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01/19/2015

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One last thought: Neil Levy has recently (see his 2014 here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003860/) argued a new line against those who think psychopaths are morally responsible which seems to be connected to their ability to acquire specific moral knowledge (broadly understood). He claims that because the psychopath's deficits prevent them from fully understanding what personhood is and why it's valuable, and because understanding what personhood is necessary in order to ground the claim that one has intended harm, then the psychopath cannot intend harm. And, if one must intend harm to another in order to be morally responsible for any particular act (or so many argue), then psychopaths are not morally responsible on these grounds. This is quick and fast but hopefully you get the gist of some of what Neil is trying to do.

Tumors all the way down.

Another very thoughtful question Justin. Just as I'm writing this the case of James Holmes--of the theater massacre--is on the news; he's going to plead not guilty by reason of insanity. It probably won't work. Juries these days, even carefully instructed on jurisdictional law, sometimes produce verdicts that seem to flout a sensible interpretation of the circumstances. Jeffrey Dahmer here in Wisconsin was a serial killer who didn't just kill, but did a lot of things that are beyond nightmarish (necrophilia, cannibalism, amateur lobotomy. . .). Because he tried (badly) to hide his crimes he was found to appreciate wrongfulness. But another ground--which could equally have exonerated him--was whether he could conform behavior to the law. Using preponderance, sufficient members of the jury concluded--on a split vote--that he could. Now this is essentially a question about an ability to choose the good--freedom from compulsion. Who could say that anyone could have done what he did except that some deep deviant drives were at work? Sure, I'll eat a spoonful of warm puppy poo if you gave me a (couple?) million dollars (remember Divine in Pink Flamingos?--no CGI there, and Divine did it only as part of the job!). How much money would make one willfully choose to do what Dahmer did? And remember--his payoff was just doing all those hideous things for the sake of doing them.

As I'm going to argue next month, there seems to be a trend toward taking responsibility as based on (internalist) free will as being less and less worthwhile, at least in law. The guilty finding in the Dahmer case is best explained (I think) as a jury that collectively did not follow the letter of the law in order to convict him, and based more on the horror of his actions than on any question of whether he genuinely could have refrained. It's just one case, I know. But I think it demonstrates that when push comes to shove, many people want to find psychopaths responsible for their deeds, and the motivation to do so probably increases with the perceived heinousness of the actions.

Holmes killed 12 people and wounded 70. I'll be much surprised--no matter what the laws are in Colorado (I haven't checked)--if his plea finally succeeds.

Re empathy and the reduction in volume of the amygdala, there seems to be both a diminishment of perception (those studies showing a lack of awareness of fear in others, eg
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871724/
) but also perversion, in that many such individuals have
"inverted social reward in which being cruel is enjoyable and being kind is not"
http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25162519/
As you'd know, the behaviours and brain changes are present from a very early age (eg 2 years old), and persist into adulthood.

The further complication is the overlap of similar behaviours in those with poor decision making (associated with decreased VM prefrontal cortical surface area) and with heightened threat-perception/anxiety (amygdala again).

Depending on what brain regions are affected, we could argue that one person lacks empathy, but can with effort intellectually appreciate morality and has the ability to control impulses, and so may be MR; while those with prefrontal deficits may be less so.

I'm with you, Brent.

Thanks, Alan! I'm on the fence about the Holmes case, the insanity plea *could* work. And, by the tone of your comment I'm assuming you think it should. You might be right but do you think Holmes is a psychopath? His symptoms seem more akin to psychosis.

Dahmer on the other hand seems to be a psychopath. That said, he had deep emotions for his mother (as many psychopaths do). So, to say that he couldn't feel in the right sort of way, to the point that he should be exculpated for his crimes seems off to me. I do get the thrust of what your saying re: the nature of the crime and the type of person it would take in order to follow through with those abhorrent desires. But to say that he was forced to act on those desires to me is a stretch. Now, you didn't say he was forced but I'm assuming that something like being forced it was folks are assuming when they claim the psychopath is relevantly different from you or I. That's where I get off the bus. We all have beliefs and desires and we all can refrain. When we can't refrain, then it's time to exculpate. Having a brain that disallows you to refrain is exculpating, the psychopath doesn't seem to have such a brain, or at least the data on them doesn't suggest that to me.

FWIW, I like your error theory re: the guilty finding about Dahmer. How vicious an act is surely has an affect on perceived guilt (or ability in general) by jurors and judges alike. That said, why think Dahmer couldn't refrain?

I'm fascinated by the Tsaernov case as well (as a Massachusetts native this one hits close to home). A friend of mine is covering the case for the Boston Globe so we stay in close contact about jury selection etc. They are currently asking the jurors questions about the death penalty. It's truly fascinating stuff.(Sad and terrible what happened, but fascinating to see how others react to those that are being accused).

Anyway, thanks for the comment, Alan.

David, thanks for chiming in.

The data does suggest diminished perception and perversion. And, having worked with kids aged 5-21 I can tell you first hand that the behaviors that they exhibit are already quite abhorrent, even VERY early on. Laughing while others are bleeding from their decision to pounce, etc. So, the abnormalities in the brain are surely "not their fault" just as our brain being what it is at that age is "not our fault".

But, their brains in no way suggest that they cannot refrain from doing what they do. Just because some brains make certain behaviors more or less difficult it doesn't follow that folks are more or less responsible for what they do. As long as their brains afford them the opportunity to act knowledgeably or refrain from acting in any given instance, then I don't see how they are not morally responsible.

In your last paragraph you mention degrees of MR, but again I wonder what exactly that's referring to. Not to rehash the entire debate in the last thread but it's interesting that it comes up in this conversation given that this debate is the first where I heard the degree talk.

Further, why think those with prefrontal deficits are less responsible for what they do? I get that the data suggests it might be harder to refrain, but harder doesn't = less morally responsible (whatever that means), does it? As long as the brain region allows for refraining or acting why is that not enough (assuming the epistemic condition can be met as well (for those of us (unlike say Neil Levy) who think that the epistemic condition is distinct from the control condition)?

If degrees of difficulty do make some difference to control and hence to degree of responsibility - as I know you're inclined to deny - wouldn't it be relevant that psychopaths lack the kind of automatic inhibition of anti-social mpulses that most of us pick up in early life? Yes, there are other means of control, but they require conscious effort. In that sense the psychopath's degree of responsibility may be diminished, independently of questions about moral knowledge.

Hi Pat, thanks for your comment (and question).

*If* degrees of difficulty do make a difference to one's MR then I think you're absolutely right that it would affect how responsible the psychopath was given that it might be *more* difficult for them to refrain from certain acts. But, as you note, I'm inclined to deny that.

But your point is well-taken. Maybe one could argue that the psychopath lacks relevant control and is not MR on those grounds, which of course is not a failure of meeting the epistemic condition but instead the control condition.

Justin, please clarify my confusions based on prior two posts and comments:
-Even though you deny degrees of MR, I thought you were OK with degrees of blameworthiness and punishment, in which case, would you be OK with less degrees of blame and punishment for a psychopath, assuming he possessed, for instance, diminished degrees of moral knowledge or control? (Maybe I'm just transposing John's comments onto you.)

-Why do you agree with Brent's comment (from Harris) that it's tumors all the way down? I would have thought that sort of view was the basis for a misguided skepticism about FW and MR that leads to the most problematic sort of objective stance.

Thanks for the comment Eddie, and my apologies for not being clear.

I am okay with degrees of blameworthiness and punishment but it doesn't follow (at least for me) that the psychopath should receive less of either, at least not necessarily. If pressed I would adopt something like Mckenna's view re: MR as a conversation with others in the moral community. So, how much blame the psychopath would deserve would be a function of more than just what abilities the psychopath has. The psychopath would need to be morally responsible for performing the act but that's just one requirement one must meet in order to be justified in blaming another (or punishing).

I agree with tumors all the way down in the sense that if the psychopath is not morally responsible, then none of us are (because I'm not convinced the data suggests that they *cannot* refrain from doing what they do). So I agree with that line of reasoning. I don't agree that the psychopath is not morally responsible. But for those that do, I think the tumors talk is a very difficult objection which is why I agreed with it in the abstract.

FWIW, I think psychopaths are morally responsible and I think we (and they) have libertarian free will (of the agent-causal variety).

Hopefully that made sense. I'm in between classes (teaching inductive logic today) and will be sure to clarify further if it was incoherent.

I often get lost in the psychopathy dialectic. Given determinism, neither the psychopath nor anyone else could refrain. Of course, that general worry is what leads us to posit that full-fledged "could" is not required. Instead, something like reasons-responsiveness is required. But then the psychopath case seems to put pressure on exactly what is required to be reasons-responsive. If the psychopath possess normative capacities X and Y but lacks feature Z, the psychopath puts pressure on reasons-responsiveness to explain why Z is not required for responsibility. Merely to notice that the psychopath possesses capacities X and Y is not enough to conclude that the psychopath can be held responsible.

For this reason, I think that the appeals to the scientific literature are often premature. They might help us to distinguish X, Y, and Z, though even there I'm a bit skeptical. More philosophy, as always, is needed!

Justin - I did argue that, in "Responsible Psychopaths," Philosophical Psychology, 16 (2003), 417-29, though I'd probably revise some bits today.. As Eddie's post reminds me, you could remove the reference to degrees of responsibility and frame the argument instead in terms of degrees of blameworthiness or etc.

Eddy, I appreciate that you don't agree with hard incompatibilsm, but "misguided" and "problematic"? The position deserves more respect than that.

It would be unbecoming, likewise, if an MR skeptic suggested that compatiliblism was intuition pumping sophistry invented for the sole purpose of justifying more careers in the field.

Sorry Brent, I was indeed too quick and imprecise with those modifiers in response to your one sentence comment. I meant to suggest that the 'tumors all the way down' analogy is, in my view, a misguided way to present skepticism--indeed, one that shows the position less respect than it deserves--and it suggests a problematic form of skepticism, since it suggests we treat everyone as if they had a mental defect that needed to be cured, not the sort of objective stance that I think sophisticated skeptics like Pereboom mean to promote.

It would indeed be unbecoming if an MR skeptic suggested that compatibilist positions and arguments were sophistry. I only wish scientific skeptics like Harris and Coyne would understand the positions and present them charitably before they trashed the straw positions they create.

Eddie, I'm very sympathetic to your take on Harris. See here: http://aphilosopherstake.com/2012/07/29/free-will-why-sam-harris-needs-to-read-more-philosophy/

But why think that the "tumors all the way down" understanding of skeptisism suggests "we treat everyone as if they had a mental defect"? The skepticism itself doesn't entail any particular treatment for any particular person. One could think that determinism is much like a mental illness in it's limiting feature but think that certain people should be set aside as harmful to society (for consequential reasons). All I am trying to say is that a belief in such a skepticism wouldn't entail that we treat all people *the same*, as if they need a cure. We would treat them as if they couldn't have helped what they did and we should treat them based on how they treat us. I think that such a treatment is much different and we would lose a lot, but I think all skeptics share a common struggle if they think that a world void of libertarian free will is a good thing.

So, I have a question for you and others that share your view, what do you find as the key difference between Pereboom's view and Harris'? What's particularly problematic with the Harris account that is not present in the Pereboom account?

Pat, thanks so much for that reference. I'm embarrassed to have not read that yet given that I consider myself to be pretty knowledgable on the subject. Shame on me!

Craig, thanks for the comment.

I agree that more philosophy for all, especially folks drawing provocative conclusions from the scientific literature.

I can't help but think of this interesting case re: reasons-responsiveness. I was initially going to post this on it's own but decided against it. Maybe you can weigh in. I was initially going to post something titled "If Psychopaths are not Responsive to Reasons Neither is Peter Singer", maybe it's a stretch, but stay with me for a minute.

Peter Singer is convinced that consequentialism (utilitarianism in particular) is true. So, reasons to the contrary, such as reasons based on Kantian principles or VE principles are not going to be convincing to him (or motivating). The same with the psychopath. The psychopath has a self-serving view of the world, a nihilism or egoism if you will. Utilitarian reasons will not be convincing to them as to why they should not do X. Some that say that psychopaths are not responsible will appeal to the fact that they cannot respond to situations where empathy is required. But, if that's true, then why don't we think that Peter Singer is morally responsible for what he does in cases where he violates Kantian principles given that his commitment to Utilitarianism prevents hims from acting on Kantian reasons?

Maybe this is incoherent. I don't have the time to cash this out in detail. But, I'd be interested to see why Peter Singer is considered to be responsive whereas the psychopath is not. Singer is constricted by a deep commitment to his ethical view, the psychopath by theirs (which just so happens to be nihilism or egoism). Both are acting on reasons and cannot act on others so why privvy the Singer's of the world as morally responsible but the psychopaths of the world as not?

Hi Justin.

"[T]heir brains in no way suggest that they cannot refrain from doing what they do. Just because some brains make certain behaviors more or less difficult it doesn't follow that folks are more or less responsible for what they do."

I'm not sure from your comments why you wouldn't think small children are fully morally responsible (though less blameworthy?). One sees autonomy, empathy and (an occasional) response to reasons in three year olds. So are they exercising their libertarian free will under a severe degree of difficulty? Can one define a bright line for becoming a peer in the moral community?

I think when philosophers discuss psychopaths, often not enough attention is paid to what actually qualifies someone as a psychopath. From what Justin says, I get the sense that while the kids he worked with displayed the symptoms of anti-social personality disorder, most (if not all) of them were not psychopaths (properly conceived). Partly, this is because the DSM-V conflates the two disorders (which is regarded by the majority of clinicians who work on these issues as a mistake). If nothing else, it artificially inflates the number of kids who count as having psychopathy and makes psychopathy seem both less debilitating and more common than it actually is. The other reason is that the most popular diagnostic tool for measuring psychopathy comes in an adult version and a version for children--namely, Hare's PCL-R and PCL-YV. In the case of the PCL-YV, children are never classified as having "psychopathy," but rather they are classified merely as having "psychopathic tendencies." In the case of adults, on the other hand, a score of 30+ on the PCL-R suffices for a classification of being prototypically psychopathic.

There is evidence from the literature on rehabilitation and psychopathy that supports distinguishing children with psychopathic tendencies from adults with psychopathy. For instance, Michael Caldwell has done ground-breaking work rehabilitating juveniles with psychopathic tendencies--but his program doesn't seem to work on adult psychopaths (who are resistant to rehabilitation).

I say all this just to caution philosophers from drawing hasty conclusions about psychopathy unless and until we've gotten clear on what it is and what it isn't. All too often, philosophers rest content to discuss the psychopath in the abstract. I would prefer to focus on those who satisfy the conditions used by most clinicians. In this context, as I said earlier, the main tool used is the PCL-R. Here is an excerpt from a chapter I wrote with Sinnott-Armstrong recently which summarizes the PCL-R and distinguishes psychopathy from ASPD (contrary to what the authors of the DSM-V have suggested):

*********
"By far the most widely-used and reliable tool for diagnosing psychopathy is the Psychopathy Checklist–Revised (familiarly known as the PCL-R), developed by Robert Hare over the last few decades (Hare 1991). The PCL-R relies on a semi-structured interview and documented case history (when available) to assign individuals scores of 0, 1, or 2 on each of 20 items. Total scores range from 0 to 40 and reflect the degree to which the individual matches a prototypical psychopath. Eighteen of the twenty items can be divided into four facets:

Interpersonal Facet 1: glibness/superficial charm, grandiose self-image, pathological lying, conning/manipulative

Affective Facet 2: lack of guilt or remorse, callous/lack of empathy, shallow affect, refusal to accept responsibility

Lifestyle Facet 3: need for stimulation/proneness to boredom, parasitic lifestyle, failure to have realistic long-term goals, impulsivity, irresponsibility

Antisocial Facet 4: poor behavioral control, early onset behavioral problems, juvenile delinquency, revocation of conditional release, criminal versatility

Facets 1 and 2 are often combined into Factor 1, and Facets 3 and 4 are often combined into Factor 2.

An individual is officially diagnosed with psychopathy if and only if that person’s overall score is thirty or above (though a lower cutoff is used sometimes).

This technical diagnosis of psychopathy needs to be distinguished from anti-social personality disorder (ASPD). According to the current Diagnostic and Statistical Manual of the American Psychological Association (DSMIV-TR), individuals are properly diagnosed with ASPD if and only if they satisfy at least three of the following seven criteria:

1: They fail to conform to social norms with respect to lawful behavior.
2: They are frequently deceitful and manipulative in order to gain personal profit or pleasure.
3: They exhibit a pattern of impulsivity that may be manifested by a failure to plan ahead.
4: They tend to be irritable and aggressive and may repeatedly get into physical fights or commit acts of physical assault.
5: They display a reckless disregard towards the safety of themselves or others.
6: They tend to be consistently and extremely irresponsible.
7: They tend to show little remorse for the consequences of their acts.

Because only three of these seven criteria are required, two individuals can both be properly diagnosed with ASPD even if they share no symptoms at all in common, since one of them might meet criteria 1-3, whereas the other meets criteria 4-7. As a result, ASPD covers a much more diverse group than psychopathy. The ASPD group is also larger: Experts estimate that 80% or more of medium-security inmates meet the ASPD diagnosis whereas 20% or fewer from the same population should be diagnosed with psychopathy (Serin 1996). In addition, whereas psychopathy is a useful predictor of violent recidivism (see below), ASPD is of very limited use when it comes to violence risk assessment (Hart & Hare 1996).

These differences between ASPD and psychopathy are crucial here. The diversity within the diagnosis of ASPD and its failure to predict future behavior are strong reasons to doubt that ASPD is a unified mental disease. The great numbers of criminals with ASPD also provides a strong argument against making them all eligible for the insanity defense. However, these considerations do not have the same force against counting psychopathy as a mental disease or against making psychopaths eligible for the insanity defense."

*********

For me (and for like-minded philosophers, psychologists, and legal theorists), it is the first two facets of the PCL-R which best capture both the hallmark of psychopathy and highlight the responsibility undermining features of the disorder. It is the affective deficits in particular that arguably preclude psychopaths from being able to engage in normal practical reasoning and moral cognition. But even for those like Justin who suggest that these impairments are not sufficient for undermining responsibility, there is a puzzle--namely, if one deems that psychopathy is neither exculpating nor mitigating, one thereby sets the bar for (full) responsibility so low that nearly everyone will clear it (including young children). I take it this is the point David Duffy was making in his latest comment. In my mind, this is a reductio of the view. Wherever we place the bar for full responsibility, it ought to be high enough to exclude most children and adolescents. Yet, by placing the bar low enough to accommodate the adult psychopath--with all of his affective deficits and impairments in moral cognition--then it's hard to see why we ought not similarly treat young children who have yet to display fully developed moral cognition as fully responsible.

p.s. For those interested in this debate, I have a stash of 200+ articles on (a) moral philosophy and psychopathy, (b) legal philosophy and psychopathy, and (c) the science of psychopathy. Email me and I will send links to the Dropbox folders. It's also worth pointing out that our own Dana Nelkin has a piece on psychopaths in the latest volume of Ethics--which I have downloaded but have yet to read. Here is the reference and abstract:


Nelkin, D. (in press). “Psychopaths, Incorrigible Racists, and the Faces of Responsibility,” Ethics.

Psychopaths pose a puzzle. On the one hand, when we focus on the apparent pleasure they can take in the pain of others, they seem the paradigms of evil and blameworthiness. On the other hand, when we focus on their apparent psychological incapacities, they seem to possess what are paradigm excuses on plausible accounts of moral responsibility. In this paper, I examine two influential responses to the puzzle: a solution that claims that psychopaths are morally blameworthy in one sense and not in another, and a solution that rejects the accounts of moral responsibility on which psychopaths have excuses. According to the first, psychopaths are properly appraised as cruel, but are not accountable for their actions, nor are they the proper object of moral demands or reactive attitudes such as resentment and indignation. According to the second, the cruelty that psychopaths display is sufficient for their being accountable. In assessing the two approaches, I offer a new argument against a shared commitment of both, namely, that psychopaths, as understood by the parties in the debate, show cruelty in their actions. The argument appeals to a symmetry between negative and positive appraisals, such as cruelty and kindness. I then go on to show how a proper understanding of the role of moral demands can help resolve a key point of contention about the very nature of moral responsibility. I conclude that two sorts of moral appraisal come apart, but that psychopaths turn out not to be the best illustration of the distinction.

Hi Justin, you say "FWIW, I think psychopaths are morally responsible and I think we (and they) have libertarian free will (of the agent-causal variety)." If psychopaths have libertarian free will, then they have the unconditional ability to do otherwise, which I take it is the reason they are MR even though they might have a harder time conforming their conduct to the law. It's only when that ability ceases to exist that someone is not MR for the libertarian. I'm wondering if there are any evidence-based proposals for how a sufficiently severe mental disease or defect undermines LFW - what the mechanism might be, etc. such that we could, with enough neuroscientific knowledge, confidently say that particular individuals don't have the unconditional ability to do otherwise and thus are not MR.

Great question, Tom! That's what the topic of my next post. :)

Thanks for the follow-up, David.

My 2 year old is not morally responsible because he does not meet the epistemic condition. I think Psychopaths can meet the epistemic condition thus I see a difference between psychopaths and children.

I think lived experience gives us knowledge (or at least good reasons to believe certain things) and it's not clear to me that very young children have enough lived experience to be "knowledgeable" in the relevant moral respects. I also believe that cognitive maturity is needed to be morally responsible but this maturity need not include empathy. This second point might just be another way of making the first point for me. I also think that there is a pragmatic component to knowledge and justification, thus, many children will not be able to comprehend these pragmatic considerations given there complexity.

Hi Thomas, and thanks so much for your in-depth comments!

I agree that we should not draw hasty conclusions from the data. And FWIW, when I appealed to my anecdotal experience I was trying to point to the most severe cases. I often had a good track record with minimizing harms on shift so I was the staff used to work with the most severe cases. As I progressed in the field and took a management position (which entailed sitting on the treatment team for these severe cases) the gist I got from the clinical team was that these severe cases were textbook cases of psychopathy. I was trying to point to those cases and not the cases where folks just had "tendencies" as I mentioned. I didn't outright claim that they were psychopaths because the clinicians I worked with claimed that it was too early to diagnose a child but that was a technicality (for better or worse). So, apologies for not being more specific. And, I try as best as I can to not use fringe cases when discussing psychopaths, I try to use the method that you suggest. So, while I agree it would be quick and fast to draw a conclusion about psychopaths from a population that aren't "psychopaths" because they are a couple of years short of adulthood, I'd be shocked if at least some of my worst cases (ages 12-18) didn't develop into full-blown psychopathy.

Another interesting point to be made is that if those cases never turned out to be cases of psychopathy, then it seems that we might be able to trace responsibility of the psychopath to a time to before they "officially" have the condition that renders them exculpated. Given that many of us would grant that 16-year-olds have some level of moral responsibility for much of what they do it might follow that the action that was necessary for them to partake in to prevent the illness from setting in was up-to-them in the right sort of way.

Anyway, you've given me much to chew on with your comments so thanks again (while I digest them).

Justin,

You said:

"Given that many of us would grant that 16-year-olds have some level of moral responsibility for much of what they do it might follow that the action that was necessary for them to partake in to prevent the illness from setting in was up-to-them in the right sort of way."

So, does this mean you *do* think responsibility comes in degrees after all? If responsibility doesn't come in degrees, then I presume it can't come in levels either! :)

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