If you are reading this, I suspect you are a human (our household felines, though brilliant in their own way, adamantly reject the value of literacy). You are classified homo sapiens sapiens in scientific nomenclature. Sapiens, indicating intelligence in Latin, repeats to emphasize our firm belief that we are doubly the smartest creatures on earth and to distinguish our subspecies from homo sapiens neanderthalensis and our other supposedly less intelligent cousins now gone extinct. You and I resemble each other genetically to a remarkable degree: whatever your gender, skin color, blood type, or preference for Star Trek or Star Wars franchises, we are virtually identical in those spiraled strands of chemical instructions. We are also identical in our opening and closing chapters, however brief, all first gestating in a womb and all eventually ceasing our rhythms of breath and heartbeat somehow. Knowing the inevitability of that cessation point motivated the writing of this book, because despite attempted escape into social media, high art, or sports fandom, that final moment will visit us all, whomever we are and from wherever we are.

Death must be managed, cognitively, so that we can function, and practically, to maintain the health of the living. Deaths happen in predictable patterns, once diagnosis is made; it may be fast, slow, or halting in its progression, and chronic conditions may take years for eventual decline. These can be described as dying trajectories and cultures usually have expectations based on scripts derived from worldview, experience, and health epistemology. Communicating across cultures brings challenges of language, but also of worldview and expectations. Relaying the bad news of a terminal diagnosis is never easy, but becomes even more difficult if a culture has proscriptions against mention of death. Informed consent becomes particularly burdensome when patients’ cultures are more collectivistic and/or agency is not individualized. Arts provide fertile bodies of information about how cultures think about and approach mortality.

Module 2 discusses the processes by which people learn the behaviors, beliefs, and roles of their culture. We begin to discuss how cultures focus differently, such as individualistic or collectivistic orientation. These orientations affect who makes and implements choices, along with a sense of obligation to others (or not). Modes of cognition may be described as analytic or holistic, with implications for how people relate to the world and the people around them.

Healthcare providers try to prepare their patients and clients for death, but may encounter obstacles from their own ethos in addition to client resistance. Palliative and hospice care provide affordable and humane avenues that differ slightly. Palliative care focuses on client comfort and may coincide with other treatments. Hospice, by definition, follows cessation of treatment. Previously discussed issues of agency, consent, and epistemology now coalesce, potentially to impede or prevent provision of the best end-of-life care, whatever that may be for the patient. Controversial issues include euthanasia and organ donation, though euthanasia is probably millennia old. Patient-centered communication provides tools to bridge understanding. People need support in these situations, which may need to be offered in particular ways.

This chapter of the handbook consists of a two-part discussion of moral communication, highlighting the topic of punishment. In the first part, the authors focus on what makes human forms of communication distinctive, whether linguistic or nonlinguistic, and on what distinguishes moralized norms from normative attitudes and behaviors. They argue that the transgression of moralized norms is distinctive in that it tends to provoke a strong desire to punish transgressors, where such punishment has a communicative dimension. In the second part, the authors review psychological research on why people punish and discuss its communicative aspects. They propose that a communicative framework not only resolves major ongoing debates between traditional camps (retributive vs. consequentialist) but also potentially accounts for some otherwise puzzling findings. Studying the symbolic meaning of punishment along with its intended recipients opens up promising new avenues for research into factors that could modulate people‘s taste for punishment.

This chapter proposes a way to investigate and evaluate the moral standing of cultural customs different from one’s own without falling into ethnocentrism. As a methodological approach the authors adopt the perspective of “moral realism,” which is the view that there are absolute moral truths that supply all human beings with good reasons for their judgments about what is right or wrong and possess a normative authority that supersedes social consensus and personal desire. According to the authors genuine moral absolutes are abstract forms that provide the skeletal structure for the development of any genuinely moral cultural tradition; while it is their fate to be specified and implemented locally and to assume an historically provincial moral shape. To illustrate this relationship between moral reality and cultural specificity, the authors analyze several ethnographic examples of distinctive and even clashing moral traditions. These include clashes between Brahman Hindu Indian and Western secular views of a widow’s obligations and tensions between Native American whalers’ and whaling protesters’ attitudes toward whaling.

Module 1 lays the foundation for understanding culture and cultural differences to be discussed later in the text by examining basic elements of the psychology of culture. Anthropological evidence suggests humans evolved cognitive enhanced capacities to facilitate social interaction, but which also made us unavoidably aware of our mortality. Cultures have increased in complexity and diversified, developing unique systems of values and ethics.

This chapter of the handbook posits utilitarianism as a standard of rational moral judgment. The author does not directly defend utilitarianism as a theory but investigates cases of apparent contradiction between people’s moral decisions (sometimes grounded in nonutilitarian principles) and the consequences of those decisions that they themselves would consider worse for themselves and everybody else. For example, when some people use a moral principle (e.g., bodily autonomy) to assertively make a decision (e.g., to not get vaccinated), it has negative moral consequences for others (e.g., infecting people) and for themselves (risking infection). The author asks whether such contradictions in moral reasoning can provide insights into some of the determinants of such reasoning. These insights, importantly, are valuable even for those who do not adopt utilitarianism as a normative model. From over a dozen candidate moral contradictions, the author concludes that many deviations from utilitarian considerations in moral contexts are reflections of familiar nonmoral cognitive biases, but some arise from adherence to strong moral rules or principles (e.g., protected or sacred values).

This chapter of the handbook tackles a foundational question in moral psychology: What constitutes the moral domain? To answer this question, we first have to know how our minds determine right from wrong. The authors argue that our intuitive, culturally flexible perceptions of harm drive our judgments of the moral domain. This is not the dominant view of the moral domain, but the most popular models of the past and present need not be the most accurate ones. Instead, these paradigms reflect broader shifts in our values as a society and a field of research. The Turielian moral domain of the 1970s and 1980s took inspiration from the cognitive revolution, positing harm as a universal value that fully determines how people decide right from wrong. The Haidtian paradigm of today is influenced by the rise of cross-cultural psychology, arguing that harm is just one of many intuitive, culturally activated moral values. Ultimately, neither paradigm gets it completely right, but the authors argue that we can build a better paradigm by combining the strengths of each. In this model, harm is the key driver of moral judgments, but perceptions of harm are intuitive and culturally variable.

This chapter of the handbook introduces some core elements of moral decision making by framing it from one particular perspective: expected utility theory. In its classic form, expected utility theory focuses on the outcomes of actions: the expected utility of a decision is the sum of the values associated with the different possible outcomes of the decision weighted by the probability of their occurrence. As such, expected utility theory is well suited to explain the moral choices recommended by utilitarianism, which characterizes right actions in terms of the maximization of aggregate utility. As the authors point out, however, expected utility theory can be also used to model nonutilitarian decision making by assigning utilities to actions themselves, not just their outcomes. This action-based form of expected utility theory can readily accommodate the fact that people tend to assign low utility to actions that violate moral norms. Further, action-based expected utility theory can explain a wide range of phenomena revealed by empirical research on moral decision making, such as interpersonal disagreement about fairness, in-group bias, and outcome neglect.

This chapter of the handbook suggests some lessons from moral psychology for ethics and metaethics. The authors note that empirical research on a wide range of topics, including moral character, happiness and well-being, free will and moral responsibility, and moral judgment, has had a profound influence on recent philosophical theorizing about the foundations of morality. In their chapter they focus on one issue of particular importance: the reliability and trustworthiness of moral judgment. They critically assess three lines of argument that threaten to undermine epistemic confidence in our moral judgments, namely process debunking arguments, arguments from disagreement, and arguments from irrelevant influences. Though the jury is still out on how successful these arguments are, there is little question that they have potentially profound implications both for moral epistemology and philosophical methodology. Perhaps the most important lesson for ethics and metaethics to be drawn from moral psychology, then, may be that future progress in moral philosophy is likely to depend on philosophers and psychologists working together, rather than in isolation from one another.

As people approach the end, both the dying and loved ones may find solace and support in cultural practices. Some practices may be disturbing to the routines and requirements of sterile environments, for instance the sudden appearance of group ritual practices or artifacts. Awareness of some possible cultural practices may help healthcare professionals respond more appropriately when faced with the unexpected. Ultimately, this closing chapter may be smoother and more meaningful for all involved. The wake immediately follows death and may extend for some days, bringing family and community together to accommodate the loss. Mourners may express their grief in culturally specific ways, according to emotional display rules. Funerals and commemorations may do more for the living than the dead, but they become important parts of psychological adjustment to loss. Ancestral veneration particularly aligns with Terror Management Theory, connecting past, present, and future generations in cultural immortality.

Module 5 provides an overview of ways in which cultures describe health and well-being. Measurement of well-being is problematic, requiring both objectivity and sensitivity to cultural conceptualizations. Attempts to describe universals of well-being include Maslow’s Hierarchy of Needs. Historically, humans participated in rituals that enhanced well-being. Indigenous cultures often conceptualize well-being holistically, emphasizing connections to social, natural, and spiritual levels of existence. This module defines terms of reference for healthcare systems, including traditional medicine and complementary and alternative medicine (CAM), along with conventional medicine, describing the predominant Euro-American system.

Module 8 turns to discussion of death from academic and cultural perspectives. Our approaches and responses to mortality are shaped by our worldview and cognitive style, but everyone has some response when we are reminded of death. Generally, our fear of personal death is somewhat alleviated by identification with our cultures and traditions. Terror Management Theory (TMT) provides an explanatory model for ways people accommodate their fears and anxieties around death. TMT proposes that all culture defends us from existential terror, whether by soothing our fears or distracting us from death’s immediacy. Ultimately, people everywhere want whatever they consider to be a good death, which often, but not always, includes a lack of pain and connection to loved ones.

This chapter of the handbook discusses the moral dimensions of political attitudes and behavior. The authors argue that a person’s political views – both at the level of political ideology as a whole and views on specific matters of economic and social policy – are profoundly shaped by their beliefs about right and wrong. These political views in turn drive people’s political behavior, not just at the ballot box or on the campaign trail, but in the community more generally. One downside of the way in which moral convictions fuel political attitudes and behavior is that they tend to interfere with productive communication across partisan divides, fueling a kind of animosity that stifles cooperation and compromise. Divergence in people’s moral convictions, then, leads inexorably to political polarization and gridlock. To address this problem, the authors discuss a number of potentially promising interventions, some of which target individuals’ attitudes (e.g., promoting empathy, reducing negative stereotypes), and others that aim at improving the quality of interpersonal relationships (e.g., increasing contact, fostering dialogue across political divides).