We investigate how making highly consequential, highly undesirable decisions affects emotions and preference for autonomy. We examine individuals facing real or hypothetical decisions to discontinue their infants’ life support who either choose personally or have physicians choose for them. Findings from a multidisciplinary approach consisting of a qualitative analysis of in‐depth interviews and three laboratory studies reveal that perceived personal causality for making tragic decisions generates more negative feelings than having the same choices externally made. Tragic decisions also undermine coping abilities, weakening the desire for autonomy. Consequently, participants disliked making decisions but also resented relinquishing their option to choose.

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This paper examines parents' experiences of medical decision-making and coping with having a critically ill baby in the Neonatal Intensive Care Unit (NICU) from a cross-cultural perspective (France vs. U.S.A.). Though parents' experiences in the NICU were very similar despite cultural and institutional differences, each system addresses their needs in a different way. Interviews with parents show that French parents expressed overall higher satisfaction with the care of their babies and were better able to cope with the loss of their child than American parents. Central to the French parents' perception of autonomy and their sense of satisfaction were the strong doctor-patient relationship, the emphasis on medical certainty in prognosis versus uncertainty in the American context, and the "sentimental work" provided by the team. The American setting, characterized by respect for parental autonomy, did not necessarily translate into full parental involvement in decision-making, and it limited the rapport between doctors and parents to the extent of parental isolation. This empirical comparative approach fosters a much-needed critique of philosophical principles by underscoring, from the parents' perspective, the lack of "emotional work" involved in the practice of autonomy in the American unit compared to the paternalistic European context. Beyond theoretical and ethical arguments, we must reconsider the practice of autonomy in particularly stressful situations by providing more specific means to cope, translating the impersonal language of "rights" and decision-making into trusting, caring relationships, and sharing the responsibility for making tragic choices.

It is no surprise that bioethics and sociology developed an adversarial relationship: bioethicists value the clear descriptions of ethically charged situations provided by social scientists, but doubt the ability of those trained in social science to logically derive and discern 'the good'. For their part, social scientists -experts in observing and collecting data about the way the world is -find bioethicists ignorant of the ways elegantly crafted solutions to ethical problems get altered when incarnated in varied social and cultural settings. This discipline-centred self-affirmation can be a satisfying exercise, but it offers nothing to the project of promoting more moral medicine and health care. The articles collected in this volume demonstrate the value of collaboration between social scientists and bioethicists. Focusing on four themes found in recent sociological research in bioethics -ethics of research, the creation of moral boundaries, bioethics and social policy, and the bioethical imagination -this anthology offers practical models of co-operative work where the strengths of each discipline are brought together to advance our understanding of bioethical issues and to show the way toward just and effective social policy.

Ethical issues around triage have been at the forefront of debates during the Covid‐19 pandemic. This essay compares both discussion and guidelines around triage and the reality of what happened in the United States and in Europe, both in anticipation of and during the first wave of the pandemic. Why did the issue generate so many vivid debates in the United States and so few in most European countries, although the latter were also affected by the rationing of health care resources? Are countries with socialized health care systems better equipped to face the hard choices of triaging? Important lessons in transparency, trust, and accountability for policy‐makers can be drawn from this comparison, demonstrating that fostering public involvement and ethical debate remains a critical element for the sustained acceptance of any triage plan.