Feelings of shame,embarrassment and guilt and their neural correlates: A systematic review

This systematic review aimed to provide a comprehensive summary of the current literature on the neurobiological underpinnings of the experience of the negative moral emotions: shame, embarrassment and guilt. PsycINFO, PubMed and MEDLINE were used to identify existing studies. Twenty-one functional and structural magnetic resonance imaging and positron emission tomography studies were reviewed. Although studies differed considerably in methodology, their findings highlight both shared and distinct patterns of brain structure/function associated with these emotions. Shame was more likely to be associated with activity in the dorsolateral prefrontal cortex, posterior cingulate cortex and sensorimotor cortex; embarrassment was more likely to be associated with activity in the ventrolateral prefrontal cortex and amygdala; guilt was more likely to be associated with activity in ventral anterior cingulate cortex, posterior temporal regions and the precuneus. Although results point to some common and some distinct neural underpinnings of these emotions, further research is required to replicate findings.     

YOUNG PEOPLE TODAY

The new sociology of childhood sees children as competent social agents with important contributions to make. And yet the phase of childhood is fraught with tensions and contradictions. Public policies are required, not only to protect children, but also to control them and regulate their behaviour. For children and young people in the UK, youth justice has become increasingly punitive. At the same time, social policies have focused more on children's inclusion and participation. In this interplay of conflict and contradictions, the role the media play is critical in contributing to the moral panic about childhood and youth. In this article, we consider media representations of “antisocial” children and young people and how this belies a moral response to the nature of contemporary childhood. We conclude by considering how a rights‐based approach might help redress the moralised politics of childhood representations in the media.     

Beyond “Media Panics”:

This paper presents a critical review of the use of “moral panics” theory as a means of understanding public debates about children and media, and specifically of the notion of “media panics.” Following a brief presentation of the origins and key aspects of media panics theory, it focuses on six key issues that are at stake. It argues that there are some problems with the epistemology of media panics theory, with its account of intentionality, and with its claim to rationality. It further suggests that media panics theory tends to provide a “presentist” view of history, and a rather oversimplified account of cultural and generational politics; and that it neglects the positive positions that are also often rehearsed in public debate. The final section of the article provides brief discussions of two approaches that might provide productive alternatives to media panics theory: social constructionism and new cultural history.     

Moral Distress at the End of a Life: When Family and Clinicians Do Not Agree on Implantable Cardioverter-Defibrillator Deactivation

A 63-year-old man with end-stage ischemic cardiomyopathy presented with incessant ventricular tachycardia. He had been hospitalized multiple times in the past year for severe heart failure. As he approached end of life and was regularly receiving defibrillator shocks, his care team recommended deactivation of his implantable cardioverter-defibrillator. However, his family did not wish to allow deactivation, reporting a religious obligation to prolong his life, regardless of the risk of suffering. The patient was unable to adequately participate in the decision-making process. An implantable cardioverter-defibrillator can serve to avoid sudden death but may lead to a prolonged death from heart failure. This possibility forces the examination of values regarding prolongation of life, sometimes producing disagreement among stakeholders. Although ethical consensus holds that defibrillator deactivation is legal and ethical, disagreements about life prolongation may complicate decision making. The ethical, technical, and medical complexity involved in this case speaks to the need for clear, prospective communication involving the patient, the patient's family, and members of the care team.     

Drinking and moral order: Drunken comportment revisited

MacAndrew and Edgerton's seminal Drunken Comportment revealed that normative expectations to drunken behaviour differ greatly across cultures. Such variation also exists within cultures, where different drinking contexts may be associated with great normative variation. However, why social regulation of drunken comportment varies has largely been left unexplored. To examine the basis of such differences, two Norwegian drinking contexts are compared: (i) the high school graduation celebration and (ii) the two introduction weeks at university. Data comprise 71 qualitative interviews and field notes from participant observation. The two practices take place within a time span of only four months and involve many of the same participants. Alcohol plays a key role in both contexts. However, while the first context allows for heavy intoxication, sexual explorations and violating norms that ordinarily regulate behaviour in public, the second context is associated with much more control. We argue that the basis of this difference may be found in the differing value priorities of these practices, with participants' behaviour being guided primarily by hedonism and social integration, respectively. When applied to drinking practices in general this conceptual apparatus might elucidate the basis of context-specific norms and intra-cultural variation in drunken comportment.     

Sleep and moral awareness

The implications of sleep for morality are only starting to be explored. Extending the ethics literature, we contend that because bringing morality to conscious attention requires effort, a lack of sleep leads to low moral awareness. We test this prediction with three studies. A laboratory study with a manipulation of sleep across 90 participants judging a scenario for moral content indicates that a lack of sleep leads to low moral awareness. An archival study of Google Trends data across 6 years highlights a national dip in Web searches for moral topics (but not other topics) on the Monday after the Spring time change, which tends to deprive people of sleep. Finally, a diary study of 127 participants indicates that (within participants) nights with a lack of sleep are associated with low moral awareness the next day. Together, these three studies suggest that a lack of sleep leaves people less morally aware, with important implications for the recognition of morality in others.     

Is the hospital decision to seek accreditation an effective one?

The rapid expansion in the number of accredited hospitals justifies inquiry into the motives of hospitals in seeking accreditation and its social effectiveness. This paper presents a simple decision‐theoretic framework where cost reductions and improved quality of care represent the endpoint benefits from accreditation. We argue that hospital accreditation, although acting as a market‐signaling device, might be a socially inefficient institution. First, there is at present no convincing evidence for accreditation causing output quality improvements. Second, hospitals could seek accreditation, even though doing so is socially inefficient, because of moral hazard, consumer misperceptions, and nonprofit motivations. Finally, hospitals that seek accreditation need not themselves believe in output quality improvements from accreditation. Consequently, while awaiting additional evidence on accreditation, policy makers and third‐party payers should exercise caution in encouraging such programs. Copyright © 2014 John Wiley & Sons, Ltd.