A question of intent: Application of the Knobe effect in teaching ethics

Purpose/objectives: The Knobe effect refers to a measurable tendency among people to believe that undesirable side effects are brought about intentionally while desirable side effects are brought about unintentionally. People blame decision-makers for bad outcomes but do not credit them for good outcomes. The purpose of this study was to determine if the same is true for dental students and whether, as health care practitioners, students might mistakenly expect a benefit-of-the-doubt entitlement for themselves that the public is unwilling to bestow when an outcome is bad. Methods: Over three years, roughly 500 first-year dental students were posed two previously published standardized Knobe cases requiring a yes/no response. The survey was conducted as part of a classroom exercise with aggregated responses recorded digitally, anonymously, in real time. Results: The Knobe phenomenon was confirmed among dental students but the effect was muted in comparison to that of the public. Dental students aligned with the general public in declining credit for a good outcome but not in attributing blame for a bad outcome. Overall, dental students' negative responses exceeded their positive responses for both questions—confirming the Knobe effect but also revealing that dental students were less willing to take a stance by positively assigning either praise or blame. Conclusion: Using an in-class survey instrument to demonstrate the Knobe effect among dental students may be one way of making more concrete an unjustified benefit-of-the-doubt entitlement these future professionals may otherwise expect for themselves.