Assignment: Medicating Amorality?

Assignment: Medicating Amorality?

The principled difficulties with treating psychopathy suggested above stems from considerations of traditional treatment techniques. But what about new ones? If empathy cannot be therapeutically induced, perhaps it can be done neuropharmalogically. Molly Crockett and colleagues’ recent success with modulating responses to morally significant situations by means of the administration of SSRIs is very promising [1]. The authors build on evidence that: “prosocial and affiliative behaviors are associated with intact or enhanced serotonin function, whereas antisocial and aggressive behaviors are associated with impaired or reduced serotonin function.” [1, pg. 17433] In their study, they found that increasing a person’s serotonin increased her acceptance of some unfair offers in the Ultimatum Game (but not the really unfair ones).[footnoteRef:10] It also had the effect of increasing people’s judgment that so-called personal harms are unacceptable, even when such harms are necessary to save the many.[footnoteRef:11] This is particularly relevant to psychopathy as Koenigs et al. [44] found that some psychopaths—so-called low-anxious psychopaths (also known as ‘primary psychopaths’)—are more willing than nonpsychopaths to endorse such harms to the individual when it is required to save the many.[footnoteRef:12] Psychopaths have also been found to be more likely to reject moderately unfair offers in Ultimatum Games [46]. Increasing serotonin, then, is a very promising lead in the search for a treatment of psychopathy. [10: In the Ultimatum Game, a certain amount of money is provisionally allocated two people who may share it under the following conditions. Person 1 is to make an offer of how to split the money, e.g. 70/30, and person 2 must either accept or reject that offer. Only if person 2 accepts person 1’s offer, does either of them receive any money.] [11: Personal harms are harms that involve physical contact with the victim, e.g. one pushes another to his or her death. They contrast with impersonal harms where, for instance, one dispatches the victim by pulling a lever or pushing a button. The scenarios are supposed to involve a moral dilemma between harming the one and saving the many.] [12: A couple of points bear mentioning here. First, Cima, Tonnaer, and Hauser [45] found no statistically significant difference between psychopaths and nonpsychopaths on moral dilemmas of the type used by Koenigs and colleagues [44] and Crockett and colleagues [1], though they did use a lower cut-off point for psychopathy (26 vs. 30 points). Koenigs and colleagues also do not find a difference between the two groups on personal harm dilemmas unless they divide the psychopaths into high-anxious and low-anxious groups. Interestingly, even low-anxious psychopaths find personal harm scenarios unacceptable almost half of the time (0.58 versus 0.46 for nonpsychopaths). Second, both groups of psychopaths in the Koenigs et al. study were more likely to endorse impersonal harms to save the many. Third, though the studies show a statistically significant difference between psychopath and nonpsychopath responses, it is hardly as dramatic as one would expect given the current hype about psychopaths. ]

Assignment: Medicating Amorality?

Unfortunately, it turns out that the effects described above are driven by people who are already quite empathetic.[footnoteRef:13] Increased serotonin has no effect on low-empathy scorers. Since psychopaths are notoriously low in empathy, Crockett and colleagues recognize that the therapy is unlikely to be effective with psychopaths. But why should serotonin not be effective with psychopaths or with people who are not very empathetic if, as the authors claimed, it “directly modifies subjects’ moral judgments and behavior by means of enhancing aversion to personally harming others” [1, pg. 17433]? And why do we see no increased tendency among empathetic subjects with increased serotonin levels to accept quite unfair offers in the Ultimatum Game (18-22% of the stake)? One assumes that this is because the people judge that there is a limit to how much unfairness they should accept. But if this is right, increased serotonin levels do not directly modify moral behavior in this case. If it does not do it in this instance, why should we assume that it does so in the other cases? What is, after all, the difference between the cases that would motivate (justify) such a difference? In short, the fact that increased serotonin has no effect on low empathy subjects and no effect on high empathy subjects once offers are sufficiently unfair together suggest that increased serotonin does not modify moral judgment or behavior directly at all. More likely, the effect is mediated by the subject’s other attitudes, beliefs, propensities, and so on. Increased serotonin levels undergird psychological phenomena that are only some of the pieces of the puzzle of human moral judgment. [13: The Interpersonal Reactivity Index [47], which is used by the authors to establish the level of empathy of their subjects, is a hodgepodge of measures, which includes one’s tendency to take others’ perspective, feel sympathy for them, experience emotions in response to their emotions, distress at their distressing situation, or one’s tendency to engage with fictional characters. ]

It is notable is that according to Crockett and colleagues, serotonin therapy boosts pre-existing tendencies or dispositions. Let us assume, with these authors that high-empathy subjects are already quite reluctant to harm others and are distressed and saddened by the prospects of such harm. Increasing their serotonin level enhances this tendency somewhat (approx. 0.15 on a 0-1 scale). But the concern for the welfare of others is unlikely to be blocked by, or meet much resistance in, the person’s other concerns, tendencies, and attitudes. This points to something that we already surely knew: a subject’s judgment of what is morally acceptable is not reducible to one factor, such as preventing harm to individuals simpliciter. Typically, a moral judgment reflects a wider assessment of the situation, which is the result of a person’s general moral outlook, the neurophysiological underpinnings of which are likely to be considerably complex. We might capture this idea by saying that a subject’s moral beliefs, judgments, attitudes, and behavior are a unified whole. They constitute her outlook on the social world—which, for most of us, simply is the world—and capture her attitude to life with others. One’s view of the world, one’s attitude towards it, is hardly an independent variable that can be modified by direct operation on some of the neurological properties that instantiate it. A Weltanschauung is not merely a matter of having a handful of interconnected ideas, perhaps of a rather lofty nature; it is a diffuse network of beliefs, assumptions, attitudes, and affective dispositions related to a vision of how to live (including how to live with others). Removing a handful of those or replacing them with others is hardly sufficient to change it. For we work at maintaining a relatively coherent worldview, so that if parts of it come into conflict, we must resolve it in a way that coheres, more or less, with our overall view, or with those parts of it that are central and of greatest importance. Therefore, to change a person’s Weltanschauung, one must change it wholesale or change a critical amount, so that the subject can do the rest of the work himself as part of bringing his belief system into a coherent equilibrium. But it does not appear that this can be achieved by means of modulating certain neurotransmitters, as is evidence by the fact that increased serotonin has no effect on low-empathy subjects.

Permalink: https://nursingpaperslayers.com/assignment-medicating-amorality/

I think we ought to conclude that there are rather formidable difficulties with the project of altering elements of a subject’s moral outlook—such as their tendency to find harmful actions acceptable—because harm-considerations are only one part of a network of closely interrelated beliefs and attitudes. One might increase the salience of harms and the aversion towards them, but if the subject does not generally endorse an outlook on human affairs that places the feelings and wellbeing of others at the very center of what is important, any such influence will be swamped by the other beliefs, attitudes, etc. that constitute their socio-moral outlook. I have suggested that this is due to the dynamic unity of moral, or socio-moral, outlook. If things fall into imbalance, if a person who does not place a high premium on individuals not being harmed compared to the welfare of the many, inducing aversion to harm or empathy will not have the desired effect. For these other ideals of what is of greatest importance will correct the “intruding” thoughts and attitudes.

Nevertheless, it is certainly possible to modify a person’s moral outlook. And if it can be done through other influences, it is not impossible to imagine that it could be done pharmacologically. But it is unlikely to be achievable directly. Such a change would require changes to other parts of a person’s Weltanschauung. That is, the subject would have to complete the work that drugs initiate in her. If this is thought to be problematic in the ordinary individual, the difficulties facing pharmacological intervention in psychopathic populations are formidable indeed. For here we are not talking about enhancing a moral tendency or other; we must implant a tendency that is more or less absent. Furthermore, we require that our “implant” replace their own narrowly self-interested Weltanschauung in its entirety. But everything that we know about the mind, of moral attitudes, of people’s socio-moral outlook suggests that this is impossible. We would not merely have to enhance, reinforce, or even alter their moral outlook, but we would need to give them one in the first place and, by doing so, alter their entire personality.

Assignment: Medicating Amorality?

I have focused on just one new neurotechnology for the possible treatment of psychopathy here, but it illustrates a deeper, more principled difficulty with any treatment options that are targeted at globally immoral and antisocial beliefs, attitudes, and behaviors.[footnoteRef:14] I suggested that this is partly because of what is involved in moral alteration (given the unity of a person’s socio-moral outlook), and partly due to the particular disorder that psychopathy is. If psychopathy is, at core, the most moral of disorders, then it seems that we must agree with William Reid and Carl Gacono that psychopathy is a disorder that is untreatable in all its aspects [20]. [14: Gregor Hassler and colleagues have recently reported success modulating behavioral responses with cathecolamine depletion [3]. By administering alphamethyl-paratyrosine (AMPT), which inhibits tyrosine hydroxylase, which is essential for the formation of cathecolamines (e.g. epinephrine, norepineprhine, and dopamine), the authors produced reduced adaptive responses in a couple of simple learning tasks. In certain parts of the probabilistic reversal learning and passive avoidance learning tasks, AMPT drugged subjects performed worse than controls. This supports the literature that suggests that dopamine plays an important role in various forms of learning [48]. Upon finding abnormal responses to negative reinforcement in passive avoidance learning tasks in youths with psychopathic tendencies, Elizabeth Finger and colleagues [2] suggest that treatment with dopamine or cathecolamine enhancing drugs increases reinforcement learning, and should therefore be considered as a treatment option for psychopathy or psychopathic tendencies. The focus of this treatment intervention is no longer the modulation of emotions that should increase social and moral concern, but on psychopaths’ deficient learning. Though not often recognized, psychopaths have significant practical reasoning deficits [49]. Could one fix them, it should have important and enduring effects on their behavior. But these deficits are unlikely to exhaust their socio-moral impairments. And as we have seen, without a more encompassing change of orientation towards how to lead one’s life, such interventions will not have the desired effect.]

Assignment: Medicating Amorality?

To return to Chartrand’s idea that treatment of Cluster B Personality Disorders requires willingness or commitment to moral change for a moment, I think that the best way to flesh this intuition out is in terms of the unity of a subject’s socio-moral outlook. Because of the relative unity or coherence of a person’s Weltanschauung, one cannot merely fiddle with one part of it and expect it or everything else to stay intact. Type B Personality Disorders are conditions where subjects have a divergent Weltanschauung. In Chartrand’s view these are all conditions whose disease classification is contingent on normative assessment. They constitute disorders insofar as they represent problems that a subject experiences relative to others or to society more generally. Whether or not we agree with this position, we can certainly agree that psychopathy is well conceived as a moral disorder and, for that reason, requires moral commitment on the part of the psychopath to be treatable. But here is the rub, of course. For psychopaths are supposed to be without a conscience [19], to be fundamentally amoral. And since truly making and upholding commitments is plausibly itself a moral activity, we should not expect psychopaths to be able to do so. What would be required is either a wholesale change in moral outlook or, as I have called it, Weltanschauung, or a commitment to moral change. Any current treatment, even of the neuropsychological or neuropharmalogical kind, is so far removed from being able to accomplish anything so fundamental that I don’t think it is premature to conclude that the prospect for treating or curing psychopathy are grim.

Collepals.com Plagiarism Free Papers

Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.

Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS

Why Hire Collepals.com writers to do your paper?

Quality- We are experienced and have access to ample research materials.

We write plagiarism Free Content

Confidential- We never share or sell your personal information to third parties.

Support-Chat with us today! We are always waiting to answer all your questions.