The Sociopath Next Door (24 page)

Heinz's Dilemma

Turning now from evolutionary psychology to developmental psychology, we come to the interesting question of how conscience develops in human children. Does conscience flower naturally in children's minds as their other mental abilities increase, or do children acquire and adjust their moral sense as they experience life, from lessons taught by family, society, and culture?

Conscience as an emotion has not been studied in this way, but we can learn much from what is known about its intellectual partner,
moral reasoning.
Moral reasoning is the thought process that attends conscience and helps it decide what to do. If we try, we can express our moral reasoning in words, concepts, and principles.

Joe was engaged in moral reasoning as he drove along in his Audi, along with his tormented conscience, and tried to figure out whether he should go to an important meeting at work or return home to feed his dog, Reebok.
Conscience
, as we know, was Joe's intervening sense of obligation based in his emotional attachment to his dog.
Moral reasoning
was the process by which he determined just what that obligation consisted of, and how to accomplish it. (Exactly how hungry will the dog be? Could he die of thirst? Which is more important, the meeting or Reebok? What is the right thing to do?)

Where does it come from, this nearly universal ability to ask moral and ethical questions of ourselves, about everything from whether or not to feed the dog to whether or not to launch a nuclear missile?

The systematic study of moral reasoning began in the 1930s with Swiss psychologist Jean Piaget. In one of his most influential works,
The Moral Judgment of the Child,
Piaget analyzed children's perspectives on authority, lying, stealing, and the concept of justice. He began by recording detailed observations of how children at different ages conceived of rules and played games, and of how they interpreted moral dilemmas. Piaget's approach was “structural,” meaning that he believed human beings developed psychologically and philosophically in a progressive fashion, each cognitive-developmental step building on the previous one, and that the course of this development proceeded in the same order for all children.

Piaget described two general stages of moral development. The first stage is the “morality of constraint,” or “moral realism,” in which children obey rules because rules are regarded as inalterable. At this black-and-white stage of reasoning, young children believe that a particular deed is either absolutely right or absolutely wrong and that people will inevitably be punished for wrong behavior that is discovered, an expectation Piaget called “imminent justice.” The second Piagetian stage is the “morality of cooperation,” or “reciprocity.” At this stage, children view rules as relative and subject to alteration under certain circumstances, and their concept of justice gives consideration to people's intentions. Older children can “decenter” their point of view (make it less egocentric), and moral rules are understood as important to the functioning of society, rather than only as ways to avoid individual bad outcomes.

Continuing in the Piagetian tradition, and influenced also by the work of the American philosopher John Dewey, psychologist and educator Lawrence Kohlberg began his work on moral judgment in the late 1960s, at Harvard University's Center for Moral Education. Kohlberg's ambition was to discover whether or not there truly were universal stages of moral development.

Kohlberg's theory is based on interviews with boys, ages six to sixteen, in the United States, Taiwan, Mexico, Turkey, and the Yucatán. During these interviews, the children listened to ten stories, each involving a moral dilemma of some kind. The best known of these stories, a little vignette composed nearly forty years ago, is strikingly evocative of the current controversy surrounding pharmaceutical corporations and the cost of prescription medications. It is Heinz's dilemma, which, in paraphrase, is this:

Heinz's wife is dying from a rare form of cancer. According to the doctors, there is one drug that could save her, a radium compound that a druggist in Heinz's town has recently discovered. The ingredients for the drug are expensive to begin with, and the druggist is charging ten times what it costs him to make the medicine. The druggist pays two hundred dollars for the radium and charges his customers two thousand dollars for a small dose. Heinz goes to everyone he can think of and asks to borrow money. Still, he ends up with only about one thousand dollars. Heinz explains to the druggist that his wife will die without the drug, and asks him to sell the medicine at a cheaper price or to take payment later. But the druggist replies, “No, I discovered the drug, and I'm going to make money from it.” Heinz becomes desperate. He breaks into the druggist's store and steals the drug for his wife.

     Should Heinz have done that?

Kohlberg was primarily interested not in the children's yes or no answers to “Should Heinz have done that?” but in the reasoning behind their responses, which he recorded. Based on his many interviews, he proposed that children follow a universal course from self-interest to principled behavior that can be described by a three-level scheme of moral development. The three levels of moral development require increasingly complex and abstract thought patterns, each level displacing the previous one as the child matures cognitively.

According to Kohlberg's theory of moral development, seven- to ten-year-old children reason on the “preconventional level,” at which they defer to adult authority and obey rules based only on expectations of punishment and reward. Kohlberg considered that the preconventional reasoning of young children was essentially “premoral.” The most typical “premoral” response to Heinz's dilemma would be, “No, Heinz shouldn't have done that, because now he'll be punished.”

Beginning at about age ten, children move to the “conventional level” of moral reasoning (conventional in the societal sense), when their behavior is guided by the opinions of other people and a desire to conform. At this level, obeying authority becomes a value in itself, without reference either to immediate rewards and punishments or to higher principles. Kohlberg believed that by the time a child was thirteen, most moral questions were answered on the conventional level. The conventional reasoning about Heinz's theft would be, “No, he shouldn't have stolen the drug. Stealing is against the law. Everyone knows that.”

Sometime during adolescence, according to Kohlberg, a few people develop beyond the conventional level to the third and highest level, which he called “postconventional morality.” This third level requires the individual to formulate abstract moral principles and to act on them to satisfy his own conscience, rather than to gain the approval of others. At the postconventional level, moral reasoning transcends the concrete rules of society, rules that the individual now understands are often in conflict with one another anyway. His reasoning is informed instead by fluid, abstract concepts such as freedom, dignity, justice, and respect for life. Where Heinz is concerned, a person reasoning at the postconventional level might well insist that human life was more valuable than money, and that the sanctity of life was a moral law that superseded society's rules about stealing. (“Yes, it's a difficult problem, but it's understandable that Heinz would steal the lifesaving drug that the druggist was withholding for reasons of money.”)

Kohlberg believed that most people never completely achieved postconventional moral reasoning, even in adulthood, because when he interviewed older boys and young men in his studies, he found that fewer than 10 percent of them offered clear level-three responses. As a footnote here, I would mention that this view of Kohlberg's, if right, might help to explain the passing strange fact that moral outrage from the public is relatively limited when it comes to the aforementioned wealthy pharmaceutical companies. Perhaps most of us, Americans especially, are inclined to accept the druggist's proprietary claim, “I discovered the drug, and I'm going to make money from it.” Honoring ownership above all other features of a situation is a part of conventional moral reasoning—or it is at least among men raised in North America.

Enter Gender and Culture

What factor does Kohlberg's system of moral development leave out, even at its highest level? Answer: Heinz's relationship with his spouse, which is appreciably more personal, and perhaps more compelling, than even the most evolved understanding of the general sanctity of life.

And what, most likely, is the major flaw in Kohlberg's overall research design? It is that when he originally asked his moral questions, he asked them only of boys. Kohlberg, a brilliant social scientist, somehow managed to overlook half the human race.

This oversight was addressed in 1982, in a groundbreaking book by Carol Gilligan, entitled
In a Different Voice: Psychological Theory and Women's Development.
A student of Kohlberg's, Gilligan too was interested in advancing a universal stage theory of moral development, but she strongly disagreed with the limited content of the moral levels Kohlberg had proposed. Kohlberg, she said, had produced a model of moral reasoning that was based on an “ethic of justice,” a preoccupation with “the rules,” be they concrete or abstract. Gilligan believed that Kohlberg had derived only an “ethic of justice” because he had interviewed only males, and that if women were interviewed, a very different system of ideals would emerge. She interviewed women who were making momentous decisions in their lives and discovered that these women were thinking about the
caring
thing to do, rather than pondering “the rules.” Women, decided Gilligan, reasoned morally according to an “ethic of care,” rather than a male “ethic of justice.” She theorized that this was so because girls identify with their mothers and tend to have experiences within the family that emphasize interpersonal responsiveness.

Gilligan argued eloquently that neither vantage point was superior to the other, but that the two ethics simply informed two different voices. Men spoke of attachment to societal and personal rules, and women spoke of attachment to people. Women's moral development, Gilligan said, was based not solely on changes in cognitive capability but also on maturational changes in the way the self and the social environment were perceived.

A woman's postconventional judgment regarding Heinz's dilemma would refer to the importance of his relationship with his wife, and might assert as well that the druggist's claim was immoral because he was allowing someone to die when he could do something to prevent it. Gilligan was persuaded that postconventional reasoning in women focused on the value of doing no harm to self or others, which is more specific and relational, and in many ways more demanding, than a principle such as the general sanctity of life.

Thanks to Carol Gilligan, psychologists and educators now understand that moral reasoning has more than one dimension and that people develop morally in much more complex ways than we first believed. In the last twenty years, newer studies have shown us that both women and men may use both an “ethic of care” and an “ethic of justice” in their moral reasoning. These two voices speak in complex choruses, and gender differences are far more intricate than a single unambiguous line between all women and all men.

We now know also that there are probably no universal stages of moral development through which all human beings everywhere pass, even when we divide the human race in half by gender. Cultural relativism exists even in the moral domain. And if moral reasoning has two dimensions, one of justice and one of care, then why not three dimensions, or hundreds, or more? Why not as many perspectives as there are human situations, values, and ways to raise children?

One illustration of the significance of context and culture in moral judgment is the work of Joan Miller and David Bersoff of Yale University. Miller and Bersoff have studied American children and adults from New Haven, Connecticut, as compared with Hindu children and adults from Mysore City, in southern India. They point out that American culture encourages highly individualistic views of the self—autonomy and personal achievement for both boys
and
girls—versus Hindu Indian culture, which teaches an interdependent concept of the self to both sexes—the value of permanent ties to other people, and of subordinating one's personal ambitions to the goals of the group.

In their studies of moral development, Miller and Bersoff found that Hindu Indians tend to regard interpersonal responsibilities as socially enforceable moral duties, as opposed to the American view of such tasks as occasions for personal decision making. For example, whether or not to take care of one's sister who has Down's syndrome after one's parents can no longer do so would be viewed by an American as a choice, a decision that had moral implications, but a choice nonetheless. The same situation would be seen by a Hindu Indian as a nonnegotiable moral imperative (dharma), along with an expectation that the family would compel the fulfillment of this duty if necessary. Furthermore, Indians believe that interpersonal duty is a natural part of what most individuals are inclined to do anyway, as opposed to Americans, who believe that social expectations and personal wishes are almost always opposed to each other and that one must somehow strike a “balance” between them.

Such differences in belief and early instruction are large, and they tend to create substantial cross-cultural diversity in moral reasoning. Miller and Bersoff report that Hindu Indians, both men and women, develop according to a “duty-based perspective,” a dimension of moral judgment that is different from both the “ethic of justice” and the “ethic of care.” They conclude, “We interpret our results as implying that qualitatively distinct types of interpersonal moral codes develop in American and Hindu Indian cultures, reflecting the contrasting cultural views of the self emphasized in each setting.”

And yet, despite the many and diverse processes of moral judgment spun off by our various human cultures, in the final analysis there is something more to the heart of the matter, something deeper and much less variable. This fixed psychological element is our sense of an irreconcilable contest between moral forces. An overall perception of good and evil as a duality in human life would seem to be completely and astonishingly universal (astonishing to social scientists at least). Good versus evil is the ageless, culture-free human plot, and the undertones of a seemingly universal moral struggle are readily recognized by both genders in all cultures. I would expect a woman from the south of India to possess this fundamental sense of a divided moral realm, and she would expect the same of me. For example, where poor, desperate Heinz is concerned, independent of a judgment regarding how he should resolve his dilemma—what he should or should not
do
—there will be a general, if unspoken, agreement across cultures that Heinz, with his commitment to someone he loves, has the higher moral ground as the story begins, and that the selfish druggist is behaving badly.