Cruel to be kind but not cruel for cash : harm aversion in the dictator game

People regularly take prosocial actions, making individual sacrifices for the greater good. Similarly, people generally avoid causing harm to others. These twin desires to do good and avoid harm often align, but sometimes they can diverge, creating situations of moral conflict. Here, we examined this moral conflict using a modified dictator game. Participants chose how much money to allocate away from a recipient who was designated as an orphan, creating a sense of harm. This money was then reallocated to either the participant or a charity. People were strongly prosocial: they allocated more money away from the orphan for charity than for themselves. Furthermore, people left more money with the orphan when the harm was framed as a means (taking) than as a side effect (splitting). As is predicted by dual-process theories of moral decision making, response times were longer with the take action and were positively correlated with the amount taken from the orphan. We concluded that just as people take positive actions for the greater good, they are similarly more willing to cause harm when it benefits others rather than themselves

High risk bladder cancer: current management and survival

PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC) in the Comprehensive Cancer Center North-Netherlands (CCCN) and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18%) patients with high risk NMIBC underwent a transurethral resection (TUR) as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p < 0.001). In multivariate analysis, age (60-79 years OR 0.40 and > 80 years OR 0.1 p = 0.001) and treatment in non-teaching hospitals (OR 0.25; p < 0.001) were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49%) and progression in 84 /392 (21.4%) patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8). CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates