Normas Sociaisi e Decisões Socialmente Críticas face a imigrantes

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Who should be prioritized? : the impact of meritocracy norm on medical decisions toward a low status group

Publication . Madeira, Filipa; Costa-Lopes, Rui; Dovidio, John F.

This dissertation investigates whether (a) social status predicts prioritization in medical decisions and (b) whether the salience of meritocracy explains the effect of patient’ social status on those decisions. When deciding about prioritizing patients for a treatment or a medical procedure, providers rely on medical evidence and on the symptoms expressed by patients (Dovidio & Fiske, 2012). However, research shows a systematic disproportionate negative impact of medical decisions on members of low-status groups, such as racialized immigrant groups (Hicken et al., 2018; Smedley, et al., 2003). In previous research, implicit prejudice, stereotyping, and conservative ideologies were found to explain, at least under certain circumstances, status-based differentials in medical outcomes (Green et al., 2007). In the present thesis, we offer a novel and complementary perspective: the influence of social norms. In particular, we examine whether the Meritocracy norm explains differences in the prioritization, as a function of patient’ social status. We do so by investigating the impact of Meritocracy on socially critical decisions in the medical context and involving a low status group, the African immigrants. We propose medical decisions to be less favorable toward the low status group, particularly when the meritocracy norm is salient; thus, meritocracy norm is conceptualized as a moderator of the relationship between social status and medical decisions. We also propose that the adverse effect of meritocracy should operate when it is possible to infer a person's personal responsibility for the state of health and when the legitimizing meaning of meritocracy is salient. Particularly, we propose that in a situation involving medical decisions, such as transplants or expensive medical treatments, meritocracy operates through its legitimizing meaning, which may reduce the preference for members of socially disadvantaged groups. We present empirical evidence that provides general support for the hypotheses in seven studies and a systematic review analyzing, in medical settings, how the intergroup biases of the Portuguese towards the low status group portrayed are reinforced and legitimized in the presence of meritocracy, a social norm that regulates social relations.

2019-09Doctoral thesis

Open access

Distributive justice criteria and social categorization processes predict healthcare allocation bias

Publication . Madeira, Filipa; Bú, Emerson Araújo Do; Freitas, Gonçalo; Pereira, Cicero Roberto

Objectives Drawing on theories of distributive justice and intergroup discrimination, we examined how much distributive justice criterion and racial group membership contribute to bias in healthcare allocation decisions, by testing a theoretical model that specifies perceived stereotypicality and individual responsibility as a serial mediation process in the relationship between disease's contraction controllability (controllable vs. non-controllable) and bias in medical decision-making. Method White Portuguese medical students (N = 213) participated in an online experimental study conducted in two phases. In phase 1, we manipulated the cause of disease contagion and the salience of patient's racial categorization, and measured the stereotypicality of behaviour. In phase 2, we assessed perceived responsibility and likelihood of recommending medical treatment. Results Controllable (vs. non-controllable) contraction behaviours in phase 1 were perceived as more stereotypic. As a spillover effect, more stereotypical behaviours in phase 1 predicted more patient's responsibility for their disease in phase 2. Importantly, controllable behaviours of disease contraction in phase 1 negatively affected recommendations for medical treatment in phase 2; and this negative effect was serially mediated by the stereotypicality of behaviour and patient responsibility. Furthermore, patients' skin colour moderated this process, meaning that perceptions of controllable behaviour as more stereotypic were stronger for Black than for White patients. Conclusions This research shows how stereotyping and social categorization bias allocation decisions through the patient's level of responsibility in decision-making processes. The findings are discussed in light of principles of distributive justice and the literature on intergroup relations with respect to racial disparities in health care.

2023Journal article

Open access

Primes and Consequences: A Systematic Review of Meritocracy in Intergroup Relations

Publication . Madeira, Filipa; Costa-Lopes, Rui; Dovidio, John F.; Freitas, Gonçalo; Mascarenhas, Mafalda F

Psychological interest in Meritocracy as an important social norm regulating most of the western democratic societies has significantly increased over the years. However, the way Meritocracy has been conceptualized and operationalized in experimental studies has advanced in significant ways. As a result, a variety of paradigms arose to understand the social consequences of Meritocracy for intergroup relations; in particular, to understand the adverse consequences of Meritocracy for disadvantaged group members. The present research seeks to understand whether there is strong support for the idea that (manipulated) Meritocracy disproportionally affects members of low status groups, and also to understand which specific components of this norm have been successfully manipulated and to what consequences. And this is particularly important given the recent call for greater transparency in how the success of experimental manipulations is reported. Thus, we carried out a systematic review examining the content of different prime tasks, summarizing prime manipulation checks' effectiveness, and analyzing whether priming Meritocracy leads to less favorable orientations toward low status groups. Results across 33 studies revealed that despite the existing differences in the components highlighted, the salience of any of the Meritocracy dimensions facilitates the use of internal causal attributions, negative evaluations and stereotyping toward low status groups, affecting negatively decisions involving low-status group members, particularly in specific domains, as organizational contexts. These results carry both practical and theoretical implications for future research on the role of Meritocracy in intergroup settings.

2019Journal article

Open access