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What, If Anything, Can Syndromes Like Autism and Sociopathy/Psychopathy Tell Us About the Roles Reason and Emotion Can in Play in Shaping Moral Judgment?

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Before getting into these issues, though, it must be established that autistics really are moral and psychopaths really are not. The latter seems to be well-established, but the former may be questionable. However, in order to determine if autistics can be a valid case study for morality it must be established what should be used to determine what counts as, at least, moral enough. The first thing to take into account is, in fact, moral performance. As stated by Prinz in the quote above, the moral/conventional distinction is a key indicator of moral performance

The moral/conventional distinction is the ability to tell a moral rule from one that is merely conventional.

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One’s own emotional response toward a hypothetical action can influence judgments of its moral acceptability. Some individuals with autism spectrum disorder (ASD) exhibit atypical emotional processing, and moral judgments. Research suggests, however, that emotional deficits in ASD are due to co-occurring alexithymia, meaning atypical moral judgments in ASD may be due to alexithymia also. Individuals with and without ASD (matched for alexithymia) judged the moral acceptability of emotion-evoking statements and identified the emotion evoked. Moral acceptability judgments were predicted by alexithymia. Crucially, however, this relationship held only for individuals without ASD. While ASD diagnostic status did not directly predict either judgment, those with ASD did not base their moral acceptability judgments on emotional information. Findings are consistent with evidence demonstrating that decision-making is less subject to emotional biases in those with ASD. In typical individuals, alexithymia was associated with atypical moral acceptability judgments. Individuals with more severe alexithymia considered it less acceptable to induce happiness in others, and more acceptable to induce sadness, fear, disgust, and anger. In individuals with ASD, however, alexithymia did not predict moral acceptability judgments. This differential pattern of results suggests the reliance on two different strategies when making judgments of moral acceptability

This conclusion was supported by analyses comparing the identification of emotion with moral acceptability judgments; whereas the degree to which emotion identification was (a)typical correlated with moral acceptability judgments in those without ASD, these were uncorrelated in individuals with ASD. Although typical individuals judged the moral acceptability of emotion-evoking statements based on the emotion likely to be evoked, and alexithymia, characterized by reduced emotion identification, negatively impacted on this process, those with ASD did not rely on emotion judgments when judging moral acceptability. If alexithymia predicts moral judgments in disorders, screening for alexithymia may contribute to decreasing the proportion of individuals with mental health issues currently in the criminal justice system. Systematic examination of the role of alexithymia across a number of clinical conditions is therefore warranted to fully characterize moral reasoning in individuals with psychiatric conditions.

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A plausible way to approach the last question requires a satisfactory philosophical interpretation of the empirical evidence that appears to show that psychopaths fail to draw the distinction between conventional and moral norms

Specifically, I will consider a recent philosophical debate polarized between supporters of rationalist and sentimentalist accounts of moral understanding. These opponents have discussed whether the case of psychopathy offers empirical support for their account and undermine the rival view. I will argue that the available empirical data leave the outcome of this discussion indeterminate. However, this implies that both these principal theories of moral understanding, if independently motivated, would imply that psychopaths have certain deficits that might affect their moral understanding and, consequently, their moral responsibility. Moreover, due to the work of the psychologist Robert Hare, focusing on psychopathy appears to be more promising than considering the general notion of antisocial personality disorder.3 In the last three decades, Hare has offered and investigated an operational refinement of Harvey Cleckley's classical clinical characterization of psychopathy (Hare 1991, Cleckley 1976). Hare's notion of psychopathy demarcates a relevant subgroup amongst the individuals that are classified as having antisocial personality disorder (ASPD) by the Diagnostic and Statistical Manual for Mental Disorder (DSM IV) (American Psychiatric Association 1994).

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In either case, empathy effects a whole variety of psychiatric disorders to a greater or lesser degree. There is particular emphasis on psychopathy here, but psychopathy and autism are on a neurodevelopmental mental spectrum and they do overlap. A whole range of neurodevelopmental disorders are on this neurodevelopmental spectrum including learning disability, schizophrenia, bipolar disorder, ADHD, autism, psychopathy. It was an error in DSM 5 to separate neurodevelopmental disorders from schizophrenia

In clinical practice, patients are often on more than one points of this neurodevelopmental spectrum and each aspect of the spectrum that they present with needs treatment.

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Hare RD. The Psychopathy Checklist-Revised. Multi-Health Systems; Toronto: 1991.

Cleckley HM. The Mask of Sanity: An Attempt to Clarify some Issues About the So-called Psychopathic Personality. Mosby; St. Louis (MO): 1976.

American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 4th Ed. American Psychiatric Association; Washington, D.C: 1994.

Blair J, Mitchell D, Blair K. The Psychopath: Emotion and the Brain. Blackwell; Oxford: 2005.

Patrick CJ, editor. Handbook of Psychopathy. The Guildford Press; New York/London: 2006.

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