if provided):

I have now collected two reviews from two experts in the field, whom I thank for their detailed and thoughtful reviews. Both reviewers think that the paper has potential, but they suggest major changes before it can be published. The main change regards the acknowledgement of the fact that you do not really have a control group, so you cannot make any causal statement. One of the reviewer even suggests to collect additional data. I don't feel strong about this, but I agree with the reviewer that the paper would greatly improve with more data. However, I won't make my decision conditional on this. Needless to say that also the other comments should be addressed. I also have a couple more comments, one regarding the section on dual process theories of moral reasoning. I have a review article on the topic, which you might find useful, as it covers virtually all the literature on the topic (Capraro, 2019). Also, the perspective article on what social and behavioural science can do to support pandemic response, published by Van Bavel et al in Nature Human Behaviour might be a useful general reference. Of course, it is not a requirement to cite these works, but I'm mentioning them because they look very related.

I am looking forward for the revision.

Van Bavel, J. J., et al. (2020). Using social and behavioural science to support COVID-19 pandemic response. Nature Human Behaviour, 4, 460-471.

Capraro, V. (2019). The dual-process approach to human sociality: A review. Available at SSRN 3409146.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: Review PONE-D-21-14926

The authors present a pre-registered study comparing a 2014 sample with a 2020 sample on moral utilitarianism. The authors rely on the terror management theory to predict that old people more at risk during the pandemic (2020 sample) should be less utilitarian more confident in their choices and should experience greater emotion than old people (associated in age) in 2014. The authors test these predictions on three categories of moral dilemmas (personal rights, agent-centered permissions, and special obligations). The main difference observed (which was also preregistered) was a difference to personal rights moral dilemmas (which commonly require to harm/kill someone for the greater good), a result consistent with the predictions from the dual-process specification of terror management theory. No differences between the two waves are observed for confidence and emotion elicitation.

The paper is well-written, concise, and the research question is clearly defined. Overall, I’m quite positive toward seeing this paper published, given some amendments, some of which are important however. Yet, I feel like it is a timely publication, which has the merit to crosspollinate the use of fictitious sacrificial dilemmas which largely lack ecological validity, yet with a real-world impacting context (COVID-19 pandemic). I have a few suggestions which I think should be addressed to increase the appeal of the paper.

An important weakness of the research is the absence of a true control group (old people with no fear of the COVID-19). The participants were drawn from the part of the Hillblom Aging Network, and I’m left puzzled why the authors did not try to collect additional data selecting participants from the network who did not exhibit anxiety signs regarding COVID-19. As a result, this decreases the appeal of the results. I leave the editor with the decision to collect additional data or not, but at least this should be included as a critical limitation (what if old people without fear/anxiety toward COVID-19 showed the same decrease in moral utilitarianism to sacrificial moral dilemmas?).

Another weakness of the paper is the discussion section. Regarding the context, much more could be said about moral utilitarianism during the COVID-19 pandemic. The results presented in this paper are interesting: old people are less utilitarian in the context of COVID-10 pandemic. Yet this is something quite opposed to what happens worldwide: health care provided have come in several states to endorse utilitarianism because of a lack of resources (for instance, by favoring the young at the expense of the older). Although I’m aware that this is not the very same topic, some discussion might be interesting and might help improve the discussion section. Finally, what is the take-home message of your research? Why is it an important one? (I personally think that it is an important research). The discussion section should answer more thoroughly such questionings.

References:

Vearrier, L., & Henderson, C. M. (2021, June). Utilitarian principlism as a framework for crisis healthcare ethics. In Hec Forum (Vol. 33, No. 1, pp. 45-60). Springer Netherlands.

Minor:

Unless this is a requirement from the journal, please replace “Material and method” by Method. Material is a subsection of Method.

Please format all the Tables according to the APA7 guidelines

I wish the authors good luck with their research.

Reviewer #2: This paper, “No utilitarians in a pandemic? Shifts in moral reasoning during the COVID-19 global health crisis” by Antoniou et al. presents the results of a pre-registered study analyzing moral judgements made by older adults in response to hypothetical dilemmas collected in two waves: one in 2014 and the other one during 2020. Dilemmas had three moral categories: Personal Rights (PRs), Agent-centered Permissions (APs), and Special Obligations (SOs).

Results show that participants’ responses did not change substantially when considering all three categories, but there was a significant difference in the direction hypothesized by the authors when restricting the analysis to just the PR category. Ratings of the emotion elicited by the decision did not significantly change.

There are several things to like about this paper, including the comparison of moral decisions in a time window pre- versus post- pandemic onset. The topic is timely and relevant and the statistical analyses are sound. The authors should also be commended for clearly outlining their hypotheses and pre-registering their analyses before collecting the second wave of data. However, there are several weak points in the manuscript which the authors need to address before I could recommend publication. These issues, some of which are major points, are entirely about the way in which the authors framed the paper and the interpretation of the observed results.

Major issues:

1- Causal interpretation: Several parts of the paper suggest that the authors are interpreting these findings in a causal way. Abstract: “We investigated the influence of…” (line 30) or Discussion: “we examined the effect of a global health crisis on…” (line 327). This study is 100% observational and the authors need to be clear and upfront about this. Moreover, they should avoid using terms such as “influence” or “effect” of the pandemic on moral choices given that the pandemic is not an experimental treatment. In one paragraph in the Discussion (lines 369-381), the authors acknowledge that many things happened between 2014 and 2020 and that the effect cannot be attributed to only the pandemic. (For example, could this study have been re-written as “No utilitarians during the Trump administration”?). Even if the results would have shown a clear and strong change in moral responses (which is not the case), this study cannot speak about the causal effect of the pandemic on moral choices (after all, it would be impossible to have such experimental treatment and the observational data presented here is clearly insufficient to suggest a causal role played by the pandemic). Similarly, this implies that this study cannot be thought of as a “real-world replication of the experimental manipulation in Tremoliere and colleagues” (line 339) since there is no experimental manipulation here.

2- Pre-registration: the main result inspiring the title and the take-home message of the paper is based on one of the three categories of moral dilemmas (PRs). The authors claim to have planned and pre-registered “subsidiary analyses focusing exclusively on the subset of dilemmas involving personal rights” (line 159). However, the registry in the Open Science Framework (https://osf.io/g2wtp) does not support that claim. There is no mention to such subsidiary analysis which suggests that the focus on dilemmas involving PRs was indeed exploratory. Therefore, the significant result found using PR dilemmas should be labeled in that way. There is nothing inherently wrong with the data not supporting the main hypothesis and to try publishing the results of a subsequent exploratory analysis, but the authors should be explicit about it. Given that this is a pre-registered study, every analysis that was not described in the registry should be labeled as exploratory.

3- Issues with the title: The title is misleading and problematic in at least three ways. First, the question “No utilitarians in a pandemic?” cannot be answered unless making a massive overstatement of the findings in the paper. The main result is that there is no overall change in utilitarian decision-making during the pandemic (i.e., results do not support the hypothesis H1 pre-registered by the authors), as 2 out of 3 categories of moral dilemmas show no significant difference.

Second, a shift in utilitarian decision-making does not imply that there is a shift in moral “reasoning”. As the authors correctly pointed out in lines 102-106, people might make utilitarian decisions for a variety of reasons that may or may not include engaging in utilitarian reasoning. In fact, DP theories (lines 107-126) suggest that making non-utilitarian decisions is consistent with a process different than reasoning, namely, emotional harm avoidance. So, one should not assume that the mechanism underlying the reduction in utilitarian choices is a “shift in moral reasoning” unless the data is accompanied by observations that support such mechanistic interpretation. Instead of presenting more data to test this mechanism, the authors could simply use mechanism-neutral language and refer to utilitarian “judgements” or “decisions”.

Third, it is also inaccurate to portrait participants making utilitarian decisions as “utilitarians”. While there are some stable individual differences in utilitarian thinking, recent studies in the literature suggest that terms such as “deontological” or “utilitarian” describe decisions made by people rather than people itself. This is because lay people (unlike philosophers) may make utilitarian choices without necessarily engaging in utilitarian thinking (Conway et al., 2018). Instead, it is more accurate to refer to participants as “people making utilitarian choices” or “utilitarian decision-makers” or “people making utilitarian judgements”, etc.

Other points:

4- External validity of the findings: This work studies moral responses made by individuals who are older than most participants in psychological research. This leaves open the question of whether and how these results are present in other populations. While the authors do not necessarily need to address this with more data, they should flag the possibility that age differences could play an important role in moral judgements. For example, a recent pre-print (Navajas et al., 2020, https://osf.io/ktv6z) found that moral decisions about dilemmas of the COVID-19 crisis correlate with utilitarian decision-making in hypothetical scenarios. Importantly, these utilitarian decisions became more prevalent in participants proceeding from countries where the crisis was more severe. Therefore, one could argue that such observations support the idea that a more dangerous context correlates with making more utilitarian decisions. This apparent discrepancy between empirical observations across studies could stem from the use of different methodologies but also from the measurement of utilitarian choices in populations which are very different in terms of age.

5- Limitations: When describing the limitations of the present work in the Discussion, the authors should also add the fact that there were different economic incentives to participate in the study in the 2014 versus 2020 wave of data collection.

6- Introduction (lines 52-60): please expand on the arguments made by competing theoretical predictions. What does it mean when Savulescu and colleagues claim “There are no egalitarian in a pandemic”?

**********

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Reviewer #1: No

Reviewer #2: No

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PLoS One. 2021 Oct 22;16(10):e0259110. doi: 10.1371/journal.pone.0259110.r002

Author response to Decision Letter 0


28 Jul 2021

Dear Dr. Valerio Capraro,

Thank you for giving us the opportunity to submit a revised draft of the manuscript titled “No utilitarians in a pandemic? Shifts in moral reasoning during the COVID-19 global health crisis” to PLOS ONE. We appreciate the time and effort that you and the reviewers have dedicated to providing your valuable feedback on this manuscript. We are grateful to the reviewers for their insightful comments on the paper. We have been able to incorporate major changes to reflect the suggestions provided by the reviewers. Below you may find a point-by-point response to the reviewers’ comments and concerns.

Comments from Reviewer 1

Comment 1: An important weakness of the research is the absence of a true control group (old people with no fear of the COVID-19). The participants were drawn from the part of the Hillblom Aging Network, and I’m left puzzled why the authors did not try to collect additional data selecting participants from the network who did not exhibit anxiety signs regarding COVID-19.

Response 1: Thank you for this suggestion. In the preregistration (https://osf.io/g2wtp), for this reason we had proposed conducting a sensitivity analysis only including wave 2 participants who either (1) described themselves as either very worried or somewhat worried about the coronavirus outbreak, or (2) have taken at least two of the five described possible responses to the coronavirus outbreak. However, all respondents in wave 2 met criterion (2) of having taken at least two of the five possible responses to the pandemic, so this analysis would have been superfluous; more broadly, we conclude that all of the participants in wave 2 were practically affected by concerns about the pandemic. For this reason, the primary comparison was between the wave 1 cohort prior to the pandemic and the wave 2 cohort during the pandemic, although this does not exclude all other potential differences between cohorts. (At the same time, we note that a selected subgroup of older adults during COVID-19 that were unafraid of COVID-19 would itself have unique features distinguishing it from the wave 1 cohort, such that this might itself have introduced other uncontrolled differences in risk tolerance or anxiety.) To address the reviewer’s concerns given the patterns of response in our cohorts, we have conducted the following:

• While all of our wave 2 respondents met our prespecified criterion for being affected by the pandemic, we have conducted a further analysis to examine how different degrees of anxiety affect utilitarian responses (see “Result” section “Utilitarian judgments - overall and in personal rights dilemmas” lines 305-313). For this we split the sample of the 2020 wave in two categories: Worried (by collapsing the levels: Very worried and Somewhat worried) and Not worried (by collapsing the levels: Not too worried and Not at all worried). Estimated coefficients and p values differed only trivially with no significant effect of low level of worry on utilitarian responses.

• Emphasized this point and the asymmetry of our sample in our discussion (see “Discussion” section lines 368-372). Most participants in the 2020 wave had changed their lives in at least two ways in response to the pandemic (reporting worry and adopting a measure), which naturally evokes an asymmetry between the two samples.

Comment 2: Regarding the context, much more could be said about moral utilitarianism during the COVID-19 pandemic. The results presented in this paper are interesting: old people are less utilitarian in the context of COVID-10 pandemic. Yet this is something quite opposed to what happens worldwide: health care provided have come in several states to endorse utilitarianism because of a lack of resources (for instance, by favoring the young at the expense of the older). Although I’m aware that this is not the very same topic, some discussion might be interesting and might help improve the discussion section.

Response 2: We agree with this suggestion and we have, accordingly, revised the discussion to emphasize this point (see “Discussion” section lines 420-430). We added a paragraph combining our findings and the points raised in the proposed reference: “Vearrier, L., & Henderson, C. M. (2021, June). Utilitarian principlism as a framework for crisis healthcare ethics. In Hec Forum (Vol. 33, No. 1, pp. 45-60). Springer Netherlands.”

Comment 3: Finally, what is the take-home message of your research? Why is it an important one? The discussion section should answer more thoroughly such questionings.

Response 3: We agree with this and we have included your suggestion throughout the in the discussion section. We elaborated the discussion by emphasizing why this research is important and which the associated implications are (see “Discussion” section lines 431-442).

Comment 4: Unless this is a requirement from the journal, please replace “Material and method” by Method. Material is a subsection of Method.

Response 4: According to the journal’s requirements this element (Material and Method) can be renamed as needed. We have thus incorporated your suggestion throughout the manuscript (see “Method” section line 167).

Comment 5: Please format all the Tables according to the APA7 guidelines

Response 5: Thank you so much for your suggestion. We have followed the journal’s guidelines for tables (https://journals.plos.org/plosone/s/tables and https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf), which depart slightly from the APA7 guidelines. (For example, the journal’s guidelines call for the title to be on the same line as the table number, and also display borders and lines separating each cell.)

Comments from Reviewer 2

Comment 1: Several parts of the paper suggest that the authors are interpreting these findings in a causal way. Abstract: “We investigated the influence of…” (line 30) or Discussion: “we examined the effect of a global health crisis on…” (line 327). This study is 100% observational and the authors need to be clear and upfront about this. Moreover, they should avoid using terms such as “influence” or “effect” of the pandemic on moral choices given that the pandemic is not an experimental treatment. In one paragraph in the Discussion (lines 369-381), the authors acknowledge that many things happened between 2014 and 2020 and that the effect cannot be attributed to only the pandemic. Even if the results would have shown a clear and strong change in moral responses (which is not the case), this study cannot speak about the causal effect of the pandemic on moral choices (after all, it would be impossible to have such experimental treatment and the observational data presented here is clearly insufficient to suggest a causal role played by the pandemic). Similarly, this implies that this study cannot be thought of as a “real-world replication of the experimental manipulation in Tremoliere and colleagues” (line 339) since there is no experimental manipulation here.

Response 1: Thank you for pointing this out. We agree with this comment. Therefore, we have changed the causal tone (by replacing words like effect or influence) with words that reflect better the observational nature of our study (e.g., context):

• in the “Abstract” (see lines 29-31): “We investigated moral judgments in the context of the contemporary global crisis among older adults, who are at greatest personal risk from the pandemic.”

• in the “Hypotheses and research questions” (see lines 143-144): “The current study utilizes a unique opportunity to study utilitarian judgments within the context of COVID-19 pandemic.”

• in the “Discussion” (see lines 336-338, 428-430, 431-434): e.g., “In this preregistered study, we examined individual judgments about hypothetical moral dilemmas during a global health crisis in a cohort of older adults at increased personal risk of severe complications from infection.” & “Non-utilitarian and utilitarian considerations may engage distinct social and individual ramifications depending on actors’ roles in a health-crisis context.” & “In summary, the present study represents a unique opportunity to examine utilitarian judgments during a global health crisis. Respondents during the COVID-19 pandemic gave fewer utilitarian responses to hypothetical dilemmas concerning conflicts between individual personal rights and the best overall outcome.”

We have accordingly removed our suggestion that this study can be thought of as a “real-world replication of the experimental manipulation in Tremoliere and colleagues” (see lines 347-348)

Comment 2: The main result inspiring the title and the take-home message of the paper is based on one of the three categories of moral dilemmas (PRs). The authors claim to have planned and pre-registered “subsidiary analyses focusing exclusively on the subset of dilemmas involving personal rights” (line 159). However, the registry in the Open Science Framework (https://osf.io/g2wtp) does not support that claim. There is no mention to such subsidiary analysis which suggests that the focus on dilemmas involving PRs was indeed exploratory. Therefore, the significant result found using PR dilemmas should be labeled in that way. There is nothing inherently wrong with the data not supporting the main hypothesis and to try publishing the results of a subsequent exploratory analysis, but the authors should be explicit about it.

Response 2: We appreciate this comment; the analysis restricted to PR dilemmas is labeled a “sensitivity analysis” in the preregistration (second to last paragraph): “we will repeat the primary analyses for hypotheses 1-3, but restricted to responses to PR dilemmas (which have been the main focus of dual process moral theories to date).” For this reason, we have first reported the primary analysis including dilemmas from all categories, before reporting the PR results. The PR-restricted analyses are planned and not post hoc.

Comment 3: The title is misleading and problematic.

Response 3: We agree, and we changed the title accordingly to reflect better the take home message of our study: “Reduced Utilitarian Willingness to Violate Personal Rights during the COVID-19 Pandemic”. See lines 3-4. We additionally have changed the subtitle of the study to: “Utilitarian Judgements during COVID-19” (see heading throughout the manuscript).

Comment 4: As the authors correctly pointed out in lines 102-106, people might make utilitarian decisions for a variety of reasons that may or may not include engaging in utilitarian reasoning. In fact, DP theories (lines 107-126) suggest that making non-utilitarian decisions is consistent with a process different than reasoning, namely, emotional harm avoidance. So, one should not assume that the mechanism underlying the reduction in utilitarian choices is a “shift in moral reasoning” unless the data is accompanied by observations that support such mechanistic interpretation. Instead of presenting more data to test this mechanism, the authors could simply use mechanism-neutral language and refer to utilitarian “judgements” or “decisions”.

Response 4: Thank you for pointing this out. We have accordingly replaced the moral reasoning term to utilitarian judgments in:

• subheadings of the “Introduction” (see line 84)

• the section “Hypotheses and research questions” (see lines 143-144)

• in the “Discussion” (see lines 431-432)

Comment 5: This work studies moral responses made by individuals who are older than most participants in psychological research. This leaves open the question of whether and how these results are present in other populations. While the authors do not necessarily need to address this with more data, they should flag the possibility that age differences could play an important role in moral judgements.

Response 5: Thank you for pointing this out. We have incorporated an additional paragraph in the “Discussion” addressing this issue. See lines 382-391.

Comment 6: In the discussion authors should also add the fact that there were different economic incentives to participate in the study in the 2014 versus 2020 wave of data collection.

Response 6: Thank you for pointing this out. See in the “Discussion” section lines 396-401: “Also, given logistical constraints in promptly responding to the 2020 pandemic, we could not match all test features between waves (as in the gift card given to participants in the 2014 wave). This could produce biases due to differential study enrollment in the 2014 versus 2020 wave of data collection, though at first glance the absence of a personal financial incentive in the second wave might have been expected to select for a more rather than less utilitarian cohort.”

Comment 7: Please expand on the arguments made by competing theoretical predictions. What does it mean when Savulescu and colleagues claim “There are no egalitarian in a pandemic”? (lines 52-60)

Response 7: Thank you for this comment; we have elaborated on the relevance of Savalescu’s claim to our research question. See lines 55-58 “In a recent article advocating for utilitarian approaches to this crisis Savulescu and colleagues [4] have claimed that “There are no egalitarians in a pandemic,” suggesting the empirical psychological claim that health crises may reduce the salience of non-utilitarian moral considerations.”

Additional clarifications

In addition to the above comments, we appreciate your suggestion to collect more data. However, given the unique opportunity to test participants inside and outside of a historic global pandemic, we were not able to collect further data that illuminate our key questions.

We look forward to hearing from you in due time regarding our submission and to respond to any further questions and comments you may have.

Attachment

Submitted filename: Response to Reviewers.docx

Decision Letter 1

Valerio Capraro

6 Sep 2021

PONE-D-21-14926R1No utilitarians in a pandemic? Shifts in moral reasoning during the COVID-19 global health crisisPLOS ONE

Dear Dr. Antoniou,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Kind regards,

Valerio Capraro

Academic Editor

PLOS ONE

Additional Editor Comments:

One of the reviewers feel that their comments were not satisfactorily addressed and (re)suggest major revision. Therefore, I would like to invite you to revise your manuscript again. In your response letter, please respond to all reviewer's comments.

I am looking forward for the revision.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: (No Response)

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The authors have addressed most of my previous concerns.

First, I would like to apologize for missing the part of the pre-registration where they stated the subsidiary analysis reported in this work. I do believe now that, although it was not the main point of the pre-registration, the result based on PR dilemmas was planned.

I have, however, two more comments about this revised version of the manuscript:

1- When you discuss the potential role of incentives in partially explaining the different results between cohorts you state: “though at first glance the absence of a personal financial incentive in the second wave might have been expected to select for a more rather than less utilitarian cohort.” Do we know how people vary in their responses to PR dilemmas based on whether or not they receive economic incentives due to their participation? While I understand the point the authors wanted to make, I do not see anything in the data or in the literature supporting this statement. Instead, I believe authors should simply acknowledge they do not know the magnitude or direction of the effect of financial incentives on their data.

2- The authors claim that “whether moral judgements are susceptible to this [age-related] effect remains unclear”. In my previous report, I pointed the authors to a recent study (Navajas et al., 2020, https://osf.io/ktv6z) that examines how demographic factors (including age) correlate with utilitarian judgements during the pandemic. [The part of my original report where I suggested authors to look at this paper was removed and did not appear in the response letter]. Discussing the relationship with those results would help better situating the findings reported in this work in the context of a fast-changing literature.

**********

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Reviewer #2: No

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PLoS One. 2021 Oct 22;16(10):e0259110. doi: 10.1371/journal.pone.0259110.r004

Author response to Decision Letter 1


1 Oct 2021

Dear Dr. Valerio Capraro,

Thank you for giving us the opportunity to re-submit a revised draft of the manuscript titled “Reduced Utilitarian Willingness to Violate Personal Rights during the COVID-19 Pandemic” to PLOS ONE. We appreciate the time and effort that you and the reviewers have dedicated to providing your valuable feedback on this manuscript. We are grateful to the reviewers for their insightful comments on the paper. We have been able to incorporate the changes to reflect the suggestions provided by reviewer #2. Below you may find a point-by-point response to reviewers’ 2 comments and suggestions.

Comments from Reviewer #2

Comment 1: When you discuss the potential role of incentives in partially explaining the different results between cohorts you state: “though at first glance the absence of a personal financial incentive in the second wave might have been expected to select for a more rather than less utilitarian cohort.” Do we know how people vary in their responses to PR dilemmas based on whether or not they receive economic incentives due to their participation? While I understand the point the authors wanted to make, I do not see anything in the data or in the literature supporting this statement. Instead, I believe authors should simply acknowledge they do not know the magnitude or direction of the effect of financial incentives on their data.

Response 1: Thank you for this suggestion. We agree with this suggestion and we have, accordingly, revised the paragraph and removed this conjecture (see “Discussion” section lines 407-410): “This could produce biases due to differential study enrollment in the 2014 versus 2020 wave of data collection and altered responses to the moral dilemmas tested, where the direction of such effects are unknown. ”

Comment 2: The authors claim that “whether moral judgements are susceptible to this [age-related] effect remains unclear”. In my previous report, I pointed the authors to a recent study (Navajas et al., 2020, https://osf.io/ktv6z) that examines how demographic factors (including age) correlate with utilitarian judgements during the pandemic. [The part of my original report where I suggested authors to look at this paper was removed and did not appear in the response letter]. Discussing the relationship with those results would help better situating the findings reported in this work in the context of a fast-changing literature.

Response 2: Thank you for this suggestion. We agree with this and we have referenced this study in the discussion section.

• We elaborated the discussion by emphasizing how demographics may affect utilitarian judgements during the pandemic (see “Discussion” section lines 382-386): “Of note, in a recent study measuring demographic factors that may affect moral judgments during the pandemic, age was negatively associated with utilitarian judgments reflecting equitable public health and positively related with judgments maximizing human life expectancy [29], indicating possibly more complex influences of age on moral considerations in the current pandemic.”

• Drawing from the Navajas 2020 paper, we additionally included a small section addressing other contextual factors such as COVID-19 severity in different countries (lines:438-440) “Other contextual factors, including regional variations in COVID-19 severity, could also affect the salience of different moral and public health considerations during this health crisis [29].

Additional clarifications

In addition to the above comments, we have updated the number cases in the introduction section due to COVID-19 pandemic (see line 43).

We look forward to hearing from you in due time regarding our re-submission and to respond to any further comments you may have.

Attachment

Submitted filename: Response to Reviewers_Sep242021.docx

Decision Letter 2

Valerio Capraro

13 Oct 2021

Reduced Utilitarian Willingness to Violate Personal Rights during the COVID-19 Pandemic

PONE-D-21-14926R2

Dear Dr. Antoniou,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Valerio Capraro

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The authors have addressed all my remaining comments. Thank you.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Acceptance letter

Valerio Capraro

15 Oct 2021

PONE-D-21-14926R2

Reduced Utilitarian Willingness to Violate Personal Rights during the COVID-19 Pandemic

Dear Dr. Antoniou:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

If we can help with anything else, please email us at plosone@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Valerio Capraro

Academic Editor

PLOS ONE

Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    S1 Appendix. Moral reasoning task.

    Moral reasoning task with the follow up questions on confidence/emotionality and the control question, categorized by moral category: Non-Moral (NM), Impersonal Moral (IM), Personal Right (PR), Agent-centered Permissions (AP), and Special Obligations (SO). Per our pre-registered analysis, only responses to PR, AP and SO dilemmas are reported in this paper.

    (RTF)

    S1 Table. Descriptive statistics: Actions adopted against COVID-19.

    Descriptive statistics for the actions adopted are represented as count (percentages) for participants who met the inclusion criteria in 2020 wave (N = 133).

    (DOCX)

    S2 Table. Self-reported confidence—All dilemmas.

    The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

    (DOCX)

    S3 Table. Self-reported emotionality—All dilemmas.

    The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

    (DOCX)

    S4 Table. Self-reported emotionality—Personal rights dilemmas.

    The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

    (DOCX)

    S5 Table. Self-reported confidence—Personal rights dilemmas.

    The coefficient Estimate contains the intercept in the first row and the slopes (beta) at the following ones. SE represents the standard error, LL and UL the lower and upper limits of the confidence interval, t the t test statistic and p the probability value (N = 242).

    (DOCX)

    Attachment

    Submitted filename: Response to Reviewers.docx

    Attachment

    Submitted filename: Response to Reviewers_Sep242021.docx

    Data Availability Statement

    De-identified behavioral data (https://osf.io/w9r4b/) are available in the Open Science Framework repository.


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