Introducing self-sampling for cervical cancer screening: A regional implementation study in Pirkanmaa, Finland.

From the perspective of standard economic theory, if individual utility depends solely on one’s own monetary payoff, responders in the Ultimatum Game (UG) should accept any non-zero offer. However, a substantial body of research has consistently shown that actual decision making in the UG deviates from this prediction of the “economic man”: proposers typically refrain from making extremely self-serving offers, and responders often reject clearly unfair low offers. At the responder level, low offers are frequently rejected on the grounds of unfairness, even when doing so requires individuals to forgo attainable gains. These findings suggest that decision making in the UG is not driven exclusively by personal monetary utility; fairness preferences and inequity aversion also constitute important behavioral foundations. Although fairness preferences exert a stable influence in the UG, under what conditions do monetary gains become sufficiently important to weaken responders’ fairness-based rejection? The existing literature has not yet provided a unified answer to this question. It should be noted that rejection of unfair offers in the UG does not necessarily arise from a single psychological motive. Existing research suggests that rejection of low offers may reflect concern for fairness itself, but may also involve strategic consideration of the material consequences of accepting a low payoff. Individuals with different social preference types also show systematic differences in proposer and responder behavior, indicating that monetary gain and fairness concerns are not two isolated forces, but may jointly enter the decision process in different ways. Based on this conclusion, researchers have increasingly focused on a core question: which exerts greater influence on UG decisions, monetary gain or fairness concern? Forsythe et al. conducted two comparative experiments, one with real monetary rewards and one without material incentives. They found that in both experiments, proposers’ offers were concentrated between 30% and 50% (78% in the incentive condition and 79% in the no-incentive condition), whereas the average rejection rates of responders were 7% and 17%, respectively. This finding suggests that responders are more likely to reject unfair offers when such rejection carries no economic cost. A subsequent question is how decisions on both sides of the game change as the total stake increases. Using a questionnaire design, Tompkinson and Bethwaite compared decisions under total stakes of $10 and $10,000 and found that, as the total stake increased, proposers offered smaller proportions (i.e., fairness declined), while responders also lowered their minimum acceptable proportion. In contrast, Munier and Zaharia, who manipulated total stake across multiple levels, reported the opposite pattern: proposers’ offer proportions remained unchanged as the total stake increased (i.e., fairness remained stable), whereas only responders’ minimum acceptance threshold declined.