Consciousness and Psychopathologyfrom responsibility. One reason for discussions like these is probably because mental illness might
have an effect on moral responsibility attributions. Another reason is obviously to help us to pre-
vent similar crimes by looking for “warning signs” in others. But this line of thought also leads
some to worry that “[t]o diagnose someone as mentally ill is to declare that the person is entitled
to adopt the sick role and that we should respond as though the person is a passive victim of the
condition” (Edwards 2009: 80).
Much of this discussion about psychopathy occurs against the backdrop of the perennial prob-
lem of free will and determinism for which there is an enormous literature (see e.g. Kane 2011;
McKenna and Pereboom 2016). For example, so-called “libertarian” free will says that the core
ideas of “could have done otherwise” and “control” over actions are essential for free will and for
holding someone morally responsible for an action. If one really couldn’t do otherwise, as deter-
minists believe, then how could we blame, punish, or otherwise hold that person morally respon-
sible? The idea, for example, is that if a man were to rob an elderly lady, then he was compelled to
do so given his state of mind at that time. But if he really couldn’t have done otherwise, how can we
really hold him morally responsible for the action? So-called “compatibilists,” on the other hand,
believe that one can still be morally responsible for an action that one cannot avoid at that time
(Frankfurt 1969, 1971). They think that the “principle of alternative possibilities” (PAP) is false:
(PAP) A person is morally responsible for what she does do only if she can do otherwise.Nonetheless, even a compatibilist believes that there are some situations in which one is not
morally responsible for an action, such as when one is externally coerced or when one desires
to behave in ways that run counter to one’s “true self ” or true motives. At least some cases of
mental illness may fall into this group, such as in obsessive compulsive disorder (OCD) and vari-
ous addictions. For example, I may strongly desire to take various drugs or drink alcohol but yet
wish that I did not have that desire.^9
Should we then conclude that, say, a psychopathic serial killer shouldn’t be punished? If
determinism is true, then it may be that we should no longer think of punishment as some kind
of retribution based on libertarian free will. Perhaps we should simply focus on deterring others
(and the criminals themselves) from committing future crimes. Most people in a society will
wish to avoid incarceration and will thus behave accordingly. But for those who still do harm
others, incarceration is at least a way to keep them from harming others in the general popula-
tion. Maybe serial killers and pedophiles really can’t help what they do and really aren’t morally
responsible, but that doesn’t mean that we should allow them out on the streets. It is also impor-
tant to note that to say that a psychopathic murderer is determined does not necessarily mean
that he is “legally insane,” which is a narrower and technical legal notion. In the United States at
least, to be legally insane has more to do with “not understanding the difference between right
and wrong,” or “not understanding the consequences of one’s actions,” which is a very high
hurdle for the defense to clear.
With regard to consciousness, it is often with respect to emotions where there is significant
focus on moral responsibility (Fischer and Ravizza 1998; Brink and Nelkin 2013). So-called
“reactive attitude theories” give moral emotions a key role in both attribution and account-
ability (or responsibility). The term “reactive attitude” was originally coined by Peter Strawson
as a way to refer to the emotional responses that arise when we respond to what people do
(Strawson 1962). Reactive attitudes are often intense conscious emotional states such as resent-
ment, indignation, disgust, guilt, hatred, love, and shame. So, for example, we get angry at and
disgusted by the pedophile murderer and our reaction is even stronger when the victim is some-
one we know or a family member.