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Damage to the prefrontal cortex increases utilitarian moral judgements


The psychological and neurobiological processes underlying moral judgement have been the focus of many recent empirical studies1,2,3,4,5,6,7,8,9,10,11. Of central interest is whether emotions play a causal role in moral judgement, and, in parallel, how emotion-related areas of the brain contribute to moral judgement. Here we show that six patients with focal bilateral damage to the ventromedial prefrontal cortex (VMPC), a brain region necessary for the normal generation of emotions and, in particular, social emotions12,13,14, produce an abnormally ‘utilitarian’ pattern of judgements on moral dilemmas that pit compelling considerations of aggregate welfare against highly emotionally aversive behaviours (for example, having to sacrifice one person’s life to save a number of other lives)7,8. In contrast, the VMPC patients’ judgements were normal in other classes of moral dilemmas. These findings indicate that, for a selective set of moral dilemmas, the VMPC is critical for normal judgements of right and wrong. The findings support a necessary role for emotion in the generation of those judgements.

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Figure 1: Lesion overlap of VMPC patients.
Figure 2: Moral judgements for each scenario type.
Figure 3: Moral judgements on individual personal moral scenarios.

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  1. Eslinger, P. J., Grattan, L. M. & Damasio, A. R. Developmental consequences of childhood frontal lobe damage. Arch. Neurol. 49, 764–769 (1992)

    Article  CAS  Google Scholar 

  2. Anderson, S. W., Bechara, A., Damasio, H., Tranel, D. & Damasio, A. R. Impairment of social and moral behavior related to early damage in human prefrontal cortex. Nature Neurosci. 2, 1032–1037 (1999)

    Article  CAS  Google Scholar 

  3. Blair, R. J. R. A cognitive developmental approach to morality: investigating the psychopath. Cognition 57, 1–29 (1995)

    Article  CAS  Google Scholar 

  4. Mendez, M. F., Anderson, E. & Shapira, J. S. An investigation of moral judgment in frontotemporal dementia. Cogn. Behav. Neurol. 18, 193–197 (2005)

    Article  Google Scholar 

  5. Moll, J., de Oliveira-Souza, R., Bramati, I. E. & Grafman, J. Functional networks in emotional moral and nonmoral social judgments. Neuroimage 16, 696–703 (2002)

    Article  Google Scholar 

  6. Heekeren, H. R., Wartenburger, I., Schmidt, H., Schwintowski, H. P. & Villringer, A. An fMRI study of simple ethical decision-making. Neuroreport 14, 1215–1219 (2003)

    Article  Google Scholar 

  7. Greene, J. D., Sommerville, R. B., Nystrom, L. E., Darley, J. M. & Cohen, J. D. An fMRI investigation of emotional engagement in moral judgment. Science 293, 2105–2108 (2001)

    Article  ADS  CAS  Google Scholar 

  8. Greene, J. D., Nystrom, L. E., Engell, A. D., Darley, J. M. & Cohen, J. D. The neural bases of cognitive conflict and control in moral judgment. Neuron 44, 389–400 (2004)

    Article  CAS  Google Scholar 

  9. Luo, Q. et al. The neural basis of implicit moral attitude–An IAT study using event-related fMRI. Neuroimage 30, 1449–1457 (2006)

    Article  Google Scholar 

  10. Wheatley, T. & Haidt, J. Hypnotic disgust makes moral judgments more severe. Psychol. Sci. 16, 780–784 (2005)

    Article  Google Scholar 

  11. Valdesolo, P. & DeSteno, D. Manipulations of emotional context shape moral judgment. Psychol. Sci. 17, 476–477 (2006)

    Article  Google Scholar 

  12. Damasio, A. R., Tranel, D. & Damasio, H. Individuals with sociopathic behavior caused by frontal damage fail to respond autonomically to social stimuli. Behav. Brain Res. 41, 81–94 (1990)

    Article  CAS  Google Scholar 

  13. Damasio, A. R. Looking for Spinoza: Joy, Sorrow, and the Feeling Brain (Harcourt, New York, 2003)

    Google Scholar 

  14. Beer, J. S., Heerey, E. H., Keltner, D., Scabini, D. & Knight, R. T. The regulatory function of self-conscious emotion: Insights from patients with orbitofrontal damage. J. Pers. Soc. Psychol. 85, 594–604 (2003)

    Article  Google Scholar 

  15. Kohlberg, L. Essays on Moral Development Vol. 1 The Philosophy of Moral Development (Harper Row, New York, 1981)

    Google Scholar 

  16. Damasio, A. R. Descartes’ Error: Emotion, Reason, and the Human Brain (Penguin, New York, 1994)

    Google Scholar 

  17. Haidt, J. The emotional dog and its rational tail: A social intuitionist approach to moral judgment. Psychol. Rev. 108, 814–834 (2001)

    Article  CAS  Google Scholar 

  18. Ongur, D. & Price, J. L. The organization of networks within the orbital and medial prefrontal cortex of rats, monkeys and humans. Cereb. Cortex 10, 206–219 (2000)

    Article  CAS  Google Scholar 

  19. Rolls, E. The orbitofrontal cortex and reward. Cereb. Cortex 3, 284–294 (2000)

    Article  Google Scholar 

  20. Koenigs, M. & Tranel, D. Irrational economic decision-making after ventromedial prefrontal damage: evidence from the ultimatum game. J. Neurosci. 27, 951–956 (2007)

    Article  CAS  Google Scholar 

  21. Anderson, S. W., Barrash, J., Bechara, A. & Tranel, D. Impairments of emotion and real-world complex behavior following childhood- or adult-onset damage to ventromedial prefrontal cortex. J. Int. Neuropsychol. Soc. 12, 224–235 (2006)

    Article  Google Scholar 

  22. Saver, J. L. & Damasio, A. R. Preserved access and processing of social knowledge in a patient with acquired sociopathy due to ventromedial frontal damage. Neuropsychologia 29, 1241–1249 (1991)

    Article  CAS  Google Scholar 

  23. Burgess, P. W. et al. The case for the development and use of “ecologically valid” measures of executive functions in experimental and clinical neuropsychology. J. Int. Neuropsychol. Soc. 12, 194–209 (2006)

    Article  Google Scholar 

  24. Hauser, M. D. Moral Minds: How Nature Designed our Universal Sense of Right and Wrong (Ecco/Harper Collins, New York, 2006)

    Google Scholar 

  25. Mikhail, J. Rawls’ Linguistic Analogy. PhD thesis, Cornell Univ. (2000)

  26. Cushman, F. A., Young, L. L. & Hauser, M. D. The role of conscious reasoning and intuition in moral judgments: Testing three principles of permissible harm. Psychol. Sci. 17, 1082–1089 (2006)

    Article  Google Scholar 

  27. Hauser, M. D., Cushman, F. A., Young, L. L., Jin, K-X. & Mikhail, J. A dissociation between moral judgments and justifications. Mind Language 22, 1–21 (2006)

    Article  Google Scholar 

  28. Frank, R. J., Damasio, H. & Grabowski, T. J. Brainvox: an interactive, multimodal visualization and analysis system for neuroanatomical imaging. Neuroimage 5, 13–30 (1997)

    Article  CAS  Google Scholar 

  29. Barrash, J. & Anderson, S. W. The Iowa Rating Scales of Personality Change (Department of Neurology, Univ. Iowa, Iowa, 1993)

    Google Scholar 

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We thank H. Damasio for making available neuroanatomical analyses of lesion patients and for preparing Fig. 1. We thank all participants for their participation in the experiments and R. Saxe for comments on the manuscript. This work was supported by grants from the National Institutes of Health, the National Science Foundation, the Gordon and Betty Moore Foundation, and the Guggenheim Foundation.

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Correspondence to Ralph Adolphs.

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Koenigs, M., Young, L., Adolphs, R. et al. Damage to the prefrontal cortex increases utilitarian moral judgements. Nature 446, 908–911 (2007).

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