Wednesday, April 08, 2026

What guides moral decision-making: rules, the greater good, or fairness?

PNAS Nexus

Rawls dilemma — image:
Conceptual illustration of the ethical dilemma in the experiement.
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Credit: Zoh et al.

When making ethical decisions, university students appear to prioritize fairness and the fate of the worst-off over either reducing total harm or obeying unconditional moral precepts, according to a study. Woo-Young Ahn and colleagues designed an experimental dilemma that pits a utilitarian approach—which seeks to minimize total harm—against an approach promoted by philosopher John Rawls, which emphasizes improving the situation of the worst-off person. Fifty-two paid volunteers from a university in South Korea were asked to allocate harm—here, the discomfort of plunging a hand into ice water—while inside fMRI scanners. In each trial, participants pressed buttons to choose between a single person experiencing a hand in ice water or a group of 3 or 4 people each experiencing the same harm for shorter times. Crucially, however, the summed time of the group was larger than the total time for the single person, representing more harm overall. In some trials, the screen shown to participants included a default option already selected. In these cases, participants could not press any buttons at all, avoiding personally causing harm. The authors expected this to be a popular approach for those who wanted to avoid causing harm directly. Most people chose to allocate the harm to the group, causing more harm overall but less unfairness. Participants chose to give 68 seconds of additional icy-cold discomfort to the group, on average, to save the lone individual from being disproportionately targeted. There was little evidence of a bias toward the default option, suggesting that participants did not feel that personally causing harm was prohibited. According to the authors, brain imaging suggests that mentalizing—modeling the mental experiences of others—is involved in this moral decision-making, along with valuation networks.

Journal

PNAS Nexus

Article Title

Decomposing the neurocomputational mechanisms of deontological moral preferences

Article Publication Date

7-Apr-2026

Who should pay for older adults' care? Caregivers answer differently

Levels of concern about costs of long term care, and access to it, are higher among those who are unpaid caregivers to people over 65, compared with those who aren’t

Michigan Medicine - University of Michigan

Caregivers vs non-caregivers: views on long-term care payment and costs — video:
Sarah Patterson, Ph.D., discusses findings from a national survey of people over 50, which finds differences between those who act as unpaid caregivers to older adults, and those who do not, in views about payment, costs and access related to long-term care including nursing homes, home care and assisted living.
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Credit: University of Michigan

When it comes to opinions about paying for, and getting access to, care for older adults, direct experience appears to matter a lot, a new University of Michigan study finds.

People aged 50 and over who serve as unpaid family caregivers for adults over 65 are more likely than non-caregivers to say that the government should have primary responsibility for paying for the care of older Americans, at 51% vs. 43%.

Non-caregivers were more likely to say that families, or older adults themselves, should have primary responsibility for costs.

More than half of all people aged 50 and over say they are very concerned about the cost of long term care for older adults, including home care, assisted living and nursing home care.

But there were differences by caregiver status here, too.

Nearly two-thirds (64%) of caregivers said they are very concerned about long term care costs, compared with 54% of non-caregivers.

And when it came to access to quality long term care, 50% of caregivers said they’re very concerned, compared with 36% of non-caregivers.

The new paper, published in the Journal of the American Geriatrics Society by a team from the U-M Institute for Healthcare Policy and Innovation, is based on data from the National Poll on Healthy Aging.

The poll of people aged 50 and over, taken in 2024, showed that just under 18% were providing care to a person over 65.

Sarah Patterson, Ph.D., a U-M demographer and sociologist, worked with the poll team on the detailed analyses contained in the new paper. She is a research assistant professor at the U-M Institute for Social Research, in the Survey Research Center.

Even after accounting for demographic differences between caregivers and non-caregivers, the gap in attitudes about payment, and concerns about cost and access persisted.

“While the full sample of adults over 50 appeared to be evenly split between seeing government and families as primary payors, when we took caregiver status into account a clear divide emerged,” said Patterson.

“Previous studies have shown lower rates of support for government-first payment among adults age 65 and older, but we find that including adults ages 50 and older increases support.”

“Because caregivers are more likely to be in their 50s and early 60s, this may be both a generational and an experience-based difference in views,” said John Biziorek, a U-M Medical School student who worked on the study during a summer research experience in Patterson’s laboratory group, supported by IHPI.

While the poll did not ask about direct government payments to caregivers, which have been proposed or enacted in some states and are being discussed at the state and national levels, another recent NPHA poll found that direct payments were a top preference among family caregivers who do not feel they have enough support in their caregiving duties.

That poll, and other past work, have found that caregivers often face high personal financial impacts from their caregiving duties, including lost wages and costs for items and services for the person they care for.

Medicare generally doesn’t cover long term stays in nursing homes, nor any time in assisted living centers. It also doesn’t generally pay family caregivers to take care of someone at home, and paid home health care is covered only under specific circumstances.

Medicaid pays for nearly two-thirds of all long term nursing home care in the United States but is only open to adults with low incomes and limited assets; limits vary by state.

National statistics show that 70% of people who survive to the age of 65 will need long term care services in the future, including nursing home or at-home care, or help with medical care and daily tasks such as making and eating meals, dressing and caring for personal hygiene.

Long-term Care Costs for Older Adults: Poll explores views of people over 50

The new paper is based on data from a poll of 3,216 adults age 50 and over who were surveyed online and via phone in February and March 2024 through the NORC AmeriSpeak panel. More information about the poll methodology is available on the poll site.

Additional data from the poll, including specifics about caregiving for individuals of any age with a health issue or disability, were released in August 2024.

Additional authors: In addition to Patterson and Bizorek, the study’s authors are Adriana Reyes, Ph.D., an assistant professor at Cornell University; deputy poll director Erica Solway, Ph.D., M.S.W., M.P.H., statistician Matthias Kirch, M.S., senior project manager Dianne C. Singer, M.P.H., research specialist Sydney N. Strunk, M.P.H., poll director Jeffrey T. Kullgren, M.D., M.P.H., M.Sc., and associate poll director J. Scott Roberts, Ph.D.

Funding/disclosures: The study was funded by the National Institute on Aging of the NIH (K99AG073473, R00AG073473), and the poll wave from which the data came was funded by both AARP and Michigan Medicine.

Paper cited: “Older Americans' Attitudes Toward Caregiving Cost Responsibility and Long Term Care Access and Costs by Caregiver Status,” JAGS.  DOI: 10.1111/jgs.70385

Journal

Journal of the American Geriatrics Society

DOI

10.1111/jgs.70385

Method of Research

Survey

Subject of Research

People

Article Title

Older Americans' Attitudes Toward Caregiving Cost Responsibility and Long Term Care Access and Costs by Caregiver Status

Depression can reduce income for years

Depression can have long-term financial consequences. A new study from the University of Southern Denmark shows that income remains lower for up to 10 years after diagnosis.

University of Southern Denmark Faculty of Health Sciences

A diagnosis of depression in connection with hospital treatment can have long-term consequences for personal finances. This is shown in a new registry-based study from the Department of Public Health, University of Southern Denmark, which follows nearly five million people in Denmark over time. The study includes only people who had contact with a hospital and therefore does not cover those treated solely by a general practitioner or private practitioners.

Income is around 10 per cent lower 10 years after diagnosis compared with people without depression, and the gap does not disappear. At the same time, the income loss for depression is greater than for several physical illnesses such as stroke and breast cancer.

Mental illness has the greatest financial impact

The study compares depression, alcohol use disorder, stroke and breast cancer. Income falls after illness in all four groups, but the decline is greatest for mental disorders.

- We see that mental disorders affect not only health, but also people’s economic life course to a considerable extent, says Emily K. Johnson, Ph.D. Student at the Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark.

She is first author of the study, which has been published in JAMA Health Forum.

- The income loss grows over time and can still be measured 10 years later. Even though mental disorders are more common in women, losses are generally greater for men, Emily K. Johnson explains.

Not just a temporary loss

While earlier studies have often focused on short-term sick leave, the new study shows that income loss persists and in many cases grows over time.

- It is not only about being away from work for a period. We see changes in the entire income trajectory, says Emily K. Johnson.

This may, among other things, reflect reduced ability to keep a job, change jobs or progress in a career.

May reinforce social inequality

Income loss is greatest among people in the middle of working life, when earnings would normally be increasing. At the same time, the loss grows over time for younger people.

- If you are affected early in your career, you may lose your footing in the labour market. That can be difficult to recover later, says Emily K. Johnson.

People outside the labour market are also hit particularly hard. For them, illness may make it even harder to enter employment.

The findings therefore suggest that illness can reinforce existing social inequality.

Income falls before the illness is registered

Income already begins to decline in the years before people receive a diagnosis of depression in hospital care. This suggests that the consequences begin before the illness is formally registered and treated.

The study includes people who had contact with a hospital, either as inpatients or outpatients, including psychiatric hospital care. People treated only by their general practitioner or by private psychologists or psychiatrists are not included.

- This suggests that the course of illness starts earlier and that the consequences for working life emerge gradually, Emily K. Johnson explains. Job loss, income loss and poor mental health can reinforce one another over time,

Registry study covering the adult population

The study is based on Danish registry data and includes all non-retired residents aged 18 to 65 between 2000 and 2018. People with illness were compared with similar people without a diagnosis, matched on factors including age, sex, education and income, and baseline health.

Income was measured as disposable income, meaning post-tax income including wages, transfers and capital income.

Can inform health policy priorities

According to the researchers, the findings can help improve decision-making in health and social policy.

- Priority setting should not be based only on how many people become ill, but also on how illness affects people’s working lives and finances, especially for those early in their careers, says Emily K. Johnson.

The study adds new knowledge by comparing mental and physical illnesses using the same method, making it possible to assess their relative consequences.

The results should be interpreted with caution

The study includes only people who had contact with a hospital and therefore does not cover everyone with depression. At the same time, it cannot establish cause and effect with certainty, especially in the case of mental disorders which are difficult to measure.

In addition, only people who survive the course of illness are included in the analyses of income over time.

Three questions for the researcher about the study:

What does the study investigate?

This study measures the income trajectories of people in Denmark with different mental and physical health hospital diagnoses, compared to the trajectories of peers without a diagnosis.

What is the most important finding?

All four diseases we studied saw income losses up to 10 years after diagnosis, but people with mental disorders were particularly affected, with income on average up to 17 per cent lower than in the control population.

How can the results be used?

The results can be used to better inform health policy priorities by taking into account not only rates of illness, but also how diseases affect people’s working lives and livelihoods.

Facts:

Income after depression and other illnesses

Depression:

After 3 years:

Men: about 12% lower income
Women: about 7% lower income

After 10 years:

Men: about 14% lower income
Women: about 10% lower income

Other illnesses, 10 years after diagnosis:

Alcohol use disorder:

Men: about 10% lower
Women: about 7% lower

Stroke:

Men: about 4% lower
Women: about 2% lower

Breast cancer:

Women: less than 1% lower

Key points:

Income loss lasts for at least 10 years
Income begins to decline before the diagnosis is made
Losses are generally greater for men than for women
Mental disorders have greater economic consequences than the physical illnesses included in the study

About the study

Method

Registry-based observational study of 4.9 million people in Denmark aged 18 to 65. People diagnosed in connection with hospital contact were matched with similar people without a diagnosis and followed for up to 10 years.

Funding

Independent Research Fund Denmark, the EU Marie Skłodowska-Curie Actions, and Helsefonden.

Read the study

Lasting Income Costs of Mental and Physical Illness, JAMA Health Forum, published 27 March 2026. Read the study: https://doi.org/10.1001/jamahealthforum.2026.0196

Journal

JAMA Health Forum

DOI

10.1001/jamahealthforum.2026.0196

Method of Research

Observational study

Subject of Research

People

Article Title

Lasting Income Costs of Mental and Physical Illness

Rivaling Atlas: Unpaid work burdens, nonrestorative sleep, and mental health

Assessing the toll of elongated working hours in community-dwelling, middle-aged adults

Osaka Metropolitan University

Work effects — image:
Long working hours affected sleep quality in both men and women and also correlated with poor mental health in women.
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Credit: Osaka Metropolitan University

Mental load, invisible work, “the extra shift”; no matter the newly coined term, unpaid work in the domestic sphere, predominantly done by women, is a hidden burden eating away at the sleep and mental health of those tasked with it. This work is essential to keep everyone’s daily lives on track, from meal prep and clean clothes to school drop-offs and doctor's appointments, yet its importance is often ignored, undermined, and even belittled by the very society dependent on it.

Add paid employment, and the recipe for disaster is complete, leaving those juggling both to drown in silent exhaustion and mental distress. This occurrence is often described as time poverty, a state in which they are overwhelmed by paid and unpaid work and unable to secure sufficient time for daily living. However, much of the research on this topic has solely focused on paid working hours, thus the impact of total working hours, paid working hours + unpaid working hours, has not been sufficiently examined.

For this reason, a research group led by Professor Akiko Morimoto from the Graduate School of Nursing and Professor Naho Sugita from the Graduate School of Economics at Osaka Metropolitan University comprehensively examined the relationship between total daily working hours, nonrestorative sleep, and mental health. A self-administered postal questionnaire with questions focused on demographic variables, total amount paid and unpaid working hours, sleep quality, and mental health was distributed across five cities in Osaka Prefecture. Out of 12,446 participants, answers from 3,959 healthy Japanese workers, 1,900 men and 2,059 women, aged 40 to 64, were analyzed.

The results revealed that, although women work fewer paid hours than men, they spend more time on unpaid work, resulting in longer working hours. A significant disparity was particularly observed in the rate of participation in household chores, with approximately 90% of women and approximately 40% of men engaging in such activities.

Furthermore, it was confirmed that longer working hours were associated with a higher risk of nonrestorative sleep for both men and women. They also correlated with a higher risk of poor mental health in women.

“For women, total daily working hours are a more important predictor of nonrestorative sleep and poor mental health than paid working hours alone,” stated Professor Morimoto. Professor Sugita concluded, “Going forward, we expect that quantifying total daily working hours and incorporating this data into policy-making and institutional design will help reduce health disparities and achieve gender equality.”

The study was published in Social Science & Medicine.

###

About OMU

Established in Osaka as one of the largest public universities in Japan, Osaka Metropolitan University is committed to shaping the future of society through the “Convergence of Knowledge” and the promotion of world-class research. For more research news, visit https://www.omu.ac.jp/en/ and follow us on social media: X, Facebook, Instagram, LinkedIn.

Journal

Social Science & Medicine

DOI

10.1016/j.socscimed.2026.118965

Method of Research

Survey

Subject of Research

People

Article Title

Associations of total daily working hours encompassing unpaid care and domestic work with nonrestorative sleep and mental health in middle-aged Japanese men and women: a cross-sectional study

KAIST develops electrode technology achieving 86% efficiency for converting CO₂ into plastic precursors

The Korea Advanced Institute of Science and Technology (KAIST)

In the process of converting carbon dioxide into useful chemicals such as ethylene—a key precursor for plastics—a major challenge has been the flooding of electrodes, where electrolyte penetrates the electrode structure and reduces performance. KAIST researchers have developed a new electrode design that blocks water while maintaining efficient electrical conduction and catalytic reactions, thereby improving both efficiency and stability.

KAIST (President Kwang Hyung Lee) announced on the 6th of April that a research team led by Professor Hyunjoon Song from the Department of Chemistry has developed a novel electrode structure utilizing silver nanowire networks—ultrafine silver wires arranged like a spiderweb—to significantly enhance the efficiency of electrochemical CO₂ conversion to useful chemical products.

In electrochemical CO₂ conversion processes, a long-standing issue has been flooding, where the electrode becomes saturated with electrolyte, reducing the space available for CO₂ to react. While hydrophobic materials can prevent water intrusion, they typically suffer from low electrical conductivity, requiring additional components and complicating the system.

To overcome this, the research team designed a three-layer electrode architecture that simultaneously repels water and enables efficient charge transport. The structure consists of a hydrophobic substrate, a catalyst layer, and an overlaid silver nanowire (Ag NW) network, which acts as an efficient current collector while preventing electrolyte flooding.

A key finding of this study is that the silver nanowires do more than just conduct electricity—they actively participate in the chemical reaction. During CO₂ reduction, the silver nanowires generate carbon monoxide (CO), which is then transferred to adjacent copper-based catalysts, where further reactions occur. This creates a tandem catalytic system, in which two catalysts cooperate sequentially, significantly enhancing the production of multi-carbon compounds such as ethylene.

The electrode demonstrated outstanding performance. It achieved 79% selectivity toward C₂₊ products in alkaline electrolytes and 86% selectivity in neutral electrolytes, representing a world-leading level. It also maintained stable operation for more than 50 hours without performance degradation. These results indicate that most of the converted products are the desired chemicals, while also overcoming the durability limitations of conventional systems.

Professor Hyunjoon Song stated, “This study is significant in showing that silver nanowires not only serve as electrical conductors but also directly participate in chemical reactions,” adding, “This approach provides a new design strategy that can be extended to converting CO₂ into a wide range of valuable products such as ethanol and fuels.”

This research, led by Jonghyeok Park (KAIST, first author), was published on March 24, 2026, in the international journal Advanced Science.

※ Paper title: “Overlaid Conductive Silver Nanowire Networks on Gas Diffusion Electrodes for High-Performance Electrochemical CO₂-to-C₂₊ Conversion,” DOI: https://doi.org/10.1002/advs.75003

< Schematic diagram of a porous polymer–copper oxide catalyst silver nanowire network electrode structure >

< Conceptual diagram of a CO₂ electrolysis electrode utilizing a stacked silver nanowire structure (AI-generated image) >

Credit

KAIST

Journal

Advanced Science

DOI

10.1002/advs.75003

Subject of Research

Not applicable

Article Title

Overlaid Conductive Silver Nanowire Networks on Gas Diffusion Electrodes for High-Performance Electrochemical CO₂-to-C₂₊ Conversion