Carsten Sauer

BACKGROUND AND STUDY AIMS: Guidelines recommend early initiation of palliative care alongside anticancer therapy. However, ongoing treatment is often associated with delayed referral to palliative care. Factors that positively influence the initiation of palliative care have been studied in the past, but there is a gap in research regarding the individual degree of influence these factors have on the willingness to initiate palliative care. Therefore, we explored the degree of influence of 11 different factors on willingness to initiate palliative care, focusing on communicational and relational aspects. METHODS: We conducted a factorial survey among 1572 members of the Swiss public. Participants were presented with vignettes designed to explore willingness to start palliative care. A response format ranging from -5 to +5 was provided. Vignettes were analysed using mixed-effects regression models. RESULTS: The physician having enough time for the conversation, the provision of detailed and understandable information, and an expression about continuity of care led to the strongest increase in willingness. There was also an increase in willingness when treatment recommendations were based on experience and patient preferences, as well as with self-disclosure, the expression of sadness by the physician, work experience, a prior patient-physician relationship and older patient age. CONCLUSION: This study offers insight into the decision-making process regarding the initiation of palliative care at an advanced stage of disease progression. Supportive communication practices and expressions of understanding for the other led to a higher willingness to start palliative care. These aspects should be considered in discussions about advanced cancer in clinical practice, as well as emphasised in medical education.

Objective: This study examines how subjective perceptions of fairness in partners’ division of labor – encompassing housework and employment – are associated with relationship satisfaction. Background: Prior research has extensively explored dissatisfaction from unequal task distribution in relationships. However, not all deviations from equality are perceived as unfair. We focus on the un-derexplored role of perceived fairness for relationship satisfaction – with a particular focus on cases where a partner perceives to contribute less than their fair share. We draw on two theoretical models as potential interpretative frameworks for the studied correlation between perceived fairness and relationship satisfaction: the distributive justice model, which posits that satisfaction peaks at perceived fairness and is lower in the case of unfair imbalance, whether one contributes more or less of their fair share, and the self-interest model, which proposes that relationship satisfaction is always higher when personal contributions are lower. Method: This study uses data from the first wave of the German Family Demography Panel Study (FReDA) collected in 2021. We restrict the sample to respondents cohabitating with a different-sex partner (N = 11,012), regress relationship satisfaction on the perceived fairness of the division of labor, and test for differences in this relationship by gender. Results: Perceived unfairness is associated with lower relationship satisfaction. This holds both for individuals who perceive to contribute more and those who perceive to contribute less than their fair share. This pattern of association is in line with the distributive justice model. Moreover, lower relationship satisfaction is more strongly associated with perceived undercontribution among women and with perceived overcontribution among men. Conclusion: Results underscore the nuanced role of fairness perceptions in relationship dynamics, highlighting the importance of gendered perspectives on relationship satisfaction.

This study investigates regional differences in pay fairness perceptions among employees in eastern and western Germany from 2009 to 2023. Using longitudinal data from the Socio-Economic Panel study, the analysis reveals substantial initial disparities: Employees in eastern Germany perceive their gross earnings as more unfair than employees in western Germany do. Over time, however, these regional differences diminish. Analyses stratified by wage deciles show that this convergence in pay fairness is primarily driven by a decrease in unfairness perceptions among low-wage employees in eastern Germany. This development, in turn, is driven by a narrowing East–West gap in actual earnings among low-wage employees. The finding of converging pay fairness perceptions in eastern and western Germany remains robust after adjusting for individual differences (gender, age, education, labor market experience, immigration background) and structural factors (economic area, public sector, organizational size), underscoring that there has been a true convergence of perceptions over time. While this development is cause for optimism, the overall convergence is driven not solely by employees in eastern Germany improving in terms of pay fairness but also by employees in western Germany showing an overall increase in perceived unfairness.

Research has consistently shown that lower earnings for women and higher earnings for men are generally regarded as fair by both women and men. Previous research has focused on structural factors to explain this phenomenon, but has neglected proximate relationships at work. This study examines how the supervisors’ gender relates to employees’ justice attitudes toward the earnings of men and women. We draw on data from two waves of a German employee panel study, conducted in 2012/2013 and 2017, to show that employees perceived higher earnings for men compared to women as fair. Exploiting our longitudinal research design, we find a change in gender bias in the justice evaluation of earnings for employees who experienced a change in supervisor gender: switching from a male to a female supervisor reduced the gender bias. This finding demonstrates that the workplace is an essential site for altering gendered beliefs about the fairness of earnings.

This study explores how gender and age interact in shaping beliefs about fair pay through a factorial survey experiment conducted with German employees. Respondents evaluated hypothetical worker descriptions varying in age, gender, and earnings. While no gender gap in fair earnings was found for the youngest hypothetical workers, a significant gap favoring men emerged with increasing age. This suggests that male workers receive a higher age premium on fair earnings than female workers. The findings highlight the need to understand how gender interacts with other characteristics to legitimize workplace inequalities.

Whether vaccination refusal is perceived as a social norm violation that affects layoff decisions has not been tested. Also unknown is whether ascribed low-status groups are subject to double standards when they violate norms, experiencing stronger sanctions in layoff preferences and expectations, and whether work performance attenuates such sanctioning. Therefore, we study layoff preferences and expectations using a discrete choice experiment within a large representative online survey in Germany (N = 12,136). Respondents chose between two employee profiles, each with information about ascribed characteristics signaling different status groups (gender, age, and ethnicity), work performance (work quality and quantity, and social skills), and whether the employees refused to vaccinate against COVID-19. We found that employees who refused vaccination were more likely to be preferred and expected to be laid off. Respondents also expected double standards regarding layoffs due to vaccination refusal, hence, harsher treatment of females and older employees. Nonetheless, their preferences did not reflect such double standards. We found little support that high work performance attenuates these sanctions and double standards, opening questions about the conditions under which social biases arise. Our results suggest detrimental consequences of vaccination refusal for individuals, the labor market, and acceptance of health policies.

The aim of this visualization is to describe justice evaluations of income inequality from a cross-country perspective for more than 72,000 respondents in 29 countries. The analyses were based on data from two large, cross-country survey programs. The International Social Survey Programme (ISSP) asked for an evaluation of the overall income distribution, and the European Social Survey (ESS) asked for justice evaluations of both bottom and top incomes. The authors find that injustice of the income distribution prevails in all studied countries except Denmark and that injustice of bottom incomes prevails in all countries. Moreover, in the countries included in both the ISSP and ESS, the share of respondents evaluating the overall income distribution as just always falls between the share evaluating bottom and top incomes as just. These results suggest that depending on the country context, different parts of the distribution (top and bottom incomes) influence its overall evaluation.

This study compares two pay evaluations: pay justice and pay satisfaction. Conceptually, pay justice entails a moral assessment and is more specific to work, whereas pay satisfaction is a broader attitude that includes non-work-related factors. We analyzed German employee data and found overall similarity in determinants but differences in proximity to work contexts. Pay satisfaction was more strongly associated with private pay comparisons and standard of living, whereas pay justice was more strongly associated with reciprocity in the employer-employee relationship through working hours, and comparisons at work. The results therefore suggest that employers can influence pay justice more easily than pay satisfaction by means of addressing imbalances in the employer-employee exchange and within organizational pay structures.

This study compares two pay evaluations: pay justice and pay satisfaction. Conceptually, pay justice entails a moral assessment and is more specific to work, whereas pay satisfaction is a broader attitude that includes non-work-related factors. We analyzed German employee data and found overall similarity in determinants but differences in proximity to work contexts. Pay satisfaction was more strongly associated with private pay comparisons and standard of living, whereas pay justice was more strongly associated with reciprocity in the employer-employee relationship through working hours and comparisons at work. The results therefore suggest that employers can influence pay justice more easily than pay satisfaction by means of addressing imbalances in the employer-employee exchange and within organizational pay structures.