This study investigates how the severity of crisis consequences and organizational response strategies influence public moral outrage and perceived offensiveness in the context of a medical negligence crisis. Grounded in the theoretical frameworks of Situational Crisis Communication Theory (SCCT) and Image Repair Theory (IRT), the research expands existing models by incorporating moral emotions and cognitive appraisals into crisis response analysis. Drawing from an experimental 2 (consequence severity: death vs. rescued) × 2 (response strategy: accommodative vs. uncaring) between-subjects design; the study tested four hypotheses using a sample of 251 adult participants in Taiwan. Findings reveal high consequence severity and uncaring response strategies significantly increase perceived offensiveness and moral outrage. Accommodative responses—characterized by apology, emotional support, and corrective actions, substantially mitigate these effects. Notably, an interaction effect was identified: when the response strategy was accommodative, the cognitive and emotional reactions (offensiveness and moral outrage) were significantly lower in low-severity conditions than in high-severity ones. However, when the response was uncaring, perceptions of offense and outrage remained uniformly high, regardless of severity. Additionally, mediation analysis confirmed that perceived offensiveness plays a pivotal role in shaping emotional reactions. While the direct effect of consequence severity on moral outrage was not significant, its indirect effect through perceived offensiveness was statistically significant. These results underscore that moral outrage is not a direct result of crisis severity or response strategy alone but rather is shaped by the degree to which the public perceives the crisis as offensive. The study contributes theoretically by integrating SCCT and IRT by identifying perceived offensiveness as a mediating variable between situational crisis features and emotional reactions. Practically, the findings offer actionable guidance for crisis communication in healthcare and similar high-stakes settings. Organizations must address the tangible consequences of crises and proactively convey empathy, assistance, and corrective actions to mitigate reputational damage. By advancing the understanding of the psychological mechanisms behind moral outrage, the study offers a more holistic framework for anticipating and managing public sentiment during organizational crises.

Consequence Severity, Organizational Response Strategy, Perceived Offensiveness, Moral Outrage, Medical Negligence Crisis