Ethics, Reason, Emotions and Brain Damage

One classic debate in ethics is whether moral decisions are grounded in reason (Kant is the paradigm of this) or in the emotions (David Hume is an excellent example here).

The March 22 issue of Nature has added some interesting information to this debate. Researchers lead by Antonio Damasio (University of Southern California) posed moral problems to a group of test subjects. As with a standard study, the subjects were divided into those with the factor to be tested (experimental group) and those without (control group). In this case, the experimental group consisted of people with damage to the ventromedial prefrontal cortex (VPC) and the control group consisted of undamaged people.

Those in the study were exposed to the usual ethical scenarios raised in college ethics classes. These scenarios involve choices regarding causing or permitting one death in order to prevent more people dying. For example, a person is offered a choice between causing one death or five in a case involving a runaway train.

From a consequentialist standpoint, the right choice is the choice that results in fewer deaths. This is the same moral view that underlies the principle of triage. On this view, a doctor should treat patients in the order that saves the most lives. Naturally, this can result in some patients dying. This view also has intuitive appeal-it just seems to make sense to do what results in fewer deaths.

 

Of course, people’s intuitions change a bit when they are asked to actually cause a death to save more people. For example, the runaway train case used in the study involved making a choice between pushing one person in front of the train in order to save five other people. Another, rather disturbing case, offered the person a choice between smothering one baby to save five or letting the five die.

 

Interestingly, people with damage to their VPC chose to kill one person to save five from the train at a rate three times that of undamaged people. In the baby case, those with VPC damage said they would smother the infant at rate five times that of undamaged people.

 

It is tempting to conclude that damage to the VPC leads a person to make immoral or at least amoral choices. However, that does not seem to be the case. The study seems to indicate that the people with VPC damage were still using moral reasoning. The difference appears to be that their moral decisions were less affected by emotional factors than people without such damage. This does make sense.

 

From an emotional standpoint, there is a huge difference between killing one person to save five people and letting one person die to save five people. This is nicely shown by my informal research conducted in my ethics classes. In my classes, I present the students with two scenarios.

 

In the first, the student imagines she is the only doctor available to treat six survivors from a plane crash. She knows that if she tries to treat the most wounded person, she can save him, but 3-4 other people will probably die. If she treats the other five first, she is sure she can save them, but the most injured person will die. Everyone always says that they would treat the five people and let the one person die.

 

In the second, the student is placed in the same basic scenario, but with a slight twist. In this crash, five people are badly wounded and need transplants right away to survive. The sixth passenger is unhurt and, through the magic of a philosophy example, is a compatible donor for the other five. Naturally, being a donor will kill him. When the students are asked what they would do, they always say they would let the five people die.

 

When asked about the difference, the students generally point out the difference between actively killing someone and letting someone die. While important moral distinctions can be drawn between killing and letting die, the end result is still the same. If results are what matter, morally, then there would actually be little moral difference between killing and letting someone die. In the examples, the sixth person would be just as dead whether he is allowed to die or is actively killed. One way to explain the difference is, as noted above, the emotional difference between killing a person and simply allowing them to perish.

 

This nicely matches the findings in the study. Those involved, it can be argued, were making the most rational choice in terms of consequences. After all, having five people live and only one die certainly seems to be a better result (other factors being the same) than having five deaths and one survivor.

 

Of course, there is still that nagging concern-there does seem to still be an important difference between killing someone to save five other people and allowing one person to die to save five. Perhaps the difference is just squeamishness. Perhaps it is something more significant. In any case, that is definitely something well worth looking into.