Why do people judge hypocrites, who condemn immoral behaviors that they in fact engage in, so negatively? We propose that hypocrites are disliked because their condemnation sends a false signal about their personal conduct, deceptively suggesting that they behave morally. We show that verbal condemnation signals moral goodness (Study 1) and does so even more convincingly than directly stating that one behaves morally (Study 2). We then demonstrate that people judge hypocrites negatively-even more negatively than people who directly make false statements about their morality (Study 3). Finally, we show that "honest" hypocrites-who avoid false signaling by admitting to committing the condemned transgression-are not perceived negatively even though their actions contradict their stated values (Study 4). Critically, the same is not true of hypocrites who engage in false signaling but admit to unrelated transgressions (Study 5). Together, our results support a false-signaling theory of hypocrisy.

Having patients weigh costs when making medical decisions has been proposed as a way to rein in health care spending. We convened twenty-two focus groups of people with insurance to examine their willingness to discuss health care costs with clinicians and consider costs when deciding among nearly comparable clinical options. We identified the following four barriers to patients’ taking cost into account: a preference for what they perceive as the best care, regardless of expense; inexperience with making trade-offs between health and money; a lack of interest in costs borne by insurers and society as a whole; and noncooperative behavior characteristic of a “commons dilemma,” in which people act in their own self-interest although they recognize that by doing so, they are depleting limited resources. Surmounting these barriers will require new research in patient education, comprehensive efforts to shift public attitudes about health care costs, and training to prepare clinicians to discuss costs with their patients.

BACKGROUND:Patients' willingness to discuss costs of treatment alternatives with their physicians is uncertain. OBJECTIVE: To explore public attitudes toward doctorpatient discussions of insurer and out-of-pocket costs and to examine whether several possible communication strategies might enhance patient receptivity to discussing costs with their physicians. DESIGN: Focus group discussions and pre-discussion and post-discussion questionnaires. PARTICIPANTS: Two hundred and eleven insured individuals with mean age of 48 years, 51 % female, 34 % African American, 27 % Latino, and 50 % with incomes below 300 % of the federal poverty threshold, participated in 22 focus groups in Santa Monica, CA and in the Washington, DC metro area. MAIN MEASUREMENTS: Attitudes toward discussing out-of-pocket and insurer costs with physicians, and towards physicians' role in controlling costs; receptivity toward recommended communication strategies regarding costs. KEY RESULTS: Participants expressed more willingness to talk to doctors about personal costs than insurer costs. Older participants and sicker participants were more willing to talk to the doctor about all costs than younger and healthier participants (OR=1.8, p=0.004; OR=1.6, p =0.027 respectively). Participants who face cost-related barriers to accessing health care were in greater agreement than others that doctors should play a role in reducing out-of-pocket costs (OR=2.4, p=0.011). Participants did not endorse recommended communication strategies for discussing costs in the clinical encounter. In contrast, participants stated that trust in one's physician would enhance their willingness to discuss costs. Perceived impediments to discussing costs included rushed, impersonal visits, and clinicians who are insufficiently informed about costs. CONCLUSIONS: This study suggests that trusting relationships may be more conducive than any particular discussion strategy to facilitating doctor-patient

No abstract

No abstract