When the Morality Pill Becomes a Thoughtless Experiment
Evan Selinger
2012-03-26 00:00:00

(editor's note: This article was co-written with Thomas Seager and Jathan Sadowski. Their bios are posted at the end of this essay.)

Thoughtless experiments crowd out good writing on science, technology, and ethics and deepen the ties between popularization and undue sensationalism. To avoid being sucked into a thoughtless experiment, readers should be on the lookout for three warning signs: 1) fake problems, 2) false social choices, and 3) ignorance of empirical evidence. Singer and Sagan’s case suffers from all of these deficiencies. As we explain why, we’ll draw comparison with a different, but related thought experiment proposed by Neil Levy, Deputy Director of the Oxford Center for Neuroethics. While we disagree with Levy’s conclusion, we respect how he addresses a difficult problem. 


A Fake Problem

Singer and Sagan could have described their reflections as a science fiction scenario constructed to expand our collective moral imagination. If that were the case, we’d be fine with how they brought ethical concerns to “The Stone”—a forum that gives the public a window into what philosophers deem important. In fact, we’d likely applaud their willingness to bracket present constraints to bring into relief fundamental questions about the relation between agency and accountability. For example, Guy Kahane’s prior version of the problem, "Would We Swallow a 'Morality' Pill?", does just this and makes for a fine piece of popular writing.



Unfortunately, Singer and Sagan word their musings in a manner that presents a fake problem as if it were a real danger. To create a titillating lead, they open by discussing a headline-grabbing case involving a small child in China being run over by two different vehicles while bystanders essentially ignored her, lying helpless in the street. Despite the suggestion that society might contain a number of callous people, their account of an admittedly terrible event does not indicate a hit and run epidemic, even if we acknowledge that there has been at least one other, similar incidents over the years.

Nevertheless, the answer to human callousness, they suggest, might lie in a study of rat behavior that could be interpreted as suggesting only some rats have empathy for other rats. They speculate that perhaps the variability among rats arises from neurochemical causes, and make the leap of faith that pills could be developed that would presumably cause rats act altruistically towards other rats, and eventually, cause humans to do the same for other humans. While they claim that the idea of the morality pill raises important moral questions about the rights of society to medicate individuals most likely to commit crimes, we fail to see any convincing evidence that scientists are really scratching their heads trying to figure out how to prophylactically medicate rodents against callousness.


Levy, by contrast, is concerned with a real problem. In “Rethinking Neuroethics in Light of the Extended Mind Thesis," he invites the reader to imagine an overfull classroom populated with distracted students. We’re asked to consider two mutually exclusive remedies for improving their education: 1) reduce the number of students in the class and re-train the teachers; or 2) provide students with pharmacological drugs that allow the students to concentrate better in the same classroom setting that they started with. 


Levy’s problem is real because lots of kids are already on Ritalin, Adderall, or other stimulants intended to help them focus. Indeed, over the past few decades, the number of prescriptions has greatly increased. Moreover, no one can deny that classrooms are strapped for resources and that parents sometimes are pressured by teachers, administrators, and other school employees to medicate their “difficult” kids. 


False Social Choices

When Singer and Sagan anchor their concerns in the evidence presented in a single rat study, they extrapolate wildly: “It seems plausible that humans, like rats, are spread along a continuum of readiness to help others. There has been considerable research on abnormal people, like psychopaths, but we need to know more about relatively stable differences (perhaps rooted in our genes) in the great majority of people as well.” They present a false choice, as if medicating the great majority of people were the only alternative available to solve important social problems.


Coincidentally, on the same day Singer and Sagan’s essay ran, the NY Times also published L. Alan Sroufe's "Ritalin Gone Wrong." Sroufe argues that most parents and physicians are too quick to blame ailments like Attention Deficit Disorder on “inborn defects” that can be fixed through prescription drugs. He explains that while technologically sophisticated studies of patients with A.D.D show anomalous brain patterns, people not trained in neuroscience tend to accept the incorrect view that such anomalies can be attributed to biochemical imbalances present at birth. This outlook inclines people to see drugs such as Ritalin and Adderall as the right way to correct their problems concentrating. 




Sroufe concludes that the pharmacological solution neglects two important factors. First, recent studies show attention-deficit drugs are only effective in the short term; in the long term, the effects taper off. Second, evidence from behavioral neuroscience demonstrates that formative experience shapes a person’s brain. Sroufe thus concludes: “Putting children on drugs does nothing to change the conditions that derail their development in the first place. Yet those conditions are receiving scant attention.” If we see things the way Sroufe does, the morality pill scenario exploits a demonstrated willingness to overplay the role of biochemistry and hastily endorse pharmacological solutions.


We’re not saying Sroufe is right. What his article shows, however, is that biochemical and brain research is subject to intense debate amongst experts. To maximize sensationalism, Singer and Sagan effectively bury this lead. Taken in the context of their piece as a whole, ending the reflections with weasel word qualifiers about brain chemistry (two big hypothetical “ifs” and a momentous “whether or not”) attempts to disguise science fiction as philosophy. To constitute a responsible thought experiment, Singer and Sagan must offer more convincing evidence that a morality pill is a plausible scientific trajectory. Anything less requires the reader to suspend disbelief.

Things get more complicated still, if, as Levy argues in a forthcoming paper, the 
complexity of neurochemistry entails that enhancement of one thing often comes at the diminishment of another:


“Serotonin, for instance, augmentation of which increases social affiliative behavior, is also involved in cardiovascular regulation, respiration, sleep-wake cycles and also appetite, pain sensitivity, and reward learning. Even within the domain of (say) morality, functions seem to dissociate in various ways, such that enhancing one leads to decrements in others. For example, enhancements of elements of moral cognition using selective serotonin reuptake inhibitors comes at the cost of an increased willingness to allow cheaters to go unpunished.


Beyond the domain of morality, enhancements of function also seem to regularly cause decrements in other functions. For instance, enhanced aspects of memory in mice, but the genetic modification also resulted in much higher sensitivity to pain. Moreover it has long been known that human beings with prodigious memories often have trouble with abstraction, presumably because recall of detail interferes with focus on the most significant aspects of a situation” (references removed, as bibliography we don’t list the bibliography here).


Considering these empirical issues allows us to appreciate why Singer and Sagan present us with a false set of social choices by virtue of treating the morality pill as something other than a science fiction postulate. In the real world, society is not facing the choice of needing to decide whether or not to design morality pills, given their possible implications for free-will. Instead, we’re confronting decisions about whether to advance in pharmacological solutions to behavioral problems given their biological tradeoffs and ability to crowd out plausible hypotheses about what causes behavioral problems to arise.



These issues also help us appreciate why Levy constrains his thought experiment with two provisos: the first option (better teaching, small class size) is significantly more expensive than the second (pharmacology), and the second option does not pose any risk to health. The fact that side effects can be a problem for people who take drugs like Ritalin does not hinder Levy’s case. He is asking us to consider a real alternative because scientists are working hard to create attention deficit medication that lacks side effects. What Levy wants us to consider is whether this is a worthy goal given the educational issues it will inspire.


Ignorance of Empirical Evidence

Singer and Sagan write in a neutral “think piece” style, as if they are merely offering up hypothetical issues for us to ponder because they are curious as to how many hands will go up in response to such questions as: “Could criminals be given the option, as an alternative to prison, of a drug-releasing implant that would make them less likely to harm others?” It seems disingenuous, though, to write as if the buck stops there, on the issue of whether criminals should be given greater control over their rehabilitation. While Singer and Sagan don’t come out and justify enforced morality pill consumption, they do hint at its permissibility. Without suggesting the threat, the article can’t offer a thought experiment that bridges present and future. After all, if the real issue on the table concerned limits that should constrain personal choice, debate over whether people should be allowed to take a morality pill might not be more contentious than the longstanding disputes over whether marijuana should be legalized and how anti-depressants should be regulated. 


Yes, some people might believe criminals would get off too easy if they could substitute pharmacology for hard time. But, Singer and Sagan’s remarks really begin to hit an ethical nerve when translated into a proposition about forcing inmates to open wide and gulp down their daily dose of morality. Once we see this, we can recognize that Singer and Sagan present us with a scenario that can be explored empirically without any ethical barriers standing in the way of investigation. For instance, the ongoing Jared Loughner case can be construed as a real version of a morality pill experiment. 


Loughner, charged with 49 felonies including the shooting of former Arizona Congresswoman Gabrielle Gifords, suffers from mental illness that makes him unfit for trial. He has been ordered by the court to take medication that could control his schizophrenia. If medical science could make him legally competent, the legal system might find him guilty and sentence him to death. In this scenario, the drugs medical science presumably developed to help people suffering from mental illness could be responsible for a patient’s death—not in some accidental way, as a side-effect, but as a direct result.


Beyond these thorny medical ethics issues, problems for legal ethics are at stake, too. Loughner’s defense attorneys have objected to medication being administered that would make him competent to stand trial. While it can be argued that Loughner’s legal status (accused of serious crimes) supersedes his medical right to informed consent, it should be obvious that the State’s power is not unlimited, even in dire cases like this one. It may be that Loughner’s attorneys feel a moral duty to argue to save his life. They may also feel that the best way to do that is to ensure that he never receives the medication needed to alleviate symptoms of his mental illness.


It’s tempting to say that all these concerns boil down to premises in an argument against the death penalty. Perhaps they support the conclusion that the legal system should not be empowered to put people to death ever, or at least not when mentally ill people commit crimes. Our point is more modest. If the core issues concerning Loughner’s case get mapped back onto the fictional morality pill scenario, it becomes clear that two questions that Singer and Sagan don’t answer become paramount. What is the standard of evidence that should be required to grant the State authority to force medically healthy adults to take a morality pill? And, how should such a requirement be enforced? Until clear and compelling answers can be given to resolve the dilemmas surrounding Loughner’s case, Sagan and Singer’s morality pill musing feel like a distraction from a real dilemma.




Levy’s article is immune to this objection. While Singer and Sagan ignore a real case with important moral implications, Levy has no choice but to speculate in thought. Lacking real-world analogs, Levy’s only alternative would be a morally irresponsible empirical experiment that would require creating two classes: one with all medicated students and another with non-medicated students who learn in an environment that has a limited class size and specially trained teachers. Conducting this experiment might advance the pool of knowledge. But, this gain could harm students in the medicated group. Because the exercise would not meet the ethical standards for conducting human subject research, it can only occur as a thought experiment. Levy thus is justified in constructing one to help investigate whether research resources currently dedicated to improved pharmaceuticals could lead to moral outcomes.


Thoughtless Experiments Redux

Thought experiments are indispensable tools for enhancing critical discourse about science, technology, and ethics. Like good models, they strip away complicated detail to bring the essence of a problem into relief. To be well prepared for the future, we need good thought experiments to crystalize thorny issues that might lie ahead. Unfortunately, not all thought experiments have the same value.

Although Levy’s considerations bracket current empirical constraints (side-effect free pharmacology), they meet our three requirements for avoiding a thoughtless experiment. Levy presents a real problem (difficulty faced by resource strapped schools), a real social choice (whether or not to solve the problem through pharmacological means), and doesn’t overlook any pertinent real dillemas (it would be unethical to empirically pursue his basic question).

In the end, Levy contends that rational consideration of his thought experiment supports the following conclusion: “Suppose the drug allows us to achieve, at a lower cost precisely the same results (in terms of academic performance and well-adjusted students) as better classrooms and more individualized teaching, in that case, it seems, it is clearly superior to alternatives.” We don’t agree. From our perspective, this way of putting things risks undervaluing important concerns about character development and self-motivation. That’s okay, as the difference is worth debating, and good debates are an ideal outcome of carefully formulated thought experiments.

By contrast, Singer and Sagan’s version of the morality pill is a thoughtless experiment. Because it is not presented a reflection on science fiction, it offers the reader a fake problem (society is facing an epidemic of bio-chemically caused moral callousness), a false social choice (whether or not to develop the morality pill), and overlooks a real dillemna that raises the core ethical issues (Jared Loughner’s case).


This article was co-written with Thomas Seager and Jathan Sadowski.

Thomas Seager is an associate professor at the School of Sustainable Engineering and the Built Environment and a Lincoln fellow of ethics and sustainability at Arizona State University.

Jathan Sadowski is a research technician in the Lincoln Center for Applied Ethics at Arizona State University. He recently completed his undergraduate degree in philosophy from Rochester Institute of Technology.