Necessity and Emotion

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5 Responses

  1. Anon says:

    Interesting that the only one that seems fairly generally rejected – the idea of not treating a terminally ill patient so we can harvest his organs – is the only one we routinely face in real life and the only one we’ll ever face with any degree of certainty about the life trade offs involved (how would you know someone would fall off the speedboat or the soldiers would hear the baby?)

  2. Zanna says:

    is it clear that no. 2 involves omission rather than action? what if we change the hypo: withhold the drugs because 3 others with a milder form of the disease, who would otherwise worsen and die, can be saved, and given the limited supply of the drug, we can either save the 3 or the 1. 100% of test-takers would then say to withhold from the 1 to save the 3. what is really being objected to, I think, is a contemplated action – namely, that of removing organs from the terminally ill patient. that action strikes most as more aggressive and invasive than the action of speeding up the boat. in fact, it’s hard to see that the action/inaction distinction does any work in explaining why test takers object to withholding the medication.

  3. Bruce Boyden says:

    I share anon’s concern — these hypos tend to involve implausible assumptions, involving certain knowledge of something that would be not at all certain in real life — and I suspect people answering the questions make mental adjustments to make the hypos more plausible.

  4. Patrick S. O'Donnell says:

    Re: the Newsweek article–It’s a good rule of thumb to keep in mind that preliminary studies are just that and their “novelty” does not necessarily speak in their favor (the history of psychiatry should suffice to make this point).

    It is long been known that psychopaths suffer from what is called, in the jargon, “flattening of affect.” Moreover, it does not make sense to say, without qualification, that “They act violently even though they know it is wrong *because* they are without remorse, guilt or shame.” Remorse, guilt or shame are after the fact (the violent deed) and thus failure to experience such feelings is testimony to the lack of a moral sense, conscience, and so forth insofar as these three emotional responses would seem to be ineluctably part of the cognitive, volitional and emotional repertoire of a person who is capable of moral action. In other words, a person with a moral sense will invariably experience either remorse, guilt or shame (these are, in important ways, different from each other) upon wrongdoing (either spontaneously, or in conjunction with the admonitions, responses and actions of others). It thus seems conceptually mistaken, or at least from the perspective of moral psychology, incoherent, to attribute a sense of “right and wrong” in the absence of a capacity to experience either remorse, guilt or shame.

    Psychoses, from schizophrenia to major mood disorders, refer to conditions that include hallucinations, delusions, pressure of thought, and thought insertion, along with disorganized speech, flattening of affect, and social or occupational dysfunction (American Psychiatric Association). As Grant Gillett notes, “Each of these represents a major departure from the natural and assured patterns of thought and feeling exhibited by normal people such that the key cognitive symptoms have been collectively termed “loss of contact with reality.” Assuming such a breakdown in basic cognition, one wonders about the reliability of the methodology and conclusions drawn from this study. Gillett further points out that “self-reflexive thought” for such individuals is quite elusive, all the more so when we appreciate that the techniques of self-examination that make for self-knowledge are “a little more difficult to master than the ability to make straightforward judgments about external states of affairs, and the judgments are much more loaded with emotive, conative, or evaluative nuances and implications. It is, therefore, understandable that self-knowledge–or the set of abilities gathered under the term ‘insight’–is highly prone to disruption by disorders of thought and judgment. That disruption is exaggerated greatly when the individual is attentionally ‘out of synch’ with others because of internal neurocognitive disfunction or a context of disordered or pathological interpersonal discourse [the meaning of the latter is explained elsewhere by Gillett].”

    The loss of contact with reality that afflicts psychotic individuals is said by Gillett to result “from a loss of attunement between the cognitive skills of the psychotic person and those of others [i.e., the rest of us]:

    “The relevant skills are built on attentional control and selectivity that can be adjusted and refined in a social context so that the subject captures the same cues and constancies as those around them. Psychosis, it is suggested, is a state in which attention is disrupted; the mechanisms do not function smoothly and do not adjust themselves to track conditions in the world in normal ways.”

    Whatever the (probably) myriad causes of such psychoses, these conditions would seem to guarantee a characterization of psychotic experience in terms of isolation and suffering of the sort that attend any lived experience so radically out of tune with others, let alone those near and dear to one.

    This would indeed seem to have implications for an insanity defense or be at least germane to “mitigating factors.”

  5. Frank says:

    Very interesting questions. I think a bit about the “baby suffocation” question here: